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Byrne C, Ward M, Saeedi S, Obuseh E. What makes an athlete? A scoping review: Assessing the use of the word athlete with anterior cruciate ligament rehabilitation review studies. Is there a standard? Scand J Med Sci Sports 2024; 34:e14596. [PMID: 38436214 DOI: 10.1111/sms.14596] [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: 07/27/2023] [Revised: 01/25/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
The term athlete does not currently have an agreed definition or standardized use across the literature. We analyzed the use of the term "athlete" amongst review studies specific to Anterior Cruciate Ligament (ACL) rehabilitation to investigate if the term was justified in its use. A comprehensive review of a database was performed to identify review papers which used the term "athlete" in the title, and which were related to ACL rehabilitation and surveillance. These papers were analyzed and their source papers were extracted for review. Twenty-eight review papers were identified. Source studies were extracted and analyzed. After removal of duplicates 223 source papers were identified. Despite using the term "athlete" in the review study titles only 5/17 (10.7%) sufficiently justified the use of this term. The term athlete was used in 117/223 (52.5%) of the source studies. Of those, 78/117 source studies (66.7%) justified the term athlete. The remaining 39/117 (33.3%) papers where participants were stated to be athletes, gave no justification. The ambiguous use of the term athlete amongst published studies highlights the need for a definition or justification of the term to be used in studies. The lack of a standard definition leads to the potential for studies to dilute high quality data by the potentially differing rehabilitation requirements and access to resources available to those with varying exercise levels. The indiscriminate use of the term athlete could lead to participants with widely ranging physical activity levels being included in the same study, and being used to create clinical advice for all. Advice could potentially vary across those of differing physical activity levels.
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Affiliation(s)
- C Byrne
- School of Medicine, University College Dublin, Dublin, Ireland
- James Connolly Hospital Emergency Department, Dublin, Ireland
| | - M Ward
- Royal College of Surgeons, Dublin, Ireland
| | - S Saeedi
- Royal College of Surgeons, Dublin, Ireland
| | - E Obuseh
- James Connolly Hospital Emergency Department, Dublin, Ireland
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2
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Jenkins W, Starke EM, Nelson M, Milleman K, Milleman J, Ward M. The effects of scaling and root planing plus home oral hygiene maintenance in Stage I/II periodontitis population: A 24-week randomized clinical trial. Int J Dent Hyg 2024. [PMID: 38289823 DOI: 10.1111/idh.12783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 07/11/2023] [Accepted: 01/07/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVES To compare the effects of powered and manual toothbrushing following scaling and root planing on bleeding on probing and other clinical indicators of periodontitis. MATERIALS AND METHODS This was a randomized, examiner-blind, parallel-design, 24-week clinical study. Eligible subjects were 18-75 years of age with Stage I or II periodontitis. All subjects received scaling and root planing (SRP) within 28 days of enrollment. Thereafter, subjects were randomized to twice daily at-home use of either a powered toothbrush (PTB) or a manual toothbrush (MTB). Randomization was balanced for gender and periodontitis stage. No other oral hygiene aids were permitted. Subjects were evaluated every 4 weeks for the following measures: bleeding on probing (BOP), surface plaque (MPI), probing pocket depth (PPD) and clinical attachment level until Week 24. RESULTS Of 328 randomized subjects, 299 subjects completed the study. For BOP at Week 24, the Least Squares (LS) Mean, standard error (SE) reduction from baseline was 0.24 (0.01) for the PTB group and 0.02 (0.01) for the MTB group, resulting in a statistically significant treatment difference of 0.22 (0.01), p-value < 0.0001. There were also concomitant reductions in MPI and PPD at Week 24, resulting in statistically significant (p-value < 0.0001) LS Mean (SE) treatment differences of 0.86 (0.04) and 0.24 (0.01), for MPI and PPD, respectively. CONCLUSION When combined with SRP, daily home oral hygiene maintenance including a powered toothbrush significantly reduced clinical symptoms of periodontitis and surface plaque levels compared to a manual toothbrush in a Stage I/II periodontitis population. (ClinicalTrials.gov Identifier: NCT04254770).
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Affiliation(s)
| | | | - Melissa Nelson
- Innovation and Strategy Chief Medical Office Philips, Bothell, Washington, USA
| | | | | | - Marilyn Ward
- Philips Oral Healthcare, Bothell, Washington, USA
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Caffrey A, Lamers Y, Murphy MM, Letourneau N, Irwin RE, Pentieva K, Ward M, Tan A, Rojas‐Gómez A, Santos‐Calderón LA, Canals‐Sans J, Leung BMY, Bell R, Giesbrecht GF, Dewey D, Field CJ, Kobor M, Walsh CP, McNulty H. Epigenetic effects of folate and related B vitamins on brain health throughout life: Scientific substantiation and translation of the evidence for health improvement strategies. NUTR BULL 2023; 48:267-277. [PMID: 36807740 PMCID: PMC10946506 DOI: 10.1111/nbu.12611] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/15/2023] [Accepted: 01/23/2023] [Indexed: 02/23/2023]
Abstract
Suboptimal status of folate and/or interrelated B vitamins (B12 , B6 and riboflavin) can perturb one-carbon metabolism and adversely affect brain development in early life and brain function in later life. Human studies show that maternal folate status during pregnancy is associated with cognitive development in the child, whilst optimal B vitamin status may help to prevent cognitive dysfunction in later life. The biological mechanisms explaining these relationships are not clear but may involve folate-related DNA methylation of epigenetically controlled genes related to brain development and function. A better understanding of the mechanisms linking these B vitamins and the epigenome with brain health at critical stages of the lifecycle is necessary to support evidence-based health improvement strategies. The EpiBrain project, a transnational collaboration involving partners in the United Kingdom, Canada and Spain, is investigating the nutrition-epigenome-brain relationship, particularly focussing on folate-related epigenetic effects in relation to brain health outcomes. We are conducting new epigenetics analysis on bio-banked samples from existing well-characterised cohorts and randomised trials conducted in pregnancy and later life. Dietary, nutrient biomarker and epigenetic data will be linked with brain outcomes in children and older adults. In addition, we will investigate the nutrition-epigenome-brain relationship in B vitamin intervention trial participants using magnetoencephalography, a state-of-the-art neuroimaging modality to assess neuronal functioning. The project outcomes will provide an improved understanding of the role of folate and related B vitamins in brain health, and the epigenetic mechanisms involved. The results are expected to provide scientific substantiation to support nutritional strategies for better brain health across the lifecycle.
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Affiliation(s)
- A. Caffrey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
| | - Y. Lamers
- British Columbia Children's Hospital Research Institute, Food Nutrition and Health Program, Faculty of Land and Food SystemsThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - M. M. Murphy
- Unit of Preventive Medicine & Public Health, Department of Basic Medical Sciences, Faculty of Medicine & Health SciencesUniversitat Rovira i Virgili, IISPVReusSpain
- CIBEROBN, ISCIIIMadridSpain
| | - N. Letourneau
- Faculty of Nursing and Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - R. E. Irwin
- Genomic Medicine Group, School of Biomedical SciencesUlster UniversityColeraineUK
| | - K. Pentieva
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
| | - M. Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
| | - A. Tan
- British Columbia Children's Hospital Research Institute, Food Nutrition and Health Program, Faculty of Land and Food SystemsThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - A. Rojas‐Gómez
- Unit of Preventive Medicine & Public Health, Department of Basic Medical Sciences, Faculty of Medicine & Health SciencesUniversitat Rovira i Virgili, IISPVReusSpain
| | - L. A. Santos‐Calderón
- Unit of Preventive Medicine & Public Health, Department of Basic Medical Sciences, Faculty of Medicine & Health SciencesUniversitat Rovira i Virgili, IISPVReusSpain
| | - J. Canals‐Sans
- Department of Psychology, Faculty of Educational Sciences and PsychologyUniversitat Rovira i VirgiliTarragonaSpain
| | - B. M. Y. Leung
- Faulty of Health SciencesUniversity of LethbridgeLethbridgeAlbertaCanada
| | - R. Bell
- Faculty of Agricultural, Life and Environment ScienceUniversity of AlbertaEdmontonAlbertaCanada
| | - G. F. Giesbrecht
- Faculty of Nursing and Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - D. Dewey
- Faculty of Nursing and Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - C. J. Field
- Faculty of Agricultural, Life and Environment ScienceUniversity of AlbertaEdmontonAlbertaCanada
| | - M. Kobor
- British Columbia Children's Hospital Research Institute, Food Nutrition and Health Program, Faculty of Land and Food SystemsThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - C. P. Walsh
- Genomic Medicine Group, School of Biomedical SciencesUlster UniversityColeraineUK
| | - H. McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical SciencesUlster UniversityColeraineUK
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4
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Allega A, Anderson MR, Andringa S, Antunes J, Askins M, Auty DJ, Bacon A, Barros N, Barão F, Bayes R, Beier EW, Bezerra TS, Bialek A, Biller SD, Blucher E, Caden E, Callaghan EJ, Cheng S, Chen M, Cleveland B, Cookman D, Corning J, Cox MA, Dehghani R, Deloye J, Deluce C, Depatie MM, Dittmer J, Dixon KH, Di Lodovico F, Falk E, Fatemighomi N, Ford R, Frankiewicz K, Gaur A, González-Reina OI, Gooding D, Grant C, Grove J, Hallin AL, Hallman D, Heintzelman WJ, Helmer RL, Hu J, Hunt-Stokes R, Hussain SMA, Inácio AS, Jillings CJ, Kaluzienski S, Kaptanoglu T, Khaghani P, Khan H, Klein JR, Kormos LL, Krar B, Kraus C, Krauss CB, Kroupová T, Lam I, Land BJ, Lawson I, Lebanowski L, Lee J, Lefebvre C, Lidgard J, Lin YH, Lozza V, Luo M, Maio A, Manecki S, Maneira J, Martin RD, McCauley N, McDonald AB, Mills C, Morton-Blake I, Naugle S, Nolan LJ, O'Keeffe HM, Orebi Gann GD, Page J, Parker W, Paton J, Peeters SJM, Pickard L, Ravi P, Reichold A, Riccetto S, Richardson R, Rigan M, Rose J, Rosero R, Rumleskie J, Semenec I, Skensved P, Smiley M, Svoboda R, Tam B, Tseng J, Turner E, Valder S, Virtue CJ, Vázquez-Jáuregui E, Wang J, Ward M, Wilson JR, Wilson JD, Wright A, Yanez JP, Yang S, Yeh M, Yu S, Zhang Y, Zuber K, Zummo A. Evidence of Antineutrinos from Distant Reactors Using Pure Water at SNO. Phys Rev Lett 2023; 130:091801. [PMID: 36930908 DOI: 10.1103/physrevlett.130.091801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/14/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
The SNO+ Collaboration reports the first evidence of reactor antineutrinos in a Cherenkov detector. The nearest nuclear reactors are located 240 km away in Ontario, Canada. This analysis uses events with energies lower than in any previous analysis with a large water Cherenkov detector. Two analytical methods are used to distinguish reactor antineutrinos from background events in 190 days of data and yield consistent evidence for antineutrinos with a combined significance of 3.5σ.
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Affiliation(s)
- A Allega
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M R Anderson
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S Andringa
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
| | - J Antunes
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Instituto Superior Técnico (IST), Departamento de Física, Avenida Rovisco Pais, 1049-001, Lisboa, Portugal
| | - M Askins
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - D J Auty
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - A Bacon
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - N Barros
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Faculdade de Ciéncias (FCUL), Departamento de Física, Campo Grande, Edifício C8, 1749-016, Lisboa, Portugal
| | - F Barão
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Instituto Superior Técnico (IST), Departamento de Física, Avenida Rovisco Pais, 1049-001, Lisboa, Portugal
| | - R Bayes
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - E W Beier
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - T S Bezerra
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - A Bialek
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - S D Biller
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - E Blucher
- The Enrico Fermi Institute and Department of Physics, The University of Chicago, Chicago, Illinois 60637, USA
| | - E Caden
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - E J Callaghan
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - S Cheng
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M Chen
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - B Cleveland
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - D Cookman
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - J Corning
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M A Cox
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Department of Physics, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - R Dehghani
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J Deloye
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - C Deluce
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - M M Depatie
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - J Dittmer
- Technische Universität Dresden, Institut für Kern und Teilchenphysik, Zellescher Weg 19, Dresden 01069, Germany
| | - K H Dixon
- Department of Physics, King's College London, Strand Building, Strand, London WC2R 2LS, United Kingdom
| | - F Di Lodovico
- Department of Physics, King's College London, Strand Building, Strand, London WC2R 2LS, United Kingdom
| | - E Falk
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - N Fatemighomi
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - R Ford
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - K Frankiewicz
- Department of Physics, Boston University, 590 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - A Gaur
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - O I González-Reina
- Universidad Nacional Autónoma de México (UNAM), Instituto de Física, Apartado Postal 20-364, México D.F. 01000, México
| | - D Gooding
- Department of Physics, Boston University, 590 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - C Grant
- Department of Physics, Boston University, 590 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - J Grove
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - A L Hallin
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - D Hallman
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - W J Heintzelman
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - R L Helmer
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - J Hu
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - R Hunt-Stokes
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - S M A Hussain
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - A S Inácio
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Faculdade de Ciéncias (FCUL), Departamento de Física, Campo Grande, Edifício C8, 1749-016, Lisboa, Portugal
| | - C J Jillings
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - S Kaluzienski
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - T Kaptanoglu
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - P Khaghani
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - H Khan
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - J R Klein
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - L L Kormos
- Physics Department, Lancaster University, Lancaster LA1 4YB, United Kingdom
| | - B Krar
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C Kraus
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - C B Krauss
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - T Kroupová
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - I Lam
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - B J Land
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - I Lawson
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - L Lebanowski
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - J Lee
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C Lefebvre
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J Lidgard
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - Y H Lin
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - V Lozza
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Faculdade de Ciéncias (FCUL), Departamento de Física, Campo Grande, Edifício C8, 1749-016, Lisboa, Portugal
| | - M Luo
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - A Maio
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Faculdade de Ciéncias (FCUL), Departamento de Física, Campo Grande, Edifício C8, 1749-016, Lisboa, Portugal
| | - S Manecki
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - J Maneira
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), Avenida Professor Gama Pinto, 2, 1649-003, Lisboa, Portugal
- Universidade de Lisboa, Faculdade de Ciéncias (FCUL), Departamento de Física, Campo Grande, Edifício C8, 1749-016, Lisboa, Portugal
| | - R D Martin
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - N McCauley
- Department of Physics, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - A B McDonald
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C Mills
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - I Morton-Blake
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - S Naugle
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
| | - L J Nolan
- School of Physics and Astronomy, Queen Mary University of London, 327 Mile End Road, London E1 4NS, United Kingdom
| | - H M O'Keeffe
- Physics Department, Lancaster University, Lancaster LA1 4YB, United Kingdom
| | - G D Orebi Gann
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - J Page
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - W Parker
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - J Paton
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - S J M Peeters
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - L Pickard
- University of California, Davis, 1 Shields Avenue, Davis, California 95616, USA
| | - P Ravi
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - A Reichold
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - S Riccetto
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - R Richardson
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - M Rigan
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - J Rose
- Department of Physics, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - R Rosero
- Chemistry Department, Brookhaven National Laboratory, Building 555, P.O. Box 5000, Upton, New York 11973-500, USA
| | - J Rumleskie
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - I Semenec
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - P Skensved
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M Smiley
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720-8153, USA
| | - R Svoboda
- University of California, Davis, 1 Shields Avenue, Davis, California 95616, USA
| | - B Tam
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J Tseng
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - E Turner
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - S Valder
- Physics & Astronomy, University of Sussex, Pevensey II, Falmer, Brighton, BN1 9QH, United Kingdom
| | - C J Virtue
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - E Vázquez-Jáuregui
- Universidad Nacional Autónoma de México (UNAM), Instituto de Física, Apartado Postal 20-364, México D.F. 01000, México
| | - J Wang
- University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH, United Kingdom
| | - M Ward
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J R Wilson
- Department of Physics, King's College London, Strand Building, Strand, London WC2R 2LS, United Kingdom
| | - J D Wilson
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - A Wright
- Department of Physics, Engineering Physics and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J P Yanez
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - S Yang
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
| | - M Yeh
- Chemistry Department, Brookhaven National Laboratory, Building 555, P.O. Box 5000, Upton, New York 11973-500, USA
| | - S Yu
- School of Natural Sciences, Laurentian University, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - Y Zhang
- Department of Physics, University of Alberta, 4-181 CCIS, Edmonton, Alberta T6G 2E1, Canada
- Research Center for Particle Science and Technology, Institute of Frontier and Interdisciplinary Science, Shandong University, Qingdao 266237, Shandong, China
- Key Laboratory of Particle Physics and Particle Irradiation of Ministry of Education, Shandong University, Qingdao 266237, Shandong, China
| | - K Zuber
- Technische Universität Dresden, Institut für Kern und Teilchenphysik, Zellescher Weg 19, Dresden 01069, Germany
- MTA Atomki, 4001 Debrecen, Hungary
| | - A Zummo
- Department of Physics & Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, Pennsylvania 19104-6396, USA
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5
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Schmidt F, Ward M, Repanos C. Postoperative serum C-reactive protein dynamics after pharyngolaryngectomy with jejunal free-flap reconstruction. Ann R Coll Surg Engl 2023; 105:263-268. [PMID: 35904323 PMCID: PMC9974345 DOI: 10.1308/rcsann.2021.0315] [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] [Accepted: 10/25/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Pharyngolaryngectomy with jejunal free-flap (JFF) reconstruction can be offered for locally advanced hypopharyngeal cancer. However, the procedure carries significant morbidity. Postoperative serial serum C-reactive protein (CRP) has been shown to be a marker predicting postoperative complications, and the aim of this study was to describe the dynamics and value of CRP in this patient group. METHODS Retrospective analysis of pharyngolaryngectomies with JFF reconstruction was performed in our institution. Daily postoperative CRP values were analysed within the first 14 days, as were complications. RESULTS Twenty-one cases were included. Total morbidity was 57.1% including 14.3% (temporary) anastomotic leaks and 14.3% flap failures. Patients in the normal group showed peak CRP levels around postoperative day 2 (2.2). Increased CRP levels on or after day 4 were associated with complications (p<0.01) with a sensitivity of 83.3% and specificity of 77.8%. In keeping with CRP kinetics from other surgical studies, peak CRP values on day 2 or 3 are expected, followed by a decline. Peaks in CRP on day 4 or later raise the suspicion of complications. CRP is not specific for any one complication but rather can help guide early appropriate clinical assessment and management. CONCLUSIONS The natural postoperative CRP response peaks around postoperative day 2 (2.2) and declines thereafter. Rising CRP levels after postoperative day 3 are suspicious of surgical complications (p<0.01) with positive and negative predictive values of 83.3% and 77.8%, respectively. Therefore, serial postoperative CRP can be used as an adjunct to monitor outcomes in this group.
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Affiliation(s)
- F Schmidt
- Portsmouth Hospitals University NHS Trust, UK
| | - M Ward
- Portsmouth Hospitals University NHS Trust, UK
| | - C Repanos
- Portsmouth Hospitals University NHS Trust, UK
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Fitzpatrick D, Laird E, Hoey L, Hughes C, McNulty H, Ward M, Strain JJ, Tracey F, Molloy A, Cunningham C, McCarroll K. 72 SEASONAL VARIATION IN HYPERPARATHYROIDISM IN OLDER IRISH ADULTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Vitamin D deficiency is common in Ireland, varies by season and can result in secondary hyperparathyroidism. High Parathyroid Hormone (PTH) levels due to low vitamin D status are associated with increased bone turnover and lower bone mineral density, especially at cortical sites such as the hip. Given the variation in vitamin D status by time of year, our study aimed to examine for seasonal differences in hyperparthyroidism in older adults.
Methods
Study participants were from a large cross-sectional study of older Irish adults recruited from hospital outpatient services and GP practices. Exclusion criteria were: eGFR< 30ml/min and elevated serum calcium (>2.5 mmol/l) in order to avoid primary hyperparathyroidism or elevated serum PTH due to advanced renal impairment. Hyperparathyroidism was defined as a PTH level > 65 ng/ml. The relationship between hyperparathyroidism and season was examined in regression models adjusting for potential factors affecting PTH.
Results
There were 4324 participants, mean age 73.8 +/- 7.9 years, 65.4% were female. Hyperparathyroidism was more prevalent in Spring versus Autumn (17.4 vs 11.4 %, P = 0.0002). The increased prevalence remained after adjusting for age, gender, body mass index, timed up and go, dairy intake, eGFR, and smoking (OR 1.6, 1.2- 2.0, P=0.0003). This also corresponded to the seasonal variation in vitamin D status with deficiency (25(OH)D < 30 nmol/l) highest in Spring (23.3%) and lowest in Autumn (16.8%).
Conclusion
We found that hyperparathyroidism fluctuates with season in an inverse relationship with vitamin D. Overall, high PTH levels were 60% more likely in Spring versus Autumn. This emphasises the importance of maintaining adequate vitamin D status all year round. While we adjusted for dairy intake, we did not have accurate measures of total dietary calcium intake which could also vary seasonally and be a contributory factor.
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Affiliation(s)
- D Fitzpatrick
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
| | - E Laird
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - L Hoey
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - C Hughes
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - H McNulty
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - M Ward
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - JJ Strain
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - F Tracey
- Causeway Hospital, Northern Health and Social Care Trust , Coleraine, Northern Ireland, United Kingdom
| | - A Molloy
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - C Cunningham
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
| | - K McCarroll
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
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O'Maoileidigh B, Kenny RA, Ward M, Scarlett S. 127 THE RELATIONSHIP BETWEEN RELIGIOUS INVOLVEMENT AND PSYCHOLOGICAL HEALTH DURING THE COVID-19 PANDEMIC: FINDINGS FROM THE IRISH LONGITUDINAL STUDY ON AGEING. Age Ageing 2022. [PMCID: PMC9620354 DOI: 10.1093/ageing/afac218.106] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Religious involvement has been shown to be protective against negative mental health outcomes and encourage positive coping behaviour among older adults. During the COVID-19 pandemic and lockdown in Ireland, public health restrictions created a barrier to in person religious participation. It is important to examine the effect this may have had on psychological health in older adults. Methods Data were from The Irish Longitudinal Study on Ageing (TILDA). Data from Wave 4 (2016), Wave 5 (2018) and the COVID-19 SCQ (2020) were used for analysis. The final sample was made up of 3,044 community-dwelling adults living in Ireland aged 60 and older. Relationships between religious participation, psychological health and loneliness were modelled using cross-sectional and longitudinal regression analyses. Results Religious attendance was positively associated with Purpose in Life [Beta(B)=0.01, 95% CI=-0.00, 0.02, p<0.05], Life Satisfaction [B=0.01, 95% CI= 0.00, 0.02, p<0.001] and Anxiety [Incident Rate Ratio= 1.04, 95% CI=1.01-1.08, p<0.01], during COVID-19. Self-Rated Mental Health significantly decreased between Wave 5 and COVID-19 relative to Religious Attendance reported at Wave 4 [OR= 0.87, 95% CI= 0.75, 0.99, p<0.05]. Loneliness also increased between Wave 5 and COVID-19 relative to Prayer Frequency reported at Wave 4 [OR=0.06, 95% CI= 0.02, 0.10, p<0.01]. Conclusion These results suggest a complex relationship between psychological health and religious participation and the barriers to it during COVID in the older population. While it there was a protective effect carried into the lockdown, there was also a negative effect regarding some domains of religious participation. Future research should focus on measuring the relationship at later stages of the pandemic and the use of alternative forms of religious practice, such as streaming religious services.
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Affiliation(s)
| | - RA Kenny
- Trinity College Dublin , Dublin, Ireland
| | - M Ward
- Trinity College Dublin , Dublin, Ireland
| | - S Scarlett
- Trinity College Dublin , Dublin, Ireland
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8
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Kavanagh M, Bradley E, Hoey L, Hughes C, McNulty H, Ward M, Strain JJ, Tracey F, Molloy A, Laird E, Cunningham C, McCarroll K. 51 VITAMIN D DEFICIENCY IS ASSOCIATED WITH INCREASED RISK OF ATRIAL FIBRILLATION: A CROSS-SECTIONAL ANALYSIS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial Fibrillation (AF) is prevalent (up to 10.9%) in Irish adults aged over 65 and significantly increases stroke risk, as well as being associated with greater stroke severity. Identifying potential contributing factors to development of AF offers opportunity for AF prevention and reduction in associated morbidity. Low vitamin D status has been associated with AF but studies are inconsistent. We aimed to assess the potential relationship between vitamin D deficiency and self-reported AF in older Irish adults.
Methods
Participants were from a large cross-sectional study of Irish adults aged >60 years, recruited from hospital outpatient services and GP practises. The diagnosis of AF was based on self-report so those with a Mini Mental State Examination (MMSE) <25 were excluded. Vitamin D deficiency was defined as a 25(OH)D <30 nmol/l. The relationship between deficiency and AF was explored in regression models.
Results
4264 participants, mean age 73.1± 8.0 years, female (67.4%) and 11.9% had AF. There was a higher prevalence of AF in those who were deficient vs non-deficient (17.2% vs 10.9%, P<0.0001). In a subsample (n = 4043), increased risk remained after adjusting for age, gender, season, vitamin D supplement use, body mass index, timed up and go, alcohol intake, smoking status, hypertension, diabetes, and heart disease (coronary artery disease and/or heart failure) (OR: 1.3, 1.1- 1.7 , P =0.023).
Conclusion
We identified that vitamin D deficiency was independently associated with a 30% increased likelihood of self-reported AF in older adults. Vitamin D is known to inhibit the renin angiotensin, aldosterone system which may play a role in both structural and electrical remodelling of the atrium. It may also have anti-inflammatory properties which could protect against AF. We were not able to distinguish between valvular and non-valvular AF though findings offer an interesting insight for potential further investigation.
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Affiliation(s)
- M Kavanagh
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
| | - E Bradley
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
| | - L Hoey
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - C Hughes
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - H McNulty
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - M Ward
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - JJ Strain
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - F Tracey
- Causeway Hospital, Northern Health and Social Care Trust , Coleraine, United Kingdom
| | - A Molloy
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - E Laird
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - C Cunningham
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
| | - K McCarroll
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
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9
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Fitzpatrick D, Laird E, Hoey L, Hughes C, McNulty H, Ward M, Strain JJ, Tracey F, Molloy A, Cunningham C, Carroll KM. 73 PREVALENCE OF SECONDARY HYPERPARATHYROIDISM BY VITAMIN D STATUS IN OLDER IRISH ADULTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Secondary hyperparathyroidism commonly results from vitamin D deficiency and can lead to accelerated bone turnover and bone loss, especially at cortical sites like the hip. It can also attenuate the response to antiresorptive treatments used for osteoporosis. However, several factors may influence PTH response. We aimed to identify the prevalence of secondary hyperparathyroidism by categories of vitamin D status in older Irish adults attending a bone health clinic.
Methods
The study population consisted of older adults (aged over 60 years) attending a bone health clinic at a large hospital. Participants with a serum calcium >2.5 mmol/l and eGFR <30 ml/min were excluded to avoid cases of primary hyperparathyroidism or elevated serum PTH due to advanced renal disease. Hyperparathyroidism was defined as a serum PTH > 65 pg/ml. 25 hydroxyvitamin D (25(OH)D) was measured with liquid chromatography mass spectroscopy.
Results
There were 800 cases identified, mean age 72.9 +/- 7.9 years, and 85.3% were female. The prevalence of secondary hyperparathyroidism by 25(OH)D categories were 28.1% (<30nmol/l), 17.4% (30-49.9 nmol/l) and 8.0% (50-74 nmol/l). Older age (P < 0.03) and lower eGFR (P = 0.01) were associated with hyperparathyroidism independent of vitamin D status.
Conclusion
Nearly one-third of patients who were vitamin D deficient (<30 nmol/L) and one-sixth who were insufficient (30-49.9 nmol/l) had hyperparathyroidism, similar to the results of other studies. However, hyperparathyroidism was also observed in 8% of those with 25(OH)D levels between 50 -74 nmol/l, suggesting that higher levels i.e. ≥ 75 nmol/l may be preferable in older adults. Lower eGFR and older age were also independently associated with higher PTH, consistent with previous research. Higher dietary and supplemental calcium intake is also known to suppress PTH response, though we were not able to account for this in our study.
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Affiliation(s)
- D Fitzpatrick
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
| | - E Laird
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - L Hoey
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - C Hughes
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - H McNulty
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - M Ward
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - JJ Strain
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, Northern Ireland, United Kingdom
| | - F Tracey
- Causeway Hospital, Northern Health and Social Care Trust , Coleraine, Northern Ireland, United Kingdom
| | - A Molloy
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - C Cunningham
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
| | - KM Carroll
- Mercer's Institute for Successful Ageing, St. James's Hospital , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
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10
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Dyer A, Dolphin H, Laird E, Hoey L, McNulty H, Hughes C, Ward M, Strain JJ, O'Kane M, Tracey F, Molloy A, Cunningham C, McCarroll K. 17 CROSS-SECTIONAL AND LONGITUDINAL RELATIONSHIPS BETWEEN MOBILITY, NEUROPSYCHOLOGICAL PERFORMANCE AND FALLS IN COMMUNITY-DWELLING OLDER ADULTS: DATA FROM TUDA. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Impaired mobility is associated with incident cognitive impairment and dementia. However, the complex bi-directional temporal relationships between subtle impairments in neuropsychological performance, mobility trajectories and falls is poorly understood.
Methods
Using data from the Trinity, Ulster Department of Agriculture (TUDA/TUDA5+) study, we evaluated cross-sectional and longitudinal relationships between impaired mobility, neuropsychological performance and falls using regression models adjusted for important clinical confounders. Older adults with potential cognitive impairment (Mini-Mental State Examination score <25) were excluded. Detailed neuropsychological assessment was performed using the RBANS (Repeatable Battery for Neuropsychological Assessment) and FAB (Frontal Assessment Battery). Impaired mobility was assessed using Irish population-specific age/sex/height-specific Timed-Up-and-Go (TUG) cut-offs.
Results
Of 4,103 participants (72.9 ± 7.9 years; 67.4% female), just under one-fifth (17.5%) met criteria for impaired mobility. Older adults with impaired mobility had significantly greater likelihood of impaired neuropsychological performance, in particular for language (OR 1.77; 1.35-2.31; p<0.001) and attention (OR 1.69; 1.37-2.08; p<0.001) domains. In 953 participants followed for a median 5.2 (IQR: 4.83-7.26) years, impaired mobility at baseline significantly predicted incident impairment in immediate memory (OR 2.56; 1.33-4.95; p<0.001). Stronger relationships were seen for impaired neuropsychological performance predicting mobility decline rather than impaired mobility predicting cognitive decline (all p<0.001). Both impaired mobility and neuropsychological performance were associated with incident falls, particularly for impairments in executive function and attention (all p<0.001). Impaired mobility in isolation had poor performance as a sole test to predict incident cognitive impairment (AUC: 0.55-0.65).
Conclusion
In both cross-sectional and longitudinal analyses, impaired mobility is associated with subtle impairments in neuropsychological performance. Whilst impaired neuropsychological performance was a greater predictor of impaired mobility rather than vice versa, our findings highlight the complex relationship between mobility and cognitive trajectories in older adults, emphasising the need for comprehensive cognitive and falls assessment in those presenting with new-onset subtle impairments in mobility and cognition.
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Affiliation(s)
- A Dyer
- Tallaght University Hospital Age-Related Healthcare, , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, , Dublin, Ireland
| | - H Dolphin
- Tallaght University Hospital Age-Related Healthcare, , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, , Dublin, Ireland
| | - E Laird
- Trinity College Dublin Department of Medical Gerontology, , Dublin, Ireland
| | - L Hoey
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - H McNulty
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - C Hughes
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - M Ward
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - JJ Strain
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - M O'Kane
- Altnagelvin Hospital, Western Health and Social Care Trust Clinical Chemistry, , Londonderry, United Kingdom
| | - F Tracey
- Northern Health and Social Care Trust Causeway Hospital, , Coleraine, United Kingdom
| | - A Molloy
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - C Cunningham
- Mercer's Institute for Successful Aging , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, , Dublin, Ireland
| | - K McCarroll
- Mercer's Institute for Successful Aging , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, , Dublin, Ireland
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11
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Breslin L, Bradley E, Fitzpatrick D, Laird E, Hoey L, Hughes C, McNulty H, Strain JJ, Ward M, Tracey F, Molloy A, Cunningham C, McCarroll K. 261 HIGH FRACTURE RISK IN OLDER IRISH ADULT FALLERS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Fracture risk due to falls depends on several factors including bone density, quality and size, hip geometry (axis length), direction of fall (forward, backwards or sideways), body mass index (BMI), type of surface impacted, body site of impact and mechanism of fall (eg syncope). We aimed to identify the fracture risk per fall in frail older Irish adults.
Methods
Participants were from the hypertensive and cognitive cohort of the Trinity, Ulster, Dept Agriculture (TUDA) study of Irish adults (aged >60) recruited from hospital outpatient services and GP practises. Falls and falls resulting in fracture in the previous year were self-reported so those with an MMSE < 25 were excluded to avoid recall bias. We identified fallers, recurrent fallers and fractures due to falls in the previous year.
Results
892 fallers, mean age 76.3 ± 8.4 yrs, 65.2% female. 23.8% had 2 falls and 24.2% ≥3 falls. Mean timed up and go was 17.3 ± 9.5 seconds. Commonest fracture due to falls were hip (20.1%), upper limb (18.5%) and lower limb (17.9%) with one fracture of neck and skull. Fracture rate per fall was 7.1%: 1.7% for hip, 1.3% for lower and 1.2% for upper limb. Annual fracture rate per faller was 16.5%. The only predictors of fall with fracture versus no fracture were female sex (OR 2.4, 1.6-3.6, P<0.001) and lower body mass index (P=0.001).
Conclusion
We identified similar hip fracture rates (1.7%) due to falls as in other studies. However, one in six fallers had sustained a fracture in the previous year reflecting the high proportion of recurrent fallers. Lower BMI and female sex predicted fall with fracture as both are strongly correlated with risk of osteoporosis. Recent guidelines now factor in recurrent falls when estimating the probability of future osteoporotic fractures.
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Affiliation(s)
- L Breslin
- Mercer's Institute for Successful Ageing, St. James Hospital , Dublin, Ireland
| | - E Bradley
- Mercer's Institute for Successful Ageing, St. James Hospital , Dublin, Ireland
| | - D Fitzpatrick
- Mercer's Institute for Successful Ageing, St. James Hospital , Dublin, Ireland
| | - E Laird
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - L Hoey
- Ulster University The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, , Coleraine, United Kingdom
| | - C Hughes
- Ulster University The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, , Coleraine, United Kingdom
| | - H McNulty
- Ulster University The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, , Coleraine, United Kingdom
| | - JJ Strain
- Ulster University The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, , Coleraine, United Kingdom
| | - M Ward
- Ulster University The Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, , Coleraine, United Kingdom
| | - F Tracey
- Northern Health and Social Care Trust Causeway Hospital, , Coleraine, United Kingdom
| | - A Molloy
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - C Cunningham
- Trinity College Dublin Mercer's Institute for Successful Ageing, St. James's Hospital, Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
| | - K McCarroll
- Trinity College Dublin Mercer's Institute for Successful Ageing, St. James's Hospital, Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
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12
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Feely O, Laird E, Hoey L, Hughes C, McNulty H, Ward M, Strain JJ, Tracey F, Molloy A, Cunningham C, Fallon N, Lannon R, McCarroll K. 126 CENTRAL ADIPOSITY IS ASSOCIATED WITH INCREASED PREVALENCE OF VERTEBRAL FRACTURES. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Increased body weight and obesity are associated with greater bone mineral density (BMD) though effects on fracture risk appear to be site specific. In particular, the relationship between Body Mass Index (BMI), abdominal weight and Vertebral Fractures (VF) is complex. Some studies have found greater incidence of VF's with obesity though results are inconsistent. Recent evidence supports a stronger association between measures of abdominal fat and VF's. We aimed to examine the association between central adiposity and VF's in older Irish adults.
Methods
Participants were from a large cross-sectional study of older Irish adults (aged >60) attending GP or hospital outpatient services. VF diagnosis was based on self-report (ie. clinical vertebral fracture) so we excluded those with a Mini Mental State Examination (MMSE) < 25. BMD was measured with DXA and patients taking antiresorptive or anabolic therapies were excluded. The relationship of waist hip ratio (a surrogate marker of central adiposity) with VF's was explored in regression models.
Results
2055 identified, mean age 69.8 ± 6.3 years (range 60-99), 58.6% female. Vertebral fracture prevalence was 6.3% (n=130). Waist hip ratio was positively associated with presence of a vertebral fracture after adjusting for age, sex, BMI, timed up and go, smoking, serum vitamin D, lumbar spine BMD and steroid use > 3 months (beta: 0.04, P<0.001).
Conclusion
We identified that central adiposity (as measured by waist/hip ratio) was associated with VF presence independent of several factors including BMI and spine BMD. This suggests that body fat distribution and/or altered bone quality may play a role. Visceral body fat (which is correlated with waist hip ratio) is associated with increased production of adipocytokines, altered vertebral geometry and micro-architecture, increased vertebral bone marrow fat and greater loading forces on the spine, all of which may mediate increased VF risk.
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Affiliation(s)
- O Feely
- St. James's Hospital Mercer's Institute for Successful Ageing, , Dublin, Ireland
| | - E Laird
- Trinity College Dublin Department of Clinical Medicine, , Dublin, Ireland
| | - L Hoey
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - C Hughes
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - H McNulty
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - M Ward
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - JJ Strain
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - F Tracey
- Ulster University The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, , Coleraine, United Kingdom
| | - A Molloy
- Northern Health and Social Care Trust Causeway Hospital, , Coleraine, United Kingdom
| | - C Cunningham
- St. James's Hospital Mercer's Institute for Successful Ageing, , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
| | - N Fallon
- St. James's Hospital Mercer's Institute for Successful Ageing, , Dublin, Ireland
| | - R Lannon
- St. James's Hospital Mercer's Institute for Successful Ageing, , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
| | - K McCarroll
- St. James's Hospital Mercer's Institute for Successful Ageing, , Dublin, Ireland
- Trinity College Dublin Department of Medical Gerontology, School of Medicine, , Dublin, Ireland
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Kelly C, Naughton P, Kennedy E, Ward M. Establishing intersectoral ‘Schools Teams’ to mitigate SARS-CoV-2 school transmission, 2020/2021. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The SARS-CoV-2 pandemic disrupted the lives of up to 100,000 school-going children in Ireland. Consequently, intersectoral ‘Schools Teams’ were established for the 2020/2021 school year to reduce SARS-CoV-2 transmission in school settings. This novel public health intervention provides learning to inform future cross-sectoral collaborative work in Public Health in responding to infectious disease threats. For the 2020/2021 school year in Ireland, intersectoral Schools Teams were formed within each of eight regional Departments of Public Health to manage mitigation of SARS-CoV-2 transmission in school settings. These teams comprised of staff from Departments of Public Health and redeployed staff from the Department of Education. A nationally agreed schools process was followed by Schools Teams to manage SARS-CoV-2 cases and outbreaks in schools. Relevant cases were referred to the regional Schools Team for a public health risk assessment (PHRA). Close contacts were determined using appropriate definitions of close contact within a school setting through the PHRA. This model with centralised procedures and linked health/education teams was novel and adaptable to additional settings. Results from the East region of Ireland showed testing of close contacts of COVID-19 was conducted in 71.8% (676/942) of schools, with 43881 tests completed. Most Schools Team members reported efficient communication within the team (88.7%), a positive team culture (96.3%) and feeling comfortable in their roles following training (82.7%). The majority of members felt the team was able to effectively support schools to reduce COVID-19 transmission (92.5%). Lessons learnt include the synergistic working of educational and health professionals towards a common goal, maximising the skills of all, ensuring a better outcome for school children. Involving educational teams in active contact tracing of COVID-19 cases in schools maximised engagement of the educational sector in the COVID-19 response.
Key messages
• Establishing intersectoral ‘Schools Teams’ pooled skills, resources and expertise, enabling development of synergistic solutions to a complex problem.
• This exemplifies a large national cross-sectoral collaborative working process involving education and public health sectors, providing a model for future responses to infectious disease threats.
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Affiliation(s)
- C Kelly
- Health Protection Surveillance Centre , Dublin, Ireland
| | - P Naughton
- Department of Public Health HSE East, CHO Area 6 , Dublin, Ireland
| | - E Kennedy
- Department of Public Health HSE East, CHO Area 6 , Dublin, Ireland
| | - M Ward
- Department of Public Health HSE East, CHO Area 6 , Dublin, Ireland
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Neilly H, McKenzie T, Ward M, Chaber A, Cale P. Potential drivers of common brushtail possum (. Aust Mammal 2022. [DOI: 10.1071/am22004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Australia’s terrestrial mammalian fauna have experienced severe declines since European settlement. On the Murray–Darling floodplain in south-eastern Australia, common brushtail possums (Trichosurus vulpecula, ‘possums’), have contracted to riparian zones. Although an important possum refuge, little is known about possum population dynamics here. We examined possum population dynamics and potential drivers across two decades on the Murray River floodplain at Calperum Station. We related possum density to satellite derived fractional cover, (a measure of the proportion of green, non-green and bare ground cover), and contextualised these findings using tree condition and grazing pressure datasets. Possum surveys were conducted between 1998 and 2019 in riparian and non-riparian habitats and density was modelled in relation to fractional cover values of green, non-green, and bare ground. Possum density fluctuated between 1998 and 2008 but in 2018 and 2019, possums were undetectable. Possum density was negatively associated with bare ground and positively associated with non-green. Overgrazing by kangaroos likely reduced vegetation cover and diversity and contributed to possum decline, via a reduction in possum food resources and increased exposure to predation. Inconsistent monitoring meant that the population decline was not detected until after it had occurred, and management interventions were not triggered, highlighting the dilemma of allocating scarce monitoring resources.
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Huang C, Foster H, Paudyal V, Ward M, Lowrie R. A systematic review of the nutritional status of adults experiencing homelessness. Public Health 2022; 208:59-67. [PMID: 35716429 DOI: 10.1016/j.puhe.2022.04.013] [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: 11/04/2021] [Revised: 04/05/2022] [Accepted: 04/29/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To identify, appraise, and describe studies focussing on the nutritional characteristics of people experiencing homelessness (PEH). STUDY DESIGN Systematic (narrative) review. METHODS We identified full-text studies of any design and in the English language of adults (≥18 years) fulfilling the European Typology criteria for homelessness, based in community or hospital settings, and which report nutritional measures. Five electronic databases, 13 grey literature sources, reference lists, and forward citations were searched. Data on study characteristics and nutrition measures were collected and synthesised narratively. Risk of bias was assessed using relevant checklists for each study type. RESULTS A total of 1130 studies were identified and retrieved. After screening, six studies were included for review: three cross-sectional studies; two case-control studies; and one randomised control trial, involving a total of 1561 participants from various settings including shelters, drop-in centres, hospitals, and hostels. All included studies were from high-income countries. Studies reported a range of nutrition measures including anthropometry (e.g., body mass index (BMI)), serum micronutrients and biomarkers, and dietary intake. Between 33.3% and 68.3% of participants were overweight or obese; 3.5%-17% were underweight; and low blood levels of iron, folate, vitamins C, D, and B12, and haemoglobin were prevalent. PEH consumed high amounts of dietary fats and alcohol, and low amounts of fruits and vegetables compared with national guidelines and housed individuals. There was moderate to high risk of selection and measurement bias and confounding in included studies. CONCLUSIONS A majority of PEH are within unhealthy BMI ranges and are deficient in serum micronutrients and nutritional biomarkers. Studies using large data sets that examine multiple aspects of nutrition are needed to describe the nutritional characteristics of PEH. REGISTRATION This systematic review is based on a prespecified protocol registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42021218900).
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Affiliation(s)
- C Huang
- School of Medicine, College of Medical, Veterinary, and Life Sciences, University of Glasgow, UK.
| | - H Foster
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, UK.
| | - V Paudyal
- School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, UK.
| | - M Ward
- Marianne Ward, Homelessness Dietitian, Dietetics, Glasgow City HSCP, Shettleston Health Centre, 420 Old Shettleston Road, Glasgow G32 7JZ, UK.
| | - R Lowrie
- PHOENIx Team, Pharmacy Services, NHS Greater Glasgow and Clyde, UK.
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16
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Karmacharya P, Crowson CS, Poudel D, Davis JM, Ogdie A, Liew J, Ward M, Ishimori M, Weisman M, Brown M, Rahbar M, Hwang M, Reveille JD, Gensler LS. OP0154 COMORBIDITY CLUSTERS IN ANKYLOSING SPONDYLITIS AND THEIR ASSOCIATION WITH DISEASE ACTIVITY AND FUNCTIONAL IMPAIRMENT: DATA FROM THE PSOAS COHORT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundComorbidities in ankylosing spondylitis (AS) occur more frequently than in the general population and are associated with higher morbidity and mortality. Some comorbidities may occur together, making one more likely in the presence of another, and different combinations of comorbidities may have differential considerations for AS management and outcomes.ObjectivesTo examine the association of baseline comorbidities with disease activity and functional status in AS.MethodsWe used baseline data from the Prospective Study Of Ankylosing Spondylitis (PSOAS) cohort, a multicenter, prospective cohort from five centers (4 in the US, 1 in Australia). AS patients ≥ 18 years fulfilling mNY criteria for AS (2002-20) were included. Patient-reported AS comorbidities (N=28) and extra-musculoskeletal manifestations (EMMs, N=2) within 3 years of enrollment (prespecified on the baseline case-report form) and only those occurring in ≥1% were included. Undocumented comorbidities were assumed to be absent if missing in <15% of patients, and those missing in >50% of patients were excluded. Comorbidity clusters were identified using K-median clustering. The optimal number of clusters was determined using scree plot of the sum of squared errors and “elbow” on the graph line. Baseline characteristics of the clusters were compared, and associations of with disease activity and functional status measures (primary outcomes: ASDAS-CRP and BASFI) were examined using linear regression adjusted for age and sex.ResultsThere were 1,270 AS patients included with a mean age of 44.6 ±14.3 years, 74.4% males, and 81.2% whites. Mean AS symptom duration was 20.6±5.6 years, 81.6% HLA-B27 positive, and CRP elevated in 27.5% of patients at baseline. Depression was the most prevalent comorbidity (31.4%) followed by hypertension (26.1%); uveitis was the most common EMM (30.4%). The five clusters identified included depression (27%), no comorbidities (22%), hypertension (21%), uveitis (20%), and asthma/low bone mass (10%) (Figure 1). The cluster with no comorbidities was significantly younger, with lower symptom duration (p<0.001). Females had higher odds of being in the depression (OR=2.00, 95% CI 1.38- 2.90) and uveitis (OR=2.09, 95% CI 1.41-3.11) clusters compared to the cluster with no comorbidities. The number of comorbidities and clusters with depression and hypertension were significantly associated with worse disease activity and functional status (Table 1).Table 1.Age and sex adjusted associations between comorbidity clusters, compared to cluster 3, and baseline disease activity/ functional status measures in ankylosing spondylitis based on Linear regression models.Cluster 1 (depression)Cluster 3 (hypertension)Cluster 4 (uveitis)Cluster 5 (asthma, low bone mass)OutcomesCoef (95% CI)Coef (95% CI)Coef (95% CI)Coef (95% CI)ASDAS-CRP0.98 (0.78-1.18)0.43 (0.18-0.68)0.04 (-0.19-0.27)0.16 (-0.12-0.44)BASFI (0-10)1.92 (1.51-2.34)1.00 (0.53-1.48)-0.03 (-0.49-0.42)0.64 (0.076-1.20)Enthesitis count1.17 (0.73-1.61)0.73 (0.19-1.26)0.18 (-0.32-0.68)0.48 (-0.13-1.08)Swollen joint count (0-44)0.27 (-0.08-0.62)0.43 (-0.01-0.86)0.31 (-0.09-0.71)-0.95 (-0.58-0.39)Tender joint count (0-46)1.24 (0.59-1.88)0.44 (-0.34-1.23)0.56 (-0.18-1.29)0.34 (-0.55-1.23)BASDAI (0-10)2.30 (1.88-2.71)0.88 (0.36-1.40)0.30 (-0.17-0.78)0.61 (0.03-1.19)Patient Global (0-10)2.25 (1.82-2.68)0.76 (0.21-1.30)-0.22 (-0.71-0.27)0.29 (-0.31-0.89)Patient Pain (0-10)2.45 (1.95-2.94)1.00 (0.37-1.62)0.19 (-0.38-0.75)0.16 (-0.54-0.85)Spinal pain (0-10)2.40 (1.89-2.91)1.05 (0.41-1.70)0.43 (-0.16-1.01)0.76 (0.04-1.47)Figure 1.Comorbidity clusters in PSOAS cohort at baselineConclusionDistinct comorbidity clusters were identified in AS patients in the PSOAS cohort. In addition to the number of comorbidities, the type of comorbidity seems to be important. Depression and hypertension clusters seem to be associated with worse disease activity and function.Disclosure of InterestsParas Karmacharya: None declared, Cynthia S. Crowson: None declared, Dilli Poudel: None declared, John M Davis III Consultant of: Dr. Davis has received consulting fees and/or honoraria from AbbVie and Sanofi-Genzyme (less than $10,000 each), Grant/research support from: Dr. Davis has received research support from Pfizer., Alexis Ogdie Consultant of: Dr. Ogdie has served as a consultant for AbbVie, Amgen, BMS, Celgene, Corrona, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB (less than 10,000 each), Grant/research support from: Dr. Ogdie has received grants from Novartis and Pfizer to Penn and from Amgen to Forward (grants more than 10,000)., Jean Liew Grant/research support from: Dr. Liew received grant/research support from Pfizer (> $10,000), Michael Ward: None declared, Mariko Ishimori: None declared, Michael Weisman Consultant of: Dr. Weisman received consulting fees for Novartis, UCB, Gilead, and GSK (< $10,000)., Matthew Brown: None declared, Mohammad Rahbar: None declared, Mark Hwang: None declared, John D Reveille Consultant of: JDR received consulting fees for UCB (< $10,000), Grant/research support from: Dr. Reveille received research support from Lilly and Janssen unrelated to this work., Lianne S. Gensler Consultant of: Dr. Gensler has received consulting fees for AbbVie, Eli Lilly, GSK, Gilead, Pfizer (< $10,000)., Grant/research support from: Dr. Gensler received grant/research support from UCB and Novartis (> $10,000).
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Halmai L, Johnson N, Ward M, Kardos A, Chattopadhyay S. Is there a unique cardiac deformation behaviour in COVID-patients? The SARS-2-DEFORM Study. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
SARS-2-DEFORM
Myocardial dysfunction is common and associated with worse outcomes in patients with ARDS, pulmonary embolism or severe sepsis due to pulmonary hypoxic vasoconstriction. Thrombotic events, myocarditis and endothelial dysfunction may contribute to these effects in COVID-19 infection. The evaluation of myocardial function can provide prognostic information regarding the severity of a current COVID-19 infection, but scarce data available on the role of Deformation Indices obtained by Speckle Tracking Analysis to describe unique features of myocardial dysfunction in COVID-19 pneumonitis. AIMS: to evaluate the value of ventricular and atrial Deformation Imaging in patients with COVID-19 infection and hypoxia who had preserved systolic function in comparison with age-, gender-, BSA, hypoxia-matched control subjects with respiratory disease on oxygen therapy, thus excluding the effects of pulmonary vasoconstriction. We also assessed the impact of biochemical and inflammatory markers on the Echo-Indices. METHODS: 21 patients with PCR-confirmed COVID-pneumonitis (15 males, age:60.1 ± 16.1yrs, range:43-89) and 31 control, PCR-negative subjects (age:62.8 ± 15.5yrs, range:22-92) on oxygen with matched biometric data were compared. 2 examiners, blinded to the clinical data performed off-line standard Echocardiographic assessment and Deformation Imaging by 2D-Speckle Tracking Analysis with the TomTec Arena software package (Unterschleissheim, Germany) in both ventricles and atria. Plasma chemistry data were compared between the groups. RESULTS: No differences found in the biometric data and the cardiac chamber sizes between the groups. The global systolic strain indices were reduced in the COVID-group in the LV, but not the EF (LV-GLS -13.6 ± 2.9 vs -16 ± 1.1%, LV-GCS -24.8 ± 2.4 vs -28.9 ± 2.8%, p = 0.001, LVEF 61 ± 3.7 vs 60.7 ± 4.9%, p = NS), and these were reduced in the RV and RA, but not the TAPSE and TDI-S` when compared to the controls (RV-FWS -12.3 ± 2.9 vs -16.2 ± 1.5%, RV-GLS -14.6 ± 3.4 vs -17.1 ± 1.7%, RASr 18.5 ± 6 vs 22.3 ± 4.8% p = 0.005. Interestingly, the dispersion of contraction was increased in the COVID-patients in both the LV (LV-SD 416.2 ± 81.8 vs 309.8 ± 69.8ms, p < 0.001) and the RV and the RA (RV-SD 414.9 ± 117 vs 303.8 ± 61ms, RA-SD 33.5 ± 6.7 vs 26.1 ± 4.7ms, p < 0.001). The right heart indices correlated well with the biochemical data (RV-FWS and RV-SD with Ferritin r = 0.54 and -0.46, p = 0.003, RASr with GLS r = 0.64, p = 0.002, RA-SD with Troponin, p = 0.01 and with the RV-coupling Index r = 0.72, p = 0.02). CONCLUSIONS: Myocardial dysfunction is common among severely ill and hypoxic COVID-19 patients. The conventional Echo-parameters of systolic function or pulmonary pressures do not appear being specific but the Deformation Indices can provide tools to detect unique changes of the myocardial function and dys-synchrony imposed by the COVID-19 infection, independently from the impact of hypoxia or raised pulmonary pressures, hence they can predict outcome more accurately.
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Affiliation(s)
- L Halmai
- Milton Keynes Hospital NHS Trust, Milton Keynes, United Kingdom of Great Britain & Northern Ireland
| | - N Johnson
- Milton Keynes Hospital NHS Trust, The University of Buckingham, Milton Keynes, United Kingdom of Great Britain & Northern Ireland
| | - M Ward
- Milton Keynes Hospital NHS Trust, Milton Keynes, United Kingdom of Great Britain & Northern Ireland
| | - A Kardos
- Milton Keynes Hospital NHS Trust, Milton Keynes, United Kingdom of Great Britain & Northern Ireland
| | - S Chattopadhyay
- Milton Keynes Hospital NHS Trust, Milton Keynes, United Kingdom of Great Britain & Northern Ireland
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18
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Adhikari P, Ajaj R, Auty D, Bina C, Bonivento W, Boulay M, Cadeddu M, Cai B, Cárdenas-Montes M, Cavuoti S, Chen Y, Cleveland B, Corning J, Daugherty S, DelGobbo P, Di Stefano P, Doria L, Dunford M, Erlandson A, Farahani S, Fatemighomi N, Fiorillo G, Gallacher D, Garcés E, García Abia P, Garg S, Giampa P, Goeldi D, Gorel P, Graham K, Grobov A, Hallin A, Hamstra M, Hugues T, Ilyasov A, Joy A, Jigmeddorj B, Jillings C, Kamaev O, Kaur G, Kemp A, Kochanek I, Kuźniak M, Lai M, Langrock S, Lehnert B, Levashko N, Li X, Litvinov O, Lock J, Longo G, Machulin I, McDonald A, McElroy T, McLaughlin J, Mielnichuk C, Monroe J, Oliviéro G, Pal S, Peeters S, Pesudo V, Piro MC, Pollmann T, Rand E, Rethmeier C, Retière F, Rodríguez-García I, Roszkowski L, Sanchez García E, Sánchez-Pastor T, Santorelli R, Sinclair D, Skensved P, Smith B, Smith N, Sonley T, Stainforth R, Stringer M, Sur B, Vázquez-Jáuregui E, Viel S, Vincent A, Walding J, Waqar M, Ward M, Westerdale S, Willis J, Zuñiga-Reyes A. Erratum: Constraints on dark matter-nucleon effective couplings in the presence of kinematically distinct halo substructures using the DEAP-3600 detector [Phys. Rev. D
102
, 082001 (2020)]. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.105.029901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Adhikari P, Ajaj R, Alpízar-Venegas M, Auty DJ, Benmansour H, Bina CE, Bonivento W, Boulay MG, Cadeddu M, Cai B, Cárdenas-Montes M, Cavuoti S, Chen Y, Cleveland BT, Corning JM, Daugherty S, DelGobbo P, Di Stefano P, Doria L, Dunford M, Ellingwood E, Erlandson A, Farahani SS, Fatemighomi N, Fiorillo G, Gallacher D, García Abia P, Garg S, Giampa P, Goeldi D, Gorel P, Graham K, Grobov A, Hallin AL, Hamstra M, Hugues T, Ilyasov A, Joy A, Jigmeddorj B, Jillings CJ, Kamaev O, Kaur G, Kemp A, Kochanek I, Kuźniak M, Lai M, Langrock S, Lehnert B, Leonhardt A, Levashko N, Li X, Lissia M, Litvinov O, Lock J, Longo G, Machulin I, McDonald AB, McElroy T, McLaughlin JB, Mielnichuk C, Mirasola L, Monroe J, Oliviéro G, Pal S, Peeters SJM, Perry M, Pesudo V, Picciau E, Piro MC, Pollmann TR, Raj N, Rand ET, Rethmeier C, Retière F, Rodríguez-García I, Roszkowski L, Ruhland JB, Sanchez García E, Sánchez-Pastor T, Santorelli R, Seth S, Sinclair D, Skensved P, Smith B, Smith NJT, Sonley T, Stainforth R, Stringer M, Sur B, Vázquez-Jáuregui E, Viel S, Walding J, Waqar M, Ward M, Westerdale S, Willis J, Zuñiga-Reyes A. First Direct Detection Constraints on Planck-Scale Mass Dark Matter with Multiple-Scatter Signatures Using the DEAP-3600 Detector. Phys Rev Lett 2022; 128:011801. [PMID: 35061499 DOI: 10.1103/physrevlett.128.011801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/15/2021] [Accepted: 11/16/2021] [Indexed: 06/14/2023]
Abstract
Dark matter with Planck-scale mass (≃10^{19} GeV/c^{2}) arises in well-motivated theories and could be produced by several cosmological mechanisms. A search for multiscatter signals from supermassive dark matter was performed with a blind analysis of data collected over a 813 d live time with DEAP-3600, a 3.3 t single-phase liquid argon-based detector at SNOLAB. No candidate signals were observed, leading to the first direct detection constraints on Planck-scale mass dark matter. Leading limits constrain dark matter masses between 8.3×10^{6} and 1.2×10^{19} GeV/c^{2}, and ^{40}Ar-scattering cross sections between 1.0×10^{-23} and 2.4×10^{-18} cm^{2}. These results are interpreted as constraints on composite dark matter models with two different nucleon-to-nuclear cross section scalings.
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Affiliation(s)
- P Adhikari
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - R Ajaj
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Alpízar-Venegas
- Instituto de Física, Universidad Nacional Autónoma de México, A.P. 20-364, México D.F. 01000, México
| | - D J Auty
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - H Benmansour
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - C E Bina
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | | | - M G Boulay
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - M Cadeddu
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
- INFN Cagliari, Cagliari 09042, Italy
| | - B Cai
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Cárdenas-Montes
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - S Cavuoti
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- Astronomical Observatory of Capodimonte, Salita Moiariello 16, I-80131 Napoli, Italy
- INFN Napoli, Napoli 80126, Italy
| | - Y Chen
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - B T Cleveland
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - J M Corning
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - S Daugherty
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
| | - P DelGobbo
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - P Di Stefano
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - L Doria
- PRISMA+, Cluster of Excellence and Institut für Kernphysik, Johannes Gutenberg-Universität Mainz, 55128 Mainz, Germany
| | - M Dunford
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - E Ellingwood
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - A Erlandson
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - S S Farahani
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - N Fatemighomi
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - G Fiorillo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - D Gallacher
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - P García Abia
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - S Garg
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - P Giampa
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - D Goeldi
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - P Gorel
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - K Graham
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - A Grobov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A L Hallin
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - M Hamstra
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - T Hugues
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
| | - A Ilyasov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A Joy
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - B Jigmeddorj
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - C J Jillings
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - O Kamaev
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - G Kaur
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - A Kemp
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - I Kochanek
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - M Kuźniak
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Lai
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
- INFN Cagliari, Cagliari 09042, Italy
| | - S Langrock
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - B Lehnert
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - A Leonhardt
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - N Levashko
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - X Li
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M Lissia
- INFN Cagliari, Cagliari 09042, Italy
| | - O Litvinov
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - J Lock
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - G Longo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - I Machulin
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A B McDonald
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - T McElroy
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - J B McLaughlin
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - C Mielnichuk
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - L Mirasola
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - J Monroe
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - G Oliviéro
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - S Pal
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - S J M Peeters
- University of Sussex, Sussex House, Brighton, East Sussex BN1 9RH, United Kingdom
| | - M Perry
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - V Pesudo
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - E Picciau
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
- INFN Cagliari, Cagliari 09042, Italy
| | - M-C Piro
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - T R Pollmann
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - N Raj
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - E T Rand
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - C Rethmeier
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - F Retière
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - I Rodríguez-García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - L Roszkowski
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- BP2, National Centre for Nuclear Research, ul. Pasteura 7, 02-093 Warsaw, Poland
| | - J B Ruhland
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - E Sanchez García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - T Sánchez-Pastor
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - R Santorelli
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - S Seth
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - D Sinclair
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - P Skensved
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - B Smith
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - N J T Smith
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - T Sonley
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - R Stainforth
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - M Stringer
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - B Sur
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - E Vázquez-Jáuregui
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- Instituto de Física, Universidad Nacional Autónoma de México, A.P. 20-364, México D.F. 01000, México
| | - S Viel
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - J Walding
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - M Waqar
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Ward
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - S Westerdale
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- INFN Cagliari, Cagliari 09042, Italy
| | - J Willis
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - A Zuñiga-Reyes
- Instituto de Física, Universidad Nacional Autónoma de México, A.P. 20-364, México D.F. 01000, México
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20
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Shepherd I, Rao K, Ward M, Hansen P, Figtree G, Vernon S, Bhindi R, Allahwala U. The Impact of Atrial Fibrillation (AF) on Coronary Collateralisation in Patients Presenting With ST Elevation Myocardial Infarction (STEMI). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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McGarrigle C, Ward M, De Looze C, O'Halloran A, Kenny R. Caring in the time of COVID-19, longitudinal trends in well-being and mental health in carers in Ireland: Evidence from the Irish Longitudinal Study on Ageing (TILDA). Arch Gerontol Geriatr 2022; 102:104719. [PMID: 35588613 PMCID: PMC9085370 DOI: 10.1016/j.archger.2022.104719] [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: 01/31/2022] [Revised: 04/20/2022] [Accepted: 05/07/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND The COVID-19 pandemic in 2020 resulted in the older population being asked to remain at home and avoid other people outside their household. This could have implications for both receipt and provision of informal caring. OBJECTIVE To determine if informal care provision by older carers changed during the first wave of the COVID-19 pandemic from pre-pandemic care and if this was associated with a change in mental health and well-being of carers. DESIGN AND SETTING Longitudinal nationally representative study of community dwelling adults from The Irish Longitudinal Study on Ageing (TILDA) (Waves 3-COVID-Wave 6). METHODS We studied a cohort of 3670 adults aged ≥60 in Ireland during the COVID-19 pandemic (July-November 2020) and compared with previous data collections from the same cohort between 2014-2018. Independent variables were caregiving status and caregiving intensity, outcome measures included depressive symptoms (CES-D8), Perceived Stress (PSS4) and Quality of life (CASP12). Mixed models adjusting for socio-demographics and physical health were estimated. RESULTS Caregiving increased from 8.2% (2014) to 15.4% (2020). Depression, and stress scores increased while quality of life decreased for all participants. Carers reported poorer mental health, and higher caring hours were associated with increased depression and stress and decreased quality of life scores on average, and increased depression was higher for women. CONCLUSIONS Informal caregiving increased during the pandemic and family caregivers reported increased adverse mental health and well-being and this continued throughout the early months of the pandemic. The disproportionate burden of depression was highest in women providing higher caring hours.
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Affiliation(s)
- C.A. McGarrigle
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland,Corresponding author
| | - M. Ward
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - C. De Looze
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - A. O'Halloran
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - R.A. Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland,Mercer's Institute for Successful Ageing, St James’ Hospital, Dublin, Ireland
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22
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Robinson A, Ward M, Kenny RA, Briggs R. 168 ANXIETY SYMPTOMS AMONG OLDER PEOPLE DURING THE COVID-19 PANDEMIC: PREVALENCE AND ASSOCIATED FACTORS. Age Ageing 2021; 50:afab219.168. [PMCID: PMC8690042 DOI: 10.1093/ageing/afab219.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background There are concerns that the COVID-19 pandemic could lead to a rise in mental health problems including anxiety amongst older people, especially those shielding alone during the pandemic. The aim of this study therefore is to examine the prevalence of anxiety symptoms during the COVID-19 pandemic amongst older people and clarify factors associated with higher burden of symptoms. Methods We analysed data from the COVID-19 study of The Irish Longitudinal Study on Ageing, conducted on over 3,100 community dwelling people aged ≥60 years from July–November 2020. Anxiety symptoms were measured with the Generalised Anxiety Disorder-7 Questionnaire with a score ≥ 10 indicating moderate–severe anxiety. Linear regression models were used to assess the association of variables of interest with anxiety symptoms. Results Almost 9% of participants (n = 3,128; mean age 71 years) had moderate–severe symptoms of anxiety. Factors independently associated with a higher burden of anxiety symptoms included female sex (β = 0.60 (0.33–0.87)); living alone (β = 0.72 (0.41–1.02)); ≥2 chronic diseases (β = 0.85 (0.41–1.30); heart disease (β = 0.95 (0.45–1.46)) and reporting frequent loneliness (β = 6.59 (6.03–7.16)). Age ≥ 80 years (β = −0.77 (−1.16—0.37)) and tertiary level education (β = −0.48 (−0.86—-0.10)) were associated with lower anxiety symptom burden. Conclusion Almost 1 in 10 of this population-representative sample of older people had moderate to severe anxiety symptoms during the COVID-19 pandemic. Strategies to address loneliness, which was particularly strongly associated with anxiety symptoms during the pandemic, should be a priority.
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Affiliation(s)
- A Robinson
- The Irish Longitudinal Study on Ageing, Dublin, Ireland
| | - M Ward
- The Irish Longitudinal Study on Ageing, Dublin, Ireland
| | - R A Kenny
- The Irish Longitudinal Study on Ageing, Dublin, Ireland
| | - R Briggs
- The Irish Longitudinal Study on Ageing, Dublin, Ireland
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23
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Hennelly N, Lalor G, Gibney S, Murphy R, Kenny RA, Ward M. 190 FACTORS ASSOCIATED WITH ADHERENCE TO COVID-19 PUBLIC HEALTH GUIDELINES AMONG OLDER ADULTS IN IRELAND. Age Ageing 2021. [PMCID: PMC8690070 DOI: 10.1093/ageing/afab219.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Older adults are at high risk from coronavirus 2019 (COVID-19). Even with the introduction of a widespread vaccination programme, adherence to public health guidelines continue to be of vital importance to reducing the spread of COVID-19. This study examines the factors associated with adherence to two public health guidelines, social distancing and mask wearing, among older adults (50 years and over) in Ireland. Methods Data from the Irish Longitudinal Study on Ageing (TILDA) COVID-19 study and previous waves of TILDA was used. The COVID-19 study data was collected between July 2020 and November 2020. Logistic regression analysis was conducted separately to examine the relationship between the independent variables and social distancing and mask wearing respectively. Along with socio-demographic variables, the Health Belief Model (HBM) was used to identify variables for inclusion in the analysis. Results In total, 2,816 participants were included in this study. Females were more likely than males to adhere to social distancing and mask wearing guidelines. Those most concerned about COVID-19 were more likely to adhere to both behaviours. Education levels were associated with adherence to both behaviours but the direction of the relationship differed. Those who trusted the Health Service Executive as a news source were more likely to socially distance, while those with less understanding of government guidance and those who trusted in government news sources were less likely to socially distance. Participants who were working were less likely to socially distance than those who weren’t. While, participants who were over 70 and those who returned the survey after the introduction of mandatory mask wearing were more likely to wear a mask. Participants who lived outside of Dublin were less likely to wear a mask. Conclusion Factors associated with adherence to public health guidelines vary according to the guideline. Differences between groups need to be considered when implementing policy around public health guidelines.
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Affiliation(s)
- N Hennelly
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland,Department of Health, The Healthy and Positive Ageing Initiative, Dublin, Ireland
| | - G Lalor
- Department of Health, The Healthy and Positive Ageing Initiative, Dublin, Ireland
| | - S Gibney
- Department of Health, The Healthy and Positive Ageing Initiative, Dublin, Ireland
| | - R Murphy
- Department of Health, Research Services and Policy Unit, Dublin, Ireland
| | - R A Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland,Department of Medical Gerontology, St James's Hospital, Dublin, Ireland
| | - M Ward
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
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24
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Dyer A, Laird E, Hoey L, Hughes C, McNulty H, Ward M, Strain JJ, Molloy A, Cunnningham C, Sexton D, McCarroll K. 43 REDUCED KIDNEY FUNCTION IS ASSOCIATED WITH POORER GLOBAL AND DOMAIN-SPECIFIC COGNITIVE PERFORMANCE IN COMMUNITY-DWELLING OLDER ADULTS. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.43] [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: 02/25/2023] Open
Abstract
Abstract
Background
Chronic Kidney Disease (CKD) is an important risk factor in the development of cognitive impairment. However, the association between reduced estimated Glomerular Filtration Rate (eGFR) and performance on domain-specific cognitive and neuropsychological assessments is less clear and may represent an important target in the promotion of optimal brain health in older adults.
Methods
Participants from the Trinity, Ulster and Department of Agriculture cohort study underwent detailed assessment of cognitive and neuropsychological function using the Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB) and Repeatable Battery for Assessment of Neuropsychological Status (RBANS). Mixed-effects Poisson and linear regression was used to assess the relationship between eGFR strata and cognitive/neuropsychological test performance.
Results
4,887 participants were included (73.94 ± 8.25 years; 67.7% female). Reduced eGFR was associated with poorer performance on all three cognitive assessments, most pronounced in those with eGFR <45 mL/mL/1.73m2 (IRR: 1.19; 95% CI: 1.09, 1.29; p < 0.001 for MMSE/IRR: 1.14; 95% CI 1.04, 1.24; p < 0.001 for the FAB/β: -3.23; 95% CI -5.18, −1.30; p = 0.001 for RBANS, fully adjusted). Reduced eGFR was associated with poorer performance on immediate memory, visual–spatial and attention RBANS domains. Associations were strongest in the youngest old (<70 years) with no association observed in those aged >80 years.
Conclusion
Reduced kidney function was associated with poorer global and domain-specific function in community-dwelling older adults. Associations were strongest for those with eGFR <45 mL/min/1.73m2 and the youngest-old, suggesting that this group may be most at risk and may benefit from potential preventative interventions.
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Affiliation(s)
- A Dyer
- St James's Hospital , Dublin, Ireland
| | - E Laird
- Trinity College Dublin , Dublin, Ireland
| | - L Hoey
- Ulster University , Coleraine, United Kingdom
| | - C Hughes
- Ulster University , Coleraine, United Kingdom
| | - H McNulty
- Ulster University , Coleraine, United Kingdom
| | - M Ward
- Ulster University , Coleraine, United Kingdom
| | - J J Strain
- Ulster University , Coleraine, United Kingdom
| | - A Molloy
- Trinity College Dublin , Dublin, Ireland
| | | | - D Sexton
- Trinity Health Kidney Centre , Dublin, Ireland
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25
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Bailey L, Ward M, DiCosimo A, Lavan A, Briggs R. 166 HEALTH TRAJECTORIES OF FRAIL, OLDER PEOPLE WHILE COCOONING DURING THE COVID-19 PANDEMIC. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.166] [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: 02/25/2023] Open
Abstract
Abstract
Background
Cocooning, i.e. staying at home and reducing interaction with others, was a key part of the strategy to protect older people during the COVID-19 pandemic.
Unfortunately, there are concerns this has had a negative impact on the physical and mental wellbeing of those who have been isolated.
Methods
We completed a survey of 150 patients (55% female, mean age 79.8 years, average Clinical Frailty Scale 4.8) attending ambulatory medical services in a large university hospital.
Questions were focused on: access to healthcare services, mental health, physical health, and attitudes to COVID-19 restrictions.
Results
Almost 40% reported that their mental health was ‘worse’ or ‘much worse’ while cocooning, while over 40% reported a decline in their physical health.
Over 57% had a scheduled healthcare-related visit cancelled while cocooning, most frequently hospital outpatient appointments.
Worryingly, almost 1/6 reported not seeking medical attention for an illness that they would usually. Of these, half did not as they were worried about catching COVID and 46% did not as this service was not currently available to them.
Conclusion
The COVID-19 pandemic and lack of access to essential services, both medical and social, has had a devastating impact on older people.
This is evident in both the acute presentations to hospital and the longer-term impact it has had on health and function.
It is important that in the future clear policies are in place to enable older people to access care when they need it.
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Affiliation(s)
- L Bailey
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
| | - M Ward
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
| | - A DiCosimo
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
| | - A Lavan
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
| | - R Briggs
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
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26
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Hillen J, Ward M, Slee M, Stanford T, Roughead E, Kalisch Ellett L, Pratt N. Utilisation of disease modifying treatment and diversity of treatment pathways in relapsing remitting multiple sclerosis. Mult Scler Relat Disord 2021; 57:103412. [PMID: 34856498 DOI: 10.1016/j.msard.2021.103412] [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: 08/19/2021] [Revised: 11/10/2021] [Accepted: 11/14/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND There is minimal information on the utilisation of Disease Modifying Treatment (DMTs) for multiple sclerosis. The appropriate and safe use of medicines is informed by utilisation studies. Outcomes can inform health interventions to improve appropriate use of medicines and post marketing surveillance activities to improve safety. OBJECTIVE To evaluate utilisation and treatment patterns of disease modifying treatments (DMTs) for relapsing remitting multiple sclerosis (RRMS). METHODS A representative sample of the Australian pharmaceutical benefits scheme data were analysed (2006-2016). Demographics of incident users and trends in incident and prevalent users were determined. Individual patient treatment pathways were determined by sequential initiation of medicines in two different periods (2006-2013 and 2014-2019). RESULTS There were 20,660 patients with at least one dispensing of a DMT for RRMS during the study period (median age 41 years, 75% female). Incident and prevalent use increased by 20% and 88%, respectively. The market was responsive to 13 new listings of DMTs over the study period. Sequential treatment was found for 66% of initiators in 2006-2013 and 28.5% of initiators in 2014-2019. Diverse treatment pathways were found, with 278 and 93 unique sequences in 2006-2013 and 2014-2019, respectively. CONCLUSION The availability of new DMTs has influenced both initial treatment choice and prevalence of users. Individualised treatment patterns and exposure to multiple medicines over time will challenge traditional pharmacovigilance systems.
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Affiliation(s)
- J Hillen
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia.
| | - M Ward
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia; Pharmacy Education, Clinical and Health Sciences, University of South Australia, Australia
| | - M Slee
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - T Stanford
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
| | - E Roughead
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
| | - L Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
| | - N Pratt
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
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27
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O'Flaherty N, Moloney K, Ahmad R, Laird E, Hughes C, McNulty H, Ward M, Strain JJ, Molloy AM, Cunningham C, McCarroll K. 135 VITAMIN D FORTIFIED MILK—EFFECT ON VITAMIN D STATUS IN OLDER ADULTS. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.135] [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: 02/25/2023] Open
Abstract
Abstract
Background
Vitamin D fortified milk is used by some older adults to boost vitamin D status. Combined vitamin D/calcium supplements often cause gastrointestinal upset which reduces adherence. Consumption of fortified milk may be a more consistent and reliable way of increasing serum 25 hydroxyvitamin D [25(OH)D], though studies of it’s efficacy in older adults are limited.
Methods
We examined the vitamin D status of users of vitamin D fortified milk in participants of a longitudinal study of community dwelling Irish adults aged >60 yrs. Patients taking vitamin D supplements were excluded and independent effects were explored in multinomial regression models. Vitamin D deficiency was defined as a 25(OH)D level < 30 nmol/l.
Results
2496 participants were identified: mean age was 70.5 ± 7.0 years (range 60–96 yrs) and 145 (5.8%) reported using vitamin D fortified milk. In those who consumed fortified milk, there was a lower prevalence of vitamin D deficiency (17.9 vs 34.5%, P < 0.001). Vitamin D fortified milk also predicted less deficiency after adjusting for age, gender, season, BMI and physical frailty (OR 0.30. CI 0.19–0.48, P < 0.001).
Conclusion
Vitamin D fortified milk was associated with a 70% reduction in the risk of vitamin D deficiency in older adults not taking vitamin D supplements. Findings support the use of vitamin D fortified milk as an effective means of improving vitamin D status. Fortified milk also contains additional calcium and so can be used to augment daily calcium intake.
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Affiliation(s)
- N O'Flaherty
- MedEl Directorate, St James's Hospital , Dublin, Ireland
| | - K Moloney
- MedEl Directorate, St James's Hospital , Dublin, Ireland
| | - R Ahmad
- MedEl Directorate, St James's Hospital , Dublin, Ireland
| | - E Laird
- School of Medicine, Trinity College Dublin , Dublin, Ireland
| | - C Hughes
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - H McNulty
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - M Ward
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - J J Strain
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - A M Molloy
- School of Medicine, Trinity College Dublin , Dublin, Ireland
| | - C Cunningham
- MedEl Directorate, St James's Hospital , Dublin, Ireland
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
| | - K McCarroll
- MedEl Directorate, St James's Hospital , Dublin, Ireland
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
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Briggs R, Ward M, Kenny RA. 171 THE ‘WISH TO DIE’ AMONGST OLDER PEOPLE IN IRELAND IN THE CONTEXT OF THE DYING WITH DIGNITY BILL. Age Ageing 2021. [PMCID: PMC8690055 DOI: 10.1093/ageing/afab216.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background ‘Wish to Die’ (WTD) involves thoughts of or wishes for one’s own death or that one would be better off dead. Assisted dying is the act of deliberately providing medical assistance to another person who wishes to end their own life. Currently, in Ireland, it is illegal to provide such assistance to people with WTD or suicidal ideation. However, a new bill that would legalise assisted dying for those with terminal illnesses, the Dying with Dignity Bill 2020, is due to be considered by lawmakers in Ireland in the coming months. In order to inform discussion around this complex issue, we examine the prevalence and longitudinal course of WTD in a large population-representative sample of older people. Methods To define WTD, participants were asked: ‘In the last month, have you felt that you would rather be dead?’ Depressive symptoms were measured using the CES-D. Mortality data were compiled by linking administrative death records to individual-level survey data from the study. Results At Wave 1, 3.5% of participants (279/8,174) reported WTD. Both persistent loneliness (OR 5.73 (95% CI 3.41–9.64)) and depressive symptoms (OR 6.12 (95% CI 4.33–8.67)) were independently associated with WTD. Of participants who first reported WTD at Wave 1 or 2, 72% did not report WTD when reassessed after 2 years, and the prevalence of depressive symptoms (−44%) and loneliness (−19%) was more likely to decline in this group at follow-up. Fifteen per cent of participants expressing WTD at Wave 1 died during a 6-year follow-up. Conclusion WTD amongst community-dwelling older people is frequently transient and is strongly linked with the course of depressive symptoms and loneliness. An enhanced focus on improving access to mental health care and addressing social isolation in older people should therefore be a public health priority, particularly in the current context of the Covid-19 pandemic.
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Affiliation(s)
- R Briggs
- The Irish Longitudinal Study on Ageing, Dublin, Ireland
| | - M Ward
- The Irish Longitudinal Study on Ageing, Dublin, Ireland
| | - R A Kenny
- The Irish Longitudinal Study on Ageing, Dublin, Ireland
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Brennan F, Laird E, Hughes C, McNulty H, Ward M, Strain JJ, Molloy AM, Cunningham C, McCarroll K. 101 FACTORS ASSOCIATED WITH FEAR OF FALLING IN OLDER IRISH ADULTS. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.101] [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: 02/25/2023] Open
Abstract
Abstract
Background
Fear of falling is common in older adults and is associated with social isolation, reduced quality of life, depression and increased mortality. We aimed to investigate the factors associated with fear of falling in a cohort of older Irish adults.
Methods
Our study included adults aged ≥60 years attending outpatient services and recruited as part of the TUDA (Trinity, Ulster and Department of Agriculture) study. Physical frailty was measured with the Timed Up and Go (TUG), cognition with the Mini Mental State Examination (MMSE) and depression with the Center for Epidemiological Studies Depression scale (CES-D). Factors associated with fear of falling were explored in multinomial regression models.
Results
5185 adults were included, 67.3% female and mean age 74.0 ± 8.3 yrs. Fear of falling varied by age: 39.4% (60-70 yrs), 51.2% (70-80 yrs), 70.4% (80 + yrs). Independent positive predictors of fear of falling were age (beta 0.01, P = 0.030), female gender (OR 2.6, CI 2.2–3.2, P < 0.001), fall in the previous year (OR 1.9, CI 1.6–2.3, P < 0.001), depression (CES-D ≥ 16) (OR 1.7, CI 1.3–2.2, P < 0.001), use of osteoporosis medications (OR 1.3, CI 1.1–1.6, P = 0.002), self reported dizziness on standing (OR 1.5, CI 1.3–1.8, P < 0.001), physical frailty (TUG >12 seconds, OR 1.30, CI 1.1–1.6, P = 0.004) and limiting outside activities (OR 16.3, CI 13.8–19.3, P < 0.001).
Conclusion
We identified a high prevalence of fear of falling, though our study sample included frail older adults attending geriatric outpatient services. Those who fell in the last year and who were female were about twice as likely to fear falling. It was also more likely in those who were physically frailer, taking osteoporosis medications and reporting orthostatic symptoms. Notably those with a fear of falling were 70% more likely to be depressed and 16 times more likely to limit outside activities highlighting its negative impact.
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Affiliation(s)
- F Brennan
- St James's Hospital , Dublin, Ireland
| | - E Laird
- School of Medicine, Trinity College Dublin , Dublin, Ireland
| | - C Hughes
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - H McNulty
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - M Ward
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - J J Strain
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - A M Molloy
- School of Medicine, Trinity College Dublin , Dublin, Ireland
| | - C Cunningham
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
| | - K McCarroll
- Mercer's Institute for Successful Ageing, St James's Hospital , Dublin, Ireland
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Hennelly N, Lalor G, Gibney S, Kenny RA, Ward M. 133 THE RELATIONSHIP BETWEEN DELAYED HEALTHCARE UTILISATION AND CHRONIC CONDITIONS AMONG OLDER ADULTS DURING THE COVID-19 PANDEMIC IN IRELAND. Age Ageing 2021. [PMCID: PMC8690032 DOI: 10.1093/ageing/afab216.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background The coronavirus 2019 (COVID-19) pandemic impacted significantly on the lives of older adults in Ireland, including the cancellation or postponement of healthcare services. This study examined the relationship between healthcare delay and older adults (50 years and over) with chronic conditions in Ireland. Methods This study used data from the Irish Longitudinal Study on Ageing (TILDA) COVID-19 study and previous waves of TILDA. The COVID-19 study data was collected between July 2020 and November 2020. Taking existing healthcare demand into account, logistic regression analysis was used to examine the relationship between healthcare delay and older adults with chronic conditions. Additional analysis, using multinomial logit regression, explored the reasons for healthcare delay, whether the delays were on the participants behalf or the health service provider. Results In total, 31.6% of participants reported healthcare delay. Older adults with two or more chronic conditions were more likely to experience healthcare delay than those with no chronic conditions. In the second analysis, older adults with two or more chronic conditions were more likely to have healthcare delayed by the provider and were also more likely to delay their own healthcare than those with no chronic conditions. Additionally, some other groups were more likely to experience healthcare delay such as: people aged 70 years and over, females, those with problematic alcohol consumption, those with third-level education, those who had visited the GP and those who reported polypharmacy. While older adults living with others and those living outside Dublin were less likely to experience healthcare delay. Conclusion The findings suggest that some groups of older adults may have been impacted more than others by healthcare delay during the pandemic. Policy and practice should focus on effective strategies to support the healthcare needs of these older adults going forward. Additionally, future research should examine the implications of healthcare delay on health outcomes.
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Affiliation(s)
- N Hennelly
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland,The Healthy and Positive Ageing Initiative, Department of Health, Dublin, Ireland
| | - G Lalor
- The Healthy and Positive Ageing Initiative, Department of Health, Dublin, Ireland
| | - S Gibney
- The Healthy and Positive Ageing Initiative, Department of Health, Dublin, Ireland
| | - R A Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland,Department of Medical Gerontology, St James's Hospital, Dublin, Ireland
| | - M Ward
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
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Ward M, Kenny RA. 201 THE BI-DIRECTIONAL ASSOCIATION BETWEEN LONELINESS AND DEPRESSION, BEFORE AND DURING THE COVID-19 PANDEMIC. Age Ageing 2021. [PMCID: PMC8690044 DOI: 10.1093/ageing/afab216.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- M Ward
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - R A Kenny
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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Moloney K, O'Flaherty N, Ahmad R, Laird E, Hughes C, McNulty H, Ward M, Strain JJ, Molloy AM, Cunningham C, McCarroll K. 130 PREDICTORS OF DRIVING STATUS IN OLDER IRISH ADULTS ATTENDING A GERIATRIC OUTPATIENT SERVICE. Age Ageing 2021. [DOI: 10.1093/ageing/afab216.130] [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: 02/25/2023] Open
Abstract
Abstract
Background
The main mode of transportation in Ireland remains travel by car. Transport mobility is important for older adults in accessing shops, healthcare, services, community and in maintaining relationships. Cessation of driving is associated with negative effects on mental health, loneliness and physical health. We aimed to explore factors associated with driving status in older adults living in an urban environment.
Methods
Study included adults aged greater than 65 years attending a geriatric outpatient service in an urban environment and recruited as part of the TUDA (Trinity Ulster, Department of Agriculture) study. We excluded those with a MMSE (Mini-Mental State Exam) less than 24 as we aimed to include only non-dementia patients. Physical frailty was measured with the Timed Up and Go (TUG) and depression with the Center for Epidemiological Studies Depression scale (CES-D). Factors associated with driving status were explored in multinomial regression models.
Results
1978 adults, mean age 77.7 ± 7.1 years, 76.0% were female. 35.5% were current drivers but this differed by age category 45.9% (65–75 years), 25% (75–85 years) and 12.5% (85+ years). 28.1% were past drivers. Positive independent predictors of current driving were younger age (P < 0.001), male gender (P < 0.001), married status (P = 0.01), higher socioeconomic status (P < 0.0001) while negative predictors included physical frailty (TUG, P < 0.001), visual impairment (P = 0.01), stroke (P < 0.001), depression (P < 0.001) and self reported loneliness (P = 0.01).
Conclusion
One third of patients attending a geriatric outpatients in an urban environment were currently driving which is much lower than in the general older Irish population. However, our study included frail adults living in more deprived socioeconomic areas and had a high proportion of females who had never learned to drive. Furthermore, access to urban public transport may be a factor. Non-drivers were more likely to have depression and report loneliness independent of other factors highlighting its negative impact.
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Affiliation(s)
- K Moloney
- MedEL Directorate, St James's Hospital , Dublin, Ireland
| | - N O'Flaherty
- MedEL Directorate, St James's Hospital , Dublin, Ireland
| | - R Ahmad
- MedEL Directorate, St James's Hospital , Dublin, Ireland
| | - E Laird
- School of Medicine, Trinity College Dublin , Dublin, Ireland
| | - C Hughes
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - H McNulty
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - M Ward
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - J J Strain
- The Nutrition Innovation Centre for Food and Health (NICHE) , School of Biomedical Sciences, , Coleraine, United Kingdom
- Ulster University , School of Biomedical Sciences, , Coleraine, United Kingdom
| | - A M Molloy
- School of Medicine, Trinity College Dublin , Dublin, Ireland
| | - C Cunningham
- MedEL Directorate, St James's Hospital , Dublin, Ireland
- Mercer’s Institute for Successful Ageing, St James’s Hospital , Dublin, Ireland
| | - K McCarroll
- MedEL Directorate, St James's Hospital , Dublin, Ireland
- Mercer’s Institute for Successful Ageing, St James’s Hospital , Dublin, Ireland
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Bailey L, Ward M, DiCosimo A, Baunta S, Cunningham C, Romero-Ortuno R, Kenny RA, Purcell R, Lannon R, McCarroll K, Nee R, Robinson D, Lavan A, Briggs R. Physical and mental health of older people while cocooning during the COVID-19 pandemic. QJM 2021; 114:648-653. [PMID: 33471128 PMCID: PMC7928635 DOI: 10.1093/qjmed/hcab015] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/07/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Cocooning or shielding, i.e. staying at home and reducing face-to-face interaction with other people, was an important part of the response to the COVID-19 pandemic for older people. However, concerns exist regarding the long-term adverse effects cocooning may have on their physical and mental health. AIM To examine health trajectories and healthcare utilization while cocooning in a cohort of community-dwelling people aged ≥70 years. DESIGN Survey of 150 patients (55% female, mean age 80 years and mean Clinical Frailty Scale Score 4.8) attending ambulatory medical services in a large urban university hospital. METHODS The survey covered four broad themes: access to healthcare services, mental health, physical health and attitudes to COVID-19 restrictions. Survey data were presented descriptively. RESULTS Almost 40% (59/150) reported that their mental health was 'worse' or 'much worse' while cocooning, while over 40% (63/150) reported a decline in their physical health. Almost 70% (104/150) reported exercising less frequently or not exercising at all. Over 57% (86/150) of participants reported loneliness with 1 in 8 (19/150) reporting that they were lonely 'very often'. Half of participants (75/150) reported a decline in their quality of life. Over 60% (91/150) agreed with government advice for those ≥70 years but over 40% (61/150) reported that they disliked the term 'cocooning'. CONCLUSIONS Given the likelihood of further restrictions in coming months, clear policies and advice for older people around strategies to maintain social engagement, manage loneliness and continue physical activity and access timely medical care and rehabilitation services should be a priority.
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Affiliation(s)
- L Bailey
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
| | - M Ward
- The Irish Longitudinal Study on Ageing, Trinity College, Dublin 1, Ireland
| | - A DiCosimo
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - S Baunta
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
| | - C Cunningham
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R Romero-Ortuno
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R A Kenny
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R Purcell
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R Lannon
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - K McCarroll
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R Nee
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - D Robinson
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - A Lavan
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
| | - R Briggs
- From the Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 1, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College, Dublin 1, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 1, Ireland
- Address correspondence to Dr R. Briggs, The Irish Longitudinal Study on Ageing (TILDA), Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin 8, Ireland.
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Adhikari P, Ajaj R, Alpízar-Venegas M, Amaudruz PA, Auty DJ, Batygov M, Beltran B, Benmansour H, Bina CE, Bonatt J, Bonivento W, Boulay MG, Broerman B, Bueno JF, Burghardt PM, Butcher A, Cadeddu M, Cai B, Cárdenas-Montes M, Cavuoti S, Chen M, Chen Y, Cleveland BT, Corning JM, Cranshaw D, Daugherty S, DelGobbo P, Dering K, DiGioseffo J, Di Stefano P, Doria L, Duncan FA, Dunford M, Ellingwood E, Erlandson A, Farahani SS, Fatemighomi N, Fiorillo G, Florian S, Flower T, Ford RJ, Gagnon R, Gallacher D, García Abia P, Garg S, Giampa P, Goeldi D, Golovko V, Gorel P, Graham K, Grant DR, Grobov A, Hallin AL, Hamstra M, Harvey PJ, Hearns C, Hugues T, Ilyasov A, Joy A, Jigmeddorj B, Jillings CJ, Kamaev O, Kaur G, Kemp A, Kochanek I, Kuźniak M, Lai M, Langrock S, Lehnert B, Leonhardt A, Levashko N, Li X, Lidgard J, Lindner T, Lissia M, Lock J, Longo G, Machulin I, McDonald AB, McElroy T, McGinn T, McLaughlin JB, Mehdiyev R, Mielnichuk C, Monroe J, Nadeau P, Nantais C, Ng C, Noble AJ, O’Dwyer E, Oliviéro G, Ouellet C, Pal S, Pasuthip P, Peeters SJM, Perry M, Pesudo V, Picciau E, Piro MC, Pollmann TR, Rand ET, Rethmeier C, Retière F, Rodríguez-García I, Roszkowski L, Ruhland JB, Sánchez-García E, Santorelli R, Sinclair D, Skensved P, Smith B, Smith NJT, Sonley T, Soukup J, Stainforth R, Stone C, Strickland V, Stringer M, Sur B, Tang J, Vázquez-Jáuregui E, Viel S, Walding J, Waqar M, Ward M, Westerdale S, Willis J, Zuñiga-Reyes A. Pulse-shape discrimination against low-energy Ar-39 beta decays in liquid argon with 4.5 tonne-years of DEAP-3600 data. Eur Phys J C Part Fields 2021; 81:823. [PMID: 34720726 PMCID: PMC8550104 DOI: 10.1140/epjc/s10052-021-09514-w] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
The DEAP-3600 detector searches for the scintillation signal from dark matter particles scattering on a 3.3 tonne liquid argon target. The largest background comes from 39 Ar beta decays and is suppressed using pulse-shape discrimination (PSD). We use two types of PSD estimator: the prompt-fraction, which considers the fraction of the scintillation signal in a narrow and a wide time window around the event peak, and the log-likelihood-ratio, which compares the observed photon arrival times to a signal and a background model. We furthermore use two algorithms to determine the number of photons detected at a given time: (1) simply dividing the charge of each PMT pulse by the mean single-photoelectron charge, and (2) a likelihood analysis that considers the probability to detect a certain number of photons at a given time, based on a model for the scintillation pulse shape and for afterpulsing in the light detectors. The prompt-fraction performs approximately as well as the log-likelihood-ratio PSD algorithm if the photon detection times are not biased by detector effects. We explain this result using a model for the information carried by scintillation photons as a function of the time when they are detected.
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Affiliation(s)
- P. Adhikari
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - R. Ajaj
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Alpízar-Venegas
- Instituto de Física, Universidad Nacional Autónoma de México, A. P. 20-364, 01000 Mexico, D.F. Mexico
| | | | - D. J. Auty
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Batygov
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
| | - B. Beltran
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - H. Benmansour
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. E. Bina
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. Bonatt
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | | | - M. G. Boulay
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - B. Broerman
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. F. Bueno
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - P. M. Burghardt
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - A. Butcher
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | | | - B. Cai
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Cárdenas-Montes
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - S. Cavuoti
- Physics Department, Università degli Studi “Federico II” di Napoli, 80126 Naples, Italy
- INFN Napoli, 80126 Naples, Italy
- INAF-Astronomical Observatory of Capodimonte, Salita Moiariello 16, 80131 Naples, Italy
| | - M. Chen
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Y. Chen
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - B. T. Cleveland
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - J. M. Corning
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - D. Cranshaw
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - S. Daugherty
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
| | - P. DelGobbo
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - K. Dering
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. DiGioseffo
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. Di Stefano
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - L. Doria
- PRISMA+ Cluster of Excellence and Institut für Kernphysik, Johannes Gutenberg-Universität Mainz, 55128 Mainz, Germany
| | | | - M. Dunford
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - E. Ellingwood
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - A. Erlandson
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - S. S. Farahani
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | | | - G. Fiorillo
- Physics Department, Università degli Studi “Federico II” di Napoli, 80126 Naples, Italy
- INFN Napoli, 80126 Naples, Italy
| | - S. Florian
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. Flower
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - R. J. Ford
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - R. Gagnon
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - D. Gallacher
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. García Abia
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - S. Garg
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. Giampa
- TRIUMF, Vancouver, BC V6T 2A3 Canada
| | - D. Goeldi
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - V. Golovko
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - P. Gorel
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - K. Graham
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - D. R. Grant
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - A. Grobov
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - A. L. Hallin
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - M. Hamstra
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. J. Harvey
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. Hearns
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. Hugues
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
| | - A. Ilyasov
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - A. Joy
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Jigmeddorj
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - C. J. Jillings
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - O. Kamaev
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - G. Kaur
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - A. Kemp
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | - I. Kochanek
- INFN Laboratori Nazionali del Gran Sasso, 67100 Assergi, AQ Italy
| | - M. Kuźniak
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Lai
- Physics Department, Università degli Studi di Cagliari, 09042 Cagliari, Italy
- INFN Cagliari, Cagliari, 09042 Italy
| | - S. Langrock
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Lehnert
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Present Address: Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720 USA
| | - A. Leonhardt
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - N. Levashko
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - X. Li
- Physics Department, Princeton University, Princeton, NJ 08544 USA
| | - J. Lidgard
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | | | - M. Lissia
- INFN Cagliari, Cagliari, 09042 Italy
| | - J. Lock
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - G. Longo
- Physics Department, Università degli Studi “Federico II” di Napoli, 80126 Naples, Italy
- INFN Napoli, 80126 Naples, Italy
| | - I. Machulin
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - A. B. McDonald
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. McElroy
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - T. McGinn
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. B. McLaughlin
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
- TRIUMF, Vancouver, BC V6T 2A3 Canada
| | - R. Mehdiyev
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - C. Mielnichuk
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - J. Monroe
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | - P. Nadeau
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - C. Nantais
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. Ng
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - A. J. Noble
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - E. O’Dwyer
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - G. Oliviéro
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. Ouellet
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - S. Pal
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - P. Pasuthip
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - S. J. M. Peeters
- University of Sussex, Sussex House, Brighton, East Sussex BN1 9RH UK
| | - M. Perry
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - V. Pesudo
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - E. Picciau
- Physics Department, Università degli Studi di Cagliari, 09042 Cagliari, Italy
- INFN Cagliari, Cagliari, 09042 Italy
| | - M.-C. Piro
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. R. Pollmann
- Department of Physics, Technische Universität München, 80333 Munich, Germany
- Present Address: Nikhef and the University of Amsterdam, Science Park, 1098 XG Amsterdam, The Netherlands
| | - E. T. Rand
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - C. Rethmeier
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | | | - I. Rodríguez-García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - L. Roszkowski
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- BP2, National Centre for Nuclear Research, ul. Pasteura 7, 02-093 Warsaw, Poland
| | - J. B. Ruhland
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - E. Sánchez-García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - R. Santorelli
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - D. Sinclair
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. Skensved
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Smith
- TRIUMF, Vancouver, BC V6T 2A3 Canada
| | - N. J. T. Smith
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - T. Sonley
- SNOLAB, Lively, ON P3Y 1M3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. Soukup
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - R. Stainforth
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - C. Stone
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - V. Strickland
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - M. Stringer
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Sur
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - J. Tang
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - E. Vázquez-Jáuregui
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- Instituto de Física, Universidad Nacional Autónoma de México, A. P. 20-364, 01000 Mexico, D.F. Mexico
| | - S. Viel
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. Walding
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | - M. Waqar
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Ward
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - S. Westerdale
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- INFN Cagliari, Cagliari, 09042 Italy
| | - J. Willis
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - A. Zuñiga-Reyes
- Instituto de Física, Universidad Nacional Autónoma de México, A. P. 20-364, 01000 Mexico, D.F. Mexico
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Brown JD, Podadera J, Ward M, Goldsmid S, Simpson DJ. The presence, morphology and clinical significance of vertebral body malformations in an Australian population of French Bulldogs and Pugs. Aust Vet J 2021; 99:378-387. [PMID: 34137021 DOI: 10.1111/avj.13094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 05/04/2021] [Accepted: 05/22/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the incidence, morphology and clinical significance of congenital vertebral malformations (CVM) in two breeds of brachycephalic dogs presenting to a referral veterinary hospital. DESIGN Prospective cohort study series. MATERIALS AND METHODS Forty-nine French Bulldogs and Pugs were prospectively evaluated and placed in one of two groups based on whether or not they presented for neurological signs referable to spinal cord disease. A computed tomography (CT) of their entire spine was obtained and the presence and classification of CVM along with the degree of spinal kyphosis recorded for all dogs. Statistical analysis was performed to identify clinical associations between these factors (P < 0.05). RESULTS CVM were prevalent across both breeds with the French Bulldog having more malformations than the Pug (Kruskal-Wallis nonparametric analysis of variance, P < 0.0001). Breed associated vertebral malformation subtypes included butterfly subtype in French Bulldogs (Chi-square, P = 0.0002), and transitional subtype in Pugs (odds ratio, 22.7; P = 0.000). A new subtype, dorsal wedge, was observed in 12 cases. The presence, number and subtype of vertebral malformation were not reliable for predicting the development of neurological signs across both breeds (Chi-square, P > 0.05). However, spinal kyphosis >35° calculated via Cobb angle was associated with Pugs that had neurological deficits (Chi-square, P = 0.028). CONCLUSIONS Congenital vertebral malformations largely appear to be incidental findings in this population of French Bulldogs but are of more significance in the Pug breed when spinal kyphosis is >35°. French Bulldogs that have spinal cord disease and CVM are more likely to have pathology distant to CVM with intervertebral disc herniation most common.
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Affiliation(s)
- J D Brown
- Surgery Department, Animal Referral Hospital, Homebush, New South Wales, Australia
| | - J Podadera
- Sydney School of Veterinary Science, The University of Sydney, Camden, New South Wales, Australia
| | - M Ward
- Sydney School of Veterinary Science, The University of Sydney, Camden, New South Wales, Australia
| | - S Goldsmid
- Surgery Department, Animal Referral Hospital, Homebush, New South Wales, Australia
| | - D J Simpson
- Surgery Department, Animal Referral Hospital, Homebush, New South Wales, Australia
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White P, Ceannt R, Kennedy E, O'Sullivan MB, Ward M, Collins A. Children are safe in schools: a review of the Irish experience of reopening schools during the COVID-19 pandemic. Public Health 2021; 195:158-160. [PMID: 34130002 PMCID: PMC8547945 DOI: 10.1016/j.puhe.2021.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/08/2021] [Indexed: 11/27/2022]
Abstract
Objectives Schools in the Republic of Ireland reopened to students and staff in late August 2020. We sought to determine the test positivity rate of close contacts of cases of coronavirus disease 2019 (COVID-19) in schools during the first half-term of the 2020/2021 academic year. Methods National-level data from the schools' testing pathway were interrogated to determine the positivity rate of close contacts of cases of COVID-19 in Irish primary, postprimary and special schools during the first half-term of 2020/2021 academic year. The positivity rates among adult and child close contacts were compared and the proportion of national cases of COVID-19 who were aged 4–18 years during the observation period was calculated to assess whether this proportion increased after schools reopened. Results Of all, 15,533 adult and child close contacts were tested for COVID-19 through the schools' testing pathway during the first half-term of the 2020/2021 academic year. Three hundred and ninety-nine close contacts tested positive, indicating a positivity rate of 2.6% (95% confidence interval: 2.3–2.8%). The positivity rates of child and adult close contacts were similarly low (2.6% vs 2.7%, P = 0.7). The proportion of all national cases of COVID-19 who were aged 4–18 years did not increase during the first half-term of the 2020/2021 school year. Conclusions The low positivity rate of close contacts of cases of COVID-19 in schools indicate that transmission of COVID-19 in Irish schools during the first half-term of the 2020/2021 academic year was low. These findings support policies to keep schools open during the pandemic.
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Affiliation(s)
- P White
- Department of Public Health, HSE South, Cork, Ireland.
| | - R Ceannt
- Department of Public Health, HSE East, Dublin, Ireland
| | - E Kennedy
- Department of Public Health, HSE East, Dublin, Ireland
| | | | - M Ward
- Department of Public Health, HSE East, Dublin, Ireland
| | - A Collins
- Office of the Clinical Director for Health Protection, HSE, Ireland; Department of Public Health, HSE Midlands, Tullamore, Ireland
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van Vollenhoven R, Bertsias G, Doria A, Isenberg D, Morand EF, Petri MA, Pons-Estel B, Rahman A, Ugarte-Gil M, Voskuyl A, Arnaud L, Bruce IN, Cervera R, Costedoat-Chalumeau N, Gordon C, Houssiau F, Mosca M, Schneider M, Ward M, Aranow C. OP0296 THE 2021 DORIS DEFINITION OF REMISSION IN SLE – FINAL RECOMMENDATIONS FROM AN INTERNATIONAL TASK FORCE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1192] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Remission is the stated goal for both patient and care-giver (1), but consensus on a definition of remission has been lacking. Previously, an international task force consisting of patient representatives and medical specialists published a frame-work for such a definition (2), but without making a final recommendation.Objectives:To achieve consensus around a definition of remission in SLE (DORIS).Methods:The DORIS task force met annually from 2015 to 2020 and consisted of patient representatives and specialists in rheumatology, nephrology, dermatology, and clinical immunology. Systemic literature reviews of several key topics were done and specific research questions were examined in suitably chosen datasets. The findings were discussed, reformulated as recommendations, and voted upon. Level of evidence (LoE), strength of recommendation (SoR), and agreement were determined in standard fashion. The final recommendation for the DORIS definition of remission was established by electronic vote after finalization of the minutes of the most recent task force meeting.Results:Based on data from the literature and from several SLE-specific data sets, five key recommendations were endorsed (Table 1) that should be seen as additions to those published previously (2). Literature reviews identified strong support for the face-, content-, construct- and criterion validity of the definition based on the clinical SLEDAI (not including anti-DNA and complement) equal to zero plus low physician global assessment and allowing stable medical treatment. Thus, the DORIS Task Force recommended a single definition of remission in SLE, based on clinical SLEDAI = 0, evaluator’s global assessment <0.5 (0-3), prednisone 5 mg/day or less, and stable antimalarials, immunosuppressives and biologics.Table 1.Vote in favorLoESoRAgreement1.Inclusion of serology [anti-DNA, complement] in the DORIS definition of remission-on-treatment does not meaningfully alter the construct validity and therefore it is not recommended to include it90%2aB8.382.While the goal of treatment is sustained remission, a definition of remission should be able to be met at any point in time; therefore, duration should not be included in the definition100%5C9.023.To date, the SLEDAI-based definitions of remission have formally been investigated more extensively than BILAG-or ECLAM-based definitions. The SLEDAI-based definitions can therefore more confidently be recommended91%2aB9.254.Remission off treatment, while the ultimate goal for many patients and providers, is achieved very rarely. In clinical research and as an outcome in clinical trials, the definition for remission-on-treatment is recommended92%2aB9.525.In clinical trials, the LLDAS definition for low disease activity and the DORIS definition of remission are both recommended as outcomes100%5C9.25The 2021 DORIS definition of remission in SLE:Conclusion:The 2021 DORIS definition of remission in SLE was established. It is recommended for use as an aspirational treatment target in clinical care, a clear concept in education, and a key outcome in research including clinical trials and observational studies.References:[1]van Vollenhoven RF, Mosca M, Bertsias G, et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis 2014;73:958-67.[2]van Vollenhoven R, Voskuyl A, Bertsias G, et al. A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). Ann Rheum Dis 2016.Disclosure of Interests:Ronald van Vollenhoven Speakers bureau: AbbVie, Galapagos, GSK, Janssen, Pfizer, UCB, Consultant of: AbbVie, AstraZeneca, Biogen, Biotest, Celgene, Galapagos, Gilead, Janssen, Pfizer, Sanofi, Servier, UCB, Vielabo, Grant/research support from: BMS, GSK, Lilly, UCB, George Bertsias: None declared, Andrea Doria: None declared, David Isenberg: None declared, Eric F. Morand: None declared, Michelle A Petri: None declared, Bernardo Pons-Estel Consultant of: GSK, Janssen, Anisur Rahman: None declared, Manuel Ugarte-Gil Grant/research support from: Janssen, Pfizer, Alexandre Voskuyl: None declared, Laurent Arnaud Consultant of: Alexion, Amgen, Astra-Zeneca, BMS, GSK, Janssen-Cilag, LFB, Lilly, Menarini France, Medac, Novartis, Pfizer, Roche-Chugaï, UCB., Ian N. Bruce: None declared, Ricard Cervera Consultant of: GSK, Alexion, Eli Lilly, Astra Zeneca, Termo-Fisher, Rubió, Nathalie Costedoat-Chalumeau: None declared, Caroline Gordon Speakers bureau: UCB, Consultant of: Center for Disease Control, Astra-Zeneca, MGP, Sanofi, UCB, Frederic Houssiau: None declared, Marta Mosca: None declared, Matthias Schneider: None declared, Michael Ward: None declared, Cynthia Aranow: None declared.
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Bobat A, Anderson V, Barnett N, Beattie V, Bostock L, Clayton K, Cole T, Foreman H, Holden S, Kefyalew S, Overton G, Roberts J, Ross J, Shepherd P, Smerdon E, Ward M. P28.03 An Autoethnographic Study Exploring the Role of the Lung Cancer Nurse Specialist in the National Optimal Lung Cancer Pathway. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Annand E, Reid P, Johnson J, Gilbert L, Taylor M, Walsh M, Ward M, Wilson A, Degeling C. Verdict on the obligations of private veterinarians attending unvaccinated Hendra virus suspect horses afforded by three citizens’ juries. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Halmai L, Ward M, Kardos A, Nemes A, Neubauer S, Wong J, Pantazis A. Evidence for abnormal deformational reserve in hypertrophic obstructive cardiomyopathy on exercise: is this a true fingerprint? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by muscle hypertrophy and fibrosis, interfering with force generation and relaxation. Abnormal ventricular (LV) myocardial deformation have been demonstrated in patients with HOCM at rest, but there is lack of data regarding the deformational mechanics in exercise in obstructive HCM.
Aims
To assess the adaptability of LV deformational behaviour to physical exercise in HOCM patients as compared to healthy controls and to examine if Deformational Imaging (DMI) can provide additional information.
Methods
28 obstructive HOCM (age 51.2±14.2yrs; 16 men, LVOT-obstruction 56±19mmHg at rest or on Valsalva maneuver) and 32 control subjects (50.9±6.8 yrs, 19 men from the MAGYAR-PATH Registry) underwent bicycle stress Echo (ESE) with full conventional 2D- and Doppler TTE, 2D- and 3D-Speckle Tracking Analysis (DMI) and 3D-Full Volume assessment both at rest and on submaximal ESE.
Results
At rest, the HOCM group had lower GLS (−14.6±4.5 vs 18.4±2.6%, p<0.01) but higher CS (−32.9±5.1 vs 28.8±2.3%) and Twist (9.9±2.6 vs 6.1±2.2°) than in control subjects. Exercise induced an increase in all strains in control subjects but less in HOCM (GLS: −21.4±3.5 vs 15.1±3.0% and CS: −33.9±3.6 vs 34.1±4.2% in controls). The increase of LV twist was blunted in HOCM (Δ1.2 vs Δ3.6° in controls). The PSS was more pronounced in HOCM on ESE (46.6±12.0 vs 21.2±9.6%, AUC: 0.71 for predicting HOCM), the UTR was slower (118±2.1 vs 133.1±14.1°/s) and occurred later in HOCM. The MD of Strain increased in HOCM on ESE (Δ85.1 vs Δ8.1ms in controls). The Twist had positive correlation with LVOT-obstruction (R2=0.54, p<0.01) and inverse correlation with UTR (R2=−0.72, p<0.02). The UTR/Twist ratio diminished only in HOCM on exercise (−6.0±0.8 vs −13.1±2.5 1/s). The MD, the PSS on ESE and the UTR/Twist ratio predicted the HOCM deformation phenotype accurately (AUC: 0.72, cut-off 6.0 1/s).
Conclusions
The HOCM patients had attenuated Strain and Rotational response on exercise implying impaired deformational adaptability with post-systolic shortening and pronounced mechanical dispersion of peak Strain on exercise which was more accurate to identify the HOCM phenotype than other Echo-indices. These findings support evidence for reduced systolic-diastolic coupling efficiency in HOCM patients on exercise which can contribute to the development of exercise-related breathlessness, dynamic LVOT-obstruction and arrhythmias in patients with HOCM. These distinct deformational patterns on exercise can help in the differential diagnosis of patients with LV hypertrophy of unknown aetiology with good sensitivity and specificity and can also aid in the risk stratification workup in HOCM.
DMI Predictors for HOCM
Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): Milton Keynes University Hospital Research Founding
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Affiliation(s)
- L Halmai
- Milton Keynes Hospital NHS Trust, Milton Keynes, United Kingdom
| | - M Ward
- Milton Keynes Hospital NHS Trust, Milton Keynes, United Kingdom
| | - A Kardos
- Milton Keynes Hospital NHS Trust, Milton Keynes, United Kingdom
| | - A Nemes
- University of Szeged, Faculty of Medicine, Cardiology Center, Szeged, Hungary
| | - S Neubauer
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom
| | - J Wong
- Harefield Hospital, Department of Cardiology, London, United Kingdom
| | - A Pantazis
- Harefield Hospital, Department of Cardiology, London, United Kingdom
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Williams M, Sweet M, Armstrong R, McInerney M, Ward M. #CroakeyGO: Walking as an act of journalism to engage not distance the public in health reporting. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Health as it is reported in mainstream media is narrow and communities are often excluded, despite being where the experience of health occurs. A wide range of research indicates that it is through narratives of community members that media and health messages are best conveyed, and community members now have a range of platforms for quickly conveying information to each other and the media. However, there have been surprisingly few innovations for journalists to use this material, or to better connect with the public and report more accurately about health.
Our experience across several journalism projects demonstrates how quickly and deeply health content can be developed in collaboration with communities. One example is #CroakeyGO - an innovation in public interest journalism that gathers, walks and talks with community members together at a defined time and location about health-related matters.
#CroakeyGO brings together diverse voices from local communities - people who might otherwise not connect. This stimulates discussion about health issues beyond the individual, including system- and environmental-level issues that impact local lives. #CroakeyGO also means respecting Indigenous peoples' connection to Country on which we walk and reflecting on intergenerational inequities and solutions Indigenous knowledges offer.
To date we have published more than 40 articles from #CroakeyGO events around metropolitan and regional Australia. We have collaboratively produced social media and other editorial content with community members and stimulated enduring networks for health planning, advocacy and research. #CroakeyGO reinforces that improving health in a community requires more than just additional services, and that transformations in journalism can facilitate and support rather than hinder collective action.
Key messages
Innovations in journalism are required and possible to improve health reporting. Communities are willing to engage in health reporting.
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Affiliation(s)
- M Williams
- National Centre for Cultural Competence, University of Sydney, Camperdown, Australia
- Croakey.org, Cygnet, Australia
| | - M Sweet
- Croakey.org, Cygnet, Australia
| | - R Armstrong
- Croakey.org, Cygnet, Australia
- Sydney,Australia
| | - M McInerney
- Croakey.org, Cygnet, Australia
- Melbourne,Australia
| | - M Ward
- Rock Lily Design, Cygnet, Australia
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Angelino D, Caffrey A, Moore K, Laird E, Moore AJ, Gill CIR, Mena P, Westley K, Pucci B, Boyd K, Mullen B, McCarroll K, Ward M, Strain JJ, Cunningham C, Molloy AM, McNulty H, Del Rio D. Phenyl‐γ‐valerolactones and healthy ageing: Linking dietary factors, nutrient biomarkers, metabolic status and inflammation with cognition in older adults (the VALID project). NUTR BULL 2020. [DOI: 10.1111/nbu.12444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- D. Angelino
- Human Nutrition Unit Department of Veterinary Science University of Parma Parma Italy
- Faculty of Bioscience and Technology for Food, Agriculture, and Environment University of Teramo Teramo Italy
| | - A. Caffrey
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - K. Moore
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - E. Laird
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - A. J. Moore
- School of Geography and Environmental Sciences Ulster University Coleraine UK
| | - C. I. R. Gill
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - P. Mena
- Human Nutrition Unit Department of Food and Drug University of Parma Parma Italy
| | - K. Westley
- School of Geography and Environmental Sciences Ulster University Coleraine UK
| | - B. Pucci
- School of Geography and Environmental Sciences Ulster University Coleraine UK
| | - K. Boyd
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - B. Mullen
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - K. McCarroll
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - M. Ward
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - J. J. Strain
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - C. Cunningham
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - A. M. Molloy
- Department of Clinical Medicine School of Medicine Trinity College DublinTrinity Centre for Health Sciences Dublin 8 Ireland
| | - H. McNulty
- Nutrition Innovation Centre for Food and Health (NICHE) School of Biomedical Sciences Ulster University Coleraine UK
| | - D. Del Rio
- Human Nutrition Unit Department of Veterinary Science University of Parma Parma Italy
- School of Advanced Studies on Food and Nutrition University of Parma Parma Italy
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Trappe A, Useckaite Z, Ward M, Davage H, Lennon J, Carter S, McKone E, Donnelly S, McNally P, Coppinger J. ePS3.02 Increased extracellular vesicles mediate inflammatory signalling in cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Breit C, Ablah E, Ward M, Okut H, Helmer S, Tenofsky P. Discussion on: Breast cancer risk assessment in patients who test negative for a hereditary cancer syndrome. Am J Surg 2020; 219:434-435. [DOI: 10.1016/j.amjsurg.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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O'Brien S, Garvey P, Baker K, Brennan M, Cormican M, Cuddihy J, De Lappe N, Ellard R, Fallon Ú, Irvine N, Murphy S, O'Brien D, O'Connor M, O'Hare C, O'Sullivan MB, Part AM, Rooney P, Ryan A, Waldron G, Ward M, McKeown PJ. Investigation of a foodborne outbreak of Shigella sonnei in Ireland and Northern Ireland, December 2016: the benefits of cross-border collaboration and commercial sales data. Public Health 2020; 182:19-25. [PMID: 32120067 DOI: 10.1016/j.puhe.2020.01.008] [Citation(s) in RCA: 2] [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: 08/27/2019] [Revised: 12/11/2019] [Accepted: 01/09/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To describe a cross-border foodborne outbreak of Shigella sonnei that occurred in Ireland and Northern Ireland (NI) in December 2016 whilst also highlighting the valuable roles of sales data and international collaboration in the investigation and control of this outbreak. STUDY DESIGN A cross-border outbreak control team was established to investigate the outbreak. METHODS Epidemiological, microbiological, and environmental investigations were undertaken. Traditional analytical epidemiological studies were not feasible in this investigation. The restaurant chain provided sales data, which allowed assessment of a possible increased risk of illness associated with exposure to a particular type of heated food product (product A). RESULTS Confirmed cases demonstrated sole trimethoprim resistance: an atypical antibiogram for Shigella isolates in Ireland. Early communication and the sharing of information within the outbreak control team facilitated the early detection of the international dimension of this outbreak. A joint international alert using the European Centre for Disease Control's confidential Epidemic Intelligence Information System for Food- and Waterborne Diseases and Zoonoses (EPIS-FWD) did not reveal further cases outside of the island of Ireland. The outbreak investigation identified that nine of thirteen primary case individuals had consumed product A from one of multiple branches of a restaurant chain located throughout the island of Ireland. Product A was made specifically for this chain in a food production facility in NI. S. sonnei was not detected in food samples from the food production facility. Strong statistical associations were observed between visiting a branch of this restaurant chain between 5 and 9 December 2016 and eating product A and developing shigellosis. CONCLUSIONS This outbreak investigation highlights the importance of international collaboration in the efficient identification of cross-border foodborne outbreaks and the value of using sales data as the analytical component of such studies.
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Affiliation(s)
- S O'Brien
- HSE-Health Protection Surveillance Centre, Dublin, Ireland; Department of Public Health HSE-NW, Sligo, Ireland.
| | - P Garvey
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
| | - K Baker
- Food Standards Agency Northern Ireland, Belfast, Northern Ireland, Ireland
| | - M Brennan
- Food Safety Authority of Ireland, Dublin, Ireland
| | - M Cormican
- National Salmonella, Shigella and Listeria Reference Laboratory, Galway, Ireland
| | - J Cuddihy
- Department of Public Health HSE-SE, Kilkenny, Ireland
| | - N De Lappe
- National Salmonella, Shigella and Listeria Reference Laboratory, Galway, Ireland
| | - R Ellard
- Food Safety Authority of Ireland, Dublin, Ireland
| | - Ú Fallon
- Department of Public Health HSE-Midlands, Co Offaly, Ireland
| | - N Irvine
- Public Health Agency Northern Ireland, Belfast, Northern Ireland, UK
| | - S Murphy
- Environmental Health Department, Newry, Mourne & Down District Council, Northern Ireland, UK
| | - D O'Brien
- HSE Environmental Health Service Dublin Specialist Section, Dublin, Ireland
| | - M O'Connor
- Department of Public Health HSE-E, Dublin, Ireland
| | - C O'Hare
- Department of Public Health HSE-SE, Kilkenny, Ireland
| | | | - A M Part
- HSE Environmental Health Service Dublin Mid Leinster, Dublin, Ireland
| | - P Rooney
- Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - A Ryan
- Department of Public Health HSE-NW, Sligo, Ireland
| | - G Waldron
- Public Health Agency Northern Ireland, Belfast, Northern Ireland, UK
| | - M Ward
- Department of Public Health HSE-E, Dublin, Ireland
| | - P J McKeown
- HSE-Health Protection Surveillance Centre, Dublin, Ireland
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Muloi D, Ward M, Hassell J, Bettridge J, Robinson T, Pedersen A, Kang’ethe E, Kariuki S, Fèvre E, Woolhouse M. One Health genomic epidemiology of antimicrobial resistant Escherichia coli carriage in sympatric humans and livestock in Nairobi, Kenya. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Allahwala U, Nour D, Alsanjari O, Bhatia K, Nagaraja V, Cockburn J, Hildick-Smith D, Sakata Y, Ward M, Weaver J, Bhindi R. 873 Rapid Recruitment of Coronary Collaterals During ST Elevation Myocardial Infarction (STEMI): A Meta-Analysis of Over 14,000 Patients. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Halmai L, Ward M, Wong J, Nemes A, Forster T, Pantazis A. P319 Evidence for abnormal deformational reserve in hypertrophic cardiomyopathy on exercise: is it a game-changer? Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
None
Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by muscle hypertrophy and fibrosis, interfering with force generation and relaxation. Abnormal ventricular (LV) myocardial deformation have been demonstrated in patients with HOCM at rest, but there is lack of data regarding the deformational mechanics in exercise. AIMS: We wanted to assess the adaptability of LV deformational behaviour to physical exercise in HCM patients as compared to healthy control subjects.
METHODS
24 obstructive HOCM (age 51.2 ± 14.2yrs; 16 men, LVOT-obstruction 56 ± 19mmHg at rest or on Valsalva maneuver) and 32 control subjects (50.9 ± 6.8 yrs, 19 men from the MAGYAR-PATH Registry) underwent supine bicycle stress echocardiography (ESE) with measurements of 2D- and Doppler, 2D-Speckle Tracking Tracking Imaging and 3D-Full Volume Analysis. Beyond conventional LV/RV functional measurements; peak longitudinal (LS), circumferential (CS) Strain values; peak Twist and Torsion angles; post-systolic shortening index (PSS) and diastolic phase indices (Untwisting time - UTT and rate - UTR) calculated; the UTR/Twist ratio was given as "coupling index". The LV/RV-EF calculated by 3D-Full Volume Analysis off-line by TomTec Arena™ software both at rest and on submaximal ESE.
RESULTS
The HOCM group had lower resting LS (-14.6 ± 4.5 vs 18.4 ± 2.6%, p < 001) but higher CS (-32.9 ± 5.1 vs 28.8 ± 2.3%, p < 0.001) and Twist angles (9.9 ± 2.6 vs 6.1 ± 2.2º, p < 0.01) than control subjects. Exercise induced an increase in all strains in control subjects, but much less in HOCM (LS: -21.4 ± 3.5 vs 15.1 ± 3.0% and CS: -33.9 ± 3.6 vs 34.1 ± 4.2% in HOCM, p < 0.02 in controls, NS in HOCM); the increase of Twist angle was minimal in HOCM (Δ1.2 ± 1.2 vs Δ3.6 ± 2.3º in controls, p < 0.01). The PSS was more pronounced on ESE in HOCM than in controls (46.6 ± 12 vs 21.2 ± 9.6% in controls, p < 0.001). Peak UTR was slower (118 ± 2.1 vs 133.1 ± 14.1 º/s) during ESE and occured later (141 ± 19 vs 121 ± 9.1% of systolic time, p < 0.02) in HOCM than in controls. There was significant relationship between the Twist and UTR in control subjects (β=-0.0807, p < 0.001), but not in HOCM (β=-0.0046, p = 0.05). The UTR/Twist ratio diminished only in HOCM but not in controls (-8.0 ± 0.6 vs -13.1 ± 2.5 1/s, p < 0.02).
CONCLUSIONS
The HOCM patients had significantly impaired strain-adaptability; developed post-systolic shortening and no LV Torsional reserve was found on exercise. Also, I detected decreased and delayed UTR indices in the HOCM group. These findings support evidence for reduced systolic-diastolic coupling efficiency, assessed by Twist-Untwist mechanics in HOCM patients, which can contribute to the development of exercise-related symptoms and the dynamic LVOT-obstruction. This unique pattern of deformational behaviour to exercise can help in the differential diagnostic workup in patients with LV hypertrophy of unknown aetiology and also would hold additional value in the risk stratification process for patients with HCM-phenotypes.
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Affiliation(s)
- L Halmai
- Milton Keynes University Hospital, Milton Keynes, United Kingdom of Great Britain & Northern Ireland
| | - M Ward
- Milton Keynes University Hospital, Milton Keynes, United Kingdom of Great Britain & Northern Ireland
| | - J Wong
- Harefield Hospital, Department of Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - A Nemes
- University of Szeged, Faculty of Medicine, Cardiology Center, Szeged, Hungary
| | - T Forster
- University of Szeged, Faculty of Medicine, Cardiology Center, Szeged, Hungary
| | - A Pantazis
- Harefield Hospital, Department of Cardiology, London, United Kingdom of Great Britain & Northern Ireland
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Ciofani J, Allahwala U, Ward M, Figtree G, Nelson G, Rasmussen H, Hansen P, Bhindi R. 847 Lactate to Albumin Ratio (LAR) Predicts In-Hospital Mortality in Patients Presenting With ST Elevation Myocardial Infarction (STEMI). Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Allahwala U, Nour D, Bhatia K, Ward M, Lo S, Weaver J, Bhindi R. 871 Prognostic Impact of Collaterals in Patients With a Coronary Chronic Total Occlusion (CTO): A Meta-Analysis of Over 3,000 Patients. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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