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O'Brien KM, Rix AS, Grove TJ, Sarrimanolis J, Brooking A, Roberts M, Crockett EL. Characterization of the hypoxia-inducible factor-1 pathway in hearts of Antarctic notothenioid fishes. Comp Biochem Physiol B Biochem Mol Biol 2020; 250:110505. [PMID: 32966875 DOI: 10.1016/j.cbpb.2020.110505] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/09/2020] [Accepted: 09/14/2020] [Indexed: 02/06/2023]
Abstract
The ability of Antarctic notothenioid fishes to mount a robust molecular response to hypoxia is largely unknown. The transcription factor, hypoxia-inducible factor-1 (HIF-1), a heterodimer of HIF-1α and HIF-1β subunits, is the master regulator of oxygen homeostasis in most metazoans. We sought to determine if, in the hearts of Antarctic notothenioids, HIF-1 is activated and functional in response to either an acute heat stress or hypoxia. The red-blooded Notothenia coriiceps and the hemoglobinless icefish, Chaenocephalus aceratus, were exposed to their critical thermal maximum (CTMAX) or hypoxia (5.0 ± 0.3 mg of O2 L-1) for 2 h. Additionally, N. coriiceps was exposed to 2.3 ± 0.3 mg of O2 L-1 for 12 h, and red-blooded Gobionotothen gibberifrons was exposed to both levels of hypoxia. Levels of HIF-1α were quantified in nuclei isolated from heart ventricles using western blotting. Transcript levels of genes involved in anaerobic metabolism, and known to be regulated by HIF-1, were quantified by real-time PCR, and lactate levels were measured in heart ventricles. Protein levels of HIF-1α increase in nuclei of hearts of N. coriiceps and C. aceratus in response to exposure to CTMAX and in hearts of N. coriiceps exposed to severe hypoxia, yet mRNA levels of anaerobic metabolic genes do not increase in any species, nor do lactate levels increase, suggesting that HIF-1 does not stimulate metabolic remodeling in hearts of notothenioids under these conditions. Together, these data suggest that Antarctic notothenioids may be vulnerable to hypoxic events, which are likely to increase with climate warming.
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Dipasquale S, Canter B, Roberts M. Integrative Dance for Adults with Down Syndrome: Effects on Postural Stability. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2020; 13:1317-1325. [PMID: 33042366 PMCID: PMC7523910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Postural stability, one's ability to maintain an upright stable position, is a crucial aspect of functional mobility and independent living. The purpose of this study was to examine if integrative dance classes have the potential to improve the postural stability in individuals with Down syndrome (DS). Utilizing a one group design, seven participants with DS were evaluated before and after a 12-week integrative dance class (ClinicalTrials.gov#NCT03660423). Postural stability was evaluated in uni- and bilateral quiet standing using a Wii Balance Board. Stability levels were measured based on changes in center of pressure (CoP) variables. Pre to post changes were found in in CoPx displacement (Z = -2.028, p = 0.043) and average speed (Z = -2.197, p = 0.028) in the eyes closed condition and in CoPy displacement with eyes open (Z = -2.366, p = 0.018). These data indicate improved postural stability following an intervention of integrative dance and a potential for improved functional mobility and decreased fall risk for the participants involved. This preliminary study suggests the need for further research into the effects of integrative dance on postural stability in those with DS and its use as a rehabilitative tool.
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McNaughton J, Roberts M, Smith B, Carlson A, Mathesius C, Roper J, Zimmermann C, Walker C, Huang E, Herman R. Evaluation of broiler performance and carcass yields when fed diets containing maize grain from transgenic product DP-2Ø2216-6. J APPL POULTRY RES 2020. [DOI: 10.1016/j.japr.2020.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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VandeWeerd C, Yalcin A, Aden-Buie G, Wang Y, Roberts M, Mahser N, Fnu C, Fabiano D. HomeSense: Design of an ambient home health and wellness monitoring platform for older adults. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-019-00404-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Mehawed G, Tariq A, Saadat P, Joshi A, Roberts M, Perera M, Rhee H, Yeates A, Mckenzie I, Munns J, Chung E, Heathcote P, Preston J, Lawson M, Wood S, Gustafson S, Miles K, Vela I. Correlation between hybrid PSMA PET MRI and histopathology at radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32890-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Tolaney S, Jerusalem G, Salgado R, Liu X, Chen T, Zhang H, Roberts M, Zardavas D, Prat A. 133TiP A phase II trial of nivolumab + palbociclib + anastrozole in postmenopausal women with ER+/HER2– primary breast cancer: CheckMate 7A8. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Cruz RJ, McGurgan J, Butera L, Poloyac K, Roberts M, Stein W, Minervini M, Jorgensen DR, Humar A. Gastrointestinal Tract Reconstruction in Adults with Ultra-Short Bowel Syndrome: Surgical and Nutritional Outcomes. Surgery 2020; 168:297-304. [PMID: 32139142 DOI: 10.1016/j.surg.2019.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Historically, adults with ultra short bowel syndrome (USBS) have been considered candidates for lifetime parenteral nutrition (PN) or are referred for visceral transplantation. We examined the surgical and nutritional outcomes of adult patients with USBS managed at a single intestinal rehabilitation center. METHODS We retrospectively reviewed data on 588 adult patients referred to our center between January 2013 and December 2018. USBS was defined as residual small bowel (SB) length ≤ 50 cm. RESULTS Forty-five patients (7.6%) with a mean age of 46.7 years (range 17-78) were identified. Indications for enterectomy included mesenteric ischemia (n=17) and internal hernias (n=6), followed by large intraabdominal fibroids, trauma, and allograft enterectomies, with five cases each. Median SB length was 18.0 cm; 20 patients (44.4%) had their entire SB resected. Thirteen patients had an intact colon, of which nine had preservation of the ileocecal valve. Patients who underwent autologous reconstruction of their gastrointestinal (GI) tract required a lower total PN volume (29.0 ± 7.6 vs. 40.8 ± 13.2 ml/Kg/day, p=0.002) and presented better short- and long- term survival (p=0.005). Patients with no gut had higher mortality (p=0.036). Hormonal therapy with the glucagon-like peptide-2 analog teduglutide was used in nine patients (20%) five of whom were weaned off TPN. Excluding patients with no gut (n=20), discontinuation of total PN rate for patients with an end ostomy or tube decompression (n= 6), jejunocolostomy (n= 10), and jejunoileostomy (n=9) were 0%, 40%, and 77.7%, respectively. Eleven patients (44%) with some residual small intestine achieved nutritional autonomy in an average of 20 months after GI reconstruction. Fifteen patients were listed for transplantation (33.3%). Seven patients underwent isolated SB transplantation and achieved nutritional autonomy in an average of three months after transplantation. One-year patient and graft survival were 100%. After a 37-month median follow-up period, 36 of 42 patients followed by our center were still alive (85.7%). CONCLUSION Nutritional autonomy can be achieved in a significant number of patients with USBS in specialized centers with surgical and/or hormonal therapy. The presence of an intact colon and ileocecal valve can significantly increase the adaptation rate. Moreover, restoration of GI tract continuity has a positive impact on medical management and survival.
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Davidson JA, Desouza C, Fonseca V, Frias JP, Van Gaal L, Giorgino F, Chao J, Dex TA, Roberts M, Saremi A, Leiter LA. Glycaemic target attainment in people with Type 2 diabetes treated with insulin glargine/lixisenatide fixed-ratio combination: a post hoc analysis of the LixiLan-O and LixiLan-L trials. Diabet Med 2020; 37:256-266. [PMID: 31365765 PMCID: PMC7003844 DOI: 10.1111/dme.14094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2019] [Indexed: 11/29/2022]
Abstract
AIMS Both fasting (FPG) and postprandial plasma glucose (PPG) contribute to HbA1c levels. We investigated the relationship between achievement of American Diabetes Association (ADA) and American Association of Clinical Endocrinologists (AACE) recommended FPG and/or PPG targets and glycaemic efficacy outcomes in two trials. METHODS In this post hoc analysis, data from participants with Type 2 diabetes in the phase 3 LixiLan-O (NCT02058147) and LixiLan-L (NCT02058160) trials were evaluated to compare the relationship between achievement of society-recommended FPG and/or PPG targets and efficacy (HbA1c change, HbA1c goal attainment, weight change) and safety outcomes in the treatment groups. RESULTS Across treatment arms, iGlarLixi achieved the highest proportion of participants meeting both ADA- and AACE-recommended FPG and PPG targets at study end in both trials. A higher proportion of participants in the iGlarLixi (fixed-ratio combination of insulin glargine and lixisenatide) vs. insulin glargine alone or lixisenatide alone treatment arms achieved HbA1c goals (P < 0.001 for overall comparisons), irrespective of ADA- or AACE-defined targets. Hypoglycaemia rates [any, documented symptomatic (plasma glucose ≤ 3.9 mmol/l), and clinically important (plasma glucose < 3.0 mmol/l)] were low across all groups. Participants treated with iGlarLixi tended to show weight loss or less weight gain compared with participants receiving insulin glargine alone. No differences were observed in average daily basal insulin dose at week 30 between the two treatment arms or across the different FPG and PPG target groups. CONCLUSION Insulin glargine and lixisenatide as a fixed-ratio combination resulted in more participants reaching both FPG and PPG targets, leading to better HbA1c target attainment.
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Brousseau EC, Clarke JG, Dumont D, Stein LAR, Roberts M, van den Berg J. Computer-assisted motivational interviewing for contraceptive use in women leaving prison: A randomized controlled trial. Contraception 2020; 101:327-332. [PMID: 31982416 DOI: 10.1016/j.contraception.2020.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 12/20/2019] [Accepted: 01/05/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Rates of unintended pregnancies in women with a history of incarceration are high and access to contraception before and after arrest can be limited. Individualized counseling can better prepare women for healthy pregnancy or provide an opportunity for contraceptive education and access within correctional facilities. In this study, we assessed the efficacy of motivational interviewing as an individualized intervention to increase the initiation of contraceptive methods while incarcerated and continuation after release in female inmates who wanted to avoid pregnancy for at least one year after release. STUDY DESIGN We performed an RCT in a population of incarcerated women who wanted to avoid pregnancy. Women were randomized to either a computer-assisted motivational interviewing intervention group (n = 119) or an educational video with counseling control group. (n = 113). The primary outcome was initiation of a method of birth control prior to release from the correctional facility. RESULTS Initiation of contraception was higher in the intervention group (56% vs. 42%, p = 0.03), but this difference was not significant after controlling for number of male partners within the year prior to incarceration. There was no difference between the groups in the rates of pregnancies or STIs or continuation of contraception after release, which was generally low (21%). CONCLUSION Computer-assisted motivational interviewing did not improve uptake or continuation of contraception in this study. IMPLICATIONS Periods of incarceration provide an opportunity to offer contraceptive services to women who want to avoid a pregnancy. Motivational interviewing may not be an effective method to affect contraceptive behaviors in this population. Future research should explore the family planning values and preferences of women who become involved with the correctional system.
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Trankle SA, Usherwood T, Abbott P, Roberts M, Crampton M, Girgis CM, Riskallah J, Chang Y, Saini J, Reath J. Integrating health care in Australia: a qualitative evaluation. BMC Health Serv Res 2019; 19:954. [PMID: 31829215 PMCID: PMC6907151 DOI: 10.1186/s12913-019-4780-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 11/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With aging populations, a growing prevalence of chronic illnesses, higher expectations for quality care and rising costs within limited health budgets, integration of healthcare is seen as a solution to these challenges. Integrated healthcare aims to overcome barriers between primary and secondary care and other disconnected patient services to improve access, continuity and quality of care. Many people in Australia are admitted to hospital for chronic illnesses that could be prevented or managed in the community. Western Sydney has high rates of diabetes, heart and respiratory diseases and the NSW State Ministry of Health has implemented key strategies through the Western Sydney Integrated Care Program (WSICP) to enhance primary care and the outcomes and experiences of patients with these illnesses. METHODS We aimed to investigate the WSICP's effectiveness through a qualitative evaluation focused on the 10 WSICP strategies using a framework analysis. We administered 125 in-depth interviews in two rounds over 12 months with 83 participants including patients and their carers, care facilitators, hospital specialists and nurses, allied health professionals, general practitioners (GPs) and primary care nurses, and program managers. Most participants (71%) were interviewed twice. We analysed data within a framework describing how strategies were implemented and used, the experiences around these, their perceived value, facilitators and barriers, and participant-identified suggestions for improvement. RESULTS Care facilitators helped patients access services within the hospital and in primary care and connected general practices with hospital specialists and services. Rapid access and stabilisation clinics with their patient hotlines assisted patients and carers to self-manage chronic illness while connecting GPs to specialists through the GP support-line. Action plans from the hospital informed GPs and their shared care plans which could be accessed by other community health professionals and patients. HealthPathways provided GPs with local, evidence-based guidelines for managing patients. Difficulties persisted in effective widespread access to shared records and electronic communication across sectors. CONCLUSIONS The combined WSICP strategies improved patient and carer experience of healthcare and capacity of GPs to provide care in the community. Information sharing required longer-term investment and support, though benefits were evident by the end of our research.
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Perera M, Papa N, Roberts M, Udovicic C, Vela I, Bolton D, Hofman M, Lawrentschuk N, Murphy D. Clinical utility of PSMA PET in biochemically recurrent prostate cancer: A systematic review and meta-analysis. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/s1569-9056(19)34651-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Schoser B, Kishnani P, Bratkovic D, Byrne B, Clemens P, Goker-Alpan O, Ming X, Roberts M, Schwenkreis P, Sivakumar K, van der Ploeg A, Sitaraman S, Barth J, Lagast H, Mozaffar T. PRECLINICAL APPROACHES AND EARLY CLINICAL RESULTS. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Waheed Q, Khan HM, He T, Roberts M, Gershenson A, Reuter N. Interfacial Aromatics Mediating Cation-π Interactions with Choline-Containing Lipids Can Contribute as Much to Peripheral Protein Affinity for Membranes as Aromatics Inserted below the Phosphates. J Phys Chem Lett 2019; 10:3972-3977. [PMID: 31246477 DOI: 10.1021/acs.jpclett.9b01639] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Membrane-binding interfaces of peripheral proteins are restricted to a small part of their exposed surface, so the ability to engage in strong selective interactions with membrane lipids at various depths in the interface, both below and above the phosphates, is an advantage. Driven by their hydrophobicity, aromatic amino acids preferentially partition into membrane interfaces, often below the phosphates, yet enthalpically favorable interactions with the lipid headgroups, above the phosphate plane, are likely to further stabilize high interfacial positions. Using free-energy perturbation, we calculate the energetic cost of alanine substitution for 11 interfacial aromatic amino acids from 3 peripheral proteins. We show that the involvement in cation-π interactions with the headgroups (i) increases the ΔΔGtransfer as compared with insertion at the same depth without cation-π stabilization and (ii) can contribute at least as much as deeper insertion below the phosphates, highlighting the multiple roles of aromatics in peripheral membrane protein affinity.
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Cho JG, Teoh A, Roberts M, Wheatley J. The prevalence of poor sleep quality and its associated factors in patients with interstitial lung disease: a cross-sectional analysis. ERJ Open Res 2019; 5:00062-2019. [PMID: 31304178 PMCID: PMC6612606 DOI: 10.1183/23120541.00062-2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/14/2019] [Indexed: 01/25/2023] Open
Abstract
Background Many patients with interstitial lung disease (ILD) experience poor sleep quality, which may contribute to decreased quality of life. Sleep disordered breathing is commonly associated with ILD but there is less information on other factors that may contribute to poor sleep quality. Methods We conducted a cross-sectional analysis of 101 patients with a diagnosis of ILD at a pulmonary rehabilitation assessment clinic. We assessed the prevalence of poor sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and performed multivariable logistic regression analysis to determine factors independently associated with poor sleep quality. Results Median forced expiratory volume in 1 s was 64% predicted (interquartile range (IQR) 50–77%) and vital capacity was 62% predicted (IQR 48–78%). 67 (66%) out of 101 patients reported poor sleep quality. The median PSQI was 8 units (IQR 4–11 units). There were no significant differences in physical or physiological parameters including age, sex distribution, body mass index or spirometry values between subjects with good sleep quality and those with poor sleep quality (all p>0.1). Multivariable logistic regression showed that depression (p=0.003) and Epworth Sleepiness Scale (p=0.03) were independently associated with poor sleep quality. Conclusion Poor sleep quality is common in patients with ILD and is independently associated with increasing symptoms of depression and sleepiness. Routine assessment of sleep quality should be undertaken and interventions targeting depression and coexisting sleep disorders may be required in symptomatic patients to determine if sleep quality and ultimately, health-related quality of life improves as a result. Poor sleep quality is common in patients with interstitial lung disease and is independently associated with increasing symptoms of depression and sleepinesshttp://bit.ly/2WeQbzw
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Amin T, Nazmul K, Roberts M, Brumby C, McMahon L. SAT-260 Signal-averaged ECG abnormalities in Chronic Kidney disease. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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NG S, Pascoe E, Johnson D, Hawley C, Polkinghorne K, McDonald S, Clayton P, Rabindranath K, Roberts M, Viecelli A. SAT-053 CENTRE-EFFECTS AND INCIDENT HAEMODIALYSIS VASCULAR ACCESS: A BINATIONAL REGISTRY ANALYSIS. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Amin T, Karim N, Roberts M, McMahon L. SAT-058 Signal-averaged ECG abnormality and mortality in hemodialysis patients: A prospective study. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Englezos J, Desai A, Roberts M, Russell E. SUN-315 CAN ADMINISTRATION OF CLINOLEIC 20% DURING HAEMODIALYSIS ASSIST IN WEIGHT STABILISATION AND WEIGHT GAIN IN MALNOURISHED PATIENTS? Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Redfern J, Hyun K, Singleton A, Hafiz N, Raeside R, Spencer L, Carr B, Caterson I, Cullen J, Ferry C, Santo K, Hayes A, Leung RWM, Raadsma S, Swinbourne J, Cho JG, King M, Roberts M, Kok C, Jenkins C, Chow C. ITM support for patients with chronic respiratory and cardiovascular diseases: a protocol for a randomised controlled trial. BMJ Open 2019; 9:e023863. [PMID: 30826759 PMCID: PMC6430023 DOI: 10.1136/bmjopen-2018-023863] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Simple and scalable strategies are needed to improve 'out-of-hospital' support and management for people living with cardiovascular disease (CVD) and respiratory disease. Text messaging via mobile phones has been shown to be effective in helping promote lifestyle change and is supported by quantitative and qualitative evidence. The aim of this study is to test the effectiveness and implementation of a 6-month text messaging support programme for people with CVD and respiratory disease as an addition to cardiac and pulmonary outpatient rehabilitation. METHODS AND ANALYSIS Pragmatic randomised controlled trial (n=310) to test the effectiveness of a 6-month text message support programme on clinical outcomes in people with CVD and chronic respiratory disease who are attending outpatient cardiac and pulmonary rehabilitation. The study includes a nested process evaluation to inform scalability and implementation across settings. The intervention group will receive a text message support programme comprising five messages per week for 26 weeks and the control group will continue with standard care. The primary outcome is exercise capacity (6 min walk distance). Secondary outcomes include clinical measures (proportion of people meeting the Australian guideline-recommended blood pressure and cholesterol targets), lifestyle outcomes (smoking rates, achievement of national guidelines for nutrition and physical activity), quality of life, mood (Hospital Anxiety and Depression Scale), medication adherence and attendance at and completion of rehabilitation. ETHICS AND DISSEMINATION Primary ethics approval was received from the Sydney Local Health District Hospital Human Research Ethics Committee and associated Governance committees at sites. Results will be disseminated via the usual scientific forums including peer-reviewed publications and presentations at international conferences. At its conclusion, the study will determine the effectiveness and implementation of a simple programme that aims to improve health outcomes and attendance at rehabilitation for people with CVD and chronic respiratory disease. TRIAL REGISTRATION NUMBER ACTRN12616001167459.
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Roberts M, Hayhurst C, Shires J, Northmore T. TM1-2 Diffuse low grade glioma after the 2016 WHO update, seizure characteristics, imaging correlates and outcomes. Journal of Neurology, Neurosurgery and Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectivesSeizures are a common presenting symptom in patients with low grade glioma (LGG). Exact mechanisms of epileptogenesis are unknown and the influence of radiological and histological characteristics are not well studied, particularly after the 2016 WHO reclassification of gliomas. We aimed to define predictors of seizure development and outcome in patients with LGG.DesignRetrospective single institution case series.Subjects63 patients who underwent resection of supratentorial LGG in a single institution, 45 presented with seizures.MethodsRetrospective analysis of patient records to assess seizure outcome and other demographics including radiological variables, tumour characteristics, type of surgery and histology based on the 2016 WHO update.ResultsAfter surgery, 33 patients (73%) who presented with seizures were Engel class I at median follow up of 43 months. Complete and near total resection were associated with improved Engel class compared to subtotal resection. Awake craniotomy gave improved seizure outcomes compared to under general anaesthesia (84% vs 65%). Molecular genetics did not predict seizure outcome. Updated histology did not predict seizures at diagnosis, only tumour heterogeneousity on initial MRI (p=0.043). Tumour volume at presentation impacted EOR but not seizure outcome.ConclusionsSeizure outcome is directly related to EOR. Tumour histology based on molecular genetics did not predict seizure development or outcome. Use of awake craniotomy results in greater EOR and improved Engel class.
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Rodrigues TS, Azraai M, Crosthwaite A, Patel S, Farouque O, Ramchand J, Lim R, Roberts M, Ierino F, Burrell L. The Peguero-Lo Presti Criteria Improve the Sensitivity of the Electrocardiogram to Diagnose Left Ventricular Hypertrophy in Patients with End-Stage Kidney Disease. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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McAlindon T, Roberts M, Driban J, Schaefer L, Haugen IK, Smith SE, Duryea J, Cunha D, Blanco F, Fernández-Garcia JL, Eaton C. Incident hand OA is strongly associated with reduced peripheral blood leukocyte telomere length. Osteoarthritis Cartilage 2018; 26:1651-1657. [PMID: 30172836 PMCID: PMC6345164 DOI: 10.1016/j.joca.2018.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/23/2018] [Accepted: 08/10/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate the relationship of telomere length to the prevalence and incidence of hand osteoarthritis in a longitudinal cohort. DESIGN We conducted a cross-sectional and longitudinal analysis of data from a subset of participants in the Osteoarthritis Initiative (OAI) recruited between February 2004 and May 2006. 274 individuals were eligible for the study based on availability of both baseline and 48-month hand radiographs and peripheral blood leucocyte telomere length data. Mean telomere length of peripheral blood leukocytes (PBL)s from the DNA samples was determined using a validated quantitative polymerase chain reaction (PCR)-based assay, and hand radiographs were analyzed and graded using the Kellgren-Lawrence scale. RESULTS In joint -level analyses, prevalent Interphalangeal Joint Osteoarthritis (IPJOA) was significantly associated with PBL telomere length in the baseline sample in unadjusted analyses (RR = 2.84; 95% CI:0.87-9.29) or in models adjusted for age, sex, and body mass index (aRR = 1.10; 95% CI: 0.96-1.27). The association in crude and adjusted analyses appeared slightly stronger with incident IPJOA, especially in the subset with normal hands at baseline (aRR = 1.62; 95% CI: 1.02-2.57). PBL telomere length was also associated with prevalent HOA at baseline (significant in unadjusted analysis: RR = 1.22; 95% CI 1.06-1.42), but not after adjusting for covariates: aRR = 1.12; 95% CI: 0.96-1.30). The magnitude of association was stronger for incident HOA, especially incident symptomatic HOA (aRR = 1.53; 95% CI: 1.09-2.15). CONCLUSIONS In summary, the results of this exploratory analysis are confirmatory of previous work showing a cross-sectional relationship between telomere length and HOA and add to the field by demonstrating an even stronger association with incident IPJOA, both radiographic and symptomatic.
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Pinargote P, Qureshi R, Salazar W, Roberts M, Eaton C, Snetselaar L, LeBoff M, Manson J, Kato I, LeBlanc ES. 640. Prospective Association of Serum Vitamin D Level with Sepsis-Mortality in Postmenopausal Women: Results From the Women’s Health Initiative. Open Forum Infect Dis 2018. [PMCID: PMC6255439 DOI: 10.1093/ofid/ofy210.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Backgrounds Vitamin D deficiency has been studied in the critically ill, and has been associated with worse morbidity and mortality rates, especially in those admitted with sepsis. Sepsis is a major cause of ICU admissions and accounts for 250,000 deaths per year. Dihydroxyvitamin D can inhibit the production of interleukins, tumor necrosis factor and can also increase the expression of endogenous antimicrobial peptides. This study sought to assess if low serum concentrations of 25(OH)D were associated with higher sepsis mortality rates. Methods This is a prospective study composed of participants from the Women’s health Initiative (WHI) in the Vitamin D/Calcium trial who have been followed for an average of 15 years. The analysis sample consists of participants who had 25(OH)D measured at baseline. Patients with kidney disease and self-reported cancer at enrollment were excluded. Vitamin D deficiency was defined as levels 2 20 ng/mL, which was categorized into severe deficiency [25(OH)D 212 ng/mL] and mild deficiency [25(OH) of 12–20 ng/mL]. Cox proportional hazard model was used to study the association between serum Vitamin D and sepsis mortality. Results 10,814 participants were included in the study (mean age = 64.4 years). At baseline, 49.26% (n = 5,328) of the sample had vitamin D deficiency and of those who died from sepsis, 57.7% (n = 41) where found to be vitamin D deficient. We found statistically significant increased hazard ratios (HR) for sepsis mortality in mild (HR = 1.19; 95% CI 1.00–1.41) and severe vitamin D deficiency (HR = 1.82; 95% CI: 1.50–2.21) in age adjusted and fully adjusted models (Table 1). Conclusion Vitamin D deficiency is associated with increased risk of sepsis mortality in postmenopausal women, which was seen in all ages. A clinical trial evaluating adequate supplementation in patients with sepsis is recommended to assess clinical significance. ![]()
Disclosures All authors: No reported disclosures.
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Roberts M, VandeWeerd C, Roth D, Sappington E, Alluri S, Yalcin A, Lowenkron J. INSIGHTS ON CAREGIVING IN THE VILLAGES, FL: FINDINGS FROM CAREGIVERS PARTICIPATING IN A BRAIN HEALTH CLINICAL TRIAL. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gandley RE, Bregand-White J, Brands J, Tang G, Gorman L, James, Roberts M, Jeyabalan A, Hubel CA. 253. Sublingual microvascular density and glycocalyx barrier dynamics, during and after normal and preeclamptic pregnancy. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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