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Collins S, Jones A, Woodward S, Sturt J. P254 Establishing face validity of the MAGIC programme for people with cystic fibrosis diabetes (CFD). J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30586-5] [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]
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Setchell K, Cathcart F, Beverley Z, Cunningham S, Jones A. WS07.5 Pilot study - exercise response and enjoyment of virtual reality in an inpatient stay. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30204-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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O’Gorman C, Jones A, Thorpy MJ, Tabuteau H. 0739 Efficacy and Safety of AXS-12 in the Treatment of Narcolepsy: Results from a Phase 2, Double-Blind, Placebo-Controlled, Crossover Trial. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Narcolepsy is a chronic, debilitating, neurological disease characterized by excessive daytime sleepiness (EDS), cataplexy, and sleep-wake dysregulation. Existing treatments are limited, provide variable efficacy, and have significant tolerability issues. AXS-12 (reboxetine) is a potent, and highly selective norepinephrine reuptake inhibitor with potential for therapeutic differentiation in narcolepsy.
Methods
The CONCERT study was a Phase 2, double-blind, randomized, placebo-controlled, crossover trial of AXS-12 in narcolepsy subjects exhibiting moderate and severe symptoms of cataplexy and EDS. Subjects were randomized (1:1) to treatment with AXS-12 followed by placebo, or placebo followed by AXS-12. AXS-12 dosing was 8mg/day for week 1, escalated to 10mg/day for week 2. Crossover occurred after a one-week down-titration/washout. The primary endpoint was the change in weekly cataplexy attacks from baseline, averaged over the 2-week treatment period for overall treatment effect. Secondary endpoints included improvements in EDS, cognitive function, sleep quality and sleep-related symptoms.
Results
Twenty-one subjects were randomized. The baseline mean weekly number of cataplexy attacks was 30.0 and mean ESS score was 18.1, reflecting moderate and severe illness on both core symptoms. AXS-12 met the prespecified primary endpoint, demonstrating a statistically significantly greater reduction in the mean number of weekly cataplexy attacks (-13.0 with AXS-12 vs -0.3 with placebo; p<0.001) over 2 weeks of treatment. Statistically significant reductions in EDS were observed for AXS-12 compared to placebo, assessed by changes in the Epworth Sleepiness Scale (-6.0 vs -3.1; p=0.003), number of weekly inadvertent naps (-5.88 vs -0.98; p<0.001). AXS-12 was associated with improved cognitive function (p<0.002) and sleep quality (p<0.007), and reduced night awakenings (p<0.05). Rapidity of effect was observed with significant symptomatic improvements occurring as early as week 1 starting at the lower 8mg dose. AXS-12 was safe and well-tolerated with no serious adverse events or discontinuations due to adverse events.
Conclusion
AXS-12 is a novel approach for the treatment of narcolepsy with the potential for comprehensive clinical symptom management compared to current treatments. In this Phase 2 study, AXS-12 resulted in statistically significant improvements in cataplexy, excessive sleepiness, cognitive function and night awakenings in patients with narcolepsy with a favorable safety profile.
Support
Axsome Therapeutics.
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Jones A, Moore R, McKechnie A. Redeployment to research? Br Dent J 2020; 228:736-737. [PMID: 32444713 PMCID: PMC7243227 DOI: 10.1038/s41415-020-1693-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Jones A, Pryke J. Implementation of a pilot paediatric interdisciplinary x-ray clinic following audit of compliance with the cerebral palsy integrated pathway (CPIP) standards. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.311] [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]
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Jones A. How Big Tobacco uses disruptive tactics to deny child rights to be tobacco-free. Int J Tuberc Lung Dis 2020; 24:470-476. [PMID: 32398195 DOI: 10.5588/ijtld.19.0600] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The denial of children's rights is at the heart of the tobacco industry's interference in health policies. Big Tobacco (composed of the five largest tobacco companies) controls 80% of the global market, and mergers and acquisitions have solidified interference on an industrial scale. Driven by shareholder demand for profits, the industry needs children to replace the sick, the dying and those that have stopped smoking. With no apparent intention of ending their marketing of addictive, lethal products, which kill 8 million people a year, the industry is aggressively releasing new products and using front groups, corporate social responsibility (CSR) and philanthropy to disrupt tobacco control. The industry presents itself as caring about children and positions itself as part of the solution, not the problem. While the interference tactics of Big Tobacco are well documented, their misleading concerns about children (while simultaneously denying their rights) demands a more strategic response, with integrated use of treaties and frameworks to protect children. For this review, searches were conducted between 2015 and 2019 for articles in English referring to tobacco industry tactics that harm child health rights. A narrative synthesis was used to combine the evidence and author's experience in industry reporting. The analysis reveals that the tobacco industry delays interventions to protect children by expanding its use of allied front groups, flooding markets with novel products and disrupting tobacco control policies. To combat this approach, stakeholders in health need to reclaim the child health agenda. A variety of existing mechanisms can be used to develop more integrated and policy coherent reporting processes for protecting current and future generations of children.
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Nadolski A, Vieira JD, Sobrin JA, Kofman AM, Ade PAR, Ahmed Z, Anderson AJ, Avva JS, Basu Thakur R, Bender AN, Benson BA, Bryant L, Carlstrom JE, Carter FW, Cecil TW, Chang CL, Cheshire JR, Chesmore GE, Cliche JF, Cukierman A, de Haan T, Dierickx M, Ding J, Dutcher D, Everett W, Farwick J, Ferguson KR, Florez L, Foster A, Fu J, Gallicchio J, Gambrel AE, Gardner RW, Groh JC, Guns S, Guyser R, Halverson NW, Harke-Hosemann AH, Harrington NL, Harris RJ, Henning JW, Holzapfel WL, Howe D, Huang N, Irwin KD, Jeong O, Jonas M, Jones A, Korman M, Kovac J, Kubik DL, Kuhlmann S, Kuo CL, Lee AT, Lowitz AE, McMahon J, Meier J, Meyer SS, Michalik D, Montgomery J, Natoli T, Nguyen H, Noble GI, Novosad V, Padin S, Pan Z, Paschos P, Pearson J, Posada CM, Quan W, Rahlin A, Riebel D, Ruhl JE, Sayre JT, Shirokoff E, Smecher G, Stark AA, Stephen J, Story KT, Suzuki A, Tandoi C, Thompson KL, Tucker C, Vanderlinde K, Wang G, Whitehorn N, Yefremenko V, Yoon KW, Young MR. Broadband, millimeter-wave antireflection coatings for large-format, cryogenic aluminum oxide optics. APPLIED OPTICS 2020; 59:3285-3295. [PMID: 32400613 DOI: 10.1364/ao.383921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/25/2020] [Indexed: 06/11/2023]
Abstract
We present two prescriptions for broadband ($ {\sim} 77 - 252\;{\rm GHz} $), millimeter-wave antireflection coatings for cryogenic, sintered polycrystalline aluminum oxide optics: one for large-format (700 mm diameter) planar and plano-convex elements, the other for densely packed arrays of quasi-optical elements-in our case, 5 mm diameter half-spheres (called "lenslets"). The coatings comprise three layers of commercially available, polytetrafluoroethylene-based, dielectric sheet material. The lenslet coating is molded to fit the 150 mm diameter arrays directly, while the large-diameter lenses are coated using a tiled approach. We review the fabrication processes for both prescriptions, then discuss laboratory measurements of their transmittance and reflectance. In addition, we present the inferred refractive indices and loss tangents for the coating materials and the aluminum oxide substrate. We find that at 150 GHz and 300 K the large-format coating sample achieves $ (97 \pm 2)\% $ transmittance, and the lenslet coating sample achieves $ (94 \pm 3)\% $ transmittance.
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Ramanathan S, Colemon A, Jones A, Jackson R. Cause and Consequence of
MAGEB2
expression in cancer. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.02272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Perry A, Yevich S, Jones A. Abstract No. 635 Historical review of dosimetric trends in interventional radiology. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Liu X, Jones A, Tam A. Abstract No. 636 Impact of localizer type/sequence and table off-centering on image quality and radiation dose in computed tomography-guided interventional radiology procedures. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.697] [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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Perera D, Jones A. 31 Understanding of Comprehensive Geriatric Assessment Among Fifth Year Medical Students. Age Ageing 2020. [DOI: 10.1093/ageing/afz183.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
There are 191 foundation programme jobs in geriatrics in the North East.1 Students often don’t receive teaching sessions on the comprehensive geriatric assessment (CGA). It is an assessment foundation trainees use on a daily basis on the geriatric ward and the acute take.
Methods
We designed a series of teaching sessions for fifth year medical students, delivered by different members of the multidisciplinary team. A pre- and post-session questionnaire assessed their understanding.
Results
Nine students completed the pre-session questionnaire:22% were able to define CGA11% identified the different components22% identified the target population, the benefits of CGA and the members involved44% offered solutions to obtaining a history from patients with confusion100% identified the barriers to carrying out CGA
Seven students carried out the post session questionnaire; the table below represents the number that answered correctly.
Conclusions
The majority of foundation trainees will have at least one job in geriatric medicine and participate in the acute take. The average age of hospital admissions has been rising for years,2 highlighting the importance of being able to accurately and thoroughly assess the older population. The initial questionnaire demonstrated the limited understanding that fifth year students had on the comprehensive geriatric assessment. Following sessions by different members of the MDT there was clear improvement.
The sessions covered: general overview of CGA; session by the frailty pharmacist; functional assessment by physiotherapy team; cognitive assessment by the dementia and delirium team; and life as an F1 on geriatric medicine. Positive feedback was received, emphasising the improvement in confidence in preparation for foundation training.
References
1. Oriel website: https://www.oriel.nhs.uk/Web/FND.
2. NHS digital Hospital Admitted Patient Care Activity 2015–16.
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Jones A, Mamudu HM, Squires GD. Mortgage possessions, spatial inequality, and obesity in large US metropolitan areas. Public Health 2020; 181:86-93. [PMID: 31978778 DOI: 10.1016/j.puhe.2019.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/29/2019] [Accepted: 11/27/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES As social determinants of health, mortgage possessions (primarily foreclosures in the US context) and housing instability have been associated with certain mental and physical health outcomes at the individual level. However, individual risks of foreclosure and of poor health are spatially patterned. The objective of this study is to examine the extent to which area-specific social and economic characteristics help explain the relationship between mortgage possessions and obesity prevalence in 75 of the 100 most populous US metropolitan areas. STUDY DESIGN This is a cross-sectional study. METHODS The study relies on three sources of data: the Selected Metropolitan/Micropolitan Area Risk Trends (SMART) project, RealtyTrac foreclosure data, and the American Community Survey. Focal social and economic characteristics include foreclosure rates, levels of racial residential segregation, and poverty. Obesity prevalence and several control measures for each metropolitan area are also used. Ordinary least squares regression, weighted using the SMART project data, is used, and statistical significance is set at 0.05. RESULTS The results suggest that mortgage possessions are independently associated with higher obesity prevalence and that foreclosures operate through the specific channel of racial residential segregation and its tie to the racial composition of a metropolitan area. Socio-economic status of an area, and not poverty, is related to foreclosures and obesity prevalence. CONCLUSION Mortgage possessions not only are socio-economic but also have negative health consequences, such as obesity. The findings provide an empirical base for other researchers to uncover the relationships between segregation, mortgage possessions, and obesity at the individual level of analysis. The public health community should be engaged in addressing the issue of foreclosures in the US because the failure to engage may have broad financial and health consequences across large cities.
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Toukhsati S, Jones A, Fletcher S, Milligan D, Kwee J, Justice K, Liu M, Hwang J, Duong V, Galea A, Zheng J, Hare D. 642 Psychological Denial is a Risk Factor for All-Cause Unplanned Rehospitalisations Following Acute Myocardial Infarction. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.649] [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]
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Whiteman I, Jones A, Selvarajah K, De Silva C, Sathiadas G, Umasankar N, Osmond C, Phillips D, Ragunathan R. 747 Poor Domestic Smoke Ventilation is associated With an Increased Risk of Rheumatic Heart Disease in Sri Lankan Children. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.754] [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]
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Eastwood P, Barnes M, Mackay S, Wheatley J, Hillman D, Nguyen XL, Lewis R, Campbell M, Petelle B, Walsh J, Jones A, Palme C, Bizon A, Meslier N, Bertolus C, Maddison K, Laccourreye L, Raux G, Denoncin K, Attali V, Gagnadoux F, Launois S. Bilateral hypoglossal nerve stimulation for treatment of obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fecht D, Jones A, Hill T, Lindfield T, Thomson R, Hansell AL, Shukla R. Inequalities in rural communities: adapting national deprivation indices for rural settings. J Public Health (Oxf) 2019; 40:419-425. [PMID: 28453666 PMCID: PMC6051444 DOI: 10.1093/pubmed/fdx048] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 04/11/2017] [Indexed: 11/16/2022] Open
Abstract
Background Deprivation indices have been widely used in healthcare research and planning in the United Kingdom. Existing indices, however, are dominated by characteristics of urban populations that may be less relevant in capturing the nature of rural deprivation. We explore if deprivation indices can be modified to make them more sensitive to displaying rural disadvantage in England. Methods The analysis focussed on the 2011 Carstairs Index (Carstairs2011) and the 2010 English Index of Multiple Deprivation (IMD2010). We removed all urban areas as identified by the Office for National Statistics Rural–Urban Area Classifications and mapped the Carstairs2011 and IMD2010 across the remaining rural areas using rural-specific quintiles. Results Our method was effective in displaying much greater heterogeneity in rural areas than was apparent in the original indices. We received positive feedback from Directors of Public Health who confirmed that the observed patterns mirror their experiences and first-hand knowledge on the ground. Conclusions Our maps of Carstairs2011 and IMD2010 for rural areas might strengthen the evidence base for rural planning and service provision. The modified deprivation indices, however, were not specifically formulated for rural populations and further work is needed to explore alternative input variables to produce a more rural-specific measure of deprivation.
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Oginni OA, Robinson EJ, Jones A, Rahman Q, Rimes KA. Mediators of increased self-harm and suicidal ideation in sexual minority youth: a longitudinal study. Psychol Med 2019; 49:2524-2532. [PMID: 30468143 DOI: 10.1017/s003329171800346x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sexual minority youth have elevated suicidal ideation and self-harm compared with heterosexual young people; however, evidence for mediating mechanisms is predominantly cross-sectional. Using a longitudinal design, we investigated self-esteem and depressive symptoms as mediators of increased rates of suicidal ideation or self-harm (SISH) among sexual minority youth, and the roles of childhood gender nonconformity (CGN) and sex as moderators of these relationships. METHOD In total, 4274 youth from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort reported sexual orientation at age 15 years, and past-year SISH at age 20 years. Self-esteem and depressive symptoms were assessed at ages 17 and 18 years, respectively. CGN was measured at 30-57 months. Covariates included sociodemographic variables and earlier measures of mediator and outcome variables. Mediation pathways were assessed using structural equation modelling. RESULTS Sexual minority youth (almost 12% of the sample) were three times more likely than heterosexual youth to report past-year SISH (95% confidence interval 2.43-3.64) at 20 years. Two mediation pathways were identified: a single mediator pathway involving self-esteem and a multiple-mediated pathway involving self-esteem and depressive symptoms. Although CGN was associated with past-year SISH, it did not moderate any mediation pathways and there was no evidence for moderation by sex. CONCLUSIONS Lower self-esteem and increased depressive symptoms partly explain the increased risk for later suicidal ideation and self-harm in sexual minority youth. Preventive strategies could include self-esteem-enhancing or protecting interventions, especially in female sexual minority youth, and treatment of depression.
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Gallagher S, Sirohi Campbell N, Jones A. P316 THE EFFECTS OF ALLERGEN SUBCUTANEOUS IMMUNOTHERAPY ON SYMPTOMS OF POLLEN FOOD ALLERGY SYNDROME. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Elmahi E, Sanghvi MM, Jones A, Aye CYL, Lewandowski AJ, Aung N, Cooper JA, Paiva JM, Lukaschuk E, Piechnik SK, Neubauer S, Petersen SE, Leeson P. P2249Does self-reported pregnancy loss identify women at risk of an adverse cardiovascular phenotype in later life? Insights from UK biobank. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Cardiovascular disease (CVD) is more common in women who have had pregnancy complications such as spontaneous pregnancy loss. We used cross-sectional data from the UK Biobank Imaging Enhancement Study to determine whether pregnancy loss is associated with cardiac or vascular remodelling in later life, which might contribute to this increased risk.
Methods
Pregnancy history was reported by women participating in UK Biobank between 2006 and 2010 at age 40–69 years using a self-completed touch-screen questionnaire. Self-reported pregnancy loss was related to cardiovascular measures collected in those women who had participated in the Imaging Enhancement Study up to the end of 2015. Cardiac structure and function were assessed by magnetic resonance (CMR) steady-state free precession imaging at 1.5 Tesla. Three long axes cines (horizontal, vertical and LV outflow tract) and a complete short axis stack were acquired, covering both ventricles. Tagging was used to measure myocardial strain in basal, midventricular and apical short axes views. Carotid intima-media thickness (CIMT) measurements were taken for both common carotid arteries using a CardioHealth Station. Statistical associations with CMR and carotid measures were adjusted for age, BMI and other cardiovascular risk factors.
Results
Data were available on 2660 women of whom 113 were excluded because of pre-existing CVD and 8 had no pregnancy information available. Of the remaining 2539, 466 were nulligravid and 2073 had a history of pregnancies, of whom 622 reported at least one pregnancy loss (92% miscarriages and 8% stillbirths) and 1451 reported no pregnancy loss. No significant differences in cardiac or carotid parameters were evident in women who reported pregnancy loss compared to other groups (Table 1).
CMR cardiac geometry & CIMT measurements Variable Pregnancy History Adjusted Means ± SE Effect Size (%) 95% CI P LVEDV (ml) Pregnancy Loss 122.2±1.0 0 – – No Pregnancy 124.1±1.4 1.58 (−0.83, 4.05) 0.20 Pregnancy (no loss) 122.2±0.8 0.2 (−1.42, 1.48) 0.97 LVESV (ml) Pregnancy Loss 47.8±0.6 0 – – No Pregnancy 48.0±0.8 0.45 (−3.19, 4.22) 0.81 Pregnancy (no loss) 47.3±0.5 −1.01 (−3.19, 1.22) 0.37 VEF (%) Pregnancy Loss 60.6±0.3 0 – – No Pregnancy 61.0±0.4 0.42 (−0.50, 1.35) 0.37 Pregnancy (no loss) 61.0±0.2 0.43 (−0.14, 0.99) 0.14 LVM (g) Pregnancy Loss 70.6±0.6 0 – – No Pregnancy 70.5±0.8 −0.15 (−2.68, 2.44) 0.91 Pregnancy (no loss) 70.4±0.5 −0.26 (−1.81, 1.30) 0.74 CIMT (μm) Pregnancy Loss 633.3±6.5 0 – – No Pregnancy 619.3±8.4 −2.22 (−5.04, 0.68) 0.13 Pregnancy (no loss) 627.1±4.9 −0.99 (−2.75, 0.81) 0.28
Conclusion
Women who self-report pregnancy loss do not have significant differences in cardiac or carotid structure in later life to explain past epidemiological findings of increased cardiovascular risk in this population. This may be because this risk operates through other disease mechanisms or that self-report is not a sufficiently reliable way to identify pregnancy loss, and thereby allocate women into risk groups.
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Jones A, Hauser J, Karunakaran A, Drechsler K, Taylor A, Muthurangu V, Batterham R. P3419Independent effects of visceral, subcutaneous and liver fat, and fat-free mass on cardiometabolic risk factors in teenagers. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Cardiometabolic (CM) disorders begin earlier than previously thought. Better understanding of drivers of CM risk in the young is needed to address this. Adiposity is an established concern but studies largely rely on indirect markers eg. body mass index (BMI) to assess it. BMI is known to reflect both skeletal size & adiposity.
This study aimed to compare effects of BMI with independent effects of liver fat percentage (LFP), fat-free mass (FFM), & subcutaneous (SAT) & visceral (SAT) adipose tissue on CM risk in teenagers.
Healthy teens [N=82; Age 13–19y; 39 overwt/obese; 46F/36M] had volumetric magnetic resonance (MR) tissue mapping (neck-to-knee T2*-IDEAL). BMI z-score (WHO age/sex reference; zBMI), systolic BP (SBP), fasting blood (TRIGlyceride; CHOLesterol; HDL; IL6; CRP; white blood cells [WBC]; LEPTIN), & insulin & glucose response [0, 20, 40, 60, 90, 120 & 240 min] to a mixed meal (75g glucose + cream) were assessed. Indices of insulin resistance (HOMA-IR) and sensitivity (MATSUDA-IS) were derived from fasting measures & integrated meal responses, respectively. Independent effects of LFP, FFM, SAT & VAT were tested by conditional regression in a 4 compartment model (4CM).
Higher zBMI was positively correlated with TRIG, IL6, CRP, WBC, HOMA-IR, LEPTIN & SBP, & inversely with HDL & MATSUDA-IS (Table). The 4CM showed that SAT was responsible for most of these links but VAT contributed to lower MATSUDA-IS, SAT was positively correlated with CHOL (zBMI was not), & FFM was a significant predictor of HDL, CRP & LEPTIN. It was solely responsible for the association of zBMI with SBP. There were no independent effects of LFP. zBMI was strongly driven by both FFM & SAT, limiting its ability to differentiate effects of skeletal size from those of adiposity.
Correlation coefficients BMI TRIG (mmol/L) CHOL (mmol/L) HDL (mmol/L) IL6 (pg/mL) CRP (mg/L) WBC (x109/L) HOMA-IR MATSUDA-IS LEPTIN (ng/mL) SBP (mmHg) Median (IQR) 23.4 (20.3, 29.6) 0.64 (0.52, 1.00) 3.5 (3.2, 4.0) 1.2 (1.0, 1.3) 4.0 (2.6, 6.7) 0.67 (0.22, 1.80) 5.6 (4.7, 7.1) 1.5 (0.8, 2.2) 9.3 (5.5, 12.6) 11.1 (2.1, 24.6) 114 (108, 120) zBMI 0.33§ 0.16 −0.43‡ 0.27¶ 0.69‡ 0.51‡ 0.54‡ −0.48‡ 0.77‡ 0.27¶ LFP 0.18 −0.06 0.18 0.19 0.00 −0.06 0.11 0.23 −0.21 −0.00 0.13 VAT 0.07 0.18 0.08 −0.22 0.09 −0.00 0.12 0.19 −0.35§ −0.08 0.09 SAT 0.89‡ 0.37§ 0.33§ −0.25¶ 0.37§ 0.57‡ 0.45† 0.61‡ −0.44† 0.85‡ −0.10 FFM 0.86‡ 0.04 −0.16 −0.34§ −0.02 0.31¶ −0.01 0.25 −0.25 0.39§ 0.34§ ¶P<0.05; §P<0.01; †P<0.001; ‡P<0.0001.
We found associations of zBMI with CM risk in teens that are usually interpreted as due to adiposity. Although SAT was largely responsible, FFM & VAT were important too & the link between BMI & SBP was due solely to FFM. Associations of CM risk factors with BMI may reflect non-adipose tissue effects & should be interpreted cautiously in the young.
Acknowledgement/Funding
Alexander Jones is funded by a British Heart Foundation Intermediate Clinical Research Fellowship (FS/18/22/33479)
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Razieh C, Khunti K, Davies MJ, Edwardson CL, Henson J, Darko N, Comber A, Jones A, Yates T. Association of depression and anxiety with clinical, sociodemographic, lifestyle and environmental factors in South Asian and white European individuals at high risk of diabetes. Diabet Med 2019; 36:1158-1167. [PMID: 31081286 DOI: 10.1111/dme.13986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2019] [Indexed: 11/27/2022]
Abstract
AIM To investigate the prevalence and correlates of depressive and anxiety symptoms within South Asian and white European populations at high risk of developing Type 2 diabetes. METHODS Data were collected at baseline, and at 12, 24 and 36 months from 1429 white European individuals (age 64±7 years, 35.8% women) and 160 South Asian individuals (age 59±9 years, 30.6% women) who were at high risk of Type 2 diabetes and who took part in two Type 2 diabetes prevention trials in Leicestershire, UK. The Hospital Anxiety and Depression Scale was administered during each study visit. Clinical, sociodemographic, lifestyle and environmental data were collected. RESULTS At baseline, the burden of depressive symptoms varied by ethnic group and gender, with 9.9% of white European men, 14.9% of white European women, 23.6% of South Asian men and 29.2% of South Asian women exceeding the cut-off score for mild-to-severe depression. During the course of the study and after adjustment for clinical, sociodemographic, lifestyle and environmental factors, depressive symptoms remained higher in the South Asian compared to the white European participants [score higher by 1.5, 95% CI 0.9-2.1]. Levels of anxiety were also higher in the South Asian participants, although associations were attenuated after adjustment. Social deprivation, BMI, proximity to fast-food outlets and physical activity were correlates for depression in both the South Asian and white European participants. CONCLUSIONS A higher burden of depressive symptoms was consistently evident among the South Asian individuals, even after adjustment for multiple covariates. It is important to understand both the reasons why these differences are present, to help reduce health inequalities, and whether higher levels of depressive symptoms affect the uptake of and retention rates in diabetes prevention programmes in South Asian communities.
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Davies J, Scott S, Dobra R, Brendell R, Brownlee K, Carr S, Cosgriff R, Simmonds N, Jahan R, Jones A, Matthews J, Brown S, Galono K, Miles K, Pao C, Shafi N, Watson D, Orchard C, Davies G, Pike K, Shah S, Bossley C, Fong T, Macedo P, Ruiz G, Waller M, Baker L. Fair selection of participants in clinical trials: The challenge to push the envelope further. J Cyst Fibros 2019; 18:e48-e50. [DOI: 10.1016/j.jcf.2019.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 07/17/2019] [Indexed: 12/20/2022]
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Jones A, Angelopoulou O, Noriega L. Survey of data remaining on second hand memory cards in the UK. Comput Secur 2019. [DOI: 10.1016/j.cose.2019.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Reid F, Jones A. The world ovarian cancer coalition every woman study: Identifying global and local challenges, and the opportunities to improve survival and quality of life for women no matter where they live. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.094] [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]
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Green H, Edwards G, Smith M, Sajedi N, Kenna D, Jones A. P150 Achromobacter prevalence, species distribution and infection status results from a large UK adult cystic fibrosis centre. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30444-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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