1
|
Aarhus L, Molaug I, Engdahl B. No accelerated 20-year hearing decline after occupational noise exposure has ceased: The HUNT study. Am J Ind Med 2024; 67:10-17. [PMID: 37830428 DOI: 10.1002/ajim.23543] [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: 06/23/2023] [Revised: 09/06/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES It has been suggested that noise exposure can accelerate hearing decline after the noise exposure has ceased. We aimed to assess long-term hearing decline in persons with and without prior occupational noise exposure. METHODS We conducted a population-based longitudinal study in Norway using the Trøndelag Health Study (HUNT) from 1996 to 1998 (baseline) and from 2017 to 2019 (follow-up). The sample included 1648 participants with baseline age ≥55 years (42% men, mean age 60 years) and <5 years occupational noise exposure after baseline. We analyzed the association between occupational noise exposure before baseline and mean hearing decline between 1998 and 2018 (20-year decline) at each frequency, adjusted for age, sex, education, and impulse noise exposure before baseline. RESULTS Occupational noise exposure before baseline (N = 603) was associated with baseline hearing loss, but not with later accelerated 20-year decline, at any frequency. Noise-exposed persons had less subsequent 20-year decline at 3 kHz than did nonexposed. Restricting the noise-exposed group to persons who also had a baseline Coles notch (hearing thresholds at 3, 4, or 6 kHz of 10 dB or more compared with thresholds at 1 or 2 kHz and 6 or 8 kHz; N = 211), the exposed group showed less 20-year decline at both 3 and 4 kHz, as well as less accelerated 20-year decline at 8 kHz, compared with the nonexposed. CONCLUSION Our large long-term longitudinal study shows no increased risk of continuing hearing decline after occupational noise exposure has ceased. The finding supports a conclusion that ear damage stops when the noise exposure is ended.
Collapse
Affiliation(s)
- Lisa Aarhus
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
- Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | - Ina Molaug
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Bo Engdahl
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
2
|
Gmel G, Marmet S, Bertholet N, Wicki M, Studer J. Longitudinal Associations between Sensation Seeking and Its Components and Alcohol Use in Young SWISS Men-Are There Bidirectional Associations? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12475. [PMID: 36231775 PMCID: PMC9566284 DOI: 10.3390/ijerph191912475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/15/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
The association between alcohol use and sensation seeking is well known. Less is known about whether longitudinal changes in alcohol use are associated with changes in sensation seeking and in which direction influence might flow. 5125 men aged 20.0 years old at baseline and 25.4 years old at follow-up responded to the Brief Sensation Seeking Questionnaire, which measures four subscales of experience seeking, boredom susceptibility, thrill- and adventure-seeking, and disinhibition. Alcohol use was measured using volume (drinks per week) and binge drinking (about 60 g or more per occasion). Associations were calculated using cross-lagged panel models and two-wave latent change score models. Correlations between the latent change scores for alcohol use and the sensation-seeking subscales were all positive, being largest for disinhibition (r > 0.3) and much smaller (r ~ 0.1) for the others. Disinhibition was the dominant effect over the entire sensation-seeking scale. Cross-lagged paths were (except for thrill- and adventure-seeking) bidirectional and mostly higher from alcohol use to sensation seeking (e.g., pathvolume-disinhibition = 0.136, and pathdisinhibition-volume = 0.072). Again, effects were highest for disinhibition. Given the bidirectional links between sensation seeking and alcohol use, preventive efforts aiming to achieve stable positive changes in alcohol use and personality should target both simultaneously and focus on disinhibition.
Collapse
Affiliation(s)
- Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 23A, 1011 Lausanne, Switzerland
- Research Department, Addiction Switzerland, Avenue Louis-Ruchonnet 14, 1003 Lausanne, Switzerland
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 250 College Street, Toronto, ON M5T 1R8, Canada
- Alcohol and Research Unit, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, UK
| | - Simon Marmet
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 23A, 1011 Lausanne, Switzerland
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, 4600 Olten, Switzerland
| | - Nicolas Bertholet
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 23A, 1011 Lausanne, Switzerland
| | - Matthias Wicki
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 23A, 1011 Lausanne, Switzerland
- Institute for Research, Development and Evaluation, Bern University of Teacher Education, 3012 Bern, Switzerland
| | - Joseph Studer
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 23A, 1011 Lausanne, Switzerland
- Service of Adult Psychiatry North-West, Department of Psychiatry, Lausanne University Hospital, Chemin des Chaux, 1196 Prangins, Switzerland
| |
Collapse
|
3
|
Peña A, Olson ML, Hooker E, Ayers SL, Castro FG, Patrick DL, Corral L, Lish E, Knowler WC, Shaibi GQ. Effects of a Diabetes Prevention Program on Type 2 Diabetes Risk Factors and Quality of Life Among Latino Youths With Prediabetes: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2231196. [PMID: 36094502 PMCID: PMC9468887 DOI: 10.1001/jamanetworkopen.2022.31196] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
IMPORTANCE Latino youths are disproportionately impacted by prediabetes and type 2 diabetes (T2D). Lifestyle intervention is the first-line approach for preventing or delaying T2D among adults with prediabetes. OBJECTIVE To assess the efficacy of a diabetes prevention program among Latino youths aged 12 to 16 years with prediabetes. DESIGN, SETTING, AND PARTICIPANTS This 2-group parallel randomized clinical trial with 2:1 randomization assessed a lifestyle intervention against usual care among Latino youths with prediabetes and obesity with 6- and 12-month follow-up. The study was conducted at YMCA facilities in Phoenix, Arizona from May 2016 to March 2020. INTERVENTION Participants were randomized to lifestyle intervention (INT) or usual care control (UCC). The 6-month INT included 1 d/wk of nutrition and health education and 3 d/wk of physical activity. UCC included 2 visits with a pediatric endocrinologist and a bilingual, bicultural registered dietitian to discuss diabetes risks and healthy lifestyle changes. MAIN OUTCOMES AND MEASURES Insulin sensitivity, glucose tolerance, and weight-specific quality of life (YQOL-W) at 6- and 12-month follow-up. RESULTS A total of 117 Latino youths (mean [SD] age, 14 [1] years; 47 [40.1%] girls) were included in the analysis. Overall, 79 were randomized to INT and 38 to UCC. At 6 months, the INT led to significant decreases in mean (SE) 2-hour glucose (baseline: 144 [3] mg/dL; 6 months: 132 [3] mg/dL; P = .002) and increases in mean (SE) insulin sensitivity (baseline: 1.9 [0.2]; 6 months: 2.6 [0.3]; P = .001) and YQOL-W (baseline: 75 [2]; 6 months: 80 [2]; P = .006), but these changes were not significantly different from UCC (2-hour glucose: mean difference, -7.2 mg/dL; 95% CI, -19.7 to 5.3 mg/dL; P for interaction = .26; insulin sensitivity: mean difference, 0.1; 95% CI, -0.7 to 0.9; P for interaction = .79; YQOL-W: mean difference, 6.3; 95% CI, -1.1 to 13.7; P for interaction = .10, respectively). Both INT (mean [SE], -15 mg/dL [4.9]; P = .002) and UCC (mean [SE], -15 mg/dL [5.4]; P = .005) had significant 12-month reductions in 2-hour glucose that did not differ significantly from each other (mean difference, -0.3; 95% CI, -14.5 to 14.1 mg/dL; P for interaction = .97). At 12 months, changes in mean (SE) insulin sensitivity in INT (baseline: 1.9 [0.2]; 12 months: 2.3 [0.2]; P = .06) and UCC (baseline: 1.9 [0.3]; 12 months: 2.0 [0.2]; P = .70) were not significantly different (mean difference, 0.3; 95% CI, -0.4 to 1.0; P for interaction = .37). At 12 months, YQOL-W was significantly increased in INT (basline: 75 [2]; 12 months: 82 [2]; P < .001) vs UCC (mean difference, 8.5; 95% CI, 0.8 to 16.2; P for interaction = .03). CONCLUSIONS AND RELEVANCE In this randomized clinical trial, both INT and UCC led to similar changes in T2D risk factors among Latino youths with diabetes; however, YQOL-W was improved in INT compared with UCC. Diabetes prevention interventions that are effective in adults also appeared to be effective in high risk youths. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02615353.
Collapse
Affiliation(s)
- Armando Peña
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix
| | - Micah L. Olson
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children’s Hospital, Phoenix, Arizona
| | - Elva Hooker
- Ivy Center for Family Wellness, The Society of St Vincent de Paul, Phoenix, Arizona
| | - Stephanie L. Ayers
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix
| | | | | | | | - Elvia Lish
- Ivy Center for Family Wellness, The Society of St Vincent de Paul, Phoenix, Arizona
| | - William C. Knowler
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona
| | - Gabriel Q. Shaibi
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children’s Hospital, Phoenix, Arizona
| |
Collapse
|
4
|
Sahasrabudhe SA, Terluk MR, Rudser KD, Cloyd JC, Kartha RV. Biological Variation in Peripheral Inflammation and Oxidative Stress Biomarkers in Individuals with Gaucher Disease. Int J Mol Sci 2022; 23:ijms23169189. [PMID: 36012454 PMCID: PMC9409136 DOI: 10.3390/ijms23169189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
The lack of reliable biomarkers is a significant challenge impeding progress in orphan drug development. For appropriate interpretation of intervention-based results or for evaluating candidate biomarkers, other things being equal, lower variability in biomarker measurement would be helpful. However, variability in rare disease biomarkers is often poorly understood. Type 1 Gaucher disease (GD1) is one such rare lysosomal storage disorder. Oxidative stress and inflammation have been linked to the pathophysiology of GD1 and validated measures of these processes can provide predictive value for treatment success or disease progression. This study was undertaken to investigate and compare the extent of longitudinal biological variation over a three-month period for various blood-based oxidative stress and inflammation markers in participants with GD1 on stable standard-of-care therapy (N = 13), treatment-naïve participants with GD1 (N = 5), and in age- and gender-matched healthy volunteers (N = 18). We utilized Bland–Altman plots for visual comparison of the biological variability among the three measurements. We also report group-wise means and the percentage of coefficient of variation (%CV) for 15 biomarkers. Qualitatively, we show specific markers (IL-1Ra, IL-8, and MIP-1b) to be consistently altered in GD1, irrespective of therapy status, highlighting the need for adjunctive therapies that can target and modulate these biomarkers. This information can help guide the selection of candidate biomarkers for future intervention-based studies in GD1 patients.
Collapse
Affiliation(s)
- Siddhee A. Sahasrabudhe
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Marcia R. Terluk
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Kyle D. Rudser
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - James C. Cloyd
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Reena V. Kartha
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
- Correspondence: ; Tel.: +1-612-626-2436; Fax: +1-612-626-9985
| |
Collapse
|
5
|
Lega C, Cattaneo L, Costantini G. How to Test the Association Between Baseline Performance Level and the Modulatory Effects of Non-Invasive Brain Stimulation Techniques. Front Hum Neurosci 2022; 16:920558. [PMID: 35814951 PMCID: PMC9265211 DOI: 10.3389/fnhum.2022.920558] [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] [Received: 04/14/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Behavioral effects of non-invasive brain stimulation techniques (NIBS) can dramatically change as a function of different factors (e.g., stimulation intensity, timing of stimulation). In this framework, lately there has been a growing interest toward the importance of considering the inter-individual differences in baseline performance and how they are related with behavioral NIBS effects. However, assessing how baseline performance level is associated with behavioral effects of brain stimulation techniques raises up crucial methodological issues. How can we test whether the performance at baseline is predictive of the effects of NIBS, when NIBS effects themselves are estimated with reference to baseline performance? In this perspective article, we discuss the limitations connected to widely used strategies for the analysis of the association between baseline value and NIBS effects, and review solutions to properly address this type of question.
Collapse
Affiliation(s)
- Carlotta Lega
- Department of Psychology and Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Milan, Italy
- *Correspondence: Carlotta Lega
| | - Luigi Cattaneo
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Trento, Italy
- Centre for Medical Sciences (CISMed), University of Trento, Trento, Italy
| | - Giulio Costantini
- Department of Psychology and Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Milan, Italy
| |
Collapse
|
6
|
Eklund M, Tjörnstrand C. Resident and staff perceptions of an activity- and recovery-based intervention in supported housing for people with severe mental illness - a longitudinal pilot study. BMC Psychiatry 2022; 22:404. [PMID: 35710347 PMCID: PMC9205036 DOI: 10.1186/s12888-022-04050-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND People with severe mental illness who reside in supported housing (SH) and need a high level of assistance are at risk of an everyday life with little meaning and low community participation. Interventions to counteract that seem warranted, which was the rationale for this study. The aim was to investigate how residents and staff perceived an intervention designed to enhance meaningful everyday activity and personal recovery. METHODS The intervention, termed Active in My Home (AiMH), was led by an occupational therapist. It consisted of five individual and three group sessions, and AiMH staff acted as supporters. Twenty-nine AiMH participants and 43 staff members were included in this un-controlled study with three measurement points - before (T1), at completion (T2), and 6-9 months after completion of AiMH (T3). The data collection was based on self-report questionnaires addressing perceptions of satisfaction, meaningfulness, and recovery-oriented support. RESULTS The residents' satisfaction with the SH per se was rated high (at 75% of the maximum score) and did not change over the study period from T1 to T3 (p = 0.544); nor did the participants' perceived recovery-oriented support from the AiMH supporter (p = 0.235). Satisfaction with AiMH was rated by both participants and staff at T2. Their scores differed regarding general satisfaction (p = 0.008), staff scoring higher, but no differences were found regarding satisfaction with group sessions, individual sessions, or support of activity (p-values 0.062-0.836). The staff rated the SH unit's provision of meaningful activities higher than the AIMH participants at T2 (p = 0.029) but not at T1 (p = 0.226) or T3 (p = 0.499). CONCLUSION This study has offered some glimpses of how AiMH participants and staff perceived the AiMH intervention. It has also generated some ideas for better support for meaningful activity and recovery-oriented support in SH for people with mental illness, such as assisting SH residents in identifying activity opportunities and making activity choices when providing support for meaningful activity in the SH context. TRIAL REGISTRATION Registered at ClinicalTrials.gov ID: NCT05157854.
Collapse
Affiliation(s)
- Mona Eklund
- Department of Health Sciences, Lund University, P. O. Box 157, SE-22100, Lund, Sweden.
| | - Carina Tjörnstrand
- grid.4514.40000 0001 0930 2361Department of Health Sciences, Lund University, P. O. Box 157, SE-22100 Lund, Sweden
| |
Collapse
|
7
|
Shevorykin A, Bickel WK, Carl E, Sheffer CE. Future Thinking Priming Especially Effective at Modifying Delay Discounting Rates among Cigarette Smokers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8717. [PMID: 34444463 PMCID: PMC8393805 DOI: 10.3390/ijerph18168717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/08/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Tobacco use remains one of the world's greatest preventable causes of death and disease. While most smokers want to quit, few are successful, highlighting a need for novel therapeutic approaches to support cessation efforts. Lower delay discounting (DD) rates are associated with increased smoking cessation success. Future thinking priming (FTP) reliably reduces DD rates in large populations. Smokers consistently discount more than nonsmokers, and evidence suggests that changes in DD rates are rate dependent. This study examined whether smoking status moderated the effect of FTP on DD rates and, if so, if the moderation effect could be attributed to differences in baseline rates of DD. METHODS Moderation analysis was conducted to determine whether the effect of FTP, versus neutral priming (NP), on DD differed among smokers and nonsmokers. RESULTS Smoking status moderated the effect of condition (FTP vs. NP) on post-intervention DD scores (b = -0.2919, p = 0.0124) and DD change scores (b = -0.2975, p = 0.0130). There was no evidence of rate dependence effects in the current sample. CONCLUSIONS FTP had a greater effect on decreasing DD rates among smokers than nonsmokers. FTP is effective and simple to administer, which makes it a promising therapeutic approach for aiding smoking cessation.
Collapse
Affiliation(s)
- Alina Shevorykin
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; (E.C.); (C.E.S.)
| | - Warren K. Bickel
- Virginia Tech, The Fralin Biomedical Research Institute at VTC, Roanoke, VA 24016, USA;
| | - Ellen Carl
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; (E.C.); (C.E.S.)
| | - Christine E. Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; (E.C.); (C.E.S.)
| |
Collapse
|
8
|
Mills KL, Siegmund KD, Tamnes CK, Ferschmann L, Wierenga LM, Bos MGN, Luna B, Li C, Herting MM. Inter-individual variability in structural brain development from late childhood to young adulthood. Neuroimage 2021; 242:118450. [PMID: 34358656 PMCID: PMC8489572 DOI: 10.1016/j.neuroimage.2021.118450] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 06/28/2021] [Accepted: 08/02/2021] [Indexed: 12/15/2022] Open
Abstract
A fundamental task in neuroscience is to characterize the brain’s developmental course. While replicable group-level models of structural brain development from childhood to adulthood have recently been identified, we have yet to quantify and understand individual differences in structural brain development. The present study examined inter-individual variability and sex differences in changes in brain structure, as assessed by anatomical MRI, across ages 8.0–26.0 years in 269 participants (149 females) with three time points of data (807 scans), drawn from three longitudinal datasets collected in the Netherlands, Norway, and USA. We further investigated the relationship between overall brain size and developmental changes, as well as how females and males differed in change variability across development. There was considerable inter-individual variability in the magnitude of changes observed for all examined brain measures. The majority of individuals demonstrated decreases in total gray matter volume, cortex volume, mean cortical thickness, and white matter surface area in mid-adolescence, with more variability present during the transition into adolescence and the transition into early adulthood. While most individuals demonstrated increases in white matter volume in early adolescence, this shifted to a majority demonstrating stability starting in mid-to-late adolescence. We observed sex differences in these patterns, and also an association between the size of an individual’s brain structure and the overall rate of change for the structure. The present study provides new insight as to the amount of individual variance in changes in structural morphometrics from late childhood to early adulthood in order to obtain a more nuanced picture of brain development. The observed individual- and sex-differences in brain changes also highlight the importance of further studying individual variation in developmental patterns in healthy, at-risk, and clinical populations.
Collapse
Affiliation(s)
- Kathryn L Mills
- Department of Psychology, University of Oregon, USA; PROMENTA Research Center, Department of Psychology, University of Oslo, Norway.
| | - Kimberly D Siegmund
- Department of Population and Public Health Sciences, University of Southern California, USA
| | - Christian K Tamnes
- PROMENTA Research Center, Department of Psychology, University of Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Lia Ferschmann
- PROMENTA Research Center, Department of Psychology, University of Oslo, Norway
| | - Lara M Wierenga
- Institute of Psychology, Leiden University, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University, The Netherlands
| | - Marieke G N Bos
- Institute of Psychology, Leiden University, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University, The Netherlands
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, USA
| | - Chun Li
- Department of Population and Public Health Sciences, University of Southern California, USA
| | - Megan M Herting
- Department of Population and Public Health Sciences, University of Southern California, USA.
| |
Collapse
|
9
|
Herold F, Törpel A, Hamacher D, Budde H, Zou L, Strobach T, Müller NG, Gronwald T. Causes and Consequences of Interindividual Response Variability: A Call to Apply a More Rigorous Research Design in Acute Exercise-Cognition Studies. Front Physiol 2021; 12:682891. [PMID: 34366881 PMCID: PMC8339555 DOI: 10.3389/fphys.2021.682891] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/21/2021] [Indexed: 12/19/2022] Open
Abstract
The different responses of humans to an apparently equivalent stimulus are called interindividual response variability. This phenomenon has gained more and more attention in research in recent years. The research field of exercise-cognition has also taken up this topic, as shown by a growing number of studies published in the past decade. In this perspective article, we aim to prompt the progress of this research field by (i) discussing the causes and consequences of interindividual variability, (ii) critically examining published studies that have investigated interindividual variability of neurocognitive outcome parameters in response to acute physical exercises, and (iii) providing recommendations for future studies, based on our critical examination. The provided recommendations, which advocate for a more rigorous study design, are intended to help researchers in the field to design studies allowing them to draw robust conclusions. This, in turn, is very likely to foster the development of this research field and the practical application of the findings.
Collapse
Affiliation(s)
- Fabian Herold
- Department of Neurology, Medical Faculty, Otto von Guericke University, Magdeburg, Germany.,Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | | | - Dennis Hamacher
- Department of Sport Science, German University for Health and Sports (DHGS), Berlin, Germany
| | - Henning Budde
- Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
| | - Liye Zou
- Exercise and Mental Health Laboratory, Institute of KEEP Collaborative Innovation, School of Psychology, Shenzhen University, Shenzhen, China
| | - Tilo Strobach
- Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
| | - Notger G Müller
- Department of Neurology, Medical Faculty, Otto von Guericke University, Magdeburg, Germany.,Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
| | - Thomas Gronwald
- Department of Performance, Neuroscience, Therapy and Health, Faculty of Health Sciences, MSH Medical School Hamburg, Hamburg, Germany
| |
Collapse
|
10
|
Zongo A, Simpson S, Johnson JA, Eurich DT. Effect of a pharmacy comprehensive chronic diseases care plan on use of lipid-lowering drugs among patients with hypertension. J Manag Care Spec Pharm 2021. [DOI: 10.18553/jmcp.2021.27.4.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Arsène Zongo
- School of Public Health, University of Alberta, Edmonton, Canada; Faculty of Pharmacy, Université Laval, Quebec City, Canada; and Population Health and Optimal Health Practices Research Unit, CHU de Québec, Université Laval Research Centre, Quebec City, Canada
| | - Scot Simpson
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Canada
| | | | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Canada
| |
Collapse
|
11
|
Berner C, Marculescu R, Frommlet F, Kurnikowski A, Schairer B, Aigner C, Bieglmayer C, Hecking M. Parathyroid Hormone Concentrations in Maintenance Hemodialysis: Longitudinal Evaluation of Intact and Biointact Assays. Kidney Med 2021; 3:343-352.e1. [PMID: 34136780 PMCID: PMC8178455 DOI: 10.1016/j.xkme.2020.12.015] [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] [Indexed: 11/24/2022] Open
Abstract
Rationale & Objective Management of chronic kidney disease mineral and bone disorder requires parathyroid hormone (PTH) concentrations. “Biointact” PTH immunoassays detect “whole” PTH (wPTH), whereas “intact” immunoassays measure PTH plus PTH fragments (iPTH). We aimed to determine whether longitudinal changes in PTH concentrations can be evaluated using biointact and intact immunoassays alike. Study Design Open noninterventional longitudinal cohort study. Setting & Participants PTH concentrations were measured quarterly up to 5 times in 102 hemodialysis patients. Predictors & Tests Compared Age, sex, phosphate levels, and others as clinical predictors for PTH trend. Tests compared were iPTH immunoassays from Siemens and Roche and wPTH immunoassays from Roche and DiaSorin. Outcomes PTH concentration trend; regression equations; test bias. Analytical Approach Predictive regression-to-the-mean model for PTH slope; Bland-Altman plots, Passing-Bablok regression, and reference change values for test comparisons. Results wPTH concentrations were similar with both immunoassays (wPTH-Roche = 11.7 + 0.97 × wPTH-DiaSorin, r = 0.99; mean ± 1.96 SD bias, 8.2 ± 43.3 pg/mL [17.5% ± 40.9%], by Bland-Altman plots). iPTH-Siemens concentrations were higher than iPTH-Roche concentrations (iPTH-Siemens = −5.4 + 1.33 × iPTH-Roche, r = 0.99; mean ± 1.96 SD bias, 84.0 ± 180.2 pg/mL [21.1% ± 29.8%], by Bland-Altman plots). iPTH-Roche and iPTH-Siemens concentrations were 2- and 2.5-fold higher than wPTH concentrations, respectively. Full agreement among all 4 immunoassays in detecting both significant and insignificant changes in PTH concentrations, upward or downward from one quarter to the next, was reached in 87% of consecutive measurements. In a predictive model, baseline PTH concentrations > 199 pg/mL (wPTH-Roche), 204 pg/mL (wPTH-DiaSorin), 386 pg/mL (iPTH-Roche), and 417 pg/mL (iPTH-Siemens) correctly predicted declining PTH concentration trend in 62% to 68% of patients, but age, sex, hemodialysis vintage, and calcium and phosphate levels were no significant predictors. Limitations Limited number of immunoassays, only 59 patients attended all quarterly samplings. Conclusions wPTH-Roche and wPTH-DiaSorin concentrations were similar, while iPTH was higher than wPTH concentrations. The iPTH-Siemens immunoassay is either higher calibrated or detects more fragments than iPTH-Roche. However, longitudinal PTH concentration changes largely coincided with all tested immunoassays.
Collapse
Affiliation(s)
- Carolin Berner
- Division of Nephrology & Dialysis, Department of Medicine III, Medical University of Vienna
- Nephrology & Dialysis, 1st Medical Department, Kaiser Franz Josef Hospital Vienna, Medical University of Vienna, Vienna, Austria
| | - Rodrig Marculescu
- Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
| | - Florian Frommlet
- Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Medical University of Vienna, Vienna, Austria
| | - Amelie Kurnikowski
- Division of Nephrology & Dialysis, Department of Medicine III, Medical University of Vienna
| | - Benjamin Schairer
- Division of Nephrology & Dialysis, Department of Medicine III, Medical University of Vienna
| | - Christof Aigner
- Division of Nephrology & Dialysis, Department of Medicine III, Medical University of Vienna
| | - Christian Bieglmayer
- Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
| | - Manfred Hecking
- Division of Nephrology & Dialysis, Department of Medicine III, Medical University of Vienna
- Address for Correspondence: Manfred Hecking, MD, PhD, Medical University of Vienna, Medicine III, Clinical Division of Nephrology & Dialysis, Währinger Gürtel 18-20, Vienna, 1090 Austria.
| |
Collapse
|
12
|
Harbourne RT, Dusing SC, Lobo MA, McCoy SW, Koziol NA, Hsu LY, Willett S, Marcinowski EC, Babik I, Cunha AB, An M, Chang HJ, Bovaird JA, Sheridan SM. START-Play Physical Therapy Intervention Impacts Motor and Cognitive Outcomes in Infants With Neuromotor Disorders: A Multisite Randomized Clinical Trial. Phys Ther 2020; 101:6056331. [PMID: 33382406 PMCID: PMC7910024 DOI: 10.1093/ptj/pzaa232] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/29/2020] [Accepted: 11/23/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Our objective was to evaluate the efficacy of the Sitting Together and Reaching to Play (START-Play) intervention in young infants with neuromotor disorders. METHOD This randomized controlled trial compared usual care early intervention (UC-EI) with START-Play plus UC-EI. Analyses included 112 infants with motor delay (55 UC-EI, 57 START-Play) recruited at 7 to 16 months of age across 5 sites. START-Play included twice-weekly home visits with the infant and caregiver for 12 weeks provided by physical therapists trained in the START-Play intervention; UC-EI was not disrupted. Outcome measures were the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley); the Gross Motor Function Measure; reaching frequency; and the Assessment of Problem Solving in Play (APSP). Comparisons for the full group as well as separate comparisons for infants with mild motor delay and infants with significant motor delay were conducted. Piecewise linear mixed modeling estimated short- and long-term effects. RESULTS For infants with significant motor delay, positive effects of START-Play were observed at 3 months for Bayley cognition, Bayley fine motor, and APSP and at 12 months for Bayley fine motor and reaching frequency outcomes. For infants with mild motor delay, positive effects of START-Play for the Bayley receptive communication outcome were found. For the UC-EI group, the only difference between groups was a positive effect for the APSP outcome, observed at 3 months. CONCLUSION START-Play may advance reaching, problem solving, cognitive, and fine motor skills for young infants with significant motor delay over UC-EI in the short term. START-Play in addition to UC-EI may not improve motor/cognitive outcomes for infants with milder motor delays over and above usual care. IMPACT Concepts of embodied cognition, applied to early intervention in the START-Play intervention, may serve to advance cognition and motor skills in young infants with significant motor delays over usual care early intervention. LAY SUMMARY If you have a young infant with significant delays in motor skills, your physical therapist can work with you to develop play opportunities to enhance your child's problem solving, such as that used in the START-Play intervention, in addition to usual care to help your child advance cognitive and motor skills.
Collapse
Affiliation(s)
| | - Stacey C Dusing
- University of Southern California, Los Angeles, California, USA
| | | | | | | | - Lin-Ya Hsu
- University of Washington, Seattle, Washington, USA
| | - Sandra Willett
- Munroe Meyer Institute, University of NE Medical Center, Omaha, Nebraska, USA
| | | | | | | | - Mihee An
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea
| | - Hui-Ju Chang
- Duquesne University, Pittsburgh, Pennsylvania, USA
| | | | | |
Collapse
|
13
|
Bonkhoff AK, Hope T, Bzdok D, Guggisberg AG, Hawe RL, Dukelow SP, Rehme AK, Fink GR, Grefkes C, Bowman H. Bringing proportional recovery into proportion: Bayesian modelling of post-stroke motor impairment. Brain 2020; 143:2189-2206. [PMID: 32601678 DOI: 10.1093/brain/awaa146] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/09/2020] [Accepted: 03/23/2020] [Indexed: 01/05/2023] Open
Abstract
Accurate predictions of motor impairment after stroke are of cardinal importance for the patient, clinician, and healthcare system. More than 10 years ago, the proportional recovery rule was introduced by promising that high-fidelity predictions of recovery following stroke were based only on the initially lost motor function, at least for a specific fraction of patients. However, emerging evidence suggests that this recovery rule is subject to various confounds and may apply less universally than previously assumed. Here, we systematically revisited stroke outcome predictions by applying strategies to avoid confounds and fitting hierarchical Bayesian models. We jointly analysed 385 post-stroke trajectories from six separate studies-one of the largest overall datasets of upper limb motor recovery. We addressed confounding ceiling effects by introducing a subset approach and ensured correct model estimation through synthetic data simulations. Subsequently, we used model comparisons to assess the underlying nature of recovery within our empirical recovery data. The first model comparison, relying on the conventional fraction of patients called 'fitters', pointed to a combination of proportional to lost function and constant recovery. 'Proportional to lost' here describes the original notion of proportionality, indicating greater recovery in case of a more severe initial impairment. This combination explained only 32% of the variance in recovery, which is in stark contrast to previous reports of >80%. When instead analysing the complete spectrum of subjects, 'fitters' and 'non-fitters', a combination of proportional to spared function and constant recovery was favoured, implying a more significant improvement in case of more preserved function. Explained variance was at 53%. Therefore, our quantitative findings suggest that motor recovery post-stroke may exhibit some characteristics of proportionality. However, the variance explained was substantially reduced compared to what has previously been reported. This finding motivates future research moving beyond solely behaviour scores to explain stroke recovery and establish robust and discriminating single-subject predictions.
Collapse
Affiliation(s)
- Anna K Bonkhoff
- Department of Neurology, University Hospital Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Juelich, Juelich, Germany.,Queen Square Institute of Neurology, University College London, London, UK
| | - Thomas Hope
- Wellcome Centre for Human Neuroimaging, University College London, UK
| | - Danilo Bzdok
- Mila - Quebec Artificial Intelligence Institute, Montreal, Canada.,Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Canada
| | - Adrian G Guggisberg
- Clinical Neuroscience, University of Geneva, Medical School, 1202 Geneva, Switzerland
| | - Rachel L Hawe
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada
| | - Sean P Dukelow
- Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada
| | - Anne K Rehme
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Gereon R Fink
- Department of Neurology, University Hospital Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Juelich, Juelich, Germany
| | - Christian Grefkes
- Department of Neurology, University Hospital Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Juelich, Juelich, Germany
| | - Howard Bowman
- School of Psychology, University of Birmingham, Birmingham, UK.,School of Computing, University of Kent, Canterbury, UK
| |
Collapse
|
14
|
Pudas S, Josefsson M, Nordin Adolfsson A, Landfors M, Kauppi K, Veng-Taasti LM, Hultdin M, Adolfsson R, Degerman S. Short Leukocyte Telomeres, But Not Telomere Attrition Rates, Predict Memory Decline in the 20-Year Longitudinal Betula Study. J Gerontol A Biol Sci Med Sci 2020; 76:955-963. [PMID: 33367599 PMCID: PMC8140048 DOI: 10.1093/gerona/glaa322] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Indexed: 12/17/2022] Open
Abstract
Leukocyte telomere length (LTL) is a proposed biomarker for aging-related disorders, including cognitive decline and dementia. Long-term longitudinal studies measuring intra-individual changes in both LTL and cognitive outcomes are scarce, precluding strong conclusions about a potential aging-related relationship between LTL shortening and cognitive decline. This study investigated associations between baseline levels and longitudinal changes in LTL and memory performance across an up to 20-year follow-up in 880 dementia-free participants from a population-based study (mean baseline age: 56.8 years, range: 40–80; 52% female). Shorter baseline LTL significantly predicted subsequent memory decline (r = .34, 95% confidence interval: 0.06, 0.82), controlling for age, sex, and other relevant covariates. No significant associations were however observed between intra-individual changes in LTL and memory, neither concurrently nor with a 5-year time-lag between LTL shortening and memory decline. These results support the notion of short LTL as a predictive factor for aging-related memory decline, but suggest that LTL dynamics in adulthood and older age may be less informative of cognitive outcomes in aging. Furthermore, the results highlight the importance of long-term longitudinal evaluation of outcomes in biomarker research.
Collapse
Affiliation(s)
- Sara Pudas
- Department of Integrative Medical Biology, Umeå University, Sweden
| | - Maria Josefsson
- Center for Ageing and Demographic Research, Umeå University, Sweden
| | | | - Mattias Landfors
- Department of Medical Biosciences, Pathology, Umeå University, Sweden
| | - Karolina Kauppi
- Department of Integrative Medical Biology, Umeå University, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | | | - Magnus Hultdin
- Department of Medical Biosciences, Pathology, Umeå University, Sweden
| | - Rolf Adolfsson
- Department of Clinical Sciences, Umeå University, Sweden
| | - Sofie Degerman
- Department of Medical Biosciences, Pathology, Umeå University, Sweden.,Department of Clinical Microbiology, Umeå University, Sweden
| |
Collapse
|
15
|
Gmel G, Marmet S, Studer J, Wicki M. Are Changes in Personality Traits and Alcohol Use Associated? A Cohort Study Among Young Swiss Men. Front Psychiatry 2020; 11:591003. [PMID: 33424662 PMCID: PMC7785805 DOI: 10.3389/fpsyt.2020.591003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022] Open
Abstract
Objective: It is well known that certain personality traits are associated with alcohol use. Because less is known about it, we wished to investigate whether changes in alcohol use were longitudinally associated with changes in personality and in which direction the influence or causation might flow. Methods: Data came from the self-reported questionnaire answers of 5,125 young men at two time points during the Cohort study on Substance Use Risk Factors (C-SURF). Their average ages were 20.0 and 25.4 years old at the first and second wave assessments, respectively. Four personality traits were measured: (a) aggression-hostility; (b) sociability; (c) neuroticism-anxiety; and (d) sensation seeking. Alcohol use was measured by volume (drinks per week) and binge drinking (about 60+ grams per occasion). Cross-lagged panel models and two-wave latent change score models were used. Results: Aggression-hostility, sensation seeking, and sociability were significantly and positively cross-sectionally associated with both alcohol use variables. Drinking volume and these three personality traits bidirectionally predicted each other. Binge drinking was bidirectionally associated with sensation-seeking only, whereas aggression-hostility and sociability only predicted binge drinking, but not vice versa. Changes in alcohol use were significantly positively associated with changes in aggression-hostility, sensation seeking, and sociability. Associations reached small Cohen's effect sizes for sociability and sensation seeking, but not for aggression-hostility. Associations with neuroticism-anxiety were mostly not significant. Conclusion: The direction of effects confirmed findings from other studies, and the association between changes in personality and alcohol use support the idea that prevention programs should simultaneously target both.
Collapse
Affiliation(s)
- Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Alcohol and Research Unit, University of the West of England, Bristol, United Kingdom
| | - Simon Marmet
- Addiction Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Joseph Studer
- Addiction Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Matthias Wicki
- Addiction Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
16
|
Tew M, Dalziel K, Dowsey M, Choong PF, Clarke P. Exploring the Impact of Quality of Life on Survival: A Case Study in Total Knee Replacement Surgery. Med Decis Making 2020; 40:302-313. [PMID: 32297839 DOI: 10.1177/0272989x20913266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. There is growing evidence that quality of life (QoL) has a strong association with mortality. However, incorporation of QoL is uncommon in standard survival modeling. Methods. Using data extracted from a registry of patients undergoing total knee replacement (TKR), the impact of incorporating QoL in survival modeling was explored using 4 parametric survival models. QoL was incorporated and tested in 2 forms, which are baseline and change in QoL due to intervention. Life expectancy and quality-adjusted life years (QALYs) were calculated and comparisons made to a reference model (no QoL) to translate the findings in the context of modeled economic evaluations. Results. A total of 2858 TKR cases (2309 patients) who had TKR between 2006 and 2015 were included in this analysis. Increases in baseline and change in QoL were associated with a reduction in mortality. Compared to the reference model, differences of up to 0.32 life years and 0.53 QALYs were observed, and these translated into a 9.5% change in incremental effectiveness. These differences were much larger as the strength of the association between QoL and mortality increased. Conclusions. This work has demonstrated that the inclusion of QoL measures (at baseline and change from baseline) when extrapolating survival does matter. It can influence health outcomes such as life expectancy and QALYs, which are relevant in cost-effectiveness analysis. This is important because neglecting the correlation between QoL and mortality can lead to imprecise extrapolations and thus risk misleading results affecting subsequent decisions made by policy makers.
Collapse
Affiliation(s)
- Michelle Tew
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Kim Dalziel
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Michelle Dowsey
- Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
- Department of Orthopaedics, St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Peter F Choong
- Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
- Department of Orthopaedics, St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Philip Clarke
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| |
Collapse
|
17
|
Cattaneo G, Bartrés-Faz D, Morris TP, Solana Sánchez J, Macià D, Tormos JM, Pascual-Leone A. The Barcelona Brain Health Initiative: Cohort description and first follow-up. PLoS One 2020; 15:e0228754. [PMID: 32045448 PMCID: PMC7012435 DOI: 10.1371/journal.pone.0228754] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 01/22/2020] [Indexed: 11/19/2022] Open
Abstract
The Barcelona Brain Health Initiative is a longitudinal cohort study that began in 2017 and aims to understand and characterize the determinants of brain health maintenance in middle aged adults. A cohort of 4686 individuals between the ages of 40 and 65 years free from any neurological or psychiatric diseases was established, and we collected extensive demographic, socio-economic information along with measures of self-perceived health and lifestyles (general health, physical activity, cognitive activity, socialization, sleep, nutrition and vital plan). Here we report on the baseline characteristics of the participants, and the results of the one-year follow-up evaluation. Participants were mainly women, highly educated, and with better lifestyles compared with the general population. After one year 60% of participants completed the one-year follow-up, and these were older, with higher educational level and with better lifestyles in some domains. In the absence of any specific interventions to-date, these participants showed small improvements in physical activity and sleep, but decreased adherence to a Mediterranean diet. These changes were negatively associated with baseline scores, and poorer habits at baseline were predictive of an improvement in lifestyle domains. Of the 2353 participants who completed the one-year follow-up, 73 had been diagnosed with new neurological and neuropsychiatric diseases. Changes in vital plan at follow-up, as well as gender, sleep quality and sense of coherence at baseline were shown to be significant risk factors for the onset of these diagnoses. Notably, gender risk factor decreased in importance as we adjusted by sleep habits, suggesting its potential mediator effects. These findings stress the importance of healthy lifestyles in sustaining brain health, and illustrate the individual benefit that can be derived from participation in longitudinal observational studies. Modifiable lifestyles, specifically quality of sleep, may partially mediate the effect of other risk factors in the development of some neuropsychiatric conditions.
Collapse
Affiliation(s)
- Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - David Bartrés-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Timothy P. Morris
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Javier Solana Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Dídac Macià
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Josep M. Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States of America
| |
Collapse
|
18
|
Holper L. Combining threshold analysis and GRADE to assess sensitivity to bias in antidepressant treatment recommendations adjusted for depression severity. Res Synth Methods 2019; 11:275-286. [PMID: 31873975 DOI: 10.1002/jrsm.1393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 01/07/2023]
Abstract
Threshold analysis has recently been proposed to be used in combination with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) in order to assess the sensitivity to plausible bias of treatment recommendations derived from Bayesian network meta-analysis (NMA). Here, it was aimed to apply the combination of threshold analysis and GRADE to judge quantitative and qualitative information on risk of bias in antidepressant treatment recommendations. The analysis was based on the data set provided by Cipriani et al. (The Lancet 2018) comparing 21 antidepressants in adult major depressive disorder (MDD). Primary outcomes were efficacy (response rate) and acceptability (dropout rate) adjusted for the covariate depression severity. The combined approach suggested sensitivity to plausible bias to be largest for antidepressant recommendations top ranked by Cipriani et al., that is, amitriptyline, duloxetine, paroxetine, and venlafaxine in terms of efficacy and agomelatine, escitalopram, paroxetine, and venlafaxine in terms of acceptability. Covariate ranges within which recommendations were most sensitive to plausible bias were very severe depression in terms of efficacy (smallest threshold, ie, the largest sensitivity, around 39 Hamilton Depression Rating Scale [HDRS]) and moderate depression in terms of acceptability (smallest thresholds around 16 and 35 HDRS). This indicates that treatment recommendations within these ranges may likely change if plausible bias adjustments take place. The present findings may support decision makers in judging the sensitivity to plausible bias of current antidepressant treatment recommendations to accurately guide treatment decisions in MDD depending on depression severity.
Collapse
Affiliation(s)
- L Holper
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| |
Collapse
|
19
|
Parkinson B, Meacock R, Sutton M. How do hospitals respond to price changes in emergency departments? HEALTH ECONOMICS 2019; 28:830-842. [PMID: 31237096 DOI: 10.1002/hec.3890] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 11/05/2018] [Accepted: 04/11/2019] [Indexed: 06/09/2023]
Abstract
Little is known about how prospective provider payment affects the provision of services led by unpredictable demand. We investigate hospital responses to a 32% increase in price for two treatments in emergency departments in England in April 2011 using data on 11,532,304 attendances (79 hospitals) between 2009/2010 and 2013/2014. We compare changes in the volumes of these two treatments to a treatment not attracting additional reimbursement using a difference-in-differences framework. Additional reimbursement led to 76% and 152% increases in the volumes of the two incentivised treatments. Hospitals received an additional £64.4 M between April 2011 and March 2014 for providing these treatments, of which 40% (£25.9 M) was attributable to the unanticipated hospital response to the price increase. We use time in treatment to distinguish real increases in treatment from reductions in undercoding or increases in upcoding. The association between the recorded receipt of these treatments and time spent in treatment was the same before and after the price increase, and there was no association between hospital-specific increases in recorded treatment volumes and changes in treatment times. The persistence of the treatment time increment suggests the increase in recorded treatment was a real increase in provision of treatments.
Collapse
Affiliation(s)
- Beth Parkinson
- Health Organisation, Policy and Economics, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Rachel Meacock
- Health Organisation, Policy and Economics, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Matt Sutton
- Health Organisation, Policy and Economics, School of Health Sciences, The University of Manchester, Manchester, UK
- Melbourne Institute of Applied Economic and Social Research, Faculty of Business and Economics, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
20
|
Puyraimond-Zemmour D, Granger B, Molto A, Gaujoux-Viala C, Guillemin F, Ruyssen-Witrand A, Dougados M, Fautrel B, Gossec L. Similar alteration for mental and physical aspects in health-related quality of life over 5 to 8 years in 1347 patients with early arthritis and early inflammatory back pain. Arthritis Res Ther 2019; 21:63. [PMID: 30782174 PMCID: PMC6381682 DOI: 10.1186/s13075-019-1841-y] [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: 08/09/2018] [Accepted: 02/04/2019] [Indexed: 12/03/2022] Open
Abstract
Introduction Health-related quality of life (HRQoL) is a priority for patients. The objectives were to describe the changes in HRQoL over 5–8 years in patients with early arthritis (EA) or early inflammatory back pain (IBP) and to explore factors associated to HRQoL. Patients and methods In 2 prospective observational French cohorts (ESPOIR for EA patients and DESIR for early IBP patients), HRQoL was assessed regularly over 5–8 years, using the SF36 physical and mental composite scores (PCS and MCS, range 0–100). Disease activity was assessed by DAS28-ESR and ASDAS-CRP. Univariate and multivariate linear mixed-effect models and trajectory-based mapping were applied. Results In all, 1347 patients (701 EA and 646 early IBP) were analysed: mean age 48.4 ± 12.2 and 33.9 ± 8.7 years respectively; mean disease duration 3.4 ± 1.7 and 18.2 ± 10.8 months; and 76.3% and 55.0% females. At baseline, in EA, mean PCS and MCS were respectively 40.2 ± 9.1 and 40.4 ± 11.2 and, in early IBP, were respectively 38.5 ± 8.5 and 39.8 ± 10.9. Over follow-up, HRQoL mean levels improved mostly over the first 6 months (p < 0.001). Two trajectories were evidenced in both diseases. The ‘good HRQoL’ trajectory groups, i.e. 54–61% of patients, reached levels of HRQoL close to population norms. DAS28-ESR and ASDAS-CRP over time were related to PCS (range of explained variance 9–43%, p < 0.001 in the mixed models) but not to MCS. Conclusion HRQoL was altered similarly for both physical and mental aspects in EA and early IBP. Disease activity only partly explained HRQoL: the drivers of HRQoL should be further explored. Electronic supplementary material The online version of this article (10.1186/s13075-019-1841-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Déborah Puyraimond-Zemmour
- Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France. .,Department of rheumatology, AP-HP, Pitié Salpêtrière Hospital, Paris, France. .,Hôpital Pitié-Salpêtrière, Service de Rhumatologie, 47-83, boulevard de l'Hôpital, 75013, Paris, France.
| | - Benjamin Granger
- Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France.,Department of Biostatistics, Public Health and Medical Information, AP-HP, Pitié Salpêtrière Hospital, Paris, France
| | - Anna Molto
- Paris Descartes University, Department of Rheumatology- HopitalCochin, Paris, France.,INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris- Cité, Paris, France
| | - Cécile Gaujoux-Viala
- Nîmes University Hospital, Department of Rheumatology, EA 2415, University of Montpellier, 30029, Nîmes, France
| | - Francis Guillemin
- Université de Lorraine, EA 4360 APEMAC and Inserm CIC, 1433 Epidémiologie clinique, CHRU de Brabois, Nancy, France
| | - Adeline Ruyssen-Witrand
- CHU de Toulouse, Hôpital Pierre-Paul Riquet, Toulouse, France.,UMR1027, Inserm, Faculté de Médecine, Université Paul Sabatier, Toulouse, France
| | - Maxime Dougados
- Paris Descartes University, Department of Rheumatology- HopitalCochin, Paris, France.,INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris- Cité, Paris, France
| | - Bruno Fautrel
- Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France.,Department of rheumatology, AP-HP, Pitié Salpêtrière Hospital, Paris, France
| | - Laure Gossec
- Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France.,Department of rheumatology, AP-HP, Pitié Salpêtrière Hospital, Paris, France
| |
Collapse
|
21
|
Hope TMH, Friston K, Price CJ, Leff AP, Rotshtein P, Bowman H. Recovery after stroke: not so proportional after all? Brain 2019; 142:15-22. [PMID: 30535098 PMCID: PMC6308308 DOI: 10.1093/brain/awy302] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/02/2018] [Accepted: 10/17/2018] [Indexed: 01/16/2023] Open
Abstract
The proportional recovery rule asserts that most stroke survivors recover a fixed proportion of lost function. To the extent that this is true, recovery from stroke can be predicted accurately from baseline measures of acute post-stroke impairment alone. Reports that baseline scores explain more than 80%, and sometimes more than 90%, of the variance in the patients' recoveries, are rapidly accumulating. Here, we show that these headline effect sizes are likely inflated. The key effects in this literature are typically expressed as, or reducible to, correlation coefficients between baseline scores and recovery (outcome scores minus baseline scores). Using formal analyses and simulations, we show that these correlations will be extreme when outcomes are significantly less variable than baselines, which they often will be in practice regardless of the real relationship between outcomes and baselines. We show that these effect sizes are likely to be over-optimistic in every empirical study that we found that reported enough information for us to make the judgement, and argue that the same is likely to be true in other studies as well. The implication is that recovery after stroke may not be as proportional as recent studies suggest.
Collapse
Affiliation(s)
- Thomas M H Hope
- Wellcome Centre for Human Neuroimaging, University College London, UK
| | - Karl Friston
- Wellcome Centre for Human Neuroimaging, University College London, UK
| | - Cathy J Price
- Wellcome Centre for Human Neuroimaging, University College London, UK
| | - Alex P Leff
- Institute of Cognitive Neuroscience, University College London, UK
- Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, UK
| | | | - Howard Bowman
- School of Psychology, University of Birmingham, UK
- School of Computing, University of Kent, UK
| |
Collapse
|
22
|
Affiliation(s)
- Rachel L Hawe
- From the Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada (R.L.H., S.P.D.)
| | - Stephen H Scott
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada (S.H.S.)
| | - Sean P Dukelow
- From the Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada (R.L.H., S.P.D.)
| |
Collapse
|
23
|
Leskinen T, Stenholm S, Heinonen OJ, Pulakka A, Aalto V, Kivimäki M, Vahtera J. Change in physical activity and accumulation of cardiometabolic risk factors. Prev Med 2018; 112:31-37. [PMID: 29605421 DOI: 10.1016/j.ypmed.2018.03.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/08/2018] [Accepted: 03/28/2018] [Indexed: 11/28/2022]
Abstract
This study aims to examine the association between change in physical activity over time and accumulation of cardiometabolic risk factors. Four consecutive surveys (Time 1 to 4) were conducted with 4-year intervals in 1997-2013 (the Finnish Public Sector study). Physical activity of 15,634 cardio-metabolically healthy participants (mean age 43.3 (SD 8.7) years, 85% women) was assessed using four-item survey measure and was expressed as weekly metabolic equivalent (MET) hours in Time 1, 2, and 3. At each time point, participants were categorised into low (<14 MET-h/week), moderate (≥14 to <30 MET-h/week), or high (≥30 MET-h/week) activity level and change in physical activity levels between Time 1 and 3 (over 8 years) was determined. The outcome was the number of incident cardiometabolic risk factors (hypertension, dyslipidemia, diabetes, and obesity) at Time 4. Cumulative logistic regression was used for data analysis. Compared to maintenance of low physical activity, increase in physical activity from low baseline activity level was associated with decreased accumulation of cardiometabolic risk factors in a dose-response manner (cumulative odds ratio [cOR] = 0.73, 95% CI 0.59-0.90 for low-to-moderate and cOR = 0.67, 95% CI 0.49-0.89 for low-to-high, P for trend 0.0007). Decrease in physical activity level from high to low was associated with increased accumulation of cardiometabolic risk factors (cOR = 1.60, 95% CI 1.27-2.01) compared to those who remained at high activity level. Thus even a modest long-term increase in physical activity was associated with reduction in cardiometabolic risk whereas decrease in physical activity was related to increased risk.
Collapse
Affiliation(s)
- Tuija Leskinen
- Department of Public Health, University of Turku and Turku University Hospital, Finland; Paavo Nurmi Centre & Department of Health and Physical Activity, University of Turku, Turku, Finland.
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Department of Health and Physical Activity, University of Turku, Turku, Finland
| | - Anna Pulakka
- Department of Public Health, University of Turku and Turku University Hospital, Finland
| | - Ville Aalto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Epidemiology and Public Health, University College London Medical School, London, UK; Clinicum, Faculty of Medicine, University of Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Finland
| |
Collapse
|
24
|
Martin-Trias P, Lanteaume L, Solana E, Cassé-Perrot C, Fernández-Cabello S, Babiloni C, Marzano N, Junqué C, Rossini PM, Micallef J, Truillet R, Charles E, Jouve E, Bordet R, Santamaria J, Jovicich J, Rossi S, Pascual-Leone A, Blin O, Richardson J, Bartrés-Faz D. Adaptability and reproducibility of a memory disruption rTMS protocol in the PharmaCog IMI European project. Sci Rep 2018; 8:9371. [PMID: 29921865 PMCID: PMC6008461 DOI: 10.1038/s41598-018-27502-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 06/03/2018] [Indexed: 11/29/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) can interfere with cognitive processes, such as transiently impairing memory. As part of a multi-center European project, we investigated the adaptability and reproducibility of a previously published TMS memory interfering protocol in two centers using EEG or fMRI scenarios. Participants were invited to attend three experimental sessions on different days, with sham repetitive TMS (rTMS) applied on day 1 and real rTMS on days 2 and 3. Sixty-eight healthy young men were included. On each experimental day, volunteers were instructed to remember visual pictures while receiving neuronavigated rTMS trains (20 Hz, 900 ms) during picture encoding at the left dorsolateral prefrontal cortex (L-DLPFC) and the vertex. Mixed ANOVA model analyses were performed. rTMS to the L-DLPFC significantly disrupted recognition memory on experimental day 2. No differences were found between centers or between fMRI and EEG recordings. Subjects with lower baseline memory performances were more susceptible to TMS disruption. No stability of TMS-induced memory interference could be demonstrated on day 3. Our data suggests that adapted cognitive rTMS protocols can be implemented in multi-center studies incorporating standardized experimental procedures. However, our center and modality effects analyses lacked sufficient statistical power, hence highlighting the need to conduct further studies with larger samples. In addition, inter and intra-subject variability in response to TMS might limit its application in crossover or longitudinal studies.
Collapse
Affiliation(s)
- Pablo Martin-Trias
- Medical Psychology Unit, Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Laura Lanteaume
- Department of Clinical Pharmacology CIC-CPCET, AP-HM and Institut de Neurosciences des Systèmes (INS) UMR1106, Aix-Marseille University, Marseille, France
| | - Elisabeth Solana
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Catherine Cassé-Perrot
- Department of Clinical Pharmacology CIC-CPCET, AP-HM and Institut de Neurosciences des Systèmes (INS) UMR1106, Aix-Marseille University, Marseille, France
| | - Sara Fernández-Cabello
- Medical Psychology Unit, Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Claudio Babiloni
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy
- Department of Neuroscience, IRCCS San Raffaele Pisana, Rome, Italy
| | | | - Carme Junqué
- Medical Psychology Unit, Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Paolo Maria Rossini
- Department of Neuroscience, IRCCS San Raffaele Pisana, Rome, Italy
- Department of Geriatrics, Neuroscience & Orthopedics, Catholic University, Policlinic Gemelli, Rome, Italy
| | - Joëlle Micallef
- Department of Clinical Pharmacology CIC-CPCET, AP-HM and Institut de Neurosciences des Systèmes (INS) UMR1106, Aix-Marseille University, Marseille, France
| | - Romain Truillet
- Department of Clinical Pharmacology CIC-CPCET, AP-HM and Institut de Neurosciences des Systèmes (INS) UMR1106, Aix-Marseille University, Marseille, France
| | - Estelle Charles
- Department of Clinical Pharmacology CIC-CPCET, AP-HM and Institut de Neurosciences des Systèmes (INS) UMR1106, Aix-Marseille University, Marseille, France
| | - Elisabeth Jouve
- Department of Clinical Pharmacology CIC-CPCET, AP-HM and Institut de Neurosciences des Systèmes (INS) UMR1106, Aix-Marseille University, Marseille, France
| | - Régis Bordet
- University of Lille, Inserm, CHU Lille, U1171, Degenerative and Vascular Cognitive Disorders, Lille, France
| | - Joan Santamaria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Sleep Unit, Neurology Department, Hospital Clinic, Barcelona, Spain
| | - Jorge Jovicich
- Center for Mind/Brain Sciences (CIMEC), University of Trento, Trento, Italy
| | - Simone Rossi
- Dipartimento di Scienze Mediche, Chirurgiche e Neuroscienze, Brain Investigation & Neuromodulation Laboratory (Si-BIN Lab), University of Siena, Siena, Italy
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, MA, 02215, USA
- Institut Guttmann de Neurorehabilitacio, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Olivier Blin
- Department of Clinical Pharmacology CIC-CPCET, AP-HM and Institut de Neurosciences des Systèmes (INS) UMR1106, Aix-Marseille University, Marseille, France
| | - Jill Richardson
- Neurosciences Therapeutic Area, GlaxoSmithKline R&D, Stevenage, UK
| | - David Bartrés-Faz
- Medical Psychology Unit, Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- Institut Guttmann de Neurorehabilitacio, Universitat Autonoma de Barcelona, Barcelona, Spain.
| |
Collapse
|
25
|
Williamson PJ, Atkinson G, Batterham AM. Inter-Individual Responses of Maximal Oxygen Uptake to Exercise Training: A Critical Review. Sports Med 2018; 47:1501-1513. [PMID: 28097487 DOI: 10.1007/s40279-017-0680-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
It has recently been reported how to quantify inter-individual differences in the response to an exercise intervention using the standard deviation of the change scores, as well as how to appraise these differences for clinical relevance. In a parallel-group randomised controlled trial, the key trigger for further investigation into inter-individual responses is when the standard deviation of change in the intervention sample is substantially larger than the same standard deviation derived from a suitable comparator sample. 'True' and clinically relevant inter-individual differences in response can then be plausibly expected, and potential moderators and mediators of the inter-individual differences can be explored. We now aim to critically review the research on the inter-individual differences in response to exercise training, focusing on maximal oxygen uptake (VO2max). A literature search through the relevant bibliographic databases resulted in the identification of six relevant studies that were published prior to the influential HEalth, RIsk factors, exercise Training And GEnetics (HERITAGE) Family Study. Only one of these studies was found to include a comparator arm. Re-analysis of the data from this study, accounting for random within-subjects variation, revealed an absence of clinically important inter-individual differences in the response of VO2max to exercise training. The standard deviation of change was, in fact, larger (±5.6 mL/kg/min) for the comparator than the intervention group (±3.7 mL/kg/min). We located over 180 publications that resulted from the HERITAGE Family Study, but we could not find a comparator arm in any of these studies. Some authors did not explain this absence, while others reasoned that only inter-individual differences in exercise response were of interest, thus the intervention sample was investigated solely. We also found this absence of a comparator sample in on-going studies. A perceived high test-retest reliability is offered as a justification for the absence of a comparator arm, but the test-retest reliability analysis for the HERITAGE Family Study was over a much shorter term than the length of the actual training period between baseline and follow-up measurements of VO2max. We also scrutinised the studies in which twins have been investigated, resulting in concerns about how genetic influences on the magnitude of general within-subjects variability has been partitioned out (again in the absence of a comparator no-training group), as well as with the intra-class correlation coefficient approach to data analysis. Twin pairs were found to be sometimes heterogeneous for the obviously influential factors of sex, age and fitness, thereby inflating an unadjusted coefficient. We conclude that most studies on inter-individual differences in VO2max response to exercise training have no comparator sample. Therefore, true inter-individual differences in response cannot be quantified, let alone appraised for clinical relevance. For those studies with a comparator sample, we found that the inter-individual differences in training response were not larger than random within-subjects variation in VO2max over the same time period as the training intervention.
Collapse
Affiliation(s)
- Philip J Williamson
- Health and Social Care Institute, Teesside University, Middlesbrough, TS1 3BX, UK.
| | - Greg Atkinson
- Health and Social Care Institute, Teesside University, Middlesbrough, TS1 3BX, UK
| | - Alan M Batterham
- Health and Social Care Institute, Teesside University, Middlesbrough, TS1 3BX, UK
| |
Collapse
|
26
|
Smit RAJ, Noordam R, le Cessie S, Trompet S, Jukema JW. A critical appraisal of pharmacogenetic inference. Clin Genet 2018; 93:498-507. [PMID: 29136278 DOI: 10.1111/cge.13178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 10/25/2017] [Accepted: 11/09/2017] [Indexed: 01/06/2023]
Abstract
In essence, pharmacogenetic research is aimed at discovering variants of importance to gene-treatment interaction. However, epidemiological studies are rarely set up with this goal in mind. It is therefore of great importance that researchers clearly communicate which assumptions they have had to make, and which inherent limitations apply to the interpretation of their results. This review discusses considerations of, and the underlying assumptions for, utilizing different response phenotypes and study designs popular in pharmacogenetic research to infer gene-treatment interaction effects, with a special focus on those dealing with of clinical effects of drug treatment.
Collapse
Affiliation(s)
- R A J Smit
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.,Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - R Noordam
- Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - S le Cessie
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands
| | - S Trompet
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.,Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - J W Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
27
|
Samara MT, Goldberg Y, Levine SZ, Furukawa TA, Geddes JR, Cipriani A, Davis JM, Leucht S. Initial symptom severity of bipolar I disorder and the efficacy of olanzapine: a meta-analysis of individual participant data from five placebo-controlled studies. Lancet Psychiatry 2017; 4:859-867. [PMID: 28939419 DOI: 10.1016/s2215-0366(17)30331-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 07/07/2017] [Accepted: 07/13/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND The efficacy of antipsychotics across the initial severity range in patients with acute mania remains unclear. Therefore, we examined the influence of baseline severity on the efficacy of olanzapine. METHODS We did an individual participant data meta-analysis of double-blind, randomised controlled trials that compared olanzapine with placebo, identified through searches of the ClinicalStudyRequest.com database on Feb 2, 2016. We included patients with acute mania associated with bipolar I disorder. We examined the association between baseline and change scores on the Young Mania Rating Scale (YMRS; range 0-60) up to 3 weeks for olanzapine versus placebo groups using eight increasingly complex competing mixed-effects models for repeated measures. FINDINGS We identified 33 reports, five (15%) of which were eligible and contained data for 939 patients (552 received olanzapine; 387 received placebo). The interaction between baseline severity and treatment was significant (β=0·22, 95% CI 0·05-0·39; p=0·013). The greater the baseline severity, the greater the magnitude of the differences between olanzapine and placebo was expected. The mean estimated YMRS scores were reduced at 3 weeks in both groups, but were greater with olazapine than placebo by 2·56 points for patients with a baseline score of 20-25 (9·26 for olanzapine vs 6·70 for placebo; effect size 0·35, 95% CI 0·11-0·60), by 4·74 points for a baseline score of 25-35 (14·25 vs 9·51; 0·58, 0·34-0·86), and by 8·01 points for a baseline score of 35-60 (21·72 vs 13·71; 0·70, 0·31-1·23). INTERPRETATION Benefits of olanzapine can be expected for patients across the full spectrum of symptom severity who are likely to be treated for acute mania. Less severely ill patients seem to benefit less in terms of olanzapine efficacy, but still experience the same side-effects as more severely ill patients. Thus, clinicians and patients should carefully consider the benefit-to-risk ratio of olanzapine and its additional, prophylactic effect against relapse in the long term. The generalisability of these results to other antipsychotics, trial designs, and medical conditions remains to be established. FUNDING None.
Collapse
Affiliation(s)
- Myrto T Samara
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany; 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Yair Goldberg
- Department of Statistics, Faculty of Social Sciences, University of Haifa, Haifa, Israel
| | - Stephen Z Levine
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior and Department of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - John M Davis
- Psychiatric Institute, University of Illinois at Chicago, Chicago, IL, USA; Maryland Psychiatric Research Center, University of Maryland, Baltimore, MD, USA
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany
| |
Collapse
|
28
|
Pruessner M, Cullen AE, Aas M, Walker EF. The neural diathesis-stress model of schizophrenia revisited: An update on recent findings considering illness stage and neurobiological and methodological complexities. Neurosci Biobehav Rev 2017; 73:191-218. [DOI: 10.1016/j.neubiorev.2016.12.013] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 01/29/2023]
|
29
|
Martin AE, Desrochers A, Fahrig L. Homogenization of dispersal ability across bird species in response to landscape change. OIKOS 2016. [DOI: 10.1111/oik.03859] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Amanda E. Martin
- Geomatics and Landscape Ecology Laboratory (GLEL); Carleton Univ.; Ottawa ON Canada
| | - André Desrochers
- Centre d’Étude de la forêt; Faculté de Foresterie, de Géographie et de Géomatique, Univ. Laval; Québec City Québec Canada
| | - Lenore Fahrig
- Geomatics and Landscape Ecology Laboratory (GLEL); Carleton Univ.; Ottawa ON Canada
| |
Collapse
|
30
|
Simpson RW, Wlodarczyk JH. Transdermal Buprenorphine Relieves Neuropathic Pain: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial in Diabetic Peripheral Neuropathic Pain. Diabetes Care 2016; 39:1493-500. [PMID: 27311495 DOI: 10.2337/dc16-0123] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 05/25/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the efficacy and safety of transdermal buprenorphine in patients with diabetic peripheral neuropathic pain (DPNP). RESEARCH DESIGN AND METHODS This multicenter, randomized, double-blind, placebo-controlled, parallel-group trial enrolled patients with type 1 or type 2 diabetes and stable glycemic control who had been experiencing moderate to severe DPNP for at least 6 months on maximal tolerated conventional therapy. Patients were randomly assigned to receive buprenorphine (5 μg/h) or placebo patches. The dose was titrated to effect to a maximum of 40 μg/h. Paracetamol was available as rescue analgesia. The severity of pain and other symptoms of DPNP were assessed daily in a patient diary and at clinic visits. RESULTS One hundred eight-six patients were enrolled, with 93 randomized to either buprenorphine or placebo. A high proportion of patients did not complete the study (buprenorphine 37 of 93, placebo 24 of 93). The main reason for premature withdrawal in the buprenorphine group was adverse events commonly due to untreated nausea and/or vomiting. Among the per-protocol population, more patients in the buprenorphine group (86.3%) experienced a 30% reduction in average versus baseline pain at week 12 than those in the placebo group (56.6%, P < 0.001). A nonsignificant trend favored the buprenorphine group within the intention-to-treat analysis of the same end point (51.7% vs. 41.3%, P = 0.175). CONCLUSIONS Transdermal buprenorphine, when tolerated, is an effective therapy for DPNP and provides another option to manage this challenging painful condition. Nausea and constipation need to be managed proactively to optimize treatment outcomes.
Collapse
Affiliation(s)
- Richard W Simpson
- Eastern Clinical Research Unit, Eastern Health, Box Hill Hospital, Box Hill, VIC, Australia
| | | |
Collapse
|
31
|
Zhang X, Francis BA, Dastiridou A, Chopra V, Tan O, Varma R, Greenfield DS, Schuman JS, Huang D. Longitudinal and Cross-Sectional Analyses of Age Effects on Retinal Nerve Fiber Layer and Ganglion Cell Complex Thickness by Fourier-Domain OCT. Transl Vis Sci Technol 2016; 5:1. [PMID: 26966637 PMCID: PMC4782827 DOI: 10.1167/tvst.5.2.1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 01/03/2016] [Indexed: 11/24/2022] Open
Abstract
Purpose We studied the effects of age and intraocular pressure (IOP) on retinal nerve fiber layer (NFL) and macular ganglion cell complex (GCC) thickness in normal eyes. Methods Data from subjects from the multicenter Advanced Imaging for Glaucoma Study (AIGS) were analyzed. The data included yearly visits from the normal subjects in the AIGS study. Fourier-domain optical coherence tomography (FD-OCT) was used to measure retinal NFL and macular GCC on each visit. Mixed effect models were used to evaluate the longitudinal effect of age and IOP on the NFL and GCC thickness. The measurements at baseline were used to examine the cross-sectional effects. Results The analysis included 192 eyes (92 participants) from AIGS between 2009 and 2013. The longitudinal analyses showed overall GCC thickness decreased 0.25 ± 0.05 μm per year (P < 0.001) while the overall NFL thickness decreased 0.14 ± 0.07 μm per year (P = 0.04). The cross-sectional analyses showed the GCC thickness was 0.17 ± 0.05 μm thinner per year of baseline age (P < 0.001), while the NFL was 0.21 ± 0.06 μm thinner (P < 0.001). There was no significant IOP effect on either GCC or NFL from either the longitudinal or cross-sectional analysis. Conclusions Longitudinal and cross-sectional analyses provided consistent rates of approximately 0.2% per year of age-related thinning in NFL and GCC thicknesses. This is relevant in establishing criteria to detect glaucoma-related thinning (disease progression) in excess of normal aging. IOP does not seem to be a significant confounder for progression analysis. Translational Relevance This study demonstrated the relevance of advanced imaging technology in diagnosing and monitoring glaucoma disease.
Collapse
Affiliation(s)
- Xinbo Zhang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Brian A Francis
- Doheny Eye Institute, University of California-Los Angeles, Los Angeles, CA, USA
| | - Anna Dastiridou
- Doheny Eye Institute, University of California-Los Angeles, Los Angeles, CA, USA
| | - Vikas Chopra
- Doheny Eye Institute, University of California-Los Angeles, Los Angeles, CA, USA
| | - Ou Tan
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Rohit Varma
- USC Eye Institute, University of Southern California, Los Angeles, CA, USA
| | | | - Joel S Schuman
- UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | | |
Collapse
|
32
|
Brignole M, Arabia F, Ammirati F, Tomaino M, Quartieri F, Rafanelli M, Del Rosso A, Rita Vecchi M, Russo V, Gaggioli G. Standardized algorithm for cardiac pacing in older patients affected by severe unpredictable reflex syncope: 3-year insights from the Syncope Unit Project 2 (SUP 2) study. Europace 2015; 18:1427-33. [DOI: 10.1093/europace/euv343] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 09/07/2015] [Indexed: 11/12/2022] Open
|
33
|
Effectiveness of Soft Tissue Massage for Nonspecific Shoulder Pain: Randomized Controlled Trial. Phys Ther 2015; 95:1467-77. [PMID: 26023217 DOI: 10.2522/ptj.20140350] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 05/21/2015] [Indexed: 02/09/2023]
Abstract
BACKGROUND Soft tissue massage and exercise are commonly used to treat episodes of shoulder pain. OBJECTIVE The study objective was to compare the effects of soft tissue massage and exercise with those of exercise alone on pain, disability, and range of motion in people with nonspecific shoulder pain. DESIGN This was a randomized controlled trial. SETTING The study was conducted in public hospital physical therapy clinics in Sydney, New South Wales, Australia. PARTICIPANTS The study participants were 80 people with an average age of 62.6 years (SD=12.2) who were referred to physical therapists for treatment of nonspecific shoulder pain. INTERVENTION Participants were randomly assigned to either a group that received soft tissue massage around the shoulder and exercises (n=40) or a group that received exercise only (n=40) for 4 weeks. MEASUREMENTS The primary outcome was improvement in pain, as measured on a 100-mm visual analog scale, 1 week after the cessation of treatment. Secondary outcomes were disability and active flexion, abduction, and hand-behind-back range of motion. Measurements were obtained at baseline, 1 week after the cessation of treatment, and 12 weeks after the cessation of treatment. RESULTS The between-group difference in pain scores from the baseline to 12 weeks after the cessation of treatment demonstrated a small significant difference in favor of the group receiving exercise only (mean difference=14.7 mm). There were no significant differences between groups in any other variable. LIMITATIONS It was not possible to mask therapists or participants to group allocation. Diagnostic tests were not used on participants to determine specific shoulder pathology. CONCLUSIONS The addition of soft tissue massage to an exercise program for the shoulder conferred no additional benefit for improving pain, disability, or range of motion in people with nonspecific shoulder pain.
Collapse
|
34
|
Galetti V, Kujinga P, Mitchikpè CES, Zeder C, Tay F, Tossou F, Hounhouigan JD, Zimmermann MB, Moretti D. Efficacy of highly bioavailable zinc from fortified water: a randomized controlled trial in rural Beninese children. Am J Clin Nutr 2015; 102:1238-48. [PMID: 26468121 DOI: 10.3945/ajcn.115.117028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 08/19/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Zinc deficiency and contaminated water are major contributors to diarrhea in developing countries. Food fortification with zinc has not shown clear benefits, possibly because of low zinc absorption from inhibitory food matrices. We used a novel point-of-use water ultrafiltration device configured with glass zinc plates to produce zinc-fortified, potable water. OBJECTIVE The objective was to determine zinc bioavailability from filtered water and the efficacy of zinc-fortified water in improving zinc status. DESIGN In a crossover balanced study, we measured fractional zinc absorption (FAZ) from the zinc-fortified water in 18 healthy Swiss adults using zinc stable isotopes and compared it with zinc-fortified maize porridge. We conducted a 20-wk double-blind randomized controlled trial (RCT) in 277 Beninese school children from rural settings who were randomly assigned to receive a daily portion of zinc-fortified filtered water delivering 2.8 mg Zn (Zn+filter), nonfortified filtered water (Filter), or nonfortified nonfiltered water (Pump) from the local improved supply, acting as the control group. The main outcome was plasma zinc concentration (PZn), and the 3 groups were compared by using mixed-effects models. Secondary outcomes were prevalence of zinc deficiency, diarrhea prevalence, and growth. RESULTS Geometric mean (-SD, +SD) FAZ was 7-fold higher from fortified water (65.9%; 42.2, 102.4) than from fortified maize (9.1%; 6.0, 13.7; P < 0.001). In the RCT, a significant time-by-treatment effect on PZn (P = 0.026) and on zinc deficiency (P = 0.032) was found; PZn in the Zn+filter group was significantly higher than in the Filter (P = 0.006) and Pump (P = 0.025) groups. We detected no effect on diarrhea or growth, but our study did not have the duration and power to detect such effects. CONCLUSIONS Consumption of filtered water fortified with a low dose of highly bioavailable zinc is an effective intervention in children from rural African settings. Large community-based trials are needed to assess the effectiveness of zinc-fortified filtered water on diarrhea and growth. These trials were registered at clinicaltrials.gov as NCT01636583 and NCT01790321.
Collapse
Affiliation(s)
- Valeria Galetti
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland;
| | - Prosper Kujinga
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | | | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Fabian Tay
- Clinical Trials Center, Center for Clinical Research, University Hospital of Zurich, Zurich, Switzerland; and
| | - Félicien Tossou
- Natitingou Health Zone, Ministry of Health, Natitingou, Benin
| | - Joseph D Hounhouigan
- Laboratory of Human Nutrition, Faculty of Agricultural Sciences, Abomey-Calavi University, Cotonou, Benin
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Diego Moretti
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| |
Collapse
|
35
|
Greenberg JA, Manson JE, Buijsse B, Wang L, Allison MA, Neuhouser ML, Tinker L, Waring ME, Isasi CR, Martin LW, Thomson CA. Chocolate-candy consumption and 3-year weight gain among postmenopausal U.S. women. Obesity (Silver Spring) 2015; 23:677-83. [PMID: 25644711 PMCID: PMC4351742 DOI: 10.1002/oby.20983] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 11/12/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To test the hypothesis that greater chocolate-candy intake is associated with more weight gain in postmenopausal women. METHODS A prospective cohort study involved 107,243 postmenopausal American women aged 50-79 years (mean = 60.7) at enrollment in the Women's Health Initiative, with 3-year follow-up. Chocolate-candy consumption was assessed by food frequency questionnaire, and body weight was measured. Linear mixed models, adjusted for demographic, socio economic, anthropomorphic, and behavioral variables, were used to test our main hypotheses. RESULTS Compared with women who ate a 1 oz (∼28 g) serving of chocolate candy <1 per month, those who ate this amount 1 per month to <1 per week, 1 per week to < 3 per week and ≥3 per week showed greater 3-year prospective weight gains (kg) of 0.76 (95% CI: 0.66, 0.85), 0.95 (0.84, 1.06), and 1.40 (1.27, 1.53), respectively, (P for linear trend<0.0001). Each additional 1 oz/day was associated with a greater 3-year weight gain (kg) of 0.92 (0.80, 1.05). The weight gain in each chocolate-candy intake level increased as BMI increased above the normal range (18.5-25 kg/m(2)), and was inversely associated with age. CONCLUSIONS Greater chocolate-candy intake was associated with greater prospective weight gain in this cohort of postmenopausal women.
Collapse
Affiliation(s)
- James A Greenberg
- Brooklyn College of the City University of New York, Brooklyn, New York, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Li Y, Li XH, Huang ZJ, Yang GP, Zhang GG, Zhao SP, Guo Y, Lu SJ, Ma JL, Meng FB, Chen P, Yuan H. A randomized, double blind, placebo-controlled, multicenter phase II trial of Allisartan Isoproxil in essential hypertensive population at low-medium risk. PLoS One 2015; 10:e0117560. [PMID: 25693004 PMCID: PMC4333341 DOI: 10.1371/journal.pone.0117560] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 12/18/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Angiotensin II receptor blockers (ARBs) is a well-tolerated class of antihypertensive agents, exhibiting effective antihypertensive and cardiovascular protective function. The objective of the study was to examine the efficacy and safety of Allisartan Isoproxil, a newly developed, selective, nonpeptide blocker of the angiotensin II type 1 receptor (AT1R), in essential hypertensive patients at low-medium risk. METHODS AND FINDINGS A Phase II prospective, randomized, double-blind, placebo-controlled, multicenter trial comparing Allisartan Isoproxil 240mg versus placebo was conducted in essential hypertensive patients at low-medium risk at 8 sites in China. After a 2-week placebo baseline period, 275 patients received once-daily treatment with Allisartan Isoproxil 240mg or placebo randomly for 8 weeks. Systolic/diastolic blood pressure (SBP/DBP) was measured at week 2, 4 and 8. By the end of treatment, mean reductions from baseline of SBP and DBP in Allisartan Isoproxil and placebo groups were 14.5/10.4 and 8.3/7.7 mmHg, respectively (P<0.01). The rate of effective blood pressure control in Allisartan Isoproxil group was significantly higher than in placebo group at week 4 (61.3% vs 50.0%, P<0.05) and week 8 (67.2% vs 48.6%, P<0.01). In terms of safety and tolerability, there were no report of death and serious adverse event (SAE) in all subjects. There was no difference of frequency between two groups in adverse event (AE) and adverse drug reaction (ADR) (P>0.05). No one withdraw because of an ADR in two groups. 124 patients received additional 56 weeks treatment with Allisartan Isoproxil and 84 of them completed the study. The rate of effective BP control kept up to 80% since week 24. No significant clinical change was observed and ADRs were generally mild or moderate during the long-term study. CONCLUSIONS/SIGNIFICANCE Allisartan Isoproxil 240mg was effective and safe for essential hypertension patients at low-medium risk. TRIAL REGISTRATION http://www.chictr.org/cn/ ChiCTR-TRC-10000886.
Collapse
Affiliation(s)
- Ying Li
- Center of Clinical Pharmacology, the Third Xiangya hospital, Central South University, Changsha, China
| | - Xiao-hui Li
- Department of Pharmacology, School of Pharmaceutical Sciences, Central South University, Changsha, China
| | - Zhi-jun Huang
- Center of Clinical Pharmacology, the Third Xiangya hospital, Central South University, Changsha, China
| | - Guo-ping Yang
- Center of Clinical Pharmacology, the Third Xiangya hospital, Central South University, Changsha, China
| | - Guo-gang Zhang
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Shui-ping Zhao
- Department of Cardiology, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Ying Guo
- Department of Cardiology, Hunan Provincial People’s Hospital, Changsha, China
| | - Shi-juan Lu
- Department of Cardiology, Haikou City People’s Hospital, Haikou, China
| | - Jian-lin Ma
- Department of Cardiology, Hainan Provincial People’s Hospital, Haikou, China
| | - Fan-bo Meng
- Department of Cardiology, China Japan Union Hospital of Jilin University, Changchun, China
| | - Ping Chen
- Department of Cardiology, Shantou Central Hospital, Shantou, China
| | - Hong Yuan
- Center of Clinical Pharmacology, the Third Xiangya hospital, Central South University, Changsha, China
| |
Collapse
|
37
|
Fisher L, Hessler D, Masharani U, Strycker L. Impact of baseline patient characteristics on interventions to reduce diabetes distress: the role of personal conscientiousness and diabetes self-efficacy. Diabet Med 2014; 31:739-46. [PMID: 24494593 PMCID: PMC4028368 DOI: 10.1111/dme.12403] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 12/13/2013] [Accepted: 01/28/2014] [Indexed: 11/29/2022]
Abstract
AIMS To improve patient-centred care by determining the impact of baseline levels of conscientiousness and diabetes self-efficacy on the outcomes of efficacious interventions to reduce diabetes distress and improve disease management. METHODS Adults with Type 2 diabetes with diabetes distress and self-care problems (N = 392) were randomized to one of three distress reduction interventions: computer-assisted self-management; computer-assisted self-management plus problem-solving therapy; and health education. The baseline assessment included conscientiousness and self-efficacy, demographics, diabetes status, regimen distress, emotional burden, medication adherence, diet and physical activity. Changes in regimen distress, emotional burden and self-care between baseline and 12 months were recorded and ancova models assessed how conscientiousness and self-efficacy qualified the significant improvements in distress and management outcomes. RESULTS Participants with high baseline conscientiousness displayed significantly larger improvements in medication adherence and emotional burden than participants with low baseline conscientiousness. Participants with high baseline self-efficacy showed greater improvements in diet, physical activity and regimen distress than participants with low baseline self-efficacy. The impact of conscientiousness and self-efficacy were independent of each other and occurred across all three intervention groups. A significant interaction indicated that those with both high self-efficacy and high conscientiousness at baseline had the biggest improvement in physical activity by 12 months. CONCLUSIONS Both broad personal traits and disease-specific expectations qualify the outcomes of efficacious interventions. These findings reinforce the need to change from a one-size-fits-all approach to diabetes interventions to an approach that crafts clinical interventions in ways that fit the personal traits and skills of individual people.
Collapse
Affiliation(s)
- L Fisher
- Departments of Family and Community Medicine, San Francisco, CA, USA
| | | | | | | |
Collapse
|