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Perales-Puchalt J, Ramírez-Mantilla M, Fracachán-Cabrera M, Vidoni ED, Ellerbeck EF, Ramírez AS, Watts A, Williams K, Burns J. A text message intervention to support latino dementia family caregivers (CuidaTEXT): feasibility study. Clin Gerontol 2024; 47:50-65. [PMID: 36268684 PMCID: PMC10119327 DOI: 10.1080/07317115.2022.2137449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To test the feasibility, acceptability, and preliminary efficacy of CuidaTEXT: a bidirectional text message intervention to support Latino dementia family caregivers. METHODS CuidaTEXT is a six-month, bilingual intervention tailored to caregiver needs (e.g., education, problem-solving, resources). We used convenience sampling and reached 31 potential participants via clinics, registries, community promotion, and online advertising. We enrolled 24 Latino caregivers in a one-arm trial and assessed feasibility, acceptability, and preliminary efficacy within six months. RESULTS None of the participants unsubscribed from CuidaTEXT and 83.3% completed the follow up survey. Most participants (85.7%) reported reading most text messages thoroughly. All participants reported being very or extremely satisfied with the intervention. Participants reported that CuidaTEXT helped a lot (vs not at all, a little, or somehow) in caring for their care recipient (71.4%; n = 15), for themselves (66.7%; n = 14), and understanding more about dementia (85.7%; n = 18). Compared to baseline, at six months caregiver behavioral symptom distress (0-60) decreased from 19.8 to 12.0 and depression (0-30) from 8.8 to 5.4 (p < .05). CONCLUSIONS CuidaTEXT demonstrated high levels of feasibility, acceptability, and preliminary efficacy among Latino caregivers. CLINICAL IMPLICATIONS CuidaTEXT's feasibility and potential for widespread implementation holds promise in supporting Latino caregivers of people with dementia.
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Affiliation(s)
- Jaime Perales-Puchalt
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
- Department of Population Health, University of Kansas Medical Center, Kansas, Kansas, USA
| | | | | | - Eric D Vidoni
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
- Department of Population Health, University of Kansas Medical Center, Kansas, Kansas, USA
| | - Edward F Ellerbeck
- Department of Population Health, University of Kansas Medical Center, Kansas, Kansas, USA
| | - A Susana Ramírez
- Department of Public Health, University of California, Merced, California, USA
| | - Amber Watts
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Kristine Williams
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
- School of Nursing, University of Kansas Medical Center, Kansas, Kansas, USA
| | - Jeffrey Burns
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
- Department of Population Health, University of Kansas Medical Center, Kansas, Kansas, USA
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Levy JL, Mirek ET, Rodriguez EM, Zalma B, Burns J, Jonsson WO, Sampath H, Staschke KA, Wek RC, Anthony TG. GCN2 is required to maintain core body temperature in mice during acute cold. Am J Physiol Endocrinol Metab 2023; 325:E624-E637. [PMID: 37792040 PMCID: PMC10864021 DOI: 10.1152/ajpendo.00181.2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/01/2023] [Accepted: 09/29/2023] [Indexed: 10/05/2023]
Abstract
Nonshivering thermogenesis in rodents requires macronutrients to fuel the generation of heat during hypothermic conditions. In this study, we examined the role of the nutrient sensing kinase, general control nonderepressible 2 (GCN2) in directing adaptive thermogenesis during acute cold exposure in mice. We hypothesized that GCN2 is required for adaptation to acute cold stress via activation of the integrated stress response (ISR) resulting in liver production of FGF21 and increased amino acid transport to support nonshivering thermogenesis. In alignment with our hypothesis, female and male mice lacking GCN2 failed to adequately increase energy expenditure and veered into torpor. Mice administered a small molecule inhibitor of GCN2 were also profoundly intolerant to acute cold stress. Gcn2 deletion also impeded liver-derived FGF21 but in males only. Within the brown adipose tissue (BAT), acute cold exposure increased ISR activation and its transcriptional execution in males and females. RNA sequencing in BAT identified transcripts that encode actomyosin mechanics and transmembrane transport as requiring GCN2 during cold exposure. These transcripts included class II myosin heavy chain and amino acid transporters, critical for maximal thermogenesis during cold stress. Importantly, Gcn2 deletion corresponded with higher circulating amino acids and lower intracellular amino acids in the BAT during cold stress. In conclusion, we identify a sex-independent role for GCN2 activation to support adaptive thermogenesis via uptake of amino acids into brown adipose.NEW & NOTEWORTHY This paper details the discovery that GCN2 activation is required in both male and female mice to maintain core body temperature during acute cold exposure. The results point to a novel role for GCN2 in supporting adaptive thermogenesis via amino acid transport and actomyosin mechanics in brown adipose tissue.
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Affiliation(s)
- Jordan L Levy
- Department of Nutritional Sciences, New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey, United States
| | - Emily T Mirek
- Department of Nutritional Sciences, New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey, United States
| | - Esther M Rodriguez
- Department of Nutritional Sciences, New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey, United States
| | - Brian Zalma
- Department of Nutritional Sciences, New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey, United States
| | - Jeffrey Burns
- Department of Nutritional Sciences, New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey, United States
| | - William O Jonsson
- Department of Nutritional Sciences, New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey, United States
| | - Harini Sampath
- Department of Nutritional Sciences, New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey, United States
| | - Kirk A Staschke
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, United States
| | - Ronald C Wek
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, United States
| | - Tracy G Anthony
- Department of Nutritional Sciences, New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey, United States
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Grady K, Burns J, Teuteberg J, Allen L, Beiser D, Lindenfeld J, Yancy C, Cella D, Kirklin J, Denfeld Q, Ruo B, McIlvennan C, Walsh M, Adler E, Klein L, Murks C, Pham D, Rich J, Stehlik J, Kiernan M, Hahn E. New Ventricular Assist Device-Specific Self-Report Measures are Important for Understanding Health-Related Quality of Life: Findings from the MCS A-QOL Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Van Biesen D, Van Damme T, Pineda RC, Burns J. The impact of intellectual disability and sport expertise on cognitive and executive functions. J Intellect Disabil 2023; 27:104-120. [PMID: 35176890 DOI: 10.1177/17446295211036331] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Our aim was to identify the suitability of three assessment tools (i.e., Flanker test, Updating Word Span, and Color Trails Test) for future inclusion in the classification process of elite Paralympic athletes with intellectual disability and to assess the strength of the relation between Executive function (EF) and intelligence. Cognitive and EF assessments were performed on 59 participants, divided into four groups according to their cognitive level (with versus without intellectual disability) and sport expertise (athlete versus novice). Inhibition and working memory update skills were implicated in people with intellectual disability. For set-shifting, a more nuanced picture was observed. Strong associations between EF and intelligence was found in people with intellectual disability. Working memory updating and set-shifting are relevant EF skills to assess in the context of elite sport; however, culture-free alternatives for the Updating Word Span test are needed, and alternatives to the Color Trails Test, less reliant on literacy skills are required.
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Affiliation(s)
| | | | | | - J Burns
- Canterbury Christ Church University, UK
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Moriarty PM, Gorby L, Safarova M, Salat D, Burns J, Moreno T, Juni JE. EXTERNAL COUNTERPULSATION ON PERFORMANCE IN PATIENTS WITH MILD COGNITIVE IMPAIRMENT OR MILD ALZHEIMER'S DISEASE: A RANDOMIZED SHAM-CONTROLLED STUDY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02086-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Burns J, Mc Goldrick N, Sigerson D, Edwards M, Culshaw S, Clark C, Watling C, Braid R, O'Keefe E, Gorman M, Conway DI. A Health Inequalities Impact Assessment of the surveillance of COVID-19 in asymptomatic patients attending dental settings in Scotland. Community Dent Health 2022; 39:254-259. [PMID: 36283070 DOI: 10.1922/cdh_00170burns06] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION A key aspect of the public health response to COVID-19 in Scotland was enhanced community surveillance, including testing in dental settings. Across Scotland, dental settings offered patients over 5-years-old the opportunity to participate in community surveillance of COVID-19. METHODS A Health Inequalities Impact Assessment (HIIA) was conducted to understand the differential impacts the programme would have on the population and to improve the accessibility of the programme. HIIA is a tool to allow the assessment, understanding, and mitigation of impacts on people of a proposed policy or practice. It fulfils an organisational duty to meet the requirements of the Equality Act and Fairer Scotland Duty. The HIIA was conducted rapidly in parallel with the programme development. An action research approach included an online workshop, consultation, review of population data and a literature search. RESULTS Adjustments were required to improve the programme's accessibility. Stakeholders, including dental teams from across Scotland were involved in the consultation and brought their front-line experience in different settings. Common issues identified included digital literacy and access, language and cultural barriers to participation, and issues relating to the implications of a positive COVID-19 result. Literature indicated limited evidence on the acceptability, accessibility, and equity of asymptomatic COVID-19 surveillance. CONCLUSION This HIIA was conducted during the COVID-19 pandemic. As an example of good practice in tackling inequalities in access to programmes it should represent the benchmark for other similar initiatives.
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Affiliation(s)
- J Burns
- Public Health, NHS Ayrshire and Arran, UK
| | | | | | - M Edwards
- Public Health, NHS Ayrshire and Arran, UK
| | - S Culshaw
- School of Medicine, Dentistry and Nursing, University of Glasgow, UK
| | | | | | | | - E O'Keefe
- Department of Public Health, NHS Fife, UK
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Rehfuess E, Burns J, Ludolph R, Movsisyan A, Pfadenhauer L, Strahwald B. Public health and social measures during health emergencies such as the COVID-19 pandemic: an initial logic model to conceptualise and classify measures. Eur J Public Health 2022. [PMCID: PMC9594301 DOI: 10.1093/eurpub/ckac129.534] [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: 11/12/2022] Open
Abstract
Issue/problem In the context of the COVID-19 pandemic, public health and social measures (PHSM) are being implemented worldwide, but in very different ways. This is also due to a lacking common understanding of PHSM so far. As a result, there are limited insights regarding their components, implementation and effectiveness as well as impacts beyond health of PHSM. Description of the problem The project contributes to the WHO PHSM initiative. A logic model is being developed that offers a shared language and understanding of how PHSM are intended to achieve transmission-related outcomes, but also that non-intended consequences need to be considered. The overall approach is informed by a system-based logic model template and a staged approach to logic modeling. The development process is making use of (i) existing COVID PHSM taxonomies and related literature, (ii) existing theoretical frameworks related to complex interventions in complex systems, (iii) consultations with WHO staff and the according PHSM steering group, and (v) iterative brainstorming within the working group. Results The initial logic model is rooted in a complexity perspective which recognises that (i) all measures have both intended and unintended consequences for health and society and (ii) all elements within the logic model are interconnected and interact with each other. All PHSM operate through two basic mechanisms: reducing contacts and making contacts safer. Taken together, these two mechanisms work to reduce transmission-relevant contacts. Any specific PHSM is defined by a combination of the measure itself, the population and/or setting targeted and the mode of enactment. The central hub of the logic model connects and integrates all elements. The initial logic model was applied to school and travel measures as examples. Main messages The PHSM logic model is a conceptual basis to facilitate research on PHSM, monitoring and evaluation of PHSM, and evidence-informed decision-making.
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Affiliation(s)
- E Rehfuess
- Institute for Medical Information Processing, University of Munich , Munich, Germany
| | - J Burns
- Institute for Medical Information Processing, University of Munich , Munich, Germany
| | - R Ludolph
- High Impact Events Preparedness Unit, WHO , Geneva, Switzerland
| | - A Movsisyan
- Institute for Medical Information Processing, University of Munich , Munich, Germany
| | - L Pfadenhauer
- Institute for Medical Information Processing, University of Munich , Munich, Germany
| | - B Strahwald
- Institute for Medical Information Processing, University of Munich , Munich, Germany
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Szabo-Reed A, Clutton J, White S, Van Sciver A, White D, Morris J, Martin L, Lepping R, Shaw A, Puchalt JP, Montgomery R, Mahnken J, Washburn R, Burns J, Vidoni ED. COMbined Exercise Trial (COMET) to improve cognition in older adults: Rationale and methods. Contemp Clin Trials 2022; 118:106805. [PMID: 35636733 PMCID: PMC9354507 DOI: 10.1016/j.cct.2022.106805] [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: 03/22/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 11/18/2022]
Abstract
Substantial evidence suggests physical exercise may sustain cognitive function and perhaps prevent Alzheimer's Disease (1, 2). Current public health recommendations call for older adults to do at least 150 min a week of aerobic exercise (e.g. walking) and twice a week resistance exercise (e.g. weight lifting) for physical health. Yet, much remains unknown about how these exercise modalities support brain health independently or in combination. The COMbined Exercise Trial (COMET) is designed to test the combined and independent effects of aerobic and resistance training specifically focusing on exercise-related changes in 1) cognitive performance, 2) regional brain volume, 3) physical function, and 4) blood-based factors. To explore these questions, we will enroll 280 cognitively normal older adults, age 65-80 years, into a 52-week community-based exercise program. Participants will be randomized into one of four arms: 1) flexibility/toning- control 2) 150 min of aerobic exercise only, 3) progressive resistance training only, or 4) combined aerobic and progressive resistance training. Outcomes assessed include a comprehensive cognitive battery, blood biomarkers, brain magnetic resonance imaging, physiological biomarkers, cardiorespiratory fitness, physical function, and battery of psychosocial questionnaires is assessed at baseline, 6 and 12-months. COMET will provide rigorous randomized controlled trial data to understand the effects of the most common exercise modalities, and their combination (i.e., the standard public health recommendation), on brain health.
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Affiliation(s)
- Amanda Szabo-Reed
- KU Alzheimer's Disease Research Center, Fairway, KS, USA; Department of Internal Medicine, Division of Physical Activity and Weight Management, University of Kansas Medical Center, Kansas City, KS, USA.
| | | | - Sydney White
- KU Alzheimer's Disease Research Center, Fairway, KS, USA
| | | | - Dreu White
- KU Alzheimer's Disease Research Center, Fairway, KS, USA
| | - Jill Morris
- KU Alzheimer's Disease Research Center, Fairway, KS, USA; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Laura Martin
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA; Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kanas City, KS, USA
| | - Rebecca Lepping
- KU Alzheimer's Disease Research Center, Fairway, KS, USA; Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kanas City, KS, USA
| | - Ashley Shaw
- KU Alzheimer's Disease Research Center, Fairway, KS, USA; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jaime Perales Puchalt
- KU Alzheimer's Disease Research Center, Fairway, KS, USA; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Robert Montgomery
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jonathan Mahnken
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Richard Washburn
- Department of Internal Medicine, Division of Physical Activity and Weight Management, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jeffrey Burns
- KU Alzheimer's Disease Research Center, Fairway, KS, USA; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Eric D Vidoni
- KU Alzheimer's Disease Research Center, Fairway, KS, USA; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, Low Z, May C, Musto L, Nagi S, Nur S, Salau E, Shabbir S, Thomas MC, Uthayanan L, Vig S, Zaheer M, Zeng G, Ashcroft-Quinn S, Brown R, Hayes J, McConville R, French R, Gilliam A, Sheetal S, Shehzad MU, Bani W, Christie I, Franklyn J, Khan M, Russell J, Smolarek S, Varadarassou R, Ahmed SK, Narayanaswamy S, Sealy J, Shah M, Dodhia V, Manukyan A, O'Hare R, Orbell J, Chung I, Forenc K, Gupta A, Agarwal A, Al Dabbagh A, Bennewith R, Bottomley J, Chu TSM, Chu YYA, Doherty W, Evans B, Hainsworth P, Hosfield T, Li CH, McCullagh I, Mehta A, Thaker A, Thompson B, Virdi A, Walker H, Wilkins E, Dixon C, Hassan MR, Lotca N, Tong KS, Batchelor-Parry H, Chaudhari S, Harris T, Hooper J, Johnson C, Mulvihill C, Nayler J, Olutobi O, Piramanayagam B, Stones K, Sussman M, Weaver C, Alam F, Al Rawi M, Andrew F, Arrayeh A, Azizan N, Hassan A, Iqbal Z, John I, Jones M, Kalake O, Keast M, Nicholas J, Patil A, Powell K, Roberts P, Sabri A, Segue AK, Shah A, Shaik Mohamed SA, Shehadeh A, Shenoy S, Tong A, 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Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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10
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Perales-Puchalt J, Acosta-Rullán M, Ramírez-Mantilla M, Espinoza-Kissell P, Vidoni E, Niedens M, Ellerbeck E, Hinton L, Loera L, Ramírez AS, Lara E, Watts A, Williams K, Resendez J, Burns J. A Text Messaging Intervention to Support Latinx Family Caregivers of Individuals With Dementia (CuidaTEXT): Development and Usability Study. JMIR Aging 2022; 5:e35625. [PMID: 35482366 PMCID: PMC9100381 DOI: 10.2196/35625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/17/2022] [Accepted: 03/14/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Latinx family caregivers of individuals with dementia face many barriers to caregiver support access. Interventions to alleviate these barriers are urgently needed. OBJECTIVE This study aimed to describe the development of CuidaTEXT, a tailored SMS text messaging intervention to support Latinx family caregivers of individuals with dementia. METHODS CuidaTEXT is informed by the stress process framework and social cognitive theory. We developed and refined CuidaTEXT using a mixed methods approach that included thematic analysis and descriptive statistics. We followed 6 user-centered design stages, namely, the selection of design principles, software vendor collaboration, evidence-based foundation, caregiver and research and clinical advisory board guidance, sketching and prototyping, and usability testing of the prototype of CuidaTEXT among 5 Latinx caregivers. RESULTS CuidaTEXT is a bilingual 6-month-long SMS text messaging-based intervention tailored to caregiver needs that includes 1-3 daily automatic messages (n=244) about logistics, dementia education, self-care, social support, end of life, care of the person with dementia, behavioral symptoms, and problem-solving strategies; 783 keyword-driven text messages for further help with the aforementioned topics; live chat interaction with a coach for further help; and a 19-page reference booklet summarizing the purpose and functions of the intervention. The 5 Latinx caregivers who used the prototype of CuidaTEXT scored an average of 97 out of 100 on the System Usability Scale. CONCLUSIONS CuidaTEXT's prototype demonstrated high usability among Latinx caregivers. CuidaTEXT's feasibility is ready to be tested.
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Affiliation(s)
- Jaime Perales-Puchalt
- Alzheimer's Disease Research Center, School of Medicine, University of Kansas Medical Center, Fairway, KS, United States
| | - Mariola Acosta-Rullán
- Alzheimer's Disease Research Center, School of Medicine, University of Kansas Medical Center, Fairway, KS, United States
| | - Mariana Ramírez-Mantilla
- Department of Population Health, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Paul Espinoza-Kissell
- Alzheimer's Disease Research Center, School of Medicine, University of Kansas Medical Center, Fairway, KS, United States
| | - Eric Vidoni
- Alzheimer's Disease Research Center, School of Medicine, University of Kansas Medical Center, Fairway, KS, United States
| | - Michelle Niedens
- Alzheimer's Disease Research Center, School of Medicine, University of Kansas Medical Center, Fairway, KS, United States
| | - Edward Ellerbeck
- Department of Population Health, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Ladson Hinton
- Alzheimer's Disease Research Center, University of California, Davis, Sacramento, CA, United States
| | - Linda Loera
- Alzheimer's Association, Southland Chapter, Los Angeles, CA, United States
| | - A Susana Ramírez
- Department of Public Health, University of California, Merced, Merced, CA, United States
| | - Esther Lara
- Alzheimer's Disease Research Center, University of California, Davis, Sacramento, CA, United States
| | - Amber Watts
- Alzheimer's Disease Research Center, Department of Psychology, University of Kansas, Lawrence, KS, United States
| | - Kristine Williams
- Alzheimer's Disease Research Center, School of Nursing, University of Kansas Medical Center, Fairway, KS, United States
| | | | - Jeffrey Burns
- Alzheimer's Disease Research Center, School of Medicine, University of Kansas Medical Center, Fairway, KS, United States
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Pitarch-Castellano I, Argente-Escrig H, Frasquet M, Damià-Vidal M, Canet-Barrera A, Sevilla T, Burns J. [Validation of the Spanish version of the Charcot-Marie-Tooth disease Pediatric Scale (CMTPedS)]. Rev Neurol 2022; 74:78-82. [PMID: 35084732 DOI: 10.33588/rn.7403.2021489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION AND AIMS The Charcot-Marie-Tooth Pediatric Scale (CMTPedS) is a validated and change-sensitive tool for assessing the severity of neuropathy in children and adolescents between 3 and 20 years of age. The aim of this article is to translate and validate a Spanish version of the CMTPedS in order to disseminate its use in Spanish-speaking countries. MATERIALS AND METHODS The process used to translate the CMTPedS into Spanish was the reverse parallel translation method based on the principles of good practice for translation and the cultural adaptation process of the Food and Drug Administration Guidelines. A direct translation of the original source of the CMTPedS into Spanish was performed first and reviewed by experts in Charcot-Marie-Tooth (CMT) disease trained in the use of the CMTPedS tool. The Spanish version was then translated back into English by a linguist specialised in translation. RESULTS The preliminary Spanish version of the CMTPedS was evaluated in 18 children with CMT aged 6-20 years (mean: 13.27). The scale was well tolerated and easy for children to understand and easy for clinicians to apply. None of the patients had any difficulty completing the scale. CONCLUSIONS The Spanish version of the CMTPedS can be used for monitoring and conducting clinical trials in the Spanish population and in Spanish-speaking countries.
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Affiliation(s)
- I Pitarch-Castellano
- Hospital Universitari i Politécnic La Fe, Valencia, España
- Instituto de Investigación Sanitaria La Fe, Valencia, España
| | - H Argente-Escrig
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, España
- Hospital Universitari i Politécnic La Fe, Valencia, España
- Instituto de Investigación Sanitaria La Fe, Valencia, España
| | - M Frasquet
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, España
- Hospital Universitari i Politécnic La Fe, Valencia, España
- Instituto de Investigación Sanitaria La Fe, Valencia, España
| | - M Damià-Vidal
- Hospital Universitari i Politécnic La Fe, Valencia, España
- Instituto de Investigación Sanitaria La Fe, Valencia, España
| | | | - T Sevilla
- Universidad de Valencia, 46071 Valencia, España
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, España
- Hospital Universitari i Politécnic La Fe, Valencia, España
- Instituto de Investigación Sanitaria La Fe, Valencia, España
| | - J Burns
- University of Sydney , Sydney, New South Wales,, Australia
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12
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Watts A, VanSciver A, Clutton J, Finley K, Flores E, Szabo-Reed A, Burns J, Vacek J. Using Technology for Prescription and Adherence in an Alzheimer’s Prevention Program. Innov Aging 2021. [PMCID: PMC8679822 DOI: 10.1093/geroni/igab046.1674] [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: 11/25/2022] Open
Abstract
Healthy lifestyle change is difficult to adopt and maintain without support. Often physicians recommend exercise to their patients, but have limited means to support this change. A major goal of our study is to provide physicians with a simple method of referring patients to a program that supports adoption and maintenance of exercise that meets recommended guidelines for older adults. The Lifestyle Empowerment for Alzheimer’s Prevention program (LEAP! Rx) is a yearlong intervention to support cognitively normal older adults in adoption and maintenance of moderate to vigorous exercise, a key prevention factor for Alzheimer’s disease. The program uses the electronic medical record and builds relationships with physicians to identify patients eligible to participate. It electronically communicates about patients’ progress back to referring physicians to facilitate ongoing physician-patient interaction. Participants receive exercise coaching to reach their weekly exercise goals and have access to online lifestyle education classes (e.g., nutrition, sleep, stress management). The study is currently enrolling (n= 121 enrolled; mean age 71.4; 12% non-white, 4% Hispanic/Latino, and 83% female). Physician referrals originate from five clinics represented by 48 physicians. The study design will actively compare the physician referral process to self-referrals from the community (n=20). We have adapted the protocol to the conditions of the pandemic including online exercise coaching and support. This presentation will discuss successes and lessons learned from this novel method of recruitment and adherence to exercise.
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Affiliation(s)
- Amber Watts
- University of Kansas, Lawrence, Kansas, United States
| | - Angela VanSciver
- University of Kansas Medical Center, Fairway, Kansas, United States
| | - Jon Clutton
- University of Kansas Medical Center, Fairway, Kansas, United States
| | - Katrina Finley
- University of Kansas Medical Center, Fairway, Kansas, United States
| | - Erica Flores
- University of Kansas Medical Center, Fairway, Kansas, United States
| | | | - Jeffrey Burns
- University of Kansas Medical Center, Fairway, Kansas, United States
| | - James Vacek
- University of Kansas Medical Center, Kansas City, Kansas, United States
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13
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Narayanan M, Zaks D, Olcott P, Voronenko Y, Xu S, Haytmyradov M, Rigie D, Shao L, Burns J, Oderinde O, Shirvani S, Kuduvalli G. Physical Confirmation of Biology-Guided Radiotherapy Directed at Static Targets With Varying Shapes and Background Contrast Environments. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Iannizzi C, Dorando E, Burns J, Weibel S, Dooley C, Wakeford H, Estcourt LJ, Skoetz N, Piechotta V. Living systematic reviews in a context of rapidly emerging diseases: challenges and lessons learned. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.481] [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
In a context of a rapid emerging disease, like the COVID-19 pandemic, we are confronted with clinical uncertainty, evolving epidemiological setting and lacking evidence. Within the context of such a high-priority topic, living systematic reviews (LSRs) are an important systematic review type characterized through regular updating and permanent surveillance of continuously evolving evidence. However, with the new pandemic-related challenges, the standard LSR methodology had to be adapted.
Objectives
The objective is to discuss certain challenges that occurred when conducting LSRs in a rapidly emerging disease context. In particular, we give insights in the lessons we have learned from the conduct of two COVID-19 LSRs and highlight emerging methodological aspects.
Results
With the evolving knowledge around the virus and its caused disease, we learned that the initial plan for inclusion of study designs, publication types, interventions and comparators, outcomes and the search strategy had to be adapted. The author teams for example had to revise outcome measures or included observational data in addition to evidence from randomized controlled trials, as they provided substantial information on the safety of investigated interventions. For deciding when to update a LSR, additional aspects, such as policy relevance or waiting for important evidence dependent on the individual research question were considered. To avoid biases in the review process, we learned that transparent reporting of any methodological adaptations is highly relevant; between protocol and review, as well as between each review update.
Conclusions
Our experience showed that LSRs are highly suitable in a pandemic context, in particular when facing unexpected methodological and clinical challenges. The research question, study designs and the methodology, should be revisited and critically discussed before each update, to be flexible enough for addressing the pandemic context.
Key messages
Living systematic reviews are highly relevant in a pandemic context, but the methodology and decision when to update the review have to be adapted to respond purposeful to the emerging topic. To avoid biases in the review process, we learned that transparent reporting of any methodological adaptations is highly relevant; between protocol and review, as well as between each review update.
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Affiliation(s)
- C Iannizzi
- Evidence-based Oncology, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - E Dorando
- Evidence-based Oncology, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - J Burns
- Institute for Medical Information Processing, Biometry, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - S Weibel
- Department of Anaesthesiology, Intensive Care, Emergency, University Hospital Wuerzburg, Wuerzburg, Germany
| | - C Dooley
- Editorial & Methods Department, Cochrane Central Executive, London, UK
| | - H Wakeford
- Editorial & Methods Department, Cochrane Central Executive, London, UK
| | - LJ Estcourt
- Haematology/Transfusion Medicine, NHS Blood and Transplant, Oxford, UK
| | - N Skoetz
- Evidence-based Oncology, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - V Piechotta
- Evidence-based Oncology, Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany
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15
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Gondi S, Ellis S, Gupta M, Ellerbeck E, Richter K, Burns J, Gupta A. Physician perceived barriers and facilitators for self-measured blood pressure monitoring- a qualitative study. PLoS One 2021; 16:e0255578. [PMID: 34415946 PMCID: PMC8378703 DOI: 10.1371/journal.pone.0255578] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 07/20/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Improving hypertension management is a national priority that can decrease morbidity and mortality. Evidence-based hypertension management guidelines advocate self-measured BP (SMBP), but widespread implementation of SMBP is lacking. The purpose of this study was to describe the perspective of primary care physicians (PCPs) on SMBP to identify the barriers and facilitators for implementing SMBP. METHODS We collected data from PCPs from a large health system using semi-structured interviews based on the Theoretical Domains Framework (TDF). Responses were recorded, transcribed, and qualitatively analyzed into three overarching TDF domains based on the Behavior Change Wheel (BCW): 1) Motivation 2) Opportunity and 3) Capabilities. The sample size was based on theme saturation. RESULTS All 17 participating PCPs believed that SMBP is a useful, but underutilized tool. Although individual practices varied, most physicians felt that the increased data points from SMBP allowed for better hypertension management. Most felt that overcoming existing barriers would be difficult, but identified several facilitators: physician support of SMBP, the possibility of having other trained health professionals to assist with SMBP and patient education; improving patient engagement and empowerment with SMBP, and the interest of the health system in using technology to improve hypertension management. CONCLUSION PCPs believe that SMBP can improve hypertension management. There are numerous barriers and facilitators for implementing SMBP. Successful implementation in clinical practice will require implementation strategies targeted at increasing patient acceptability and reducing physician workload. This may need a radical change in the current methods of managing hypertension.
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Affiliation(s)
- Saahith Gondi
- Department of Biology, Wake Forest University, Winston-Salem, NC, United States of America
| | - Shellie Ellis
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Mallika Gupta
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Edward Ellerbeck
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Kimber Richter
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Jeffrey Burns
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Aditi Gupta
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States of America
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
- * E-mail:
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16
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Oderinde O, Narayanan M, Olcott P, Voronenko Y, Burns J, Zaks D, Xu S, Rigie D, Haytmyradov M, Gong R, Shao L, Shirvani S, Kuduvalli G. OC-0306 Performance evaluation of BgRT delivery directed at multiple PET-avid targets. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06853-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Davidson ZE, Bray P, Rose K, Rodrigues MJ, Corben L, North KN, Ryan MM, Burns J. Development of clinical practice guidelines for allied health and nursing assessment and management of Duchenne muscular dystrophy. Disabil Rehabil 2021; 44:5450-5467. [PMID: 34165385 DOI: 10.1080/09638288.2021.1936221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To provide evidence-based guidance specific to allied health and nursing practice for the assessment and management of individuals with Duchenne muscular dystrophy (DMD). MATERIALS AND METHODS Thirteen key focus areas were identified in consultation with health professionals and consumer advocacy groups. A series of systematic literature reviews were conducted to identify assessment and management strategies for each key focus area. A consensus process using modified Delphi methodology, including an Australia-New Zealand expert consensus meeting, was conducted. Recommendations underwent consultative review with key groups before being finalised and prepared for dissemination. RESULTS This clinical practice guideline (CPG) generated 19 evidence-based recommendations, 117 consensus-based recommendations and five research recommendations across the 13 focus areas to inform allied health assessment and management of individuals with DMD. CONCLUSIONS The resulting recommendations can be used in conjunction with existing medical CPGs to improve, standardise and advocate for allied health and rehabilitation care in DMD. The process used here may be useful for the development of CPGs in other rare diseases.Implications for rehabilitationImplementation-ready evidence-based statements to guide clinical care of individuals with DMD are provided with the potential to improve participation, function in the community and quality of life.A model for developing best practice statements for other rare neurological diseases is described.Allied health and nursing health professionals should focus research efforts to generate quality evidence to support rehabilitation practice.
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Affiliation(s)
- Z E Davidson
- Murdoch Children's Research Institute, Parkville, Australia.,Neurology Department, Royal Children's Hospital, Parkville, Australia.,Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Australia
| | - P Bray
- The Children's Hospital at Westmead, Westmead, Australia.,School of Health Sciences, University of Sydney, Sydney, Australia
| | - K Rose
- School of Health Sciences, University of Sydney, Sydney, Australia.,Department of Physiotherapy, Sydney Children's Hospital, Randwick, Australia.,ATOM International Pty Ltd, Newcastle upon Tyne, UK
| | - M J Rodrigues
- Muscular Dystrophy Association of New Zealand, Auckland, New Zealand.,Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - L Corben
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Australia.,School of Psychological Sciences, Monash University, Clayton, Australia
| | - K N North
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - M M Ryan
- Murdoch Children's Research Institute, Parkville, Australia.,Neurology Department, Royal Children's Hospital, Parkville, Australia.,Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - J Burns
- The Children's Hospital at Westmead, Westmead, Australia.,School of Health Sciences, University of Sydney, Sydney, Australia
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Conway D, Culshaw S, Edwards M, Clark C, Watling C, Robertson C, Braid R, O’Keefe E, McGoldrick N, Burns J, Provan S, VanSteenhouse H, Hay J, Gunson R. SARS-CoV-2 Positivity in Asymptomatic-Screened Dental Patients. J Dent Res 2021; 100:583-590. [PMID: 33779355 PMCID: PMC8138329 DOI: 10.1177/00220345211004849] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Enhanced community surveillance is a key pillar of the public health response to coronavirus disease 2019 (COVID-19). Asymptomatic carriage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a potentially significant source of transmission, yet remains relatively poorly understood. Disruption of dental services continues with significantly reduced capacity. Ongoing precautions include preappointment and/or at appointment COVID-19 symptom screening and use of enhanced personal protective equipment (PPE). This study aimed to investigate SARS-CoV-2 infection in dental patients to inform community surveillance and improve understanding of risks in the dental setting. Thirty-one dental care centers across Scotland invited asymptomatic-screened patients aged over 5 y to participate. Following verbal consent and completion of sociodemographic and symptom history questionnaire, trained dental teams took a combined oropharyngeal and nasal swab sample using standardized Viral Transport Medium-containing test kits. Samples were processed by the Lighthouse Lab and patients informed of their results by SMS/email with appropriate self-isolation guidance in the event of a positive test. All positive cases were successfully followed up by the national contact tracing program. Over a 13-wk period (from August 3, 2020, to October 31, 2020), 4,032 patients, largely representative of the population, were tested. Of these, 22 (0.5%; 95% CI, 0.5%-0.8%) tested positive for SARS-CoV-2. The positivity rate increased over the period, commensurate with uptick in community prevalence identified across all national testing monitoring data streams. To our knowledge, this is the first report of a COVID-19 testing survey in asymptomatic-screened patients presenting in a dental setting. The positivity rate in this patient group reflects the underlying prevalence in community at the time. These data are a salient reminder, particularly when community infection levels are rising, of the importance of appropriate ongoing infection prevention control and PPE vigilance, which is relevant as health care team fatigue increases as the pandemic continues. Dental settings are a valuable location for public health surveillance.
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Affiliation(s)
- D.I. Conway
- School of Medicine, Dentistry, Nursing,
University of Glasgow, Glasgow, UK
- Public Health Scotland, Glasgow,
UK
| | - S. Culshaw
- School of Medicine, Dentistry, Nursing,
University of Glasgow, Glasgow, UK
| | - M. Edwards
- Department of Public Health, NHS
Ayrshire and Arran, Ayr, UK
| | - C. Clark
- Public Health Scotland, Glasgow,
UK
| | | | - C. Robertson
- Public Health Scotland, Glasgow,
UK
- Mathematics and Statistics, Strathclyde
University, Glasgow, UK
| | - R. Braid
- Public Health Scotland, Glasgow,
UK
| | - E. O’Keefe
- Public Health Department, NHS Fife,
Leven, UK
| | | | - J. Burns
- Public Health Department, NHS Fife,
Leven, UK
| | - S. Provan
- Oral Health Directorate, NHS Greater
Glasgow & Clyde, Glasgow, UK
| | | | - J. Hay
- Lighthouse Lab in Glasgow, Glasgow,
UK
| | - R. Gunson
- West of Scotland Specialist Virology
Centre, Glasgow Royal Infirmary, Glasgow, UK
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19
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Donahue PT, Grove G, Stillman C, Kang C, Burns J, Hillman CH, Kramer AF, McAuley E, Vidoni E, Erickson KI. Estimating the financial costs associated with a phase III, multi-site exercise intervention trial: Investigating Gains in Neurocognition in an Intervention Trial of Exercise (IGNITE). Contemp Clin Trials 2021; 105:106401. [PMID: 33857678 DOI: 10.1016/j.cct.2021.106401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Supervised exercise interventions are expensive and time intensive. However, there are financial costs to consider in addition to the intervention itself, namely: advertising and recruitment, outcome assessments, and other trial-related costs. OBJECTIVES In this analysis, we examine the financial costs associated with the administration of Investigating Gains in Neurocognition in an Intervention Trial of Exercise (IGNITE) to quantify the costs associated with large exercise intervention trials and to provide future investigators with financial estimates if they wish to pursue studies of a similar design. METHODS Cost per randomized participant were calculated in four areas: (1) advertising and recruitment, (2) outcome assessments, (3) delivery of the intervention, and (4) other trial-related expenses. Overall trial costs associated with data analysis, faculty salaries, and indirect costs were estimated as well. RESULTS The total cost per randomized participant was estimated to be $16,494. Outcome assessments accounted for the highest proportion of per-participant (75%) and total trial (38%) costs. Neuroimaging assessments (MRI & PET) cost $8247 per randomized participant, accounting for two-thirds (67%) of outcome assessment costs and half (50%) of per-participant costs. CONCLUSION Large clinical trials of exercise are expensive (~$21 million), particularly when administering several visits to assess study aims. Outcome assessments, specifically those involving neuroimaging, accounted for a significant proportion of total costs in this analysis. Future investigators must budget accordingly if they wish to conduct a comprehensive, multi-site exercise intervention trial that examines numerous physiological and psychological outcomes.
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Affiliation(s)
- Patrick T Donahue
- University of Pittsburgh, Pittsburgh, PA, USA; Johns Hopkins University, Baltimore, MD, USA.
| | | | | | | | - Jeffrey Burns
- University of Kansas Medical Center, Kansas City, MO, USA
| | | | - Arthur F Kramer
- Northeastern University, Boston, MA, USA; University of Illinois, Champaign, IL, USA
| | | | - Eric Vidoni
- University of Kansas Medical Center, Kansas City, MO, USA
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Burns J, McCoy CP, Irwin NJ. Synergistic activity of weak organic acids against uropathogens. J Hosp Infect 2021; 111:78-88. [PMID: 33545217 DOI: 10.1016/j.jhin.2021.01.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Urinary tract infections (UTIs) are among the most common hospital-acquired infections, with an estimated 75% of UTIs caused by urinary catheters. In addition to the significant healthcare costs and patient morbidity, the escalating antimicrobial resistance reported among common uropathogens make the investigation of efficacious new antimicrobial strategies of urgent importance. AIM To examine the antibacterial activity of a suite of weak organic acids (WOAs) (citric acid, malic acid, propionic acid, mandelic acid, lactic acid, benzoic acid, pyruvic acid and hippuric acid), alone and in combination, against common nosocomial uropathogens (Proteus mirabilis, Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa). METHODS Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), minimum biofilm eradication concentration (MBEC), fractional inhibitory concentration index (FICI) values and kinetics of bactericidal activity of WOAs were determined by microdilution and time-kill assays. FINDINGS All tested WOAs displayed bactericidal activities against uropathogens in their planktonic and biofilm modes of growth when used individually. Moreover, WOAs in combination displayed synergistic activity against P. mirabilis, S. aureus and E. coli, with reductions in MIC values of up to 250-fold and significant reductions in biofilm formation. CONCLUSION The synergistic multi-mechanistic combinations identified herein are anticipated to play an important role in the treatment and prevention of catheter-associated UTIs.
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Affiliation(s)
- J Burns
- School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - C P McCoy
- School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - N J Irwin
- School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland, UK.
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21
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Droste J, Burns J, Narayan N. Improving medical workforce knowledge of adrenaline (epinephrine) administration in treatment of anaphylaxis in adults. Acute Med 2021; 20:110-115. [PMID: 34190737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
AIM To compare results of repeated surveys (2010, 2015 and 2017) regarding the knowledge of the medical workforce potentially involved in adrenaline administration for the emergency treatment of anaphylaxis in adults. METHODS Convenience samples of medical (and advanced nursing) staff were surveyed on three separate occasions (2010, 2015 and 2017). Several educational methods were used to increase awareness of the specific administration of adrenaline. RESULTS Overall, knowledge of the medical workforce regarding correct first dose adrenaline administration improved from 15% in 2010 to 49% in 2015 and finally 63% in 2017. CONCLUSION This survey comparison shows knowledge of the medical workforce regarding adrenaline administration for treatment of anaphylaxis in adults can be significantly improved by employing a variety of educational methods.
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Affiliation(s)
- J Droste
- MRCP, Dr. med., DTMH Consultant in Acute Medicine at Airedale NHS Foundation Trust
| | - J Burns
- Consultant Anaesthetist MBChB, FRCA Anaesthetic Department Airedale NHS Foundation Trust
| | - N Narayan
- Consultant in Acute Medicine, MRCP, MBChB, BSc, PGCert Bolton NHS Foundation Trust
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22
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Milne SC, Corben LA, Roberts M, Szmulewicz D, Burns J, Grobler AC, Williams S, Chua J, Liang C, Lamont PJ, Grootendorst AC, Massey L, Sue C, Dalziel K, LaGrappe D, Willis L, Freijah A, Gerken P, Delatycki MB. Rehabilitation for ataxia study: protocol for a randomised controlled trial of an outpatient and supported home-based physiotherapy programme for people with hereditary cerebellar ataxia. BMJ Open 2020; 10:e040230. [PMID: 33334834 PMCID: PMC7747606 DOI: 10.1136/bmjopen-2020-040230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Emerging evidence indicates that rehabilitation can improve ataxia, mobility and independence in everyday activities in individuals with hereditary cerebellar ataxia. However, with the rarity of the genetic ataxias and known recruitment challenges in rehabilitation trials, most studies have been underpowered, non-randomised or non-controlled. This study will be the first, appropriately powered randomised controlled trial to examine the efficacy of an outpatient and home-based rehabilitation programme on improving motor function for individuals with hereditary cerebellar ataxia. METHODS AND ANALYSIS This randomised, single-blind, parallel group trial will compare a 30-week rehabilitation programme to standard care in individuals with hereditary cerebellar ataxia. Eighty individuals with a hereditary cerebellar ataxia, aged 15 years and above, will be recruited. The rehabilitation programme will include 6 weeks of outpatient land and aquatic physiotherapy followed immediately by a 24- week home exercise programme supported with fortnightly physiotherapy sessions. Participants in the standard care group will be asked to continue their usual physical activity. The primary outcome will be the motor domain of the Functional Independence Measure. Secondary outcomes will measure the motor impairment related to ataxia, balance, quality of life and cost-effectiveness. Outcomes will be administered at baseline, 7 weeks, 18 weeks and 30 weeks by a physiotherapist blinded to group allocation. A repeated measures mixed-effects linear regression model will be used to analyse the effect of the treatment group for each of the dependent continuous variables. The primary efficacy analysis will follow the intention-to-treat principle. ETHICS AND DISSEMINATION The study has been approved by the Monash Health Human Research Ethics Committee (HREC/18/MonH/418) and the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (2019/3503). Results will be published in peer-reviewed journals, presented at national and/or international conferences and disseminated to Australian ataxia support groups. TRIAL REGISTRATION NUMBER ACTRN12618000908235.
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Affiliation(s)
- Sarah C Milne
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Physiotherapy Department, Monash Health, Cheltenham, Victoria, Australia
- School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Louise A Corben
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Roberts
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Physiotherapy Department, Monash Health, Cheltenham, Victoria, Australia
| | - David Szmulewicz
- Balance Disorders & Ataxia Service, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Cerebellar Ataxia Clinic, Alfred Health, Caulfield, Victoria, Australia
- Monash Medical Centre, Monash Health, Clayton, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - J Burns
- University of Sydney School of Health Sciences, Faculty of Medicine and Health & Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Anneke C Grobler
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Shannon Williams
- Physiotherapy Department, Royal Perth Hospital, Perth, Western Australia, Australia
- Physiotherapy Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jillian Chua
- Physiotherapy Department, Ryde Hospital, Eastwood, New South Wales, Australia
| | - Christina Liang
- Department of Neurology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, Australia
| | - Phillipa J Lamont
- Neurogenetic Unit, Royal Perth Hospital, Perth, Western Australia, Australia
| | | | - Libby Massey
- MJD Foundation, Darwin, Northern Territory, Australia
| | - Carolyn Sue
- Department of Neurology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, Australia
| | - Kim Dalziel
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | | | - Liz Willis
- MJD Foundation, Darwin, Northern Territory, Australia
| | - Aleka Freijah
- Rehabilitation Services, Royal Darwin and Palmerston Hospitals, Darwin, Northern Territory, Australia
| | - Paul Gerken
- Rehabilitation Services, Royal Darwin and Palmerston Hospitals, Darwin, Northern Territory, Australia
| | - Martin B Delatycki
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Victorian Clinical Genetics Services, Melbourne, Victoria, Australia
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Abstract
OBJECTIVES To systematically analyse the effect of pharmacological treatment of hypertension (HTN) on cognitive decline in older adults. METHODS Randomised, placebo-controlled trials with a prespecified quantitative outcome of cognition and a pharmacological intervention for at least 12 months to treat HTN in older adults (>60 years). Our primary outcome was change in cognition with pharmacological treatment of HTN. Standardised mean difference (SMD) was used to analyse different outcomes reported in the selected studies. We searched PubMed CENTRAL and the Cochrane Library from inception to 6 July 2020. Two independent reviewers assessed trial quality and extracted data. Internal and external validity of the studies was assessed. RESULTS Nine randomised controlled trials with 34 994 participants were included in the final analysis. The net SMD for change in cognition was -0.049 (CI: -0.078 to -0.019) indicating that treatment of HTN decreased cognitive decline. Heterogeneity was low with an I² of 6%. DISCUSSION Current evidence does not indicate worsening of cognition with treatment of HTN. Treatment of HTN in older adults may reduce cognitive decline. These results have important implications in clinical management of patients at risk for dementia. PROSPERO REGISTRATION NUMBER CRD42020139750.
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Affiliation(s)
- Aditi Gupta
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
- Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Sophy Perdomo
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Sandra Billinger
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Srinivasan Beddhu
- Division of Nephrology and Hypertension, University of Utah, Salt Lake City, Utah, USA
| | - Jeffrey Burns
- Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Gary Gronseth
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
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Ahmadnezhad P, Burns J, Akinwuntan A, Devos H. The Relationship Between Subjective and Objective Measures of Cognitive Workload in Older Adults with and Without Preclinical Alzheimer’s Disease. Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.09.026] [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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Ahmadnezhad P, Burns J, Akinwuntan A, Devos H. The Relationship Between Cognitive Reserve and Cognitive Workload in Older Adults with and Without Pre-clinical Alzheimer’s Disease: A Pilot Study. Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.09.025] [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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Gupta A, Kennedy K, Perales-Puchalt J, Drew D, Beddhu S, Sarnak M, Burns J. Mild-moderate CKD is not associated with cognitive impairment in older adults in the Alzheimer's Disease Neuroimaging Initiative cohort. PLoS One 2020; 15:e0239871. [PMID: 33036021 PMCID: PMC7546911 DOI: 10.1371/journal.pone.0239871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/14/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with cognitive impairment and dementia. We examined whether this relationship hold true in older adults, who have a higher prevalence of both CKD and dementia. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS We conducted a cross-sectional secondary analysis of an established observational cohort. We analyzed data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), an NIH funded, multicenter longitudinal observational study, which includes participants with normal and impaired cognition and assesses cognition with a comprehensive battery of neuropsychological tests. We included a non-probability sample of all ADNI participants with serum creatinine measurements at baseline (N = 1181). Using multivariable linear regression analysis, we related the CKD Epidemiology Collaboration equation eGFR with validated composite scores for memory (ADNI-mem) and executive function (ADNI-EF). RESULTS For the 1181 ADNI participants, the mean age was 73.7 ± 7.1 years. Mean estimated glomerular filtration rate (eGFR) was 76.4 ± 19.7; 6% had eGFR<45, 22% had eGFR of 45 to <60, 51% had eGFR of 60-90 and 21% had eGFR>90 ml/min/1.73 m2. The mean ADNI-Mem score was 0.241 ± 0.874 and mean ADNI-EF score was 0.160 ± 1.026. In separate multivariable linear regression models, adjusted for age, sex, race education and BMI, there was no association between each 10 ml/ min/1.73 m2 higher eGFR and ADNI-Mem (β -0.02, 95% CI -0.04, 0.02, p = 0.56) or ADNI-EF (β 0.01, 95% CI -0.03, 0.05, p = 0.69) scores. CONCLUSION We did not observe an association between eGFR and cognition in the older ADNI participants.
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Affiliation(s)
- Aditi Gupta
- The Kidney Institute, University of Kansas Medical Center, Kansas City, KS, United States of America
- Division of Nephrology and Hypertension, University of Kansas Medical Center, Kansas City, KS, United States of America
- Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS, United States of America
- * E-mail:
| | - Kevin Kennedy
- Kansas City Veterans Affairs, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Jaime Perales-Puchalt
- Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS, United States of America
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - David Drew
- Division of Nephrology and Hypertension, Tufts Medical Center, Boston MA, United States of America
| | | | - Mark Sarnak
- Division of Nephrology and Hypertension, Tufts Medical Center, Boston MA, United States of America
| | - Jeffrey Burns
- Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS, United States of America
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
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Esterline R, Oscarsson J, Burns J. A role for sodium glucose cotransporter 2 inhibitors (SGLT2is) in the treatment of Alzheimer's disease? Int Rev Neurobiol 2020; 155:113-140. [PMID: 32854852 DOI: 10.1016/bs.irn.2020.03.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
With the lack of success and increasing urgency for therapies capable of impacting Alzheimer's disease (AD) and its progression, there are increasing efforts to expand testing of new mechanistic hypotheses to attack the disease from different angles. Three such hypotheses are the "Mitochondrial Cascade (MC)" hypothesis, the "Endo-Lysosomal Dysfunction (ELD)" hypothesis and the "Type 3 Diabetes (T3D)" hypothesis. These hypotheses provide a rationale for new pharmacological approaches to address the mitochondrial, endo-lysosomal and metabolic dysfunction associated with AD. It is increasingly evident that there is critical interplay between the metabolic dysfunction associated with obesity/metabolic syndrome/type 2 diabetes mellitus (T2DM) and patient susceptibility to AD development. A candidate for a common mechanism linking these metabolically-driven disease states is chronically-activated mechanistic target of rapamycin (mTOR) signaling. Unrestrained chronic mTOR activation may be responsible for sustaining metabolic, lysosomal and mitochondrial dysfunction in AD, driving both the breakdown of the blood-brain barrier via endothelial cell dysfunction and hyperphosphorylation of tau and formation of amyloid plaques in the brain. It is hypothesized that sodium glucose cotransporter 2 (SGLT2) inhibition, mediated by sustained glucose loss, restores mTOR cycling through nutrient-driven, nightly periods of transient mTOR inhibition (and restoration of catabolic cellular housekeeping processes) interspersed by daily periods of transient mTOR activation (and anabolism) accompanying eating. In this way, a flexible mTOR dynamic is restored, thereby preventing or even reducing the progress of AD pathology. The first study to investigate the effect of SGLT2 inhibition in patients with AD is ongoing and focuses on the impact on energy metabolism in the brain following treatment with the SGLT2 inhibitor dapagliflozin.
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Affiliation(s)
- Russell Esterline
- BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, United States.
| | - Jan Oscarsson
- BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Jeffrey Burns
- University of Kansas Alzheimer's Disease Center, Kansas City, KS, United States
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28
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Blocker E, Fry A, Luebbers P, Burns J, Perales-Puchalt J, Hansen D, Vidoni E. Promoting Alzheimer's Risk-Reduction through Community-Based Lifestyle Education and Exercise in Rural America: A Pilot Intervention. Kans J Med 2020. [DOI: 10.17161/kjm.v13i.13872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction. Rural Americans (RA) have poorer vascular health and physical activity levels than their urban counterparts; all are dementia risk factors. Dementia risk reduction among rural individuals requires a tailored approach. The purpose of this project was to examine preliminary efficacy of a community-based physical exercise and/or dementia risk factor-reduction curriculum among rural adults 50 and older.
Methods. Seventy-five rural dwelling adults 50 and older were randomized to one of three groups: 1) 10 weeks of Alzheimer’s disease risk-reduction education (ED), 2) risk-reduction education and supervised exercise (EDEX) or 3) control group (CON). Outcomes included baseline to 10-week follow-up difference in dementia knowledge (primary outcome) and physical activity, muscular endurance, healthy lifestyle engagement, and anthropometrics (secondary outcomes).
Results. Sixty-nine adults successfully completed the 10-week study. Dementia knowledge increased in a Treatment Arm-dependent manner (χ2 = 6.95 (2), p = 0.03), being ED and EDEX superior to CON. Engagement in healthy lifestyle behaviors did not change statistically. However, participation specifically in physical activity increased over time (χ2 = 11.47 (2), p = 0.003) with EDEX reporting the greatest increases. No significant change in average daily steps was observed for any group.
Conclusion. The results suggested dementia risk-reduction education, both with and without structured exercise, leads to improvements in dementia knowledge. When coupled with regular, supervised exercise, this education intervention also helped participants increase engagement in physical activity over 10 weeks. Tailored interventions that combine Alzheimer’s disease education and regular, supervised exercise may help reduce dementia risk in rural communities.
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29
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Day MA, Ehde DM, Burns J, Ward LC, Friedly JL, Thorn BE, Ciol MA, Mendoza E, Chan JF, Battalio S, Borckardt J, Jensen MP. A randomized trial to examine the mechanisms of cognitive, behavioral and mindfulness-based psychosocial treatments for chronic pain: Study protocol. Contemp Clin Trials 2020; 93:106000. [PMID: 32302791 PMCID: PMC7195020 DOI: 10.1016/j.cct.2020.106000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/27/2020] [Accepted: 04/13/2020] [Indexed: 11/28/2022]
Abstract
This randomized trial will evaluate the mechanisms of three chronic pain treatments: cognitive therapy (CT), mindfulness meditation (MM), and activation skills (AS). We will determine the extent to which late-treatment improvement in primary outcome (pain interference) is predicted by early-treatment changes in cognitive content, cognitive process, and/or activity level. The shared versus specific role of these mechanisms across the three treatments will be evaluated during treatment (Primary Aim), and immediately post-treatment to examine relapse mechanisms (Secondary Aim). We will enroll 300 individuals with chronic pain (with low back pain as a primary or secondary condition), with 240 projected to complete the study. Participants will be randomly assigned to eight, 1.5 h telehealth group sessions of CT, MM, or AS. Mechanisms and outcomes will be assessed twice daily during 2-week baseline, 4-week treatment period, and 4-week post-treatment epoch via random cue-elicited ecological momentary assessment (EMA); activity level will be monitored during these time epochs via daily monitoring with ActiGraph technology. The primary outcome will be measured by the PROMIS 5-item Pain Interference scale. Structural equation modeling (SEM) will be used to test the primary aims. This study is pre-registered on clinicaltrials.gov (Identifier: NCT03687762). This study will determine the temporal sequence of lagged mediation effects to evaluate rates of change in outcome as a function of change in mediators. The findings will provide an empirical basis for enhancing and streamlining psychosocial chronic pain interventions. Further, results will guide future efforts towards optimizing maintenance of gains to effectively reduce relapse risk.
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Affiliation(s)
- M A Day
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia.
| | - D M Ehde
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - J Burns
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - L C Ward
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - J L Friedly
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - B E Thorn
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - M A Ciol
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - E Mendoza
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - J F Chan
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - S Battalio
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - J Borckardt
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
| | - M P Jensen
- The University of Queensland, 330 McElwain Building, Brisbane 4072, Queensland, Australia
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Smith A, Taylor M, Backes J, Littrell J, Boeckman C, Spaeth K, Gibson C, Burns J, Sullivan D. Peripheral Insulin Resistance in Cognitively Normal Older Adults Relates to Poorer Performance on a Test for Speed of Processing. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa040_076] [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
Objectives
Peripheral insulin resistance (IR) and impaired glucose metabolism increases the risk for cognitive decline. However, data looking at peripheral IR's relationship with cognition in cognitively normal adults is limited. This study aimed to assess the relationship between peripheral IR and tests of speed of processing (SOP) in cognitively normal older adults using a novel IR measure.
Methods
Baseline data from 56 cognitively normal older adults participating in a nutrition intervention study (Nutrition Interventions for Cognitive Enhancement study; NICE study) were analyzed. Fasting blood draws were attained, and peripheral IR was measured using Quest Diagnostics’ Cardio IQ Insulin Resistance Panel (Test Code: 36,509). A cognitive battery was conducted by a trained psychometrician. Z-Scores of the Digit Symbol Substitution Test, Stroop Color, Stroop Word, Stroop Interference, and Stroop Letter Number Sequencing and Crossing-Off tests were combined to give a global SOP score. We constructed ordinary least squares regression models to assess IR's relationships with individual SOP tests and global SOP, including age and education as covariates. Statistical analyses were performed using R (v. 3.6.2; R Foundation, Vienna, Austria). Statistical significance was set at P < 0.05.
Results
Participants were 77% female and had a mean age of 72.1 ± 4.9 years. Higher IR scores were related to poorer performance on the Digit Symbol Substitution Test (β = −0.26, P = 0.04). IR scores were not related to other individual cognitive tests: Stroop Color (β = −0.17, P = 0.20), Stroop Word (β = −0.19, P = 0.11), Stroop Interference (β = −0.14, P = 0.28), Stroop Letter Number Sequencing (β = 0.03, P = 0.83), Crossing-Off (β = −0.18, P = 0.15), or Global SOP (β = −0.20, P = 0.11).
Conclusions
There was a relationship between higher IR scores and poorer performance on the Digit Symbol Substitution Test. Although other SOP tests were not significantly correlated with IR scores, directionality of the relationships indicated trend for higher IR being related to lower SOP. Consequently, maintaining insulin sensitivity with healthy lifestyle choices may be important for healthy aging. Future analyses with a larger sample size will be more informative for understanding the relationship between IR and SOP.
Funding Sources
National Institute on Aging.
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Abstract
Abstract
Objectives
Skin Carotenoid Content (SCC) is a validated biomarker of vegetable intake. The objective of this study is to compare SCC to self-reported diet and supplement intake.
Methods
This cross-sectional study used baseline data from 61 participants in an ongoing intervention trial (Nutrition Interventions for Cognitive Enhancement). Participants were cognitively normal older adults (≥65 years, MMSE score >25). SCC was determined non-invasively by Resonance Raman spectroscopy (VEGGIE METER®; Longevity Link Corporation). Three measurements were taken on the fingertip and averaged. Dietary intake was obtained by 3-day diet records. A dietitian reviewed the diet records and entered the records into the Nutrition Data System for Research (version 2019). Linear regression was used to assess relationships between self-reported carotenoid intake and SCC measurement.
Results
The mean SCC was 279 ± 72.1. Correlations for self-reported individual carotenoid intake and SCC scores were beta-carotene (r2 = 0.15, β̞ = 0.38, P = 0.002), alpha-carotene (r2 = 0.10, β̞ = 0.32, P = 0.01), and lutein + zeaxanthin (r2 = 0.16, β̞ = 0.41, P = 0.001). Correlations for self-reported combined diet and supplement intake and SCC scores were beta-carotene (r2 = 0.15, β̞ = 0.38, P = 0.002), alpha carotene (r2 = 0.10, β̞ = 0.32, P = 0.01), and lutein + zeaxanthin (r2 = 0.07, β̞ = 0.26, P = 0.04). Neither reported diet nor diet and supplement intakes of beta-cryptoxanthin, lycopene, and retinol were related to SCC scores. Correlations for food group and SCC scores were dark vegetables (r2 = 0.15, β̞ = 0.39, P = 0.002), deep yellow vegetables (r2 = 0.09, β̞ = 0.30, P = 0.02), and total vegetable intake (r2 = 0.16, β̞ = 0.40, P = 0.001).
Conclusions
Within older adults, the SCC is a good indicator of dietary lutein + zeaxanthin, beta-carotene, and alpha-carotene intake. The finding that lutein + zeaxanthin relationship decreases when accounting for combined diet and supplement intake suggests need to investigate bioavailability of supplemental lutein + zeaxanthin.
Funding Sources
National Institutes of Health.
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Pasquina-Lemonche L, Burns J, Turner RD, Kumar S, Tank R, Mullin N, Wilson JS, Chakrabarti B, Bullough PA, Foster SJ, Hobbs JK. The architecture of the Gram-positive bacterial cell wall. Nature 2020; 582:294-297. [PMID: 32523118 PMCID: PMC7308169 DOI: 10.1038/s41586-020-2236-6] [Citation(s) in RCA: 172] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 02/25/2020] [Indexed: 02/05/2023]
Abstract
The primary structural component of the bacterial cell wall is peptidoglycan, which is essential for viability and the synthesis of which is the target for crucial antibiotics1,2. Peptidoglycan is a single macromolecule made of glycan chains crosslinked by peptide side branches that surrounds the cell, acting as a constraint to internal turgor1,3. In Gram-positive bacteria, peptidoglycan is tens of nanometres thick, generally portrayed as a homogeneous structure that provides mechanical strength4-6. Here we applied atomic force microscopy7-12 to interrogate the morphologically distinct Staphylococcus aureus and Bacillus subtilis species, using live cells and purified peptidoglycan. The mature surface of live cells is characterized by a landscape of large (up to 60 nm in diameter), deep (up to 23 nm) pores constituting a disordered gel of peptidoglycan. The inner peptidoglycan surface, consisting of more nascent material, is much denser, with glycan strand spacing typically less than 7 nm. The inner surface architecture is location dependent; the cylinder of B. subtilis has dense circumferential orientation, while in S. aureus and division septa for both species, peptidoglycan is dense but randomly oriented. Revealing the molecular architecture of the cell envelope frames our understanding of its mechanical properties and role as the environmental interface13,14, providing information complementary to traditional structural biology approaches.
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Affiliation(s)
- L Pasquina-Lemonche
- Krebs Institute, University of Sheffield, Sheffield, UK
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
- The Florey Institute, University of Sheffield, Sheffield, UK
| | - J Burns
- Krebs Institute, University of Sheffield, Sheffield, UK
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
| | - R D Turner
- Krebs Institute, University of Sheffield, Sheffield, UK
- Department of Molecular Biology and Biotechnology, University of Sheffield, Sheffield, UK
- Department of Computer Science, University of Sheffield, Sheffield, UK
| | - S Kumar
- Krebs Institute, University of Sheffield, Sheffield, UK
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
- Department of Biochemistry, University of Oxford, Oxford, UK
| | - R Tank
- Krebs Institute, University of Sheffield, Sheffield, UK
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
| | - N Mullin
- Krebs Institute, University of Sheffield, Sheffield, UK
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
| | - J S Wilson
- Krebs Institute, University of Sheffield, Sheffield, UK
- Department of Molecular Biology and Biotechnology, University of Sheffield, Sheffield, UK
| | - B Chakrabarti
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
| | - P A Bullough
- Krebs Institute, University of Sheffield, Sheffield, UK
- Department of Molecular Biology and Biotechnology, University of Sheffield, Sheffield, UK
| | - S J Foster
- Krebs Institute, University of Sheffield, Sheffield, UK.
- The Florey Institute, University of Sheffield, Sheffield, UK.
- Department of Molecular Biology and Biotechnology, University of Sheffield, Sheffield, UK.
| | - J K Hobbs
- Krebs Institute, University of Sheffield, Sheffield, UK.
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK.
- The Florey Institute, University of Sheffield, Sheffield, UK.
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Geiger PC, Deng F, Miller J, Morris J, Vidoni E, Burns J. Exercise‐enriched extracellular vesicles benefit brain health by decreasing protein aggregation. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.06515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Burns J, Boogaard H, Polus S, Pfadenhauer LM, Rohwer AC, van Erp AM, Turley R, Rehfuess EA. Interventions to reduce ambient air pollution and their effects on health: An abridged Cochrane systematic review. Environ Int 2020; 135:105400. [PMID: 31855800 DOI: 10.1016/j.envint.2019.105400] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/11/2019] [Accepted: 12/06/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND A broad range of interventions have been implemented to improve ambient air quality, and many of these have been evaluated. Yet to date no systematic review has been conducted to identify and synthesize these studies. In this systematic review, we assess the effectiveness of interventions in reducing ambient particulate matter air pollution and improving adverse health outcomes. METHODS We searched a range of electronic databases across multiple disciplines, as well as grey literature databases, trial registries, reference lists of included studies and the contents of relevant journals, through August 2016. Eligible for inclusion were randomized and cluster randomized controlled trials, as well as several non-randomized study designs often used for evaluating air quality interventions. We included studies that evaluated interventions targeting industrial, residential, vehicular and multiple sources, with respect to their effect on mortality, morbidity and the concentrations of particulate matter (PM - including PM10, PM2.5, coarse particulate matter and combustion-related PM), as well as several criteria pollutants, including ozone, carbon monoxide, nitrogen oxides, nitrogen dioxide, nitric oxide and sulphur dioxide. We did not restrict studies based on the population, setting or comparison. Two authors independently assessed studies for inclusion, extracted data and assessed risk of bias. We assessed risk of bias using the Graphic Appraisal Tool for Epidemiological studies (GATE) for correlation studies, as modified and employed by the UK National Institute for Health and Care Excellence. We synthesized evidence narratively, as well as graphically using harvest plots. We assessed the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. RESULTS We included 42 studies assessing 38 unique interventions. These comprised a heterogeneous mix of interventions, including those aiming to address industrial sources (n = 5; e.g. the closure of a factory), residential sources (n = 7; e.g. coal ban), vehicular sources (n = 22; e.g. low emission zones), and multiple sources (n = 4; e.g. tailored measures that target both local traffic and industrial polluters). Evidence for effectiveness was mixed. Most included studies observed either no significant association or an association favoring the intervention, with little evidence that the assessed interventions might be harmful. CONCLUSIONS Given the heterogeneity across interventions, outcomes, and methods, it was difficult to derive overall conclusions regarding the effectiveness of interventions in terms of improved air quality or health. Some evidence suggests that interventions are associated with improvements in air quality and human health, with very little evidence suggesting interventions were harmful. The evidence base highlights the challenges related to establishing the effectiveness of specific air pollution interventions on outcomes. It also points to the need for improved study design and analysis methods, as well as more uniform evaluations. The prospective planning of evaluations and an evaluation component built into the design and implementation of interventions may also be particularly beneficial.
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Affiliation(s)
- J Burns
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Germany; Pettenkofer School of Public Health, LMU Munich, Germany.
| | - H Boogaard
- Health Effects Institute, Boston, MA, USA
| | - S Polus
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Germany; Pettenkofer School of Public Health, LMU Munich, Germany
| | - L M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Germany; Pettenkofer School of Public Health, LMU Munich, Germany
| | - A C Rohwer
- Centre for Evidence-based Health Care, Division Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - R Turley
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
| | - E A Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Germany; Pettenkofer School of Public Health, LMU Munich, Germany
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Burns J, Roby A, Jaconelli T. Pneumomediastinum, subcutaneous emphysema and pneumorrhachis following cocaine insufflation: a case report. Acute Med 2020; 19:154-158. [PMID: 33020760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A case report on a 36-year-old male patient presenting to the emergency department (ED) with chest tightness, nasal sounding voice and subcutaneous emphysema 72 hours after the nasal insufflation of approximately 0.5g of cocaine. A plain radiograph of the chest demonstrated an extensive pneumomediastinum with subcutaneous emphysema extending into his neck. A computerised tomography (CT) scan confirmed the above findings, along with a pneumorrhachis of the thoracic spine. He was admitted locally for further investigation and observation. Cocaine is the second most used illicit drug in the UK. The associated complications of cocaine can vary from acute coronary syndrome to acute psychosis. Pulmonological trauma secondary to cocaine misuse is commonly associated with inhalation of cocaine; we present this rare case of subcutaneous emphysema, pneumomediastinum and pneumorrhachis secondary to nasal insufflation. It is believed that deep nasal insufflation of cocaine is followed by forceful Valsalva manoeuvre, which allows for the rapid absorption of the drug and increases the euphoric effect. This forceful inhalation can lead to barotrauma and leakage of air into the posterior mediastinum.
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Affiliation(s)
- J Burns
- Department of Emergency Medicine, York Teaching Hospitals NHS Foundation Trust
| | - A Roby
- Department of Emergency Medicine, York Teaching Hospitals NHS Foundation Trust
| | - T Jaconelli
- Department of Emergency Medicine, York Teaching Hospitals NHS Foundation Trust
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Torkamani N, Churilov L, Robbins R, Jerums G, Beik V, Radcliffe N, Patterson S, Bellomo R, Burns J, Hart GK, Lam Q, Power DA, MacIsaac RJ, Johnson DF, Zajac J, Ekinci EI. Diabetes and higher HbA1c levels are independently associated with adverse renal outcomes in inpatients following multiple hospital admissions. J Diabetes Complications 2020; 34:107465. [PMID: 31735639 DOI: 10.1016/j.jdiacomp.2019.107465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/02/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess the association between glycaemic status prior to the first hospital presentation with developing adverse renal outcomes overtime in patients with multiple hospital re-admissions. DESIGN A prospective observational cohort study. PARTICIPANTS All inpatients aged ≥54 years admitted between 2013 and 16 to a tertiary hospital. MAIN OUTCOMES We prospectively measured HbA1c levels in all inpatients aged ≥54 years admitted between 2013 and 16. Diabetes was defined as prior documented diagnosis of diabetes and/or HbA1c ≥6.5% (47·5 mmol/L). Included patients had ≥ two admissions (at least 90 days apart), baseline estimated glomerular filtration rate (eGFR) >30 ml/min/1·73m2 and no history of renal replacement therapy. We assessed several renal outcomes: (a) 50% decline in eGFR; (b) rapid decline in renal function (eGFR decline >5 mL/min/1·73m2/year) and (c) final eGFR<30 ml/min/1·73m2. RESULTS Of 4126 inpatients with a median follow-up of 465 days (254, 740), 26% had diabetes. The presence of diabetes was associated with higher odds of (a) 50% decline in eGFR (OR = 1·42;95% CI:1·18-1·70;p < 0·001); (b) rapid decline in renal function (OR = 1·40;95%CI:1·20-1·63;p < 0·001), and (c) reaching eGFR<30 ml/min/1.73m2 (OR = 1·25;95%CI:1·03-1·53;p < 0·05). Every 1% (11 mmol/L) increase in baseline HbA1c was associated with significantly greater odds of (a) >50% decline in eGFR (OR = 1·07;95% CI:1·01-1·4;p < 0·05) and (b) rapid decline in renal function (OR = 1·11;95% CI:1·05-1·18;p < 0·001). CONCLUSIONS In patients with ≥two admissions, the presence of diabetes and higher HbA1c levels were strongly and independently associated with adverse renal outcomes at follow up. Such patients are at high risk of relatively rapid deterioration in renal function and a logical target for structured preventive interventions.
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Affiliation(s)
- N Torkamani
- Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia; Department of Endocrinology, Austin Health, Melbourne, Victoria, Australia
| | - L Churilov
- Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
| | - R Robbins
- Department of Administrative Informatics, Austin Health, Heidelberg, Victoria, Australia
| | - G Jerums
- Department of Endocrinology, Austin Health, Melbourne, Victoria, Australia
| | - V Beik
- School of Engineering, RMIT University, Melbourne, Victoria, Australia
| | - N Radcliffe
- Department of General Medicine, Austin Health, Melbourne, Victoria, Australia
| | - S Patterson
- Department of Endocrinology, Austin Health, Melbourne, Victoria, Australia
| | - R Bellomo
- Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, The University of Melbourne, Parkville, Australia
| | - J Burns
- Clinical Informatics Unit, Austin Health, Heidelberg, Victoria, Australia
| | - G K Hart
- Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia; Centre for Digital Transformation of Health, University of Melbourne
| | - Q Lam
- Department of Pathology, Austin Health, Heidelberg, Victoria, Australia
| | - D A Power
- Department of Nephrology, Austin Health, Heidelberg, Victoria, Australia
| | - R J MacIsaac
- Department of Medicine, The University of Melbourne, Parkville, Australia; Department of Endocrinology and Diabetes, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - D F Johnson
- Department of General Medicine, Austin Health, Melbourne, Victoria, Australia; Department of Medicine, The University of Melbourne, Parkville, Australia
| | - J Zajac
- Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia; Department of Endocrinology, Austin Health, Melbourne, Victoria, Australia
| | - E I Ekinci
- Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia; Department of Endocrinology, Austin Health, Melbourne, Victoria, Australia.
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Strauss SB, Gordon SR, Burns J, Bello JA, Slasky SE. Differentiation between Tuberculous and Pyogenic Spondylodiscitis: The Role of the Anterior Meningovertebral Ligament in Patients with Anterior Epidural Abscess. AJNR Am J Neuroradiol 2019; 41:364-368. [PMID: 31831466 DOI: 10.3174/ajnr.a6370] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/03/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Differentiation between tuberculous and pyogenic spondylodiscitis is a diagnostic challenge because imaging often does not reliably distinguish the 2 entities and percutaneous biopsies are often culture-negative. The purpose of this study was to determine whether violation of the anterior meningovertebral ligament in the setting of anterior epidural abscess discriminates between these entities. MATERIALS AND METHODS This was a retrospective cohort study of all patients with acid-fast bacillus testing and anterior epidural abscess diagnosed on spinal MR imaging between May 2014 and September 2019, with a final diagnosis of tuberculous or pyogenic spondylodiscitis. Six cases of tuberculous spondylodiscitis (mean age, 45.5 years; 80% male) and 35 cases of pyogenic spondylodiscitis were evaluated (mean age, 56.6 years; 49% male). Demographic characteristics were recorded. Cases were assessed for anterior meningovertebral ligament destruction on MR imaging, as demonstrated by the shape of the epidural collection. Segmental location of the infection was also assessed. Independent 2-sample t tests and χ2 tests of independence were performed to evaluate the significance of the difference between the groups. RESULTS Five of 6 (83.3%) cases of tuberculous epidural abscess had an intact anterior meningovertebral ligament, and 0/35 cases of pyogenic epidural abscess demonstrated an intact ligament (P < .001). The presence of an intact anterior meningovertebral ligament had 83.3% sensitivity and 100% specificity for tuberculous spondylodiscitis, a 100% positive predictive value, and a 97.2% negative predictive value. CONCLUSIONS The presence of an intact anterior meningovertebral ligament has high sensitivity and specificity for tuberculous spondylodiscitis-associated epidural abscess, though these results should be validated in a larger sample.
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Affiliation(s)
- S B Strauss
- From the Department of Radiology (S.B.S.), Weill Cornell Medical Center, New York, New York
| | - S R Gordon
- Department of Radiology (S.R.G., J.B., J.A.B., S.E.S.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - J Burns
- Department of Radiology (S.R.G., J.B., J.A.B., S.E.S.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - J A Bello
- Department of Radiology (S.R.G., J.B., J.A.B., S.E.S.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - S E Slasky
- Department of Radiology (S.R.G., J.B., J.A.B., S.E.S.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
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Watts A, Vidoni E, Morris J, Perry M, Johnson D, Burns J. COGNITIVE PERFORMANCE, EXERCISE, AND AMYLOID BURDEN: A RANDOMIZED CONTROLLED TRIAL. Innov Aging 2019. [PMCID: PMC6841468 DOI: 10.1093/geroni/igz038.2272] [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
Exercise is a promising strategy for prevention of Alzheimer’s disease (AD). Amyloid neuroimaging can identify individuals at risk of developing AD prior to displaying symptoms. We screened adults (65+) with Florbetapir PET imaging and a comprehensive cognitive battery. We randomized 117 participants with normal cognition into a 52-week aerobic exercise program to examine the effects of aerobic exercise on cognitive performance. We compared an intensive exercise treatment group to a standard of care control group. Cognition was assessed at baseline, 26 weeks, and 52 weeks in the domains of verbal memory, visuospatial processing, attention, and executive function. Interim results on 87 participants show cardiorespiratory fitness improved in the exercise group vs. control group (t=3.66(81), p< .001). The degree of change in cardiorespiratory fitness did not differ between those with and without elevated amyloid (t=-0.37(81), p=.710). Greater improvements in cardiorespiratory fitness predicted better performance on cognitive tests including trailmaking test, Stroop test, and digit symbol substitution test, which did not differ by amyloid status. Elevated amyloid levels predicted lower cognitive scores in logical memory, space relations, and identical pictures test. Our findings suggest PET imaging is a valid marker of cognitive performance in non-impaired older adults, and that this pre-clinical amyloid status did not reduce the cognitive benefits of exercise for those who improved in cardiorespiratory fitness. Exercise interventions hold promise for cognitive maintenance among pre-symptomatic older adults with elevated amyloid levels. Finally, results highlight the importance of evaluating multiple cognitive domains which are associated differently with exercise and amyloid status.
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Affiliation(s)
- Amber Watts
- University of Kansas, Lawrence, Kansas, United States
| | - Eric Vidoni
- University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Jill Morris
- University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Mark Perry
- University of Kansas Medical Center, Kansas City, Kansas, United States
| | | | - Jeffrey Burns
- University of Kansas Medical Center, Kansas City, Kansas, United States
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Mairghani M, Elmusharaf K, Patton D, Burns J, Eltahir O, Jassim G, Moore Z. The prevalence and incidence of diabetic foot ulcers among five countries in the Arab world: a systematic review. J Wound Care 2019; 26:S27-S34. [PMID: 28880754 DOI: 10.12968/jowc.2017.26.sup9.s27] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE There is a rising incidence of diabetes worldwide; however there seems to be a higher incidence and prevalence rates in the Arab world when compared with the global average. 1 Out of the top 10 countries with the highest prevalence rates, six are Arab countries and almost 20.5 million people in that part of the world live with diabetes. Despite this, published scientific research from the 22 Arab countries is limited and seems to be of lower quality when compared with the rest of the developed world. 2 Therefore, our aim was to explore the contribution of the different Arab countries in the world literature, to identify the diabetic foot ulcer (DFU) prevalence and incidence rates and to quality appraise these studies. METHOD A systematic review, following PRISMA guidelines, was undertaken to identify the incidence and prevalence of DFUs in the Arab world. The following databases were searched: PubMed, Embase CINAHL, Web of Science (Scopus), Global Health and EBSCO Results: A total of nine papers were identified. The mean prevalence of DFU in Saudi Arabia was 11.85% (4.7-19%), in Egypt was 4.2% (1-7.4%), in Jordan was 4.65% (4-5.3%), in Bahrain was 5.9% and in Iraq was 2.7%. A single study identified DFU incidence in Saudi Arabia as 1.8% between 2009-2010. CONCLUSION The mean prevalence rates of DFU were highest in Saudi Arabia and Bahrain and lowest in Iraq. Saudi Arabia had the only reported incidence study, thus findings could not be compared to other countries of the Arab world. There were no studies identified during our search reporting prevalence rates of DFU in 17 of the 22 Arab countries. It is clear that further research is required to determine the incidence and prevalance of DFUs in the Arab world and that progress is needed in order to improve the quality of research conducted in those countries.
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Affiliation(s)
- M Mairghani
- PhD Scholar, Royal College of Surgeons in Ireland, Dublin.,Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - K Elmusharaf
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - D Patton
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - J Burns
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - O Eltahir
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - G Jassim
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
| | - Z Moore
- Senior Lecturer in Public Health at University of Limerick, Graduate Entry Medical School, University of Limerick.,Director of Research, Senior Lecturer, Royal College of Surgeons in Ireland, Dublin.,Research Officer, Royal College of Surgeons in Ireland, Dublin.,Royal College of Surgeons in Ireland, Dublin.,Senior lecturer in Family Medicine, Royal College of Surgeons in Ireland, Bahrain.,Professor of Nursing, Head of Department, Royal College of Surgeons in Ireland, Dublin
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Perales-Puchalt J, Vidoni ML, Rodríguez JL, Vidoni ED, Billinger S, Burns J, Guerchet M, Lee M. Cardiovascular health and dementia incidence among older adults in Latin America: Results from the 10/66 study. Int J Geriatr Psychiatry 2019; 34:1041-1049. [PMID: 30908765 PMCID: PMC6579616 DOI: 10.1002/gps.5107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 03/17/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Growing evidence shows that cardiovascular health (CVH) is associated with brain health. Little is known about this topic among older adults in Latin America, where the number of people living with dementia is rising. This study aimed to assess the longitudinal association between CVH and dementia in six Latin American countries. METHODS We analyzed longitudinal data from the 10/66 study that included nondementia residents at baseline aged 65+ in six Latin American countries (n = 6447) and were followed up for 3 years. An index of modifiable CVH factors (ranging from 0 to 14) was calculated. Incident dementia was modeled using competing risk regression to adjust for risk of death. RESULTS The sample included 6.2% participants with poor (0-5), 81.0% with moderate (6-10), and 12.8% with ideal CVH (11-14). At follow-up, 9.4% had developed dementia and 13.1% had died. Compared with those with poor CVH, participants with moderate and ideal levels of CVH had a significantly lower risk of dementia in both the unadjusted (subhazard ratio for moderate, 0.77; ideal, 0.59) and adjusted models (moderate, 0.73; ideal, 0.66). CONCLUSION Moderate and ideal levels of CVH in old age may protect against dementia incidence. These findings may inform health promotion efforts within dementia national plans adopted recently in some Latin American countries.
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Affiliation(s)
| | | | - Juan Llibre Rodríguez
- Facultad de Medicina Finley-Albarrán, Universidad de Ciencias Médicas de la Habana, Habana, 11500, Cuba
| | - Eric D Vidoni
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA
| | - Sandra Billinger
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Jeffrey Burns
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA
| | - Maëlenn Guerchet
- King’s College London, Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, United Kingdom
| | - MinJae Lee
- The University of Texas Health Science Center at Houston, McGovern Medical School; Houston, TX 77030, USA
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Perdomo SJ, Ward J, Liu Y, Vidoni ED, Witte E, Sisante JF, Kirkendoll K, Burns J, Billinger SA. Cardiovascular Disease Risk Influences Cerebrovascular Regulation in Older Adults. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000560494.36855.02] [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: 11/21/2022]
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Perales-Puchalt J, Gauthreaux K, Flatt J, Teylan MA, Resendez J, Kukull WA, Chan KCG, Burns J, Vidoni ED. Risk of dementia and mild cognitive impairment among older adults in same-sex relationships. Int J Geriatr Psychiatry 2019; 34:828-835. [PMID: 30864178 PMCID: PMC6502266 DOI: 10.1002/gps.5092] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 03/05/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Sexual minority discrimination might lead to a higher risk of mild cognitive impairment (MCI) and dementia. The aim of this study was to assess the risk of MCI and dementia between older adults in same-sex relationships (SSR) and opposite-sex relationships (OSR). METHODS We analyzed longitudinal data from the National Alzheimer's Coordinating Center up to September 2017. Analyses included cognitively normal individuals 55+ at baseline who had a spouse, partner, or companion as study partner at any assessment. Associations were calculated using survival analysis adjusting for demographics and APOE-e4 carrier status. RESULTS Hazard ratios of MCI and dementia did not differ statistically between SSR and OSR individuals in the total sample nor stratified by sex. CONCLUSION The lack of association between SSR and MCI and dementia warrants future research into their potential resilience mechanisms and the inclusion of sexual minority status questions in research and surveillance studies. The potential recruitment bias caused by nonprobabilistic sampling of the cohort and the reporting and ascertainment bias caused by using SSR to infer sexual minority status may have influenced our findings.
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Affiliation(s)
- Jaime Perales-Puchalt
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA; 913-588-3716,
| | - Kathryn Gauthreaux
- University of Washington, Department of Epidemiology, National Alzheimer’s Coordinating Center, Seattle, WA 98195, USA; 206-616-5647,
| | - Jason Flatt
- University of California San Francisco, Institute for Health Aging, San Francisco, CA 94143, USA; 415-476-9477,
| | - Merilee Ann Teylan
- University of Washington, Department of Epidemiology, National Alzheimer’s Coordinating Center, Seattle, WA 98195. USA; 206-616-6208,
| | - Jason Resendez
- LatinosAgainstAlzheimer’s Coalition; UsAgainstAlzheimer’s; 2 Wisconsin Circle, Suite 700, Chevy Chase, MD, 20815, USA; 202-280-0884,
| | - Walter A Kukull
- University of Washington, Department of Epidemiology, National Alzheimer’s Coordinating Center, Seattle, WA 98195, USA; 206-616-1765,
| | - Kwun CG Chan
- University of Washington, Department of Biostatistics, National Alzheimer’s Coordinating Center, Seattle, WA 98195, USA; 206-685-9177,
| | - Jeffrey Burns
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA; 913-588-0970,
| | - Eric D Vidoni
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA; 913-588-5312,
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Wolter D, Onchiri F, Emerson J, Precit M, Lee M, McNamara S, Nay L, Blackledge M, Uluer A, Mann M, Orenstein D, Hoover W, Burns J, Hoffman L. ePS6.01 Prevalence and clinical significance of Staphylococcus aureus smallcolony variants: a prospective longitudinal, multicentre study. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Szabo-Reed AN, Vidoni E, Binder EF, Burns J, Cullum CM, Gahan WP, Gupta A, Hynan LS, Kerwin DR, Rossetti H, Stowe AM, Vongpatanasin W, Zhu DC, Zhang R, Keller JN. Rationale and methods for a multicenter clinical trial assessing exercise and intensive vascular risk reduction in preventing dementia (rrAD Study). Contemp Clin Trials 2019; 79:44-54. [PMID: 30826452 PMCID: PMC6436980 DOI: 10.1016/j.cct.2019.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/28/2019] [Accepted: 02/13/2019] [Indexed: 12/29/2022]
Abstract
Alzheimer's Disease (AD) is an age-related disease with modifiable risk factors such as hypertension, hypercholesterolemia, obesity, and physical inactivity influencing the onset and progression. There is however, no direct evidence that reducing these risk factors prevents or slows AD. The Risk Reduction for Alzheimer's Disease (rrAD) trial is designed to study the independent and combined effects of intensive pharmacological control of blood pressure and cholesterol and exercise training on neurocognitive function. Six hundred and forty cognitively normal older adults age 60 to 85 years with hypertension and increased risk for dementia will be enrolled. Participants are randomized into one of four intervention group for two years: usual care, Intensive Reduction of Vascular Risk factors (IRVR) with blood pressure and cholesterol reduction, exercise training (EX), and IRVR+EX. Neurocognitive function is measured at baseline, 6, 12, 18, and 24 months; brain MRIs are obtained at baseline and 24 months. We hypothesize that both IRVR and EX will improve global cognitive function, while IRVR+EX will provide a greater benefit than either IRVR or EX alone. We also hypothesize that IRVR and EX will slow brain atrophy, improve brain structural and functional connectivity, and improve brain perfusion. Finally, we will explore the mechanisms by which study interventions impact neurocognition and brain. If rrAD interventions are shown to be safe, practical, and successful, our study will have a significant impact on reducing the risks of AD in older adults. NCT Registration: NCT02913664.
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Affiliation(s)
- Amanda N Szabo-Reed
- KU Alzheimer's Disease Center, Fairway, KS, USA; Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Eric Vidoni
- KU Alzheimer's Disease Center, Fairway, KS, USA; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Ellen F Binder
- Department of Internal Medicine, Division of Geriatrics & Nutritional Science, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
| | - Jeffrey Burns
- KU Alzheimer's Disease Center, Fairway, KS, USA; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.
| | - C Munro Cullum
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA; Department of Neurology & Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA.
| | - William P Gahan
- Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | - Aditi Gupta
- KU Alzheimer's Disease Center, Fairway, KS, USA; Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Linda S Hynan
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA; Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Diana R Kerwin
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, USA; Kerwin Research Center and Memory Care, Dallas, TX, USA.
| | - Heidi Rossetti
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Ann M Stowe
- Department of Neurology, University of Kentucky, Lexington, KY, USA.
| | - Wanpen Vongpatanasin
- Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | - David C Zhu
- Department for Radiology, Michigan State University, East Lansing, MI, USA.
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, USA; Department of Neurology & Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA.
| | - Jeffrey N Keller
- Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA, USA.
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Zafonte SJ, Rafkin L, Sosenko JM, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Dixit S, Pasha M, King K, Adcock H, Atterberry L, Fox K, Englert N, Mauras J, Permuy K, Sikes T, Adams T, Berhe B, Guendling L, McLennan L, Paganessi C, Murphy M, Draznin M, Kamboj S, Sheppard V, Lewis L, Coates W, Amado D, Moore G, Babar J, Bedard D, Brenson-Hughes J, Cernich M, Clements R, Duprau S, Goodman L, Hester L, Huerta-Saenz A, Asif I, Karmazin T, Letjen S, Raman D, Morin W, Bestermann E, Morawski J, White A, Brockmyer R, Bays S, Campbell A, Boonstra M, Stapleton N, Stone A, Donoho H, Everett H, Hensley M, Johnson C, Marshall N, Skirvin P, Taylor R, Williams L, Burroughs C, Ray C, Wolverton D, Nickels C, Dothard P, Speiser M, Pellizzari L, Bokor K, Izuora S, Abdelnour P, Cummings S, Cuthbertson D, Paynor M, Leahy M, Riedl S, Shockley R, Saad T, Briones S, Casella C, Herz K, Walsh J, Greening F, Deemer M, Hay S, Hunt N, Sikotra L, Simons D, Karounos R, Oremus L, Dye L, Myers D, Ballard W, Miers R, Eberhard C, Sparks K, Thraikill K, Edwards J, Fowlkes S, Kemp A, Morales L, Holland L, Johnson P, Paul A, Ghatak K, Fiske S, Phelen H, Leyland T, Henderson D, Brenner E, Oppenheimer I, Mamkin C, Moniz C, Clarson M, Lovell A, Peters V, Ford J, Ruelas D, Borut D, Burt M, Jordan S, Castilla P, Flores M, Ruiz L, Hanson J, Green-Blair R, Sheridan K, Garmeson J, Wintergerst G, Pierce A, Omoruyi M, Foster S, Kingery A, Lunsford I, Cervantes T, Parker P, Price J, Urben I, Guillette H, Doughty H, Haydock V, Parker P, Bergman S, Duncum C, Rodda A, Perelman R, Calendo C, Barrera E, Arce-Nunez Y, Geyer S, Martinez M, De la Portilla I, Cardenas L, Garrido M, Villar R, Lorini E, Calandra G, D’Annuzio K, Perri N, Minuto C, Hays B, Rebora R, Callegari O, Ali J, Kramer B, Auble S, Cabrera P, Donohoue R, Fiallo-Scharer M, Hessner P, Wolfgram A, Henderson C, Kansra N, Bettin R, McCuller A, Miller S, Accacha J, Corrigan E, Fiore R, Levine T, Mahoney C, Polychronakos V, Henry M, Gagne H, Starkman M, Fox D, Chin F, Melchionne L, Silverman I, Marshall L, Cerracchio J, Cruz A, Viswanathan J, Heyman K, Wilson S, Chalew S, Valley S, Layburn A, Lala P, Clesi M, Genet G, Uwaifo A, Charron T, Allerton W, Hsiao B, Cefalu L, Melendez-Ramirez R, Richards C, Alleyn E, Gustafson M, Lizanna J, Wahlen S, Aleiwe M, Hansen H, Wahlen C, Karges C, Levy A, Bonaccorso R, Rapaport Y, Tomer D, Chia M, Goldis L, Iazzetti M, Klein C, Levister L, Waldman E, Keaton N, Wallach M, Regelmann Z, Antal M, Aranda C, Reynholds A, Vinik P, Barlow M, Bourcier M, Nevoret J, Couper S, Kinderman A, Beresford N, Thalagne H, Roper J, Gibbons J, Hill S, Balleaut C, Brennan J, Ellis-Gage L, Fear T, Gray L, Law P, Jones C, McNerney L, Pointer N, Price K, Few D, Tomlinson N, Leech D, Wake C, Owens M, Burns J, Leinbach A, Wotherspoon A, Murray K, Short G, Curry S, Kelsey J, Lawson J, Porter S, Stevens E, Thomson S, Winship L, Liu S, Wynn E, Wiltshire J, Krebs P, Cresswell H, Faherty C, Ross L, Denvir J, Drew T, 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Aguirre-Castaneda V, Benavides, Lopez D, Hemp S, Allen J, Stear E, Davis T, O’Donnell R, Jones A, Roberts J, Dart N, Paramalingam L, Levitt Katz N, Chaudhary K, Murphy S, Willi B, Schwartzman C, Kapadia D, Roberts A, Larson D, McClellan G, Shaibai L, Kelley G, Villa C, Kelley R, Diamond M, Kabbani T, Dajani F, Hoekstra M, Sadler K, Magorno J, Holst V, Chauhan N, Wilson P, Bononi M, Sperl A, Millward M, Eaton L, Dean J, Olshan H, Stavros T, Renna C, Milliard, Brodksy L, Bacon J, Quintos L, Topor S, Bialo B, Bancroft A, Soto W, Lagarde H, Tamura R, Lockemer T, Vanderploeg M, Ibrahim M, Huie V, Sanchez R, Edelen R, Marchiando J, Palmer T, Repas M, Wasson P, Wood K, Auker J, Culbertson T, Kieffer D, Voorhees T, Borgwardt L, DeRaad K, Eckert E, Isaacson H, Kuhn A, Carroll M, Xu P, Schubert G, Francis S, Hagan T, Le M, Penn E, Wickham C, Leyva K, Rivera J, Padilla I, Rodriguez N, Young K, Jospe J, Czyzyk B, Johnson U, Nadgir N, Marlen G, Prakasam C, Rieger N, Glaser E, Heiser B, Harris C, Alies P, Foster H, Slater K, Wheeler D, Donaldson M, Murray D, Hale R, Tragus D, Word J, Lynch L, Pankratz W, Badias F, Rogers R, Newfield S, Holland M, Hashiguchi M, Gottschalk A, Philis-Tsimikas R, Rosal S, Franklin S, Guardado N, Bohannon M, Baker A, Garcia T, Aguinaldo J, Phan V, Barraza D, Cohen J, Pinsker U, Khan J, Wiley L, Jovanovic P, Misra M, Bassi M, Wright D, Cohen K, Huang M, Skiles S, Maxcy C, Pihoker K, Cochrane J, Fosse S, Kearns M, Klingsheim N, Beam C, Wright L, Viles H, Smith S, Heller M, Cunningham A, Daniels L, Zeiden J, Field R, Walker K, Griffin L, Boulware D, Bartholow C, Erickson J, Howard B, Krabbenhoft C, Sandman A, Vanveldhuizen J, Wurlger A, Zimmerman K, Hanisch L, Davis-Keppen A, Bounmananh L, Cotterill J, Kirby M, Harris A, Schmidt C, Kishiyama C, Flores J, Milton W, Martin C, Whysham A, Yerka T, Bream S, Freels J, Hassing J, Webster R, Green P, Carter J, Galloway D, Hoelzer S, Roberts S, Said P, Sullivan H, Freeman D, Allen E, Reiter E, Feinberg C, Johnson L, Newhook D, Hagerty N, White L, Levandoski J, Kyllo M, Johnson C, Gough J, Benoit P, Iyer F, Diamond H, Hosono S, Jackman L, Barette P, Jones I, Sills S, Bzdick J, Bulger R, Ginem J, Weinstock I, Douek R, Andrews G, Modgill G, Gyorffy L, Robin N, Vaidya S, Crouch K, O’Brien C, Thompson N, Granger M, Thorne J, Blumer J, Kalic L, Klepek J, Paulett B, Rosolowski J, Horner M, Watkins J, Casey K, Carpenter C, Michelle Kieffer MH, Burns J, Horton C, Pritchard D, Soetaert A, Wynne C, Chin O, Molina C, Patel R, Senguttuvan M, Wheeler O, Lane P, Furet C, Steuhm D, Jelley S, Goudeau L, Chalmers D, Greer C, Panagiotopoulos D, Metzger D, Nguyen M, Horowitz M, Linton C, Christiansen E, Glades C, Morimoto M, Macarewich R, Norman K, Patin C, Vargas A, Barbanica A, Yu P, Vaidyanathan W, Nallamshetty L, Osborne R, Mehra S, Kaster S, Neace J, Horner G, Reeves C, Cordrey L, Marrs T, Miller S, Dowshen D, Oduah V, Doyle S, Walker D, Catte H, Dean M, Drury-Brown B, Hackman M, Lee S, Malkani K, Cullen K, Johnson P, Parrimon Y, Hampton M, McCarrell C, Curtis E, Paul, Zambrano Y, Paulus K, Pilger J, Ramiro J, Luvon Ritzie AQ, Sharma A, Shor A, Song X, Terry A, Weinberger J, Wootten M, Lachin JM, Foulkes M, Harding P, Krause-Steinrauf H, McDonough S, McGee PF, Owens Hess K, Phoebus D, Quinlan S, Raiden E, Batts E, Buddy C, Kirpatrick K, Ramey M, Shultz A, Webb C, Romesco M, Fradkin J, Leschek E, Spain L, Savage P, Aas S, Blumberg E, Beck G, Brillon D, Gubitosi-Klug R, Laffel L, Vigersky R, Wallace D, Braun J, Lernmark A, Lo B, Mitchell H, Naji A, Nerup J, Orchard T, Steffes M, Tsiatis A, Veatch R, Zinman B, Loechelt B, Baden L, Green M, Weinberg A, Marcovina S, Palmer JP, Weinberg A, Yu L, Babu S, Winter W, Eisenbarth GS, Bingley P, Clynes R, DiMeglio L, Eisenbarth G, Hays B, Leschek E, Marks J, Matheson D, Rafkin L, Rodriguez H, Spain L, Wilson D, Redondo M, Gomez D, McDonald A, Pena S, Pietropaolo M, Shippy K, Batts E, Brown T, Buckner J, Dove A, Hammond M, Hefty D, Klein J, Kuhns K, Letlau M, Lord S, McCulloch-Olson M, Miller L, Nepom G, Odegard J, Ramey M, Sachter E, St. Marie M, Stickney K, VanBuecken D, Vellek B, Webber C, Allen L, Bollyk J, Hilderman N, Ismail H, Lamola S, Sanda S, Vendettuoli H, Tridgell D, Monzavi R, Bock M, Fisher L, Halvorson M, Jeandron D, Kim M, Wood J, Geffner M, Kaufman F, Parkman R, Salazar C, Goland R, Clynes R, Cook S, Freeby M, Pat Gallagher M, Gandica R, Greenberg E, Kurland A, Pollak S, Wolk A, Chan M, Koplimae L, Levine E, Smith K, Trast J, DiMeglio L, Blum J, Evans-Molina C, Hufferd R, Jagielo B, Kruse C, Patrick V, Rigby M, Spall M, Swinney K, Terrell J, Christner L, Ford L, Lynch S, Menendez M, Merrill P, Pescovitz M, Rodriguez H, Alleyn C, Baidal D, Fay S, Gaglia J, Resnick B, Szubowicz S, Weir G, Benjamin R, Conboy D, deManbey A, Jackson R, Jalahej H, Orban T, Ricker A, Wolfsdorf J, Zhang HH, Wilson D, Aye T, Baker B, Barahona K, Buckingham B, Esrey K, Esrey T, Fathman G, Snyder R, Aneja B, Chatav M, Espinoza O, 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A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Pugliese A, Sanders-Branca N, Ray Arce LA, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Peterson Eck S, Finney L, Albright Fischer T, Martin A, Jacqueline Muzamhindo C, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, Toledo F, Rodriguez H, Bollepalli S, Diamond F, Eyth E, Henson D, Lenz A, Shulman D, Raskin P, Adhikari S, Dickson B, Dunnigan E, Lingvay I, Pruneda L, Ramos-Roman M, Raskin P, Rhee C, Richard J, Siegelman M, Sturges D, Sumpter K, White P, Alford M, Arthur J, Aviles-Santa ML, Cordova E, Davis R, Fernandez S, Fordan S, Hardin T, Jacobs A, Kaloyanova P, Lukacova-Zib I, Mirfakhraee S, Mohan A, Noto H, Smith O, Torres N, Wherrett D, Balmer D, Eisel L, Kovalakovska R, Mehan M, Sultan F, Ahenkorah B, Cevallos J, Razack N, Jo Ricci M, Rhode A, Srikandarajah M, Steger R, Russell WE, Black M, Brendle F, Brown A, Moore D, Pittel E, Robertson A, Shannon A, Thomas JW, Herold K, Feldman L, Sherwin R, Tamborlane W, Weinzimer S, Toppari J, Kallio T, Kärkkäinen M, Mäntymäki E, Niininen T, Nurmi B, Rajala P, Romo M, Suomenrinne S, Näntö-Salonen K, Simell O, Simell T, Bosi E, Battaglia M, Bianconi E, Bonfanti R, Grogan P, Laurenzi A, Martinenghi S, Meschi F, Pastore M, Falqui L, Teresa Muscato M, Viscardi M, Bingley P, Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, Gardner J, LeBoeuf C, Bell P, McGlore O, Tennet H, Alba N, Carroll M, Baert L, Beaton H, Cordell E, Haynes A, Reed C, Lichter K, McCarthy P, McCarthy S, Monchamp T, Roach J, Manies S, Gunville F, Marosok L, Nelson T, Ackerman K, Rudolph J, Stewart M, McCormick K, May S, Falls T, Barrett T, Dale K, Makusha L, McTernana C, Penny-Thomas K, Sullivan K, Narendran P, Robbie J, Smith D, Christensen R, Koehler B, Royal C, Arthur T, Houser H, Renaldi J, Watsen S, Wu P, Lyons L, House B, Yu J, Holt H, Nation M, Vickers C, Watling R, Heptulla R, Trast J, Agarwal C, Newell D, Katikaneni R, Gardner C, Del A, Rio A, Logan H, Collier C, Rishton G, Whalley A, Ali S, Ramtoola T, Quattrin L, Mastrandea A, House M, Ecker C, Huang C, Gougeon J, Ho D, Pacuad D, Dunger J, May C, O’Brien C, Acerini B, Salgin A, Thankamony R, Williams J, Buse G, Fuller M, Duclos J, Tricome H, Brown D, Pittard D, Bowlby A, Blue T, Headley S, Bendre K, Lewis K, Sutphin C, Soloranzo J, Puskaric H, Madison M, Rincon M, Carlucci R, Shridharani B, Rusk E, Tessman D, Huffman H, Abrams B, Biederman M, Jones V, Leathers W, Brickman P, Petrie D, Zimmerman J, Howard L, Miller R, Alemzadeh D, Mihailescu R, Melgozza-Walker N, Abdulla C, Boucher-Berry D, Ize-Ludlow R, Levy C, Swenson, Brousell N, Crimmins D, Edler T, Weis C, Schultz D, Rogers D, Latham C, Mawhorter C, Switzer W, Spencer P, Konstantnopoulus S, Broder J, Klein L, Knight L, Szadek G, Welnick B, Thompson R, Hoffman A, Revell J, Cherko K, Carter E, Gilson J, Haines G, Arthur B, Bowen W, Zipf P, Graves R, Lozano D, Seiple K, Spicer A, Chang J, Fregosi J, Harbinson C, Paulson S, Stalters P, Wright D, Zlock A, Freeth J, Victory H, Maheshwari A, Maheshwari T, Holmstrom J, Bueno R, Arguello J, Ahern L, Noreika V, Watson S, Hourse P, Breyer C, Kissel Y, Nicholson M, Pfeifer S, Almazan J, Bajaj M, Quinn K, Funk J, McCance E, Moreno R, Veintimilla A, Wells J, Cook S, Trunnel J, Henske S, Desai K, Frizelis F, Khan R, Sjoberg K, Allen P, Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Chapman C, Burns J, Tsodikov A, Chang M, Deville C, Hollenbeck B, Skolarus T. Clinical Predictors and Disparities in Surveillance PSA Utilization after Prostate Cancer Treatment. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1214] [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: 10/28/2022]
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Dionne A, Burns J, Dahdah N, Tremoulet A, Baker A, Son M, Gould P, Fournier A, Newburger J, Friedman K. PRIMARY TREATMENT INTENSIFICATION WITH STEROIDS VERSUS INFLIXIMAB IN PATIENTS WITH CORONARY ARTERY ANEURYSMS AT TIME OF DIAGNOSIS. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Palad YY, Leaver AM, McKay MJ, Baldwin JN, Lunar FRM, Caube FDM, Burns J, Simic M. Knee thrust prevalence and normative hip-knee-ankle angle deviation values among healthy individuals across the lifespan. Osteoarthritis Cartilage 2018; 26:1326-1332. [PMID: 29981835 DOI: 10.1016/j.joca.2018.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 05/23/2018] [Accepted: 06/27/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To report the prevalence of varus thrust and normative values for hip-knee-ankle (HKA) angle deviation across the lifespan, and to explore associations between HKA angle deviation and selected clinical factors. DESIGN This was a cross-sectional observational study of 572 participants from the 1000 Norms Project, aged 3-101 years and who self-reported as being healthy. Video recordings (2D) of frontal plane gait were reviewed by physiotherapists for presence of knee thrust and quantification of HKA angle deviation (the difference between HKA angle at initial contact and mid-stance). Age and sex-stratified normative HKA angle deviation values were presented as means and 95% confidence intervals (CIs). Correlations were calculated between HKA angle and clinical measures (age, sex, body mass index (BMI), alignment, knee and hip strength, Knee Injury and Osteoarthritis Outcomes Scores (KOOS), foot posture index, temporo-spatial gait, and hypermobility). RESULTS Overall, 31% of the cohort had varus thrust, most prevalent among adults older than 60 years (42%) and children aged 3-9 (41%). Varus thrust was common in adolescents (25%) and adults aged 20-59 (23%). Mean HKA angle deviation for the entire cohort was 1.2° (95%CI: 1.07, 1.36) towards varus, and 2.1° (95%CI: 1.84, 2.36) among people with clinical varus thrust. Weak associations were identified between HKA angle deviation and BMI, stride width, and KOOS-Sports among adolescents, and in adults weakly associated with height. CONCLUSIONS Prevalence of varus thrust is common across the lifespan. Normative values established here can be readily used by clinicians and researchers in monitoring this gait deviation.
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Affiliation(s)
- Y Y Palad
- University of the Philippines Manila, College of Allied Medical Professions, Philippines.
| | - A M Leaver
- The University of Sydney, Faculty of Health Sciences, Australia
| | - M J McKay
- The University of Sydney, Faculty of Health Sciences, Australia
| | - J N Baldwin
- Auckland University of Technology, Faculty of Health and Environmental Sciences, New Zealand
| | - F R M Lunar
- University of the Philippines Manila, College of Allied Medical Professions, Philippines
| | - F D M Caube
- University of the Philippines Manila, College of Allied Medical Professions, Philippines
| | - J Burns
- The University of Sydney, Faculty of Health Sciences, Australia; Paediatric Gait Analysis Service of New South Wales, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - M Simic
- The University of Sydney, Faculty of Health Sciences, Australia
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Besser L, Kukull W, Knopman DS, Chui H, Galasko D, Weintraub S, Jicha G, Carlsson C, Burns J, Quinn J, Sweet RA, Rascovsky K, Teylan M, Beekly D, Thomas G, Bollenbeck M, Monsell S, Mock C, Zhou XH, Thomas N, Robichaud E, Dean M, Hubbard J, Jacka M, Schwabe-Fry K, Wu J, Phelps C, Morris JC. Version 3 of the National Alzheimer's Coordinating Center's Uniform Data Set. Alzheimer Dis Assoc Disord 2018; 32:351-358. [PMID: 30376508 PMCID: PMC6249084 DOI: 10.1097/wad.0000000000000279] [Citation(s) in RCA: 218] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 09/04/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION In 2015, the US Alzheimer's Disease Centers (ADC) implemented Version 3 of the Uniform Data Set (UDS). This paper describes the history of Version 3 development and the UDS data that are freely available to researchers. METHODS UDS Version 3 was developed after years of coordination between the National Institute on Aging-appointed Clinical Task Force (CTF), clinicians from ∼30 ADCs, and the National Alzheimer's Coordinating Center (NACC). The CTF recognized the need for updates to align with the state of the science in dementia research, while being flexible to the diverse needs and diseases studied at the ADCs. Version 3 also developed a nonproprietary neuropsychological battery. RESULTS This paper focuses on the substantial Version 3 changes to the UDS forms related to clinical diagnosis and characterization of clinical symptoms to match updated consensus-based diagnostic criteria. Between March 2015 and March 2018, 4820 participants were enrolled using UDS Version 3. Longitudinal data were available for 25,337 of the 37,568 total participants using all UDS versions. DISCUSSION The results from utilization of the UDS highlight the possibility for numerous research institutions to successfully collaborate, produce, and use standardized data collection instruments for over a decade.
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Affiliation(s)
- Lilah Besser
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
- Institute for Healthy Aging and Lifespan Studies and School of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL
| | - Walter Kukull
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | | | - Helena Chui
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, Los Angeles
| | - Douglas Galasko
- Department of Neurosciences, University of California San Diego, La Jolla, CA
| | - Sandra Weintraub
- Departments of Psychiatry and Neurology, and Cognitive Neurology and Alzheimer’s Disease Center, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Gregory Jicha
- Department of Neurology, University of Kentucky, Lexington, KY
| | - Cynthia Carlsson
- Department of Medicine, University of Wisconsin School of Medicine and Public Health; Geriatric Research, Education and Clinical Center, Madison VA Hospital, Madison, WI
| | - Jeffrey Burns
- Department of Neurology, School of Medicine, University of Kansas, Kansas City, KS
| | - Joseph Quinn
- Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR
| | - Robert A. Sweet
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Katya Rascovsky
- Department of Psychiatry, University of Pittsburgh School of Medicine
- Department of Neurology, University of Pittsburgh School of Medicine
- Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Merilee Teylan
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Duane Beekly
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - George Thomas
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Mark Bollenbeck
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Sarah Monsell
- Center for Biomedical Statistics, University of Washington, Seattle, WA
| | - Charles Mock
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Xiao Hua Zhou
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Nicole Thomas
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Elizabeth Robichaud
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Margaret Dean
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Janene Hubbard
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Mary Jacka
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Kristen Schwabe-Fry
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | - Joylee Wu
- Department of Epidemiology, National Alzheimer’s Coordinating Center, University of Washington, Seattle, WA
| | | | | | - John C. Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
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Palad Y, Leaver A, McKay M, Baldwin J, Lunar F, Caube F, Burns J, Simic M. Normative values of knee thrust among healthy individuals across the lifespan. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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