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van Zandwijk JK, Simmering JA, Schuurmann RCL, Simonis FFJ, Ten Haken B, de Vries JPPM, Geelkerken RH. Position- and posture-dependent vascular imaging-a scoping review. Eur Radiol 2024; 34:2334-2351. [PMID: 37672051 PMCID: PMC10957623 DOI: 10.1007/s00330-023-10154-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 07/17/2023] [Accepted: 07/29/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVES Position- and posture-dependent deformation of the vascular system is a relatively unexplored field. The goal of this scoping review was to create an overview of existing vascular imaging modalities in different body positions and postures and address the subsequent changes in vascular anatomy. METHODS Scopus, Medline, and Cochrane were searched for literature published between January 1, 2000, and June 30, 2022, incorporating the following categories: image modality, anatomy, orientation, and outcomes. RESULTS Out of 2446 screened articles, we included 108. The majority of papers used ultrasound (US, n = 74) in different body positions and postures with diameter and cross-sectional area (CSA) as outcome measures. Magnetic resonance imaging (n = 22) and computed tomography (n = 8) were less frequently used but allowed for investigation of other geometrical measures such as vessel curvature and length. The venous system proved more sensitive to postural changes than the arterial system, which was seen as increasing diameters of veins below the level of the heart when going from supine to prone to standing positions, and vice versa. CONCLUSIONS The influence of body positions and postures on vasculature was predominantly explored with US for vessel diameter and CSA. Posture-induced deformation and additional geometrical features that may be of interest for the (endovascular) treatment of vascular pathologies have been limitedly reported, such as length and curvature of an atherosclerotic popliteal artery during bending of the knee after stent placement. The most important clinical implications of positional changes are found in diagnosis, surgical planning, and follow-up after stent placement. CLINICAL RELEVANCE STATEMENT This scoping review presents the current state and opportunities of position- and posture-dependent imaging of vascular structures using various imaging modalities that are relevant in the fields of clinical diagnosis, surgical planning, and follow-up after stent placement. KEY POINTS • The influence of body positions and postures on the vasculature was predominantly investigated with US for vessel diameter and cross-sectional area. • Research into geometrical deformation, such as vessel length and curvature adaptation, that may be of interest for the (endovascular) treatment of vascular pathologies is limited in different positions and postures. • The most important clinical implications of postural changes are found in diagnosis, surgical planning, and follow-up after stent placement.
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Affiliation(s)
- Jordy K van Zandwijk
- Division of Vascular Surgery, Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
- Magnetic Detection & Imaging, Faculty of Science and Technology, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
| | - Jaimy A Simmering
- Division of Vascular Surgery, Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
- Multi-modality Medical Imaging (M3i) Group, Faculty of Science and Technology, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Richte C L Schuurmann
- Multi-modality Medical Imaging (M3i) Group, Faculty of Science and Technology, Technical Medical Centre, University of Twente, Enschede, The Netherlands
- Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Frank F J Simonis
- Magnetic Detection & Imaging, Faculty of Science and Technology, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Bennie Ten Haken
- Magnetic Detection & Imaging, Faculty of Science and Technology, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Jean-Paul P M de Vries
- Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Robert H Geelkerken
- Division of Vascular Surgery, Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
- Multi-modality Medical Imaging (M3i) Group, Faculty of Science and Technology, Technical Medical Centre, University of Twente, Enschede, The Netherlands
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Hedge ET, Vico L, Hughson RL, Mastrandrea CJ. Effects of Posture and Walking on Tibial Vascular Hemodynamics Before and After 14 Days of Head-Down Bed Rest. JBMR Plus 2023; 7:e10756. [PMID: 37457881 PMCID: PMC10339089 DOI: 10.1002/jbm4.10756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 04/17/2023] [Indexed: 07/18/2023] Open
Abstract
Human skeletal hemodynamics remain understudied. Neither assessments in weight-bearing bones during walking nor following periods of immobility exist, despite knowledge of altered nutrient-artery characteristics after short-duration unloading in rodents. We studied 12 older adults (8 females, aged 59 ± 3 years) who participated in ambulatory near-infrared spectroscopy (NIRS) assessments of tibial hemodynamics before (PRE) and after (POST) 14 days of head-down bed rest (HDBR), with most performing daily resistance and aerobic exercise countermeasures during HDBR. Continual simultaneous NIRS recordings were acquired over the proximal anteromedial tibial prominence of the right lower leg and ipsilateral lateral head of the gastrocnemius muscle during supine rest, walking, and standing. During 10 minutes of walking, desaturation kinetics in the tibia were slower (time to 95% nadir values 125.4 ± 56.8 s versus 55.0 ± 30.1 s, p = 0.0014). Tibial tissue saturation index (TSI) immediately fell (-9.9 ± 4.55) and did not completely recover by the end of 10 minutes of walking (-7.4 ± 6.7%, p = 0.027). Upon standing, total hemoglobin (tHb) kinetics were faster in the tibia (p < 0.0001), whereas HDBR resulted in faster oxygenated hemoglogin (O2Hb) kinetics in both tissues (p = 0.039). After the walk-to-stand transition, changes in O2Hb (p = 0.0022) and tHb (p = 0.0047) were attenuated in the tibia alone after bed rest. Comparisons of NIRS-derived variables during ambulation and changes in posture revealed potentially deleterious adaptations of feed vessels after HDBR. We identify important and novel tibial hemodynamics in humans during ambulation before and after bed rest, necessitating further investigation. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Eric T Hedge
- Schlegel‐UW Research Institute for AgingWaterlooCanada
- Department of Kinesiology and Health SciencesUniversity of WaterlooWaterlooCanada
| | - Laurence Vico
- U1059 INSERM—SAINBIOSE (Santé Ingéniérie Biologie St‐Etienne) Campus Santé InnovationUniversité Jean MonnetSaint‐Priest‐en‐JarezFrance
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Li MF, Liang HL, Chiang CL, Wu TH. Pulsatility index-adjusted doppler flow measurement of pedal arteries in peripheral artery disease patients. J Chin Med Assoc 2023; 86:98-104. [PMID: 36599144 DOI: 10.1097/jcma.0000000000000843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To examine the feasibility of using pulsatility index-adjusted (PI) flow equations to accurately characterize blood volume flow changes using Doppler technique in patients with peripheral artery disease (PAD) before and after percutaneous transluminal angioplasty (PTA). METHODS PTA was performed on 17 PAD patients (23 target vessels treated, 16 anterior tibial arteries, and 7 posterior tibial arteries). Arterial diameter, peak systolic velocity, PI, time-averaged mean velocity, and measured volume flow (MVF) of dorsalis pedis artery (DPA) and common plantar artery (CPA) were measured with duplex Doppler ultrasound before and after PTA. PI-adjusted volume flows (PIVF) were calculated as part of the MVF/PIVF relative percentage metric. RESULTS Significant changes (p < 0.001) of the MVF (mean: 33.0 mL/min, range: -20.9-102.2 mL/min) and MVF/PIVF relative percentages (mean: 51.8, range: 5.1-127.2%) in the DPA existed between before and after PTA, whereas no significant changes could be found in the CPA (mean:10.9 mL/min, p = 0.148 and mean: 21.3%, p = 0.146, respectively). Of the 7 treated posterior tibial arteries, the increments of the MVF/PIVF (mean: 60.4%, p = 0.033) was significant but not in the MVF (mean: 26.5 mL/min, p = 0.125). The ankle-brachial index also showed non-significant changes (p = 0.081). All PI-adjusted results matched clinical observations after blood flow restoration. CONCLUSION No conclusions can be drawn from the comparison of actual measured volume flow between before and after PTA. However, using the MVF/PIVF relative percentage allows for a more objective framework upon which to base clinical observations and provides clarity in situations where direct measurement provides a counter-intuitive or contradictory picture.
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Affiliation(s)
- Ming-Feng Li
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan, ROC
| | - Huei-Lung Liang
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan, ROC
| | - Chia-Ling Chiang
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Tung-Ho Wu
- Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- Department of Optometry, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan, ROC
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Zhang Y, Zhang Y, Wang Y, Xu X, Jin J, Zhang X, Zhang W, Wei W, Zhong C, Wu G. Effects of Enhanced External Counterpulsation With Different Sequential Levels on Lower Extremity Hemodynamics. Front Cardiovasc Med 2022; 8:795697. [PMID: 35004907 PMCID: PMC8739776 DOI: 10.3389/fcvm.2021.795697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: This study aimed to investigate acute hemodynamics of lower extremities during enhanced external counterpulsation with a three-level sequence at the hips, thighs, and calves (EECP-3), two-level sequence at the hips and thighs (EECP-2), and single leg three-level sequence (EECP-1). Methods: Twenty healthy volunteers were recruited in this study to receive a 45-min EECP intervention. Blood flow spectrums in the anterior tibial artery, posterior tibial artery, and dorsalis pedis artery were imaged by Color Doppler ultrasound. Mean flow rate (FR), area, pulsatility index (PI), peak systolic velocity (PSV), end-diastolic velocity (EDV), mean flow velocity (MV), and systolic maximum acceleration (CCAs) were sequentially measured and calculated at baseline during EECP-3, EECP-1, and EECP-2. Results: During EECP-3, PI, PSV, and MV in the anterior tibial artery were significantly higher, while EDV was markedly lower during EECP-1, EECP-2, and baseline (all P < 0.05). Additionally, ACCs were significantly elevated during EECP-3 compared with baseline. Moreover, FR in the anterior tibial artery was significantly increased during EECP-3 compared with baseline (P = 0.048). During EECP-2, PI and MV in the dorsalis pedis artery were significantly higher and lower than those at baseline, (both P < 0.05). In addition, FR was markedly reduced during EECP-2 compared with baseline (P = 0.028). During EECP-1, the area was significantly lower, while EDV was markedly higher in the posterior tibial artery than during EECP-1, EECP-2, and baseline (all P < 0.05). Meanwhile, FR of the posterior tibial artery was significantly reduced compared with baseline (P = 0.014). Conclusion: Enhanced external counterpulsation with three-level sequence (EECP-3), EECP-2, and EECP-1 induced different hemodynamic responses in the anterior tibial artery, dorsalis pedis artery, and posterior tibial artery, respectively. EECP-3 acutely improved the blood flow, blood flow velocity, and ACCs of the anterior tibial artery. In addition, EECP-1 and EECP-2 significantly increased the blood flow velocity and peripheral resistance of the inferior knee artery, whereas they markedly reduced blood flow in the posterior tibial artery.
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Affiliation(s)
- Yahui Zhang
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China.,Guangdong Innovative Engineering and Technology Research Center for Assisted Circulation, Shenzhen, China
| | - Yujia Zhang
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China.,Guangdong Innovative Engineering and Technology Research Center for Assisted Circulation, Shenzhen, China
| | - Yinfen Wang
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Xiuli Xu
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China.,Guangdong Innovative Engineering and Technology Research Center for Assisted Circulation, Shenzhen, China
| | - Jing Jin
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Xiaodong Zhang
- Department of Physical Education, Nanjing University of Finance and Economics, Nanjing, China
| | - Wei Zhang
- College of Computer, Jilin Normal University, Siping, China
| | - Wenbin Wei
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Chubin Zhong
- Department of Cardiac Ultrasound, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Guifu Wu
- Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China.,Guangdong Innovative Engineering and Technology Research Center for Assisted Circulation, Shenzhen, China
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Cho MJ, Bunsawat K, Kim HJ, Yoon ES, Jae SY. The acute effects of interrupting prolonged sitting with stair climbing on vascular and metabolic function after a high-fat meal. Eur J Appl Physiol 2020; 120:829-839. [DOI: 10.1007/s00421-020-04321-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 02/09/2020] [Indexed: 01/02/2023]
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Doppler Flow Measurement of Lower Extremity Arteries Adjusted by Pulsatility Index. AJR Am J Roentgenol 2019; 214:10-17. [PMID: 31670583 DOI: 10.2214/ajr.19.21280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. The purposes of this study were to estimate the blood volume flow of the lower extremities by means of Doppler technique; to establish a quantitative relationship between volume flow and pulsatility index (PI) in both healthy subjects and patients with peripheral artery disease (PAD); and to derive arterial blood flow equations in the lower extremities for more accurate volume flow estimations. SUBJECTS AND METHODS. Sixty healthy subjects were recruited. Arterial diameter, peak systolic velocity, PI, time-averaged mean velocity, and volume flow of right lower extremity arteries were measured with duplex Doppler ultrasound. Linear regression analysis was used to evaluate the relationship between volume flow and the reciprocal of PI. This quantitative relationship was also used to assess flow changes in 10 patients with PAD before, after, or both before and after percutaneous angioplasty. RESULTS. Volume flow in the common femoral artery was 434.4 mL/min; superficial femoral artery, 172.5 mL/min; popliteal artery, 92.1 mL/min; dorsalis pedis artery, 11.8 mL/min; and common plantar artery, 12.0 mL/min. Linear relationships between the reciprocal of PI and volume flow were found and expressed as linear blood flow equations. For the patients with PAD, no statistical increase in measured flow in the downstream artery after percutaneous angioplasty was found (p = 0.1), although four arteries had decreased flow. After normalization of flow measurements with PI values, however, statistical increases were observed between percentage increment (p < 0.001) calculations. CONCLUSION. When real-time PI values are factored into blood volume flow calculations in the evaluation of lower extremity arteries, discrepancies in flow measurements can be resolved, resulting in more accurate and stable measurements of clinical and diagnostic significance.
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Beltrame T, Catai AM, Rebelo AC, Tamburús NY, Zuttin RS, Takahashi ACDM, da Silva E. Associations Between Heart Rate Recovery Dynamics With Estradiol Levels in 20 to 60 Year-Old Sedentary Women. Front Physiol 2018; 9:533. [PMID: 29867572 PMCID: PMC5962759 DOI: 10.3389/fphys.2018.00533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 04/24/2018] [Indexed: 01/04/2023] Open
Abstract
It is hypothesized that estradiol levels, as well as aging, influence cardiac autonomic function in women. The main aim of this study was to test the correlations between heart rate recovery (HRR) dynamics, as a proxy of cardiac autonomic function, with estradiol levels and age in women. This cross-sectional study involved 44 healthy women. Heart rate (HR) data were obtained beat-by-beat during the entire experiment. Maximal incremental exercise testing (IET) on a cycle ergometer was performed followed by 6 min of recovery. During the IET recovery period, the overall HRR dynamics were evaluated by exponential data modeling (time constant "τ") where shorter τ indicates faster HRR adjustment. Considering the cardiac autonomic complexity, HRR dynamics were also evaluated by delta (Δ) analysis considering different HR data intervals. The relationship between HRR dynamics, estradiol levels and age was tested by Pearson product-moment correlation. The overall HRR dynamics (i.e., τ) were statistically correlated with age (r = 0.58, p < 0.001) and estradiol levels (r = -0.37, p = 0.01). The Δ analysis showed that the slower overall HRR associated with aging was a consequence of slower dynamics occurring within the 45-210 s interval, indicating slower sympathetic withdrawal. In conclusion, aging effects on HRR in women seems to be correlated with a slower sympathetic withdrawal. In addition, the cardioprotective effect previously associated with estradiol seems not to influence the autonomic modulation during exercise recovery periods in women.
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Affiliation(s)
- Thomas Beltrame
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
- Institute of Computing, University of Campinas, Campinas, Brazil
| | - Aparecida M. Catai
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - Ana C. Rebelo
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
- Department of Morphology, Federal University of Goiás, Goiânia, Brazil
| | - Nayara Y. Tamburús
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
| | - Roberta S. Zuttin
- Faculty of Social Sciences and Agriculture of Itapeva, Itapeva, Brazil
| | | | - Ester da Silva
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil
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Hughson RL, Peterson SD, Yee NJ, Greaves DK. Cardiac output by pulse contour analysis does not match the increase measured by rebreathing during human spaceflight. J Appl Physiol (1985) 2017; 123:1145-1149. [PMID: 28798205 DOI: 10.1152/japplphysiol.00651.2017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 11/22/2022] Open
Abstract
Pulse contour analysis of the noninvasive finger arterial pressure waveform provides a convenient means to estimate cardiac output (Q̇). The method has been compared with standard methods under a range of conditions but never before during spaceflight. We compared pulse contour analysis with the Modelflow algorithm to estimates of Q̇ obtained by rebreathing during preflight baseline testing and during the final month of long-duration spaceflight in nine healthy male astronauts. By Modelflow analysis, stroke volume was greater in supine baseline than seated baseline or inflight. Heart rate was reduced in supine baseline so that there were no differences in Q̇ by Modelflow estimate between the supine (7.02 ± 1.31 l/min, means ± SD), seated (6.60 ± 1.95 l/min), or inflight (5.91 ± 1.15 l/min) conditions. In contrast, rebreathing estimates of Q̇ increased from seated baseline (4.76 ± 0.67 l/min) to inflight (7.00 ± 1.39 l/min, significant interaction effect of method and spaceflight, P < 0.001). Pulse contour analysis utilizes a three-element Windkessel model that incorporates parameters dependent on aortic pressure-area relationships that are assumed to represent the entire circulation. We propose that a large increase in vascular compliance in the splanchnic circulation invalidates the model under conditions of spaceflight. Future spaceflight research measuring cardiac function needs to consider this important limitation for assessing absolute values of Q̇ and stroke volume.NEW & NOTEWORTHY Noninvasive assessment of cardiac function during human spaceflight is an important tool to monitor astronaut health. This study demonstrated that pulse contour analysis of finger arterial blood pressure to estimate cardiac output failed to track the 46% increase measured by a rebreathing method. These results strongly suggest that alternative methods not dependent on pulse contour analysis are required to track cardiac function in spaceflight.
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Affiliation(s)
- Richard L Hughson
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario Canada; and
| | - Sean D Peterson
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Nicholas J Yee
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario Canada; and
| | - Danielle K Greaves
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario Canada; and
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