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A. Shirsath M, O'Connor JD, Boyle R, Newman L, Knight SP, Hernandez B, Whelan R, Meaney JF, Kenny RA. Slower speed of blood pressure recovery after standing is associated with accelerated brain aging: Evidence from The Irish Longitudinal Study on Ageing (TILDA). Cereb Circ Cogn Behav 2024; 6:100212. [PMID: 38445293 PMCID: PMC10912350 DOI: 10.1016/j.cccb.2024.100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/17/2024] [Accepted: 02/02/2024] [Indexed: 03/07/2024]
Abstract
Background Impaired recovery of blood pressure (BP) in response to standing up is a prevalent condition in older individuals. We evaluated the relationship between the early recovery of hemodynamic responses to standing and brain health in adults over 50. Methods Participants from The Irish Longitudinal Study on Ageing (TILDA) (n=411; age 67.6 ± 7.3 years; 53.4 % women) performed an active stand challenge while blood pressure and heart rate were continuously monitored. The recovery of these parameters was determined as the slope of the BP and HR response, following the initial drop/rise after standing. We have previously reported a novel and validated measure of brain ageing using MRI data, which measures the difference between biological brain age and chronological age, providing a brain-predicted age difference (brainPAD) score. Results Slower recovery of systolic and diastolic BP was found to be significantly associated with higher brainPAD scores (i.e., biologically older brains), where a one-year increase in brainPAD was associated with a decrease of 0.02 mmHg/s and 0.01 mmHg/s in systolic and diastolic BP recovery, respectively, after standing. Heart rate (HR) recovery was not significantly associated with brainPAD score. Conclusion These results demonstrate that slower systolic and diastolic BP recovery in the early phase after standing is associated with accelerated brain aging in older individuals. This suggests that the BP response to standing, measured using beat-to-beat monitoring, has the potential to be used as a marker of accelerated brain aging, relying on a simple procedure and devices that are easily accessible.
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Affiliation(s)
- Morgana A. Shirsath
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
| | - John D. O'Connor
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
- School of Engineering, Ulster University, Northern Ireland, UK
| | - Rory Boyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Louise Newman
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
| | - Silvin P. Knight
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
| | - Belinda Hernandez
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
| | - Robert Whelan
- Trinity College Institute of Neuroscience, Trinity College, University of Dublin, Ireland
- Global Brain Health Institute, Trinity College, Trinity College Dublin, Ireland
| | - James F. Meaney
- National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College, University of, Ireland
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Homo RL, Colby DJ, Romo ML, Moreland S, Follen H, Hernandez B, Robinson D, Liesemer K, Paudel M, Crowell TA, Martin A, Armendi IF, Martinez-Bucki E, Bay J, Faestel P, Sainato R. COVID-19 mRNA vaccination and myocarditis/pericarditis in the setting of active surveillance at a military treatment facility. BMJ Mil Health 2023:e002599. [PMID: 37973371 DOI: 10.1136/military-2023-002599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/27/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Richelle L Homo
- Pediatrics, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - D J Colby
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Global Infectious Diseases, Henry M Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA
| | - M L Romo
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Global Infectious Diseases, Henry M Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA
| | - S Moreland
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Global Infectious Diseases, Henry M Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA
| | - H Follen
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - B Hernandez
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - D Robinson
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - K Liesemer
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - M Paudel
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Global Infectious Diseases, Henry M Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA
| | - T A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Global Infectious Diseases, Henry M Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA
| | - A Martin
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - I F Armendi
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - E Martinez-Bucki
- Pediatrics, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - J Bay
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - P Faestel
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - R Sainato
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
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Liu Z, Sokratian A, Duda AM, Xu E, Stanhope C, Fu A, Strader S, Li H, Yuan Y, Bobay BG, Sipe J, Bai K, Lundgaard I, Liu N, Hernandez B, Bowes Rickman C, Miller SE, West AB. Anionic nanoplastic contaminants promote Parkinson's disease-associated α-synuclein aggregation. Sci Adv 2023; 9:eadi8716. [PMID: 37976362 PMCID: PMC10656074 DOI: 10.1126/sciadv.adi8716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
Recent studies have identified increasing levels of nanoplastic pollution in the environment. Here, we find that anionic nanoplastic contaminants potently precipitate the formation and propagation of α-synuclein protein fibrils through a high-affinity interaction with the amphipathic and non-amyloid component (NAC) domains in α-synuclein. Nanoplastics can internalize in neurons through clathrin-dependent endocytosis, causing a mild lysosomal impairment that slows the degradation of aggregated α-synuclein. In mice, nanoplastics combine with α-synuclein fibrils to exacerbate the spread of α-synuclein pathology across interconnected vulnerable brain regions, including the strong induction of α-synuclein inclusions in dopaminergic neurons in the substantia nigra. These results highlight a potential link for further exploration between nanoplastic pollution and α-synuclein aggregation associated with Parkinson's disease and related dementias.
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Affiliation(s)
- Zhiyong Liu
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Arpine Sokratian
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | | | - Enquan Xu
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Christina Stanhope
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Amber Fu
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Samuel Strader
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Huizhong Li
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Yuan Yuan
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | | | - Joana Sipe
- Department of Civil and Environmental Engineering, Duke University, Durham, NC, USA
| | - Ketty Bai
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Iben Lundgaard
- Department of Experimental Medical Science, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Na Liu
- Department of Experimental Medical Science, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Belinda Hernandez
- Department of Ophthalmology and Cell Biology, Duke University, Durham, NC, USA
| | | | - Sara E. Miller
- Department of Pathology, Duke University, Durham, NC, USA
| | - Andrew B. West
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD, USA
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4
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Liu Z, Sokratian A, Duda AM, Xu E, Stanhope C, Fu A, Strader S, Li H, Yuan Y, Bobay BG, Sipe J, Bai K, Lundgaard I, Liu N, Hernandez B, Rickman CB, Miller SE, West AB. Anionic Nanoplastic Contaminants Promote Parkinson's Disease-Associated α-Synuclein Aggregation. Res Sq 2023:rs.3.rs-3439102. [PMID: 37886561 PMCID: PMC10602106 DOI: 10.21203/rs.3.rs-3439102/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Recent studies have identified increasing levels of nanoplastic pollution in the environment. Here we find that anionic nanoplastic contaminants potently precipitate the formation and propagation of α-synuclein protein fibrils through a high-affinity interaction with the amphipathic and non-amyloid component (NAC) domains in α-synuclein. Nanoplastics can internalize in neurons through clathrin-dependent endocytosis, causing a mild lysosomal impairment that slows the degradation of aggregated α-synuclein. In mice, nanoplastics combine with α-synuclein fibrils to exacerbate the spread of α-synuclein pathology across interconnected vulnerable brain regions, including the strong induction of α-synuclein inclusions in dopaminergic neurons in the substantia nigra. These results highlight a potential link for further exploration between nanoplastic pollution and α-synuclein aggregation associated with Parkinson's disease and related dementias.
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Affiliation(s)
- Zhiyong Liu
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Arpine Sokratian
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | | | - Enquan Xu
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Christina Stanhope
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Amber Fu
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Samuel Strader
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Huizhong Li
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Yuan Yuan
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | | | - Joana Sipe
- Department of Civil and Environmental Engineering, Duke University, Durham, NC, USA
| | - Ketty Bai
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
| | - Iben Lundgaard
- Department of Experimental Medical Science, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Na Liu
- Department of Experimental Medical Science, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Belinda Hernandez
- Department of Ophthalmology and Cell Biology, Duke University, Durham, NC, USA
| | | | - Sara E Miller
- Department of Pathology, Duke University, Durham, North Carolina, USA
| | - Andrew B. West
- Duke Center for Neurodegeneration and Neurotheraputics, Duke University, Durham, NC, USA
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD
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5
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Hernandez B, Cassara C, Tawil J, Lowery E, McCarthy D, Demiralp G. Pneumatosis Intestinalis after Lung Transplantation: A Single Institution Case Series. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Weber E, Peskin MF, Markham CM, Shegog R, Baumler ER, Addy RC, Temple JR, Hernandez B, Cuccaro P, Thiel MA, Gabay EK, Emery ST. Economic Evaluation of an Intervention to Prevent Adolescent Dating Violence (Me & You). J Interpers Violence 2023; 38:2983-3010. [PMID: 35617674 PMCID: PMC11010237 DOI: 10.1177/08862605221104534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Me & You: Building Healthy Relationships (Me & You) is a multilevel, technology-enhanced adolescent dating violence (DV) prevention program that aimed to reduce DV among ethnic-minority, early adolescent, urban youth. A group-randomized control trial of Me & You, conducted with 10 middle schools from a large urban school district in Southeast Texas in 2014-2015, found it to be effective in reducing DV perpetration and decreasing some forms of DV victimization. Economic evaluations of DV interventions are extremely limited, despite calls for more economic analyses to be incorporated in research. We help fill this gap by evaluating the cost-effectiveness from the payer and societal perspectives of implementing the Me & You program. Using cost data collected alongside the Me & You group-randomized trial, we computed incremental cost-effectiveness ratios. Our primary outcome was "any DV perpetrated" within 12 months of the intervention. We conducted a cost-benefit analysis beyond the intervention endpoint by using literature estimates of per-victim lifetime costs of DV. We performed sensitivity analyses to assess effects of uncertain parameters. Under the base-case scenario, the cost of the Me & You curriculum compared to the standard curriculum was $103.70 per-student from the societal perspective, and the effectiveness was 34.84 perpetrations averted, implying an incremental cost per perpetration averted of $2.98, which ranged from $0.48 to $73.24 in sensitivity analysis. Thus, we find the Me & You curriculum is cost-effective and cost-saving in most scenarios. Policymakers should carefully consider school-based DV prevention programs, and cost data should be regularly collected in adolescent prevention program evaluations.
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Affiliation(s)
- Ellerie Weber
- UTHealth, Deptartment of Management, Policy & Community Health, Houston, TX, USA
- Icahn School of Medicine at Mount Sinai, NY, USA
| | - Melissa F. Peskin
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
| | | | - Ross Shegog
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
| | - Elizabeth R. Baumler
- UTHealth, Deptartment of Management, Policy & Community Health, Houston, TX, USA
- UTMB, Center for Violence Prevention, Galveston, TX, USA
| | - Robert C. Addy
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
| | - Jeff R. Temple
- UTMB, Center for Violence Prevention, Galveston, TX, USA
| | - Belinda Hernandez
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
| | - Paula Cuccaro
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
| | - Melanie A. Thiel
- UTHealth, Deptartment of Management, Policy & Community Health, Houston, TX, USA
- UTMB, Center for Violence Prevention, Galveston, TX, USA
| | - Efrat K. Gabay
- UTHealth, Center for Health Promotion & Prevention Research, Houston, TX, USA
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Hernandez B, Dyer A, Nipoti B, McCrory C, Briggs R, Kennelly S, Finucane C, Romero-Ortuno R, Reilly R, Kenny RA. 136 DIABETES IS ASSOCIATED WITH IMPAIRED PERIPHERAL AND CEREBRAL HAEMODYNAMIC RESPONSES IN OLDER ADULTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Diabetes is associated with slower gait speed and adverse brain health outcomes in older adults. However, the putative mechanisms underlying these associations remain poorly explored. One such mechanism is via altered cerebral perfusion, which may represent an important intermediate phenotype in the association between diabetes and slower gait. We assessed the impact of diabetes on peripheral and cerebral haemodynamic responses during active stand as part of The Irish Longitudinal Study of Ageing (TILDA).
Methods
We assessed: (i) peripheral haemodynamic responses (heart rate, blood pressure, cardiac output) using finometry and (ii) Tissue Saturation Index (TSI) using Near-Infrared Spectroscopy (NIRS) during active stand in older adults.
Function-on-scalar regressions were used to model the impact of diabetes on the dynamic response to standing. Subsequently, multivariable linear models were used to model usual gait speed.
Results
Of 3,011 older adults (mean age: 64.2; 55.2% female) completing active stand, diabetes (n =193, 6.4%) was associated with significantly higher heart rate (mean 3.2, s.e. 0.02 bpm), higher cardiac output (mean 0.16, s.e. 0.04 L/min) and lower systolic blood pressure (mean –6.9, s.e. 1.8 mmHg) during standing. Additionally, diabetes was associated with significantly lower TSI from 10 seconds post-stand (mean –1.2%, s.e. 0.49%). Associations persisted following robust covariate adjustment. Diabetes was associated with significantly slower gait speed (-5.3 cm/s, CI (-8.4,-2.1)). In analysing the relationship between cerebral perfusion and gait speed, poorer recovery of TSI at 60-120 seconds post standing was associated with slower gait speed (0.53 cm/s slower gait speed per unit increase in TSI, p = 0.007).
Conclusion
Diabetes is associated with impaired peripheral and cerebral haemodynamic responses in addition to slower gait speed in community-dwelling older adults. Neuro-cardiovascular instability and altered cerebral perfusion may represent an important intermediate phenotype between diabetes and adverse health outcomes in older adults.
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Affiliation(s)
- B Hernandez
- Trinity College Dublin TILDA, , Dublin, Ireland
| | - A Dyer
- Trinity College Dublin , Dublin, Ireland
| | - B Nipoti
- University of Milan , Milan, Italy
| | - C McCrory
- Trinity College Dublin TILDA, , Dublin, Ireland
| | - R Briggs
- Trinity College Dublin , Dublin, Ireland
| | - S Kennelly
- Trinity College Dublin , Dublin, Ireland
| | - C Finucane
- Trinity College Dublin , Dublin, Ireland
| | | | - R Reilly
- Trinity College Dublin , Dublin, Ireland
| | - RA Kenny
- Trinity College Dublin TILDA, , Dublin, Ireland
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9
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Setti A, Hernandez B, Hirst R, Donoghue O, Kenny RA, Newell FN. 350 INTEGRATION OF VISION AND HEARING IS ASSOCIATED WITH GAIT VELOCITY IN A LARGE SAMPLE OF MIDDLE-AGED AND OLDER ADULTS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Multisensory integration is the ability to appropriately merge information from several senses for the purpose of perceiving and acting in the environment. Its importance for higher level cognition and function has emerged in recent years. Walking requires to combine information from multiple senses to coordinate effective movements. In this study, we tested the association between a well characterised multisensory task, the Sound-Induced Flash Illusion (SIFI), and gait velocity in 3,255 participants from The Irish Longitudinal Study on Ageing. The SIFI is the illusory perception of two flashes when one flash is presented with two beeps. We hypothesised that high SIFI susceptibility would be associated with slower gait velocity
Methods
Gait was measured under three conditions; usual pace, cognitive dual tasking, and maximal walking speed. A separate logistic mixed effects regression was run for: (1) gait at usual pace, (2) change in gait speed for the cognitive dual-task relative to usual pace, and (3) change in maximal walking speed relative to usual pace. The model controlled for covariates including age, sex, education, vision and hearing abilities, Body Mass Index, and cognitive function.
Results
Slower gait was associated with more illusions, indicating that those who integrated incongruent sensory inputs over longer intervals, also walked slower. Relative change for cognitive dual tasking and maximal walking speed were also significantly associated with SIFI at longer SOAs.
Conclusion
These findings extend growing evidence showing that mobility is associated with multisensory processing in ageing; in particular, the mechanisms appear related to the temporal dynamics of sensory integration.
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Affiliation(s)
- A Setti
- University College Cork , Cork, Ireland
- Trinity College Dublin The Irish Longitudinal Study on Ageing, , Dublin, Ireland
| | - B Hernandez
- Trinity College Dublin The Irish Longitudinal Study on Ageing, , Dublin, Ireland
| | - R Hirst
- Trinity College Dublin The Irish Longitudinal Study on Ageing, , Dublin, Ireland
| | - O Donoghue
- Trinity College Dublin The Irish Longitudinal Study on Ageing, , Dublin, Ireland
| | - RA Kenny
- Trinity College Dublin , Dublin, Ireland
| | - FN Newell
- Trinity College Dublin , Dublin, Ireland
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Donoghue OA, Hernandez B, O'Connell MDL, Kenny RA. Using conditional inference forests to examine predictive ability for future falls and syncope in older adults: Results from The Irish Longitudinal Study on Ageing. J Gerontol A Biol Sci Med Sci 2022; 78:673-682. [PMID: 35921194 DOI: 10.1093/gerona/glac156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The extent to which gait and mobility measures predict falls relative to other risk factors is unclear. This study examined predictive accuracy of over 70 baseline risk factors, including gait and mobility, for future falls and syncope using conditional inference forest models. METHODS Data from three waves of The Irish Longitudinal Study on Ageing (TILDA), a population-based study of community-dwelling adults aged ≥50 years were used (n=4,706). Outcome variables were recurrent falls, injurious falls, unexplained falls and syncope occurring over four year follow-up. Predictive accuracy was calculated using 5 fold cross-validation; as there was class imbalance, the algorithm was trained using undersampling of the larger class. Classification rate, area under the receiver operating characteristic curve (AUROC) and area under the precision recall curve (PRAUC) assessed predictive accuracy. RESULTS Highest overall accuracy was 69.7% for recurrent falls in 50-64 year olds. AUROC and PRAUC were ≤0.69 and ≤0.39 respectively for all outcomes indicating low predictive accuracy. History of falls, unsteadiness while walking, fear of falling, mobility, medications , mental health and cardiovascular health and function were the most important predictors for most outcomes. CONCLUSIONS Conditional inference forest models using over 70 risk factors resulted in low predictive accuracy for future recurrent, injurious and unexplained falls and syncope in community-dwelling adults. Gait and mobility impairments were important predictors of most outcomes but did not discriminate well between fallers and non-fallers. Results highlight the importance of multifactorial risk assessment and intervention and validate key modifiable risk factors for future falls and syncope.
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Affiliation(s)
- Orna A Donoghue
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Belinda Hernandez
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Matthew D L O'Connell
- Department of Population Health Sciences, School of Population Health and Environmental Sciences, King's College London, London, United Kingdom
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing (MISA), St James's Hospital, Dublin
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Cosatti M, D´ Angelo ME, Petkovic IE, Kogan N, Pereira DA, Tissera Y, Toledo MV, Alonso CG, Garcia L, Severina M, Rosemffet M, Bertoli A, Delavega M, Cosentino V, Maldonado Ficco H, Calle Montoro C, De la Vega Fernandez SS, Berbotto G, Rollano Perasso A, Gómez Vara AB, Landi M, Velozo E, Sattler ME, Perrotat L, Ezquer RA, Flores Trejo J, Farfan P, Rojas Tessel R, Carrizo Abarza V, Bande JM, Hernandez B, Papagno MJ, Rodriguez LA, Martin Koller V, Montoya F, Kreimer J, Luna PC, Echeverria C, Virasoro BM, Roberts K, Isnardi CA, Schneeberger EE, Pons-Estel G, Pisoni C. POS1201 SAFETY OF SARS-COV-2 VACCINES IN PATIENTS WITH RHEUMATIC DISEASES: DATA FROM THE NATIONAL REGISTRY SAR-CoVAC FROM ARGENTINA. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPatients with rheumatic diseases (RD) have been excluded from SARS-CoV-2 vaccine trials, though data appear to show safety and efficacy, mostly evidence remains in mRNA vaccines. In our country, adenovirus-vector, inactivated and heterologous scheme vaccines are frequently used.ObjectivesTo describe the safety of SARS-CoV-2 vaccines in patients with RD from the national registry SAR-CoVAC and to assess sociodemographic and clinical factors associated to AE and disease flares after vaccination.MethodsAdult patients with RD who have been vaccinated for SARS-CoV-2 from de Argentine Society of Rheumatology Vaccine Registry (SAR-CoVAC) were consecutively included between June 1st and December 21st, 2021, This is a national multicentric observational registry that includes patients that have received at least one dose of any SARS-CoV-2 available vaccines in Argentina. Data is voluntarily collected by the treating physician. Naranjo scale was use to assess the association between the AE and vaccination.Homologous and heterologous schedules were defined according to whether both vaccines received were the same or different, respectively. Descriptive statics, Chi2 test, Fischer test, T test, ANOVA and multivariate regression logistic model were used.ResultsA total of 1679 patients, with 2795 SARS-CoV-2 vaccine doses were included. Vaccines more frequently used were: Gam-COVID-Vac (1227 doses, 44%), ChAdOx1 nCov-19 (872 doses, 31%), BBIBP-CorV (482 doses, 17%) and mRAN-1273 (172 doses, 6%). Altogether, 510 EA were experienced by 449 (27%) patients. Pseudo-flu syndrome was the most frequent (11%), followed by injection site reaction (7%). They were significantly more frequent after the first dose in comparison to the second one (13% vs 7% and 9% vs 5%, respectively, p<0.001 in both cases). All were mild or moderate and no patient was hospitalized due to an AE. One case of moderate anaphylaxis was reported by a patient who received Gam-COVID-Vac. No cases of vaccine-induced thrombotic thrombocytopenia were observed. There were 25 disease flares reported, 17 (68%) cases of arthritis. Among patients with two doses, those with heterologous schedule presented AE more frequent after the second dose (39% vs 17%).Total incidence of EA was 182.5 events/10 00 doses, it was significantly lower for BBIBP-CorV (105.9 events/1000 dosis, p<0.002 for all cases). The higher incidence of AE was observed for mRAN-1273 (261.6 events/1000 doses) and ChAdOx1 nCov-19 (232.8 events/1000 doses).Patients with AE were younger [mean 55 years (SD 14) vs 59 years (SD 14), p <0.010], not Caucasian ethnicity [48% vs 35%, p<0.001], had higher education level [mean 13.8 years (SD 4) vs 11.9 years (SD 5), p<0.001], were more frequently employed [54% vs 44%, p<0.001], lived mostly in urban area [99% vs 95% p <0.001, had more frequently dyslipidemia [38% vs 28% p 0.012], and less frequently arterial hypertension [49% vs 65%, p<0.001]. Systemic lupus erythematosus [11% vs 7%, p=0.039] and Sjögren syndrome [6% vs 1.8%, p<0.001] were more frequent among them, while non inflammatory diseases were less prevalent [19% vs 31%, p<0.001]. They were taking steroids [24 vs 18%, p=0.007], antimalarials [17% vs 10%, p<0.001] and methotrexate [41% vs 31%, p <0.001] more frequently.In the multivariable analysis, mRAN-1273 and ChAdOx1 nCov-19 were associated with AE, while BBIBP-CorV with lower probability of having one. (Figure 1)Figure 1.Variables associated with the development of AE. Multivariate logistic regression modelConclusionThe incidence of AE was 1825 events/1000 doses, were significantly higher for mRAN-1273 and ChAdOx1 nCov-19 and lower for BBIBP-CorV. Most common AE was pseudo-flu syndrome. Female sex, being younger, higher education level, ChAdOx1 nCov-19 and mRAN-1273 vaccines, the use of methotrexate and antimalarials were related of EA in patients with RD.References[1]Sattui SE et al. Early experience of COVID-19 vaccination in adults with systemic rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey. RMD Open 2021;7.Disclosure of InterestsNone declared
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ElGamacy M, Ullrich T, Maksymenko K, Lupas AN, Hernandez B, Skokowa J. De novo design of cytokines, antikines, and novokines. KLINISCHE PADIATRIE 2022. [DOI: 10.1055/s-0042-1748728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M ElGamacy
- Max Planck Institute for Biology, Tübingen,
Germany
| | - T Ullrich
- Max Planck Institute for Biology, Tübingen,
Germany
| | - K Maksymenko
- Max Planck Institute for Biology, Tübingen,
Germany
| | - AN Lupas
- Max Planck Institute for Biology, Tübingen,
Germany
| | - B Hernandez
- Max Planck Institute for Biology, Tübingen,
Germany
| | - J Skokowa
- University Hospital Tübingen, Tübingen,
Germany
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13
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Sacca L, Markham C, Hernandez B, Shegog R, Peskin M, Craig Rushing S, Warren H, Tsosie M. The Impact of COVID-19 on the Delivery of Educational Programs in Native American Communities: Qualitative Study. JMIR Form Res 2022; 6:e32325. [PMID: 35348464 PMCID: PMC9004623 DOI: 10.2196/32325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/02/2022] [Accepted: 03/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background Despite the availability of culturally responsive sexual health educational programs for American Indian and Alaska Native (AI/AN) youth, barriers to their uptake and utilization persist in tribal communities. These challenges were exacerbated by the COVID-19 pandemic, which required flexible program delivery using both in-person and virtual classrooms. Objective This exploratory study provides a preliminary understanding of the extent to which pre-existing challenges impact the delivery of culturally responsive sexual health education programs in Native communities and to what extent they were exacerbated by the COVID-19 pandemic. It also highlights the challenges faced by adolescent health advocates when adapting culturally responsive health curricula to online platforms. Finally, this study discloses major socioeconomic, health, and mental challenges experienced by AI/AN youth during the pandemic. Methods An exploratory, descriptive, qualitative design approach was adopted to carry out 5 individual and 1 collective in-depth key informant interviews. A total of 8 Native and non-Native sexual health educators served as key informants and shared their personal experiences with the delivery of sexual health education programs for youth during the COVID-19 pandemic. The interviews were conducted virtually from October to November 2020 using Zoom to reach participants dispersed across different regions of the United States. We followed the consolidated criteria for reporting qualitative research (COREQ) as a reference for the study methodology. We also used the Braun and Clarke framework (2006) to conduct a thematic analysis. Results Experts’ opinions were structured according to 5 main themes: (1) competing community priorities during COVID-19; (2) moving to web-based programming: skills, training, support; (3) recruiting youth; and (4) challenges for implementation in a household environment; and (5) recommendations to overcome implementation challenges. These themes are complementary, connected, and should be considered holistically for the development, dissemination, and implementation of online sexual health programs for AI/AN youth, specifically during the COVID-19 pandemic. The results raised the following points for discussion: (1) Building partnerships with schools and community organizations facilitates program adaptation and implementation, (2) there is a need to adopt a holistic approach when addressing youth sexual health in AI/AN communities, (3) a systematic and culturally responsive adaptation approach ensures effective virtual program delivery, and (4) community and youth engagement is essential for the success of virtual sexual health programs. Conclusions Findings can provide recommendations on actions to be taken by sexual health educators and guidelines to follow to ensure cultural sensitivity, effective adaptation, and successful implementation when setting out to advocate for online sexual health programs for AI/AN youth.
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Affiliation(s)
- Lea Sacca
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Christine Markham
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Belinda Hernandez
- Center for Health Promotion and Prevention Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Ross Shegog
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Melissa Peskin
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | | | - Hannah Warren
- Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Monique Tsosie
- Inter Tribal Council of Arizona, Phoenix, AZ, United States
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Sacca L, Shegog R, Hernandez B, Peskin M, Rushing SC, Jessen C, Lane T, Markham C. Barriers, frameworks, and mitigating strategies influencing the dissemination and implementation of health promotion interventions in indigenous communities: a scoping review. Implement Sci 2022; 17:18. [PMID: 35189904 PMCID: PMC8862215 DOI: 10.1186/s13012-022-01190-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 01/18/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Many Indigenous communities across the USA and Canada experience a disproportionate burden of health disparities. Effective programs and interventions are essential to build protective skills for different age groups to improve health outcomes. Understanding the relevant barriers and facilitators to the successful dissemination, implementation, and retention of evidence-based interventions and/or evidence-informed programs in Indigenous communities can help guide their dissemination. PURPOSE To identify common barriers to dissemination and implementation (D&I) and effective mitigating frameworks and strategies used to successfully disseminate and implement evidence-based interventions and/or evidence-informed programs in American Indian/Alaska Native (AI/AN), Native Hawaiian/Pacific Islander (NH/PI), and Canadian Indigenous communities. METHODS A scoping review, informed by the York methodology, comprised five steps: (1) identification of the research questions; (2) searching for relevant studies; (3) selection of studies relevant to the research questions; (4) data charting; and (5) collation, summarization, and reporting of results. The established D&I SISTER strategy taxonomy provided criteria for categorizing reported strategies. RESULTS Candidate studies that met inclusion/exclusion criteria were extracted from PubMed (n = 19), Embase (n = 18), and Scopus (n = 1). Seventeen studies were excluded following full review resulting in 21 included studies. The most frequently cited category of barriers was "Social Determinants of Health in Communities." Forty-three percent of barriers were categorized in this community/society-policy level of the SEM and most studies (n = 12, 57%) cited this category. Sixteen studies (76%) used a D&I framework or model (mainly CBPR) to disseminate and implement health promotion evidence-based programs in Indigenous communities. Most highly ranked strategies (80%) corresponded with those previously identified as "important" and "feasible" for D&I The most commonly reported SISTER strategy was "Build partnerships (i.e., coalitions) to support implementation" (86%). CONCLUSION D&I frameworks and strategies are increasingly cited as informing the adoption, implementation, and sustainability of evidence-based programs within Indigenous communities. This study contributes towards identifying barriers and effective D&I frameworks and strategies critical to improving reach and sustainability of evidence-based programs in Indigenous communities. REGISTRATION NUMBER N/A (scoping review).
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Affiliation(s)
- Lea Sacca
- grid.267308.80000 0000 9206 2401Center for Health Promotion and Disease Prevention, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin, Houston, TX 77030 USA
| | - Ross Shegog
- grid.267308.80000 0000 9206 2401Center for Health Promotion and Disease Prevention, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin, Houston, TX 77030 USA
| | - Belinda Hernandez
- grid.267309.90000 0001 0629 5880Center for Health Promotion and Disease Prevention, University of Texas Health Science Center School of Public Health in San Antonio, 7411 John Smith Drive, Suite 1100, San Antonio, TX 78229 USA
| | - Melissa Peskin
- grid.267308.80000 0000 9206 2401Center for Health Promotion and Disease Prevention, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin, Houston, TX 77030 USA
| | - Stephanie Craig Rushing
- grid.422837.80000 0000 9966 8676Northwest Portland Area Indian Health Board, 2121 SW Broadway Suite 300, Portland, OR 97201 USA
| | - Cornelia Jessen
- grid.413552.40000 0000 9894 0703Alaska Native Tribal Health Consortium, 4000 Ambassador Drive, Anchorage, AK 99508 USA
| | - Travis Lane
- grid.470274.20000 0001 0023 3814Inter Tribal Council of Arizona, Inc., 2214 North Central Avenue, Phoenix, AZ 85004 USA
| | - Christine Markham
- grid.267308.80000 0000 9206 2401Center for Health Promotion and Disease Prevention, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin, Houston, TX 77030 USA
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15
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Diez PT, Fernández CB, Cea BV, Carrascosa EM, García AG, Candil OD, García AB, Sánchez-Torres J, Rojo PC, Solís RM, Hernandez B, Martí ML, Bosch RC, Laorden NR. 1621P Emotional distress in cancer patients during the first wave of the COVID-19 pandemic in Madrid. Ann Oncol 2021. [PMCID: PMC8454341 DOI: 10.1016/j.annonc.2021.08.1614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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16
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Sacca L, Craig Rushing S, Markham C, Shegog R, Peskin M, Hernandez B, Gaston A, Singer M, Trevino N, Correa CC, Jessen C, Williamson J, Thomas J. Assessment of the Reach, Usability, and Perceived Impact of " Talking Is Power": A Parental Sexual Health Text-Messaging Service and Web-Based Resource to Empower Sensitive Conversations with American Indian and Alaska Native Teens. Int J Environ Res Public Health 2021; 18:9126. [PMID: 34501715 PMCID: PMC8431363 DOI: 10.3390/ijerph18179126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Early sexual debut among American Indian and Alaska Native (AI/AN) adolescents has been associated with an increased risk of teenage pregnancies and sexually transmitted infections, along with an increased risk of having multiple lifetime sexual partners, and engaging in greater frequency of sex, substance abuse, and lack of condom use. A major protective factor against early sexual debut among AI/AN youth is the familial system. Interventions aiming to improve parent-child communication and parental warmth toward adolescent sexual health topics were reported to contribute to positive youth sexual health outcomes, specifically among minority youth. Healthy Native Youth thus developed the Talking is Power text-messaging service to guide parents and caring adults on how to initiate sensitive topics with youth and how to support them in making informed decisions regarding sex and healthy relationships. METHODS Descriptive statistics were used to demonstrate website analytics and reach per views and time spent on each page, and for displaying participants' responses to the questions on the usability of the Talking is Power text-messaging series. To assess the perceived impact of the series, the differences in mean percentage scores of the question assessing parental comfort in engaging in sexual health topics with youth between pre- and post-intervention were calculated using two-sample t-tests of equal variances. Descriptive content analysis was adopted to highlight emerging themes from open-ended items. RESULTS When looking at reach, 862 entrances were recorded during the specified time period (5.8% of total entrances to HNY website), while the bounce rate was set at 73.1% (22.6% greater than the industry average), and the exit rate was 54.3% (15.2% greater than the industry average). Series usability was highly ranked on the 5-Likert scale in terms of signing up for a similar series on a different topic, quality of images, texts, and links, relating to prompts, and change in sparking sensitive conversations with youth. High likelihood of recommending the series to a friend or colleague was also reported by participants (0-10). No significant difference in parental comfort levels was reported (p = 0.78 > 0.05). Main themes provided suggestions for improving the series mode of delivery, while others included positive feedback about the material, with the possibility of expanding the series to other adolescent health topics. CONCLUSION Lessons learned during the design, dissemination, and evaluation of the resource's usability, reach, and perceived impact may be of interest to other Indigenous communities who are in the process of adapting and/or implementing similar approaches.
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Affiliation(s)
- Lea Sacca
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (C.M.); (R.S.); (M.P.); (C.C.C.)
| | - Stephanie Craig Rushing
- Northwest Portland Area Indian Health Board, Portland, OR 97201, USA; (A.G.); (M.S.); (N.T.)
| | - Christine Markham
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (C.M.); (R.S.); (M.P.); (C.C.C.)
| | - Ross Shegog
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (C.M.); (R.S.); (M.P.); (C.C.C.)
| | - Melissa Peskin
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (C.M.); (R.S.); (M.P.); (C.C.C.)
| | - Belinda Hernandez
- School of Public Health, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA;
| | - Amanda Gaston
- Northwest Portland Area Indian Health Board, Portland, OR 97201, USA; (A.G.); (M.S.); (N.T.)
| | - Michelle Singer
- Northwest Portland Area Indian Health Board, Portland, OR 97201, USA; (A.G.); (M.S.); (N.T.)
| | - Nicole Trevino
- Northwest Portland Area Indian Health Board, Portland, OR 97201, USA; (A.G.); (M.S.); (N.T.)
| | - Chrystial C. Correa
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (C.M.); (R.S.); (M.P.); (C.C.C.)
| | - Cornelia Jessen
- Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA; (C.J.); (J.W.)
| | - Jennifer Williamson
- Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA; (C.J.); (J.W.)
| | - Jerri Thomas
- Inter Tribal Council of Arizona, Inc., Phoenix, AZ 85004, USA;
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17
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McCrory C, Fiorito G, Hernandez B, Polidoro S, O'Halloran AM, Hever A, Ni Cheallaigh C, Lu AT, Horvath S, Vineis P, Kenny RA. GrimAge Outperforms Other Epigenetic Clocks in the Prediction of Age-Related Clinical Phenotypes and All-Cause Mortality. J Gerontol A Biol Sci Med Sci 2021; 76:741-749. [PMID: 33211845 DOI: 10.1093/gerona/glaa286] [Citation(s) in RCA: 166] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Indexed: 12/18/2022] Open
Abstract
The aging process is characterized by the presence of high interindividual variation between individuals of the same chronical age prompting a search for biomarkers that capture this heterogeneity. Epigenetic clocks measure changes in DNA methylation levels at specific CpG sites that are highly correlated with calendar age. The discrepancy resulting from the regression of DNA methylation age on calendar age is hypothesized to represent a measure of biological aging with a positive/negative residual signifying age acceleration (AA)/deceleration, respectively. The present study examines the associations of 4 epigenetic clocks-Horvath, Hannum, PhenoAge, GrimAge-with a wide range of clinical phenotypes (walking speed, grip strength, Fried frailty, polypharmacy, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MOCA), Sustained Attention Reaction Time, 2-choice reaction time), and with all-cause mortality at up to 10-year follow-up, in a sample of 490 participants in the Irish Longitudinal Study on Ageing (TILDA). HorvathAA and HannumAA were not predictive of health; PhenoAgeAA was associated with 4/9 outcomes (walking speed, frailty MOCA, MMSE) in minimally adjusted models, but not when adjusted for other social and lifestyle factors. GrimAgeAA by contrast was associated with 8/9 outcomes (all except grip strength) in minimally adjusted models, and remained a significant predictor of walking speed, .polypharmacy, frailty, and mortality in fully adjusted models. Results indicate that the GrimAge clock represents a step-improvement in the predictive utility of the epigenetic clocks for identifying age-related decline in an array of clinical phenotypes promising to advance precision medicine.
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Affiliation(s)
- Cathal McCrory
- Department of Medical Gerontology, Trinity College Dublin, Ireland
| | - Giovanni Fiorito
- Department of Biomedical Sciences, University of Sassari, Italy.,MRC Centre for Environment and Health, School of Public Medicine, Imperial College London, UK
| | | | | | | | - Ann Hever
- Department of Medical Gerontology, Trinity College Dublin, Ireland
| | | | - Ake T Lu
- Department of Human Genetics, David Geffen School of Medicine, Department of Biostatistics Fielding School of Public Health, University of California Los Angeles
| | - Steve Horvath
- Department of Human Genetics, David Geffen School of Medicine, Department of Biostatistics Fielding School of Public Health, University of California Los Angeles
| | - Paolo Vineis
- MRC Centre for Environment and Health, School of Public Medicine, Imperial College London, UK
| | - Rose Anne Kenny
- Department of Medical Gerontology, Trinity College Dublin, Ireland
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18
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Mc Ardle A, Kwasnik A, Szenpetery A, Hernandez B, Parnell A, de Jager W, de Roock S, FitzGerald O, Pennington SR. Identification and Evaluation of Serum Protein Biomarkers Which Differentiate Psoriatic from Rheumatoid Arthritis. Arthritis Rheumatol 2021; 74:81-91. [PMID: 34114357 DOI: 10.1002/art.41899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 06/08/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To identify serum protein biomarkers which might separate early inflammatory arthritis (EIA) patients with psoriatic arthritis (PsA) from those with rheumatoid arthritis (RA) and may be used to support appropriate early intervention. METHODS The serum proteome of patients with PsA and RA was interrogated using nano-flow liquid chromatography mass spectrometry (nLC-MS/MS) (n=64 patients), an aptamer-based assay (SOMAscan) targeting 1,129 proteins (n=36 patients) and a multiplexed antibody assay (Luminex) for 48 proteins (n=64 patients). Multiple reaction monitoring assays (MRM) were developed to evaluate the performance of putative markers using the discovery cohort (n=60) and subsequently an independent cohort of PsA and RA patients (n=167). RESULTS Multivariate machine learning analysis of the protein discovery data from the three platforms revealed that it was possible to discriminate PsA from RA patients with an area under the curve (AUC) of 0.94 for nLC-MS/MS, 0.69 for bead based immunoassay measurements and 0.73 for aptamer based analysis. Subsequently in the separate verification and evaluation studies, random forest models revealed that a subset of proteins measured by MRM could differentiate PsA and RA patients with AUCs of 0.79 and 0.85 respectively. CONCLUSION We report a serum protein biomarker panel which can separate EIA patients with PsA from those with RA. With continued evaluation and refinement using additional and larger patient cohorts including those with other arthropathies we suggest the panel identified here could contribute toward improved clinical decision making.
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Affiliation(s)
- Angela Mc Ardle
- UCD Conway Institute of Biomolecular and Biomedical Research, School of Medicine, University College Dublin, Ireland
| | - Anna Kwasnik
- UCD Conway Institute of Biomolecular and Biomedical Research, School of Medicine, University College Dublin, Ireland
| | - Agnes Szenpetery
- UCD Conway Institute of Biomolecular and Biomedical Research, School of Medicine, University College Dublin, Ireland
| | - Belinda Hernandez
- School of Medical Gerontology, TILDA (The Irish Longitudinal Study on Aging), Trinity College Dublin, Ireland.,School of Mathematics and Statistics, University College Dublin, Ireland
| | - Andrew Parnell
- School of Mathematics and Statistics, University College Dublin, Ireland
| | - Wilco de Jager
- Department of Paediatric Immunology, Laboratory of Translation Immunology LTI, Wilhelmina Children Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.,Multiplex Core Facility, Laboratory of Translational Immunology LTI, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Sytze de Roock
- Multiplex Core Facility, Laboratory of Translational Immunology LTI, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Oliver FitzGerald
- UCD Conway Institute of Biomolecular and Biomedical Research, School of Medicine, University College Dublin, Ireland
| | - Stephen R Pennington
- UCD Conway Institute of Biomolecular and Biomedical Research, School of Medicine, University College Dublin, Ireland
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19
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Moloney D, O’Connor J, Newman L, Scarlett S, Hernandez B, Kenny RA, Romero-Ortuno R. Clinical clustering of eight orthostatic haemodynamic patterns in The Irish Longitudinal Study on Ageing (TILDA). Age Ageing 2021; 50:854-860. [PMID: 32894746 PMCID: PMC8098799 DOI: 10.1093/ageing/afaa174] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Orthostatic hypotension (OH) can be assessed with non-invasive continuous beat-to-beat haemodynamic monitoring during active stand (AS) testing; this yields large volumes of data outside the scope of the traditional OH definition. We explored clinical associations of different AS patterns in participants from Wave 1 of the Irish Longitudinal Study on Ageing. METHODS AS patterns were generated based on three sequential binary systolic blood pressure features: drop ≥40 mmHg within 10 sec post-stand ("immediate deficit"), failure to return to within 20 mmHg of supine level at 40 sec after standing ("stabilisation deficit") and drop ≥20 mmHg between >40 and 120 sec post-stand ("late deficit"). Eight AS groups resulted from combining the presence/absence of these three features. The groups were cross-sectionally characterised, and their ability to independently predict orthostatic intolerance (OI) during AS, and falls or syncope in the past year, was evaluated using multivariate logistic regression models. RESULTS A total of 4,899 participants were included (mean age 61), of which 3,312 (68%) had no deficits. Older age was associated with stabilisation deficit and late deficits were seen in groups with higher proportions of beta blockers and psychotropic medications. Regression models identified independent associations between OI and three immediate-deficit groups; associations seemed stronger as more deficits were present. There was a significant association between falls history and the three-deficit group (odds ratio 1.54, 95% confidence interval: 1.15-2.07, P = 0.004). CONCLUSIONS More deficits seemed associated with the higher risk of OI and falls history. Observations are not causal but the recognition of these patterns may help clinicians focus on careful prescribing.
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Affiliation(s)
- David Moloney
- Address correspondence to: Dr David Moloney, The Irish Longitudinal Study on Ageing (TILDA), Trinity Central, 152-160 Pearse Street, Dublin D02 R590, Republic of Ireland. Tel: (+353) 1 896 2509; Fax: (+353) 1 896 3407.
| | - John O’Connor
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Louise Newman
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Siobhan Scarlett
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Belinda Hernandez
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
- Falls and Syncope Unit, Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
- Falls and Syncope Unit, Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
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20
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Tonry C, McDonald K, Ledwidge M, Hernandez B, Glezeva N, Rooney C, Morrissey B, Pennington SR, Baugh JA, Watson CJ. Multiplexed measurement of candidate blood protein biomarkers of heart failure. ESC Heart Fail 2021; 8:2248-2258. [PMID: 33779078 PMCID: PMC8120401 DOI: 10.1002/ehf2.13320] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 02/01/2021] [Accepted: 03/12/2021] [Indexed: 12/13/2022] Open
Abstract
AIMS There is a critical need for better biomarkers so that heart failure can be diagnosed at an earlier stage and with greater accuracy. The purpose of this study was to design a robust mass spectrometry (MS)-based assay for the simultaneous measurement of a panel of 35 candidate protein biomarkers of heart failure, in blood. The overall aim was to evaluate the potential clinical utility of this biomarker panel for prediction of heart failure in a cohort of 500 patients. METHODS AND RESULTS Multiple reaction monitoring (MRM) MS assays were designed with Skyline and Spectrum Mill PeptideSelector software and developed using nanoflow reverse phase C18 chromatographic Chip Cube-based separation, coupled to a 6460 triple quadrupole mass spectrometer. Optimized MRM assays were applied, in a sample-blinded manner, to serum samples from a cohort of 500 patients with heart failure and non-heart failure (non-HF) controls who had cardiovascular risk factors. Both heart failure with reduced ejection fraction (HFrEF) patients and heart failure with preserved ejection fraction (HFpEF) patients were included in the study. Peptides for the Apolipoprotein AI (APOA1) protein were the most significantly differentially expressed between non-HF and heart failure patients (P = 0.013 and P = 0.046). Four proteins were significantly differentially expressed between non-HF and the specific subtypes of HF (HFrEF and HFpEF); Leucine-rich-alpha-2-glycoprotein (LRG1, P < 0.001), zinc-alpha-2-glycoprotein (P = 0.005), serum paraoxanse/arylesterase (P = 0.013), and APOA1 (P = 0.038). A statistical model found that combined measurements of the candidate biomarkers in addition to BNP were capable of correctly predicting heart failure with 83.17% accuracy and an area under the curve (AUC) of 0.90. This was a notable improvement on predictive capacity of BNP measurements alone, which achieved 77.1% accuracy and an AUC of 0.86 (P = 0.005). The protein peptides for LRG1, which contributed most significantly to model performance, were significantly associated with future new onset HF in the non-HF cohort [Peptide 1: odds ratio (OR) 2.345 95% confidence interval (CI) (1.456-3.775) P = 0.000; peptide 2: OR 2.264 95% CI (1.422-3.605), P = 0.001]. CONCLUSIONS This study has highlighted a number of promising candidate biomarkers for (i) diagnosis of heart failure and subtypes of heart failure and (ii) prediction of future new onset heart failure in patients with cardiovascular risk factors. Furthermore, this study demonstrates that multiplexed measurement of a combined biomarker signature that includes BNP is a more accurate predictor of heart failure than BNP alone.
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Affiliation(s)
- Claire Tonry
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, 97 Lisburn Rd, Belfast, BT9 7BL, UK
| | - Ken McDonald
- UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland
| | - Mark Ledwidge
- UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland
| | - Belinda Hernandez
- UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland
| | - Nadezhda Glezeva
- UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland
| | - Cathy Rooney
- UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland
| | - Brian Morrissey
- UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland
| | - Stephen R Pennington
- UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland
| | - John A Baugh
- UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland
| | - Chris J Watson
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, 97 Lisburn Rd, Belfast, BT9 7BL, UK.,UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland
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21
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Ruiz Colón GDM, Mulaney B, Reed RE, Ha SK, Yuan V, Liu X, Cao S, Ambati VS, Hernandez B, Cáceres W, Charon M, Singh B. The COVID-19 Pandemic as an Opportunity for Operational Innovation at 2 Student-Run Free Clinics. J Prim Care Community Health 2021; 12:2150132721993631. [PMID: 33615883 PMCID: PMC7900784 DOI: 10.1177/2150132721993631] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The onset of the COVID-19 pandemic and subsequent county shelter-in-place order forced
the Cardinal Free Clinics (CFCs), Stanford University’s 2 student-run free clinics, to
close in March 2020. As student-run free clinics adhering to university-guided COVID
policies, we have not been able to see patients in person since March of 2020. However,
the closure of our in-person operations provided our student management team with an
opportunity to innovate. In consultation with Stanford’s Telehealth team and educators, we
rapidly developed a telehealth clinic model for our patients. We adapted available
telehealth guidelines to meet our patient care needs and educational objectives, which
manifested in 3 key innovations: reconfigured clinic operations, an evidence-based social
needs screen to more effectively assess and address social needs alongside medical needs,
and a new telehealth training module for student volunteers. After 6 months of piloting
our telehealth services, we believe that these changes have made our services and
operations more robust and provided benefit to both our patients and volunteers. Despite
an uncertain and evolving public health landscape, we are confident that these
developments will strengthen the future operations of the CFCs.
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Affiliation(s)
- Gabriela D M Ruiz Colón
- Stanford University School of Medicine, Stanford, CA, USA.,Stanford University, Cardinal Free Clinincs, Stanford, CA, USA
| | - Bianca Mulaney
- Stanford University School of Medicine, Stanford, CA, USA.,Stanford University, Cardinal Free Clinincs, Stanford, CA, USA
| | - Ruby E Reed
- Stanford University School of Medicine, Stanford, CA, USA.,Stanford University, Cardinal Free Clinincs, Stanford, CA, USA
| | - Sierra K Ha
- Stanford University, Cardinal Free Clinincs, Stanford, CA, USA.,Stanford University, Stanford, CA, USA
| | - Victoria Yuan
- Stanford University, Cardinal Free Clinincs, Stanford, CA, USA
| | - Xichong Liu
- Stanford University School of Medicine, Stanford, CA, USA.,Stanford University, Cardinal Free Clinincs, Stanford, CA, USA
| | - Siqi Cao
- Stanford University School of Medicine, Stanford, CA, USA.,Stanford University, Cardinal Free Clinincs, Stanford, CA, USA
| | - Vardhaan S Ambati
- Stanford University, Cardinal Free Clinincs, Stanford, CA, USA.,Stanford University, Stanford, CA, USA
| | | | - Wendy Cáceres
- Stanford University School of Medicine, Stanford, CA, USA.,Stanford University, Cardinal Free Clinincs, Stanford, CA, USA
| | - Mina Charon
- Stanford University, Cardinal Free Clinincs, Stanford, CA, USA.,VA Palo Alto Division, Palo Alto, CA, USA
| | - Baldeep Singh
- Stanford University School of Medicine, Stanford, CA, USA.,Stanford University, Cardinal Free Clinincs, Stanford, CA, USA
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22
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Lin J, Li S, Pezzi T, Mohamed A, Fuller C, Chen A, Minsky B, Schwartz D, Hernandez B, Chun S. CP01.06 Veterans Affairs Insurance Disparities for Metastatic Lung Cancer in the Hawaiian Islands. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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23
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Tsai J, Schick V, Hernandez B, Pietrzak RH. Is homelessness a traumatic event? Results from the 2019-2020 National Health and Resilience in Veterans Study. Depress Anxiety 2020; 37:1137-1145. [PMID: 32949084 DOI: 10.1002/da.23098] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/31/2020] [Accepted: 09/10/2020] [Indexed: 11/09/2022] Open
Abstract
METHODS Data from a nationally representative sample of 4,069 U.S. veterans in 2019-2020 were used to examine the prevalence of full and subthreshold PTSD in veterans with a history of homelessness; identify characteristics associated with PTSD; examine the proportion of veterans who reported homelessness as an index trauma event and screened positive for PTSD. RESULTS Among veterans with a history of homelessness, lifetime prevalence of full and subthreshold PTSD was 33.0% and 32.0%; and past-month prevalence of full and subthreshold PTSD was 5.6% and 12.7%. These prevalence estimates were more than five times higher than nonhomeless veterans. Among veterans with a history of homelessness, 14.1% reported that homelessness was their "worst" traumatic event which was associated with a fivefold greater odds of current PTSD and nearly threefold greater odds of subthreshold PTSD even after adjustment for other trauma exposures. CONCLUSIONS Veterans who have been homeless have extensive trauma histories and both events that occur during homelessness and the experience of homelessness itself may be traumatic and lead to PTSD, substantiating efforts to provide trauma-informed care for this population.
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Affiliation(s)
- Jack Tsai
- U.S. Department of Veterans Affairs, National Center on Homelessness Among Veterans, Tampa, Florida, USA.,School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Vanessa Schick
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Belinda Hernandez
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA
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24
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Leu-Burke GM, Hernandez B. Transmission Of ESBL Producing Klebsiella Ozaenae Between Wildlife And Domesticated Animals. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction/Objective
Animal and human interaction can result in zoonotic transmission, colonization and risk for infectious disease. However wildlife exposure to humans through domesticated animals is not fully understood.
Alaska’s largest urban city, Anchorage, is home to approximately one thousand moose migrating into city parks and suburban backyards with an environmental impact from fecal contamination. As domesticated canines inhabit the same environment there is a potential public health for microbial transfer from wildlife to humans.
Methods
In order to determine potential risk of zoonosis from wildlife to domesticated animals, we ground collected fecal samples from three related canines (Chico, Kali, Chubs), moose habituating the canine’s backyard and from an unrelated canine (Odin) who lived nearby, but did not inhabit the same backyard environment. Observation of canine outdoor activity, including rolling and digging in the soil, was also evaluated. Using standard microbial techniques, all fecal samples were cultured for enterobacteriaceae and further identified by biochemical testing, along with antimicrobial resistance using conventional minimum inhibition concentration antibiotic panels. Phenotypic evaluation for extended spectrum beta-lactamase enzyme was performed using antibiotic disc diffusion.
Results
Fecal samples from the moose contained identical biotype and antimicrobial resistance of ESBL producing Klebsiella ozaenae with related canines Chico and Chubs. Chico and Chubs consistently exposed themselves to moose fecal matter by digging in contaminated soil, indicating aerosol transmission. Although Kali and Odin interacted with Chico and Chubs, they were not colonized suggesting a lack of microbial transmission between domesticated animals.
Conclusion
Close proximity to moose in urban Anchorage draws our attention to their commensal microbiome and potential for infectious transfer. Domesticated animals inhabit shared environment and are at risk for colonization during exposure to wildlife fecal contaminated soil and water. In a limited study, we found transfer of ESBL Klebsiella ozaenae from moose to domesticated animals in a shared urban residence. Human contact with infected domesticated animals, along with aerosol soil exposure during gardening or landscaping activities, presents opportunity for zoonosis from urban wildlife and a risk for colonization of multi-drug resistant bacteria.
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Affiliation(s)
- G M Leu-Burke
- College of Health, University of Alaska Anchorage, Anchorage, Alaska, UNITED STATES
| | - B Hernandez
- College of Health, University of Alaska Anchorage, Anchorage, Alaska, UNITED STATES
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25
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Markham CM, Peskin MF, Baumler ER, Addy RC, Thiel MA, Laris BA, Baker K, Hernandez B, Shegog R, Coyle K, Emery ST. Socio-Ecological Factors Associated With Students' Perceived Impact of an Evidence-Based Sexual Health Education Curriculum. J Sch Health 2020; 90:604-617. [PMID: 32510609 DOI: 10.1111/josh.12908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 10/03/2019] [Accepted: 01/31/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although schools often implement evidence-based sexual health education programs to address sexual and reproductive health disparities, multiple factors may influence program effectiveness. METHODS Using student-reported perceived impact measures as a proxy for program effectiveness, we employed a socio-ecological approach to examine student, teacher, school, and district factors associated with greater perceived impact of It's Your Game (IYG), an evidence-based middle school sexual health education program. The student sample was 58.7% female, 51.8% Hispanic, mean age 13.2 years, from 73 middle schools. We assessed students' (N = 4531) perceived impact of IYG on healthy decision-making (α = 0.75) and sexual communication (α = 0.71); satisfaction with IYG activities and teacher; and demographics. We assessed teachers' (N = 56) self-efficacy to teach IYG, perceived administrative support, implementation barriers, and demographics. School and district data were abstracted from state records. We used multilevel logistic regression to estimate associations between independent variables and student-reported perceived impact. RESULTS In final multivariate models, students' demographics (sex, β = 0.06, SE = 0.015), satisfaction with IYG (β = 0.21, SE = 0.012), and their IYG teacher (β = 0.18, SE = 0.013) (all p = .000) were significantly associated with perceived impact on healthy decision-making. Similar findings resulted for sexual communication. No other variables were significantly associated with perceived impact. CONCLUSIONS Helping schools select age-appropriate, culturally relevant programs, and facilitate supportive learning environments may enhance the perceived impact of sexual health education programs.
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Affiliation(s)
- Christine M Markham
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | - Melissa F Peskin
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | | | - Robert C Addy
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | | | - B A Laris
- ETR, 100 Enterprise Way, Suite G300, Scotts Valley, CA, 95066
| | - Kimberly Baker
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | - Belinda Hernandez
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | - Ross Shegog
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
| | - Karin Coyle
- ETR, 100 Enterprise Way, Suite G300, Scotts Valley, CA, 95066
| | - Susan Tortolero Emery
- The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin Street, Houston, TX, 77030
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Rawson TM, Hernandez B, Moore LSP, Blandy O, Herrero P, Gilchrist M, Gordon A, Toumazou C, Sriskandan S, Georgiou P, Holmes AH. Supervised machine learning for the prediction of infection on admission to hospital: a prospective observational cohort study. J Antimicrob Chemother 2020; 74:1108-1115. [PMID: 30590545 DOI: 10.1093/jac/dky514] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 10/11/2018] [Accepted: 11/14/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Infection diagnosis can be challenging, relying on clinical judgement and non-specific markers of infection. We evaluated a supervised machine learning (SML) algorithm for diagnosing bacterial infection using routinely available blood parameters on presentation to hospital. METHODS An SML algorithm was developed to classify cases into infection versus no infection using microbiology records and six available blood parameters (C-reactive protein, white cell count, bilirubin, creatinine, ALT and alkaline phosphatase) from 160203 individuals. A cohort of patients admitted to hospital over a 6 month period had their admission blood parameters prospectively inputted into the SML algorithm. They were prospectively followed up from admission to classify those who fulfilled clinical case criteria for a community-acquired bacterial infection within 72 h of admission using a pre-determined definition. Predictive ability was assessed using receiver operating characteristics (ROC) with cut-off values for optimal sensitivity and specificity explored. RESULTS One hundred and four individuals were included prospectively. The median (range) cohort age was 65 (21-98) years. The majority were female (56/104; 54%). Thirty-six (35%) were diagnosed with infection in the first 72 h of admission. Overall, 44/104 (42%) individuals had microbiological investigations performed. Treatment was prescribed for 33/36 (92%) of infected individuals and 4/68 (6%) of those with no identifiable bacterial infection. Mean (SD) likelihood estimates for those with and without infection were significantly different. The infection group had a likelihood of 0.80 (0.09) and the non-infection group 0.50 (0.29) (P < 0.01; 95% CI: 0.20-0.40). ROC AUC was 0.84 (95% CI: 0.76-0.91). CONCLUSIONS An SML algorithm was able to diagnose infection in individuals presenting to hospital using routinely available blood parameters.
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Affiliation(s)
- T M Rawson
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK.,Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London, UK
| | - B Hernandez
- Department of Electrical and Electronic Engineering, Imperial College London, South Kensington Campus, London, UK
| | - L S P Moore
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK.,Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London, UK
| | - O Blandy
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
| | - P Herrero
- Department of Electrical and Electronic Engineering, Imperial College London, South Kensington Campus, London, UK
| | - M Gilchrist
- Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London, UK
| | - A Gordon
- Section of Anaesthetics, Pain Medicine & Intensive Care, Imperial College London, South Kensington Campus, London, UK
| | - C Toumazou
- Department of Electrical and Electronic Engineering, Imperial College London, South Kensington Campus, London, UK
| | - S Sriskandan
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK.,Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London, UK
| | - P Georgiou
- Department of Electrical and Electronic Engineering, Imperial College London, South Kensington Campus, London, UK
| | - A H Holmes
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK.,Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London, UK
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Zeitzer JM, Joyce DS, Sterkel AL, Quevedo YL, Hernandez B, Holty J. 0781 Impact Of Suvorexant On Total Daytime Sleep Hours In Shift Workers: A Randomized, Double-blind, Placebo-controlled Clinical Field Trial. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Many shift workers have an inability to sleep during the daytime following a night shift not due to insomnia or lack of sleep pressure, but because a circadian signal promoting wakefulness is hampering their ability to maintain sleep. We have previously hypothesized that the neuropeptide hypocretin-1 is, in part, responsible for the physiologic expression of this circadian wake signal. As such, it was our intent to determine whether a pharmacologic blockade of hypocretin would enable shift workers to obtain more daytime sleep.
Methods
Nineteen shift workers took part in a placebo-controlled, double-blind field study of suvorexant. Following two weeks of baseline, participants received 10 mg suvorexant/placebo for one week and were titrated upward to 20 mg suvorexant/placebo for an additional two weeks. Subjective (diaries) and objective (actigraphy) sleep were monitored throughout. No restrictions were placed on participants’ schedules.
Results
Both subjective and objective measures of total sleep time significantly improved in the active vs. the placebo condition, increasing by 2.08 ± 0.47 hours (diary) or 1.04 ± 0.53 hours (actigraphy) by the end of the 10 mg condition, and increasing by 2.97 ± 0.56 hours (diary) or 2.16 ± 0.75 hours (actigraphy) by the end of the 20 mg condition. Physician ratings of change in the severity of symptoms similarly improved in the active group. There were no adverse events reported in the active condition.
Conclusion
Robust changes in total sleep time were observed after administration of suvorexant, a dual-hypocretin antagonist, prior to daytime sleep in a field study of shift workers. The very large changes in total sleep time, coupled with the permissive nature of the therapeutic mechanism (i.e., suppressing wake rather than inducing sleep) indicate that this could be a viable and important therapy for shift workers.
Support
Merck Sharpe and Dohme investigator-initiated study #53236
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Affiliation(s)
| | | | | | - Y L Quevedo
- VA Palo Alto Health Care System, Palo Alto, CA
| | - B Hernandez
- VA Palo Alto Health Care System, Palo Alto, CA
| | - J Holty
- Stanford University, Palo Alto, CA
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Kinoshita L, Blank E, Chen M, Doudell K, Day Y, Alipio Jocson V, Lazzeroni L, Noda A, Hernandez B, Holty J, Kuschner W, Kushida C, Yaffe K, Cheng J, Yesavage JA. 0652 A Novel Cognitive-Behavioral Therapy to Increase PAP Adherence in Veterans With Posttraumatic Stress Disorder: Preliminary Results. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The occurrence of obstructive sleep apnea (OSA) is high in veterans with posttraumatic stress disorder (PTSD). Our previous research on OSA in Vietnam-era veterans found that 69% had an AHI≥10 (Yesavage, 2012). Efficacious treatments are available for OSA, PAP therapy; however, veterans with OSA frequently fail to use them (Yesavage, 2012; Kuna, 2011). Of the veterans diagnosed with OSA, 63% were not using their prescribed PAP device. The reasons for low PAP adherence include discomfort using PAP and psychological barriers. We developed a novel cognitive-behavioral therapy (CBT) intervention to increase PAP adherence in veterans with PTSD and OSA, called CBT-OSA.
Methods
Participants included 37 veterans age 18+ from clinics at VA Palo Alto. Participants were randomly assigned to CBT-OSA or an education arm. All participants received treatment as usual in VA Pulmonary Service or a community-based Sleep Medicine Center. Participants in CBT-OSA received therapy from a Clinical Psychologist. The other veterans received education sessions. All participants received weekly, individual sessions during the first four weeks of PAP treatment. Average mask on time was calculated for each participant during week 1-4 of PAP use.
Results
An independent samples t-test was conducted to compare average mask on time in the CBT-OSA and education conditions. There was a significant difference in the average mask on time for CBT-OSA (M=235.33, SD=139.22) and education (M=136.68; SD=149.19); t(35)=-2.08, p=0.045. These results suggest that veterans who received the CBT treatment increased their PAP use compared to the veterans in the education condition.
Conclusion
CBT-OSA has shown early efficacy. CBT-OSA increased PAP adherence in veterans with PTSD compared to veterans in the education condition. Veterans receiving CBT-OSA demonstrated a longer average mask on time compared to veterans in the education condition. We are following the participants for one year to examine if CBT-OSA fosters long-term PAP adherence.
Support
This research is supported by the Research Service of the Department of Veterans Affairs (Grant Number 1I01RX001799-01A2).
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Affiliation(s)
- L Kinoshita
- VA Palo Alto Health Care System, Palo Alto, CA
| | - E Blank
- VA Palo Alto Health Care System, Palo Alto, CA
| | - M Chen
- VA Palo Alto Health Care System, Palo Alto, CA
| | - K Doudell
- University of Alabama, Tuscaloosa, AL
| | - Y Day
- VA Palo Alto Health Care System, Palo Alto, CA
| | | | | | - A Noda
- Stanford University, Palo Alto, CA
| | | | - J Holty
- VA Palo Alto Health Care System, Palo Alto, CA
| | - W Kuschner
- VA Palo Alto Health Care System, Palo Alto, CA
| | | | - K Yaffe
- San Francisco VA Medical Center, San Francisco, CA
| | - J Cheng
- VA Palo Alto Health Care System, Palo Alto, CA
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Goldblatt DL, Flores JR, Valverde Ha G, Jaramillo AM, Tkachman S, Kirkpatrick CT, Wali S, Hernandez B, Ost DE, Scott BL, Chen J, Evans SE, Tuvim MJ, Dickey BF. Inducible epithelial resistance against acute Sendai virus infection prevents chronic asthma-like lung disease in mice. Br J Pharmacol 2020; 177:2256-2273. [PMID: 31968123 DOI: 10.1111/bph.14977] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/16/2019] [Accepted: 01/03/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND PURPOSE Respiratory viral infections play central roles in the initiation, exacerbation and progression of asthma in humans. An acute paramyxoviral infection in mice can cause a chronic lung disease that resembles human asthma. We sought to determine whether reduction of Sendai virus lung burden in mice by stimulating innate immunity with aerosolized Toll-like receptor (TLR) agonists could attenuate the severity of chronic asthma-like lung disease. EXPERIMENTAL APPROACH Mice were treated by aerosol with 1-μM oligodeoxynucleotide (ODN) M362, an agonist of the TLR9 homodimer, and 4-μM Pam2CSK4 (Pam2), an agonist of the TLR2/6 heterodimer, within a few days before or after Sendai virus challenge. KEY RESULTS Treatment with ODN/Pam2 caused ~75% reduction in lung Sendai virus burden 5 days after challenge. The reduction in acute lung virus burden was associated with marked reductions 49 days after viral challenge in eosinophilic and lymphocytic lung inflammation, airway mucous metaplasia, lumenal mucus occlusion and hyperresponsiveness to methacholine. Mechanistically, ODN/Pam2 treatment attenuated the chronic asthma phenotype by suppressing IL-33 production by type 2 pneumocytes, both by reducing the severity of acute infection and by down-regulating Type 2 (allergic) inflammation. CONCLUSION AND IMPLICATIONS These data suggest that treatment of susceptible human hosts with aerosolized ODN and Pam2 at the time of a respiratory viral infection might attenuate the severity of the acute infection and reduce initiation, exacerbation and progression of asthma.
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Affiliation(s)
- David L Goldblatt
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jose R Flores
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gabriella Valverde Ha
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ana M Jaramillo
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sofya Tkachman
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carson T Kirkpatrick
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shradha Wali
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Belinda Hernandez
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David E Ost
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Jichao Chen
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Scott E Evans
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael J Tuvim
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Burton F Dickey
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Oliveira IM, Hernandez B, Kenny RA, Reilly RB. Automatic Disability Categorisation based on ADLs among Older Adults in a Nationally Representative Population using Data Mining Methods. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:2466-2469. [PMID: 31946397 DOI: 10.1109/embc.2019.8856780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The world's ageing population is rapidly increasing but people's healthspan is not being sustained. Activities of daily living and Montreal Cognitive Assessment scores from the first wave of a large nationally representative longitudinal study in ageing (TILDA) were analysed using multiple correspondence analysis, k-means clustering, network analysis and association rules mining, to find latent patterns in the data and categorise disability among older adults. It was observed that 6.2% of the population had a greater degree of frailty, specifically cognitive impairment. Additionally, the overall population showed difficulty in performing physically demanding activities. Thus, self-reported ADLs have a diagnostic importance as they indicate the level of cognitive and physical functional decline in the older population.
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Henkel E, Hernandez B, Michalek J, Mahalingam D, Arora S. COMBINATION CHEMOTHERAPY FOR PANCREATIC CANCER IN OLDER ADULTS: EFFICACY AND SAFETY ANALYSIS OF PATIENTS AT A HISPANIC-RICH NCI-DESIGNATED CANCER CENTER. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31200-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Peskin MF, Markham CM, Shegog R, Baumler ER, Addy RC, Temple JR, Hernandez B, Cuccaro PM, Thiel MA, Gabay EK, Tortolero Emery SR. Adolescent Dating Violence Prevention Program for Early Adolescents: The Me & You Randomized Controlled Trial, 2014-2015. Am J Public Health 2019; 109:1419-1428. [PMID: 31415194 PMCID: PMC6727296 DOI: 10.2105/ajph.2019.305218] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2019] [Indexed: 11/04/2022]
Abstract
Objectives. To test the efficacy of Me & You, a multilevel technology-enhanced adolescent dating violence (DV) intervention, in reducing DV perpetration and victimization among ethnic-minority early adolescent youths. We assessed secondary impact for specific DV types and psychosocial outcomes.Methods. We conducted a group-randomized controlled trial of 10 middle schools from a large urban school district in Southeast Texas in 2014 to 2015. We used multilevel regression modeling; the final analytic sample comprised 709 sixth-grade students followed for 1 year.Results. Among the total sample, odds of DV perpetration were lower among intervention students than among control students (adjusted odds ratio = 0.46; 95% confidence interval = 0.28, 0.74). Odds of DV victimization were not significantly different. There were significant effects on some specific DV types.Conclusions. Me & You is effective in reducing DV perpetration and decreasing some forms of DV victimization in early middle-school ethnic-minority students.
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Affiliation(s)
- Melissa F Peskin
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Christine M Markham
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Ross Shegog
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Elizabeth R Baumler
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Robert C Addy
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Jeff R Temple
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Belinda Hernandez
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Paula M Cuccaro
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Melanie A Thiel
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Efrat K Gabay
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Susan R Tortolero Emery
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
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Nguyen M, Hernandez B, Olalo P, Bolaris M, Nielsen K, Bizmark-Sakai R. 216 Retrospective Study on Current Treatment for Uncomplicated Abscesses in Los Angeles County Emergency Departments from 2016-2017. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Donoghue O, Hernandez B, O'Connell M, Kenny RA. 141 Using Random Forest Plots to Examine Predictive and Discriminative Ability of Mobility Measures for Future Falls. Age Ageing 2019. [DOI: 10.1093/ageing/afz102.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Slow gait speed and Timed Up-and Go (TUG) are often independent predictors of falls in regression analysis, although their ability to discriminate between fallers and non-fallers is questionable. Random forest plots can model complex interactions between predictor variables and have high classification accuracy. We compare the predictive and discriminative ability of UGS and TUG in predicting recurrent falls over 4 years using poisson regression and random forest plots.
Methods
Data from the first three waves of The Irish Longitudinal Study on Ageing (TILDA), a population-based study of community-dwelling adults aged ≥50 years were used. Baseline physical, neuro-cognitive, sensory and behavioural health were assessed. The outcome was recurrent (≥2) falls at Wave 2 or Wave 3. Poisson regression analysis was used to examine associations between UGS, TUG and falls adjusting for covariates. Random forest models were used. Predictive accuracy was calculated using 5 fold cross-validation and as there was class imbalance, the algorithm was trained using under-sampling of the larger class. Classification rate, area under the receiver operating characteristic curve (AUC) and area under the precision recall curve (PRROC) were obtained to assess predictive accuracy.
Results
In poisson regression analysis (n=4918), TUG predicted recurrent falls independent of covariates including UGS (IRR=1.06, 95% CI: 1.01, 1.12, p<0.05). The random forest model predicted 60.82% of participants correctly (61.85% of non-fallers; 55.37% of fallers). AUC was 0.63 and PRROC was 0.28.
Conclusion
Impaired mobility i.e. slower TUG performance, is an independent predictor of future recurrent falls, however it does not discriminate well between fallers and non-fallers. This is highlighted by the PRROC which provides a more conservative estimate of predictive accuracy than AUC as it accounts for the ability to identify both fallers and non-fallers. The analysis highlights the multifactorial nature and complexity of falls, and supports the need for comprehensive falls assessment.
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Affiliation(s)
- Orna Donoghue
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Belinda Hernandez
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Matthew O'Connell
- Population Health Sciences, King’s College London, London, United Kingdom
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
- Mercer’s Institute for Successful Ageing (MISA), St James’s Hospital, Dublin, Ireland
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McGivney BA, Hernandez B, Katz LM, MacHugh DE, McGovern SP, Parnell AC, Wiencko HL, Hill EW. A genomic prediction model for racecourse starts in the Thoroughbred horse. Anim Genet 2019; 50:347-357. [PMID: 31257665 DOI: 10.1111/age.12798] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2019] [Indexed: 12/26/2022]
Abstract
Durability traits in Thoroughbred horses are heritable, economically valuable and may affect horse welfare. The aims of this study were to test the hypotheses that (i) durability traits are heritable and (ii) genetic data may be used to predict a horse's potential to have a racecourse start. Heritability for the phenotype 'number of 2- and 3-year-old starts' was estimated to be h m 2 = 0.11 ± 0.02 (n = 4499). A genome-wide association study identified SNP contributions to the trait. The neurotrimin (NTM), opioid-binding protein/cell adhesion molecule like (OPCML) and prolylcarboxypeptidase (PRCP) genes were identified as candidate genes associated with the trait. NTM functions in brain development and has been shown to have been selected during the domestication of the horse. PRCP is an established expression quantitative trait locus involved in the interaction between voluntary exercise and body composition in mice. We hypothesise that variation at these loci contributes to the motivation of the horse to exercise, which may influence its response to the demands of the training and racing environment. A random forest with mixed effects (RFME) model identified a set of SNPs that contributed to 24.7% of the heritable variation in the trait. In an independent validation set (n = 528 horses), the cohort with high genetic potential for a racecourse start had significantly fewer unraced horses (16% unraced) than did low (27% unraced) potential horses and had more favourable race outcomes among those that raced. Therefore, the information from SNPs included in the model may be used to predict horses with a greater chance of a racecourse start.
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Affiliation(s)
- B A McGivney
- Plusvital Ltd, The Highline, Dun Laoghaire Industrial Estate, Dun Laoghaire, Dublin, Ireland
| | - B Hernandez
- Prolego Scientific, Nova UCD, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland.,The Irish Longitudinal Study on Aging (TILDA), Trinity College Dublin, Dublin, D02 PN40, Ireland
| | - L M Katz
- UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland
| | - D E MacHugh
- UCD Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland.,UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland
| | - S P McGovern
- Plusvital Ltd, The Highline, Dun Laoghaire Industrial Estate, Dun Laoghaire, Dublin, Ireland
| | - A C Parnell
- Prolego Scientific, Nova UCD, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland.,School of Mathematics and Statistics, Insight Centre for Data Analytics, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland
| | - H L Wiencko
- Plusvital Ltd, The Highline, Dun Laoghaire Industrial Estate, Dun Laoghaire, Dublin, Ireland
| | - E W Hill
- Plusvital Ltd, The Highline, Dun Laoghaire Industrial Estate, Dun Laoghaire, Dublin, Ireland.,UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland
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Gohar F, McArdle A, Jones M, Callan N, Hernandez B, Kessel C, Miranda-Garcia M, Lavric M, Holzinger D, Pretzer C, Lainka E, Vastert SJ, de Roock S, FitzGerald O, Pennington SR, Foell D. Molecular signature characterisation of different inflammatory phenotypes of systemic juvenile idiopathic arthritis. Ann Rheum Dis 2019; 78:1107-1113. [DOI: 10.1136/annrheumdis-2019-215051] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/14/2019] [Accepted: 04/02/2019] [Indexed: 12/13/2022]
Abstract
ObjectivesThe International League of Associations for Rheumatology classification criteria define systemic juvenile idiopathic arthritis (SJIA) by the presence of fever, rash and chronic arthritis. Recent initiatives to revise current criteria recognise that a lack of arthritis complicates making the diagnosis early, while later a subgroup of patients develops aggressive joint disease. The proposed biphasic model of SJIA also implies a ‘window of opportunity’ to abrogate the development of chronic arthritis. We aimed to identify novel SJIA biomarkers during different disease phases.MethodsChildren with active SJIA were subgrouped clinically as systemic autoinflammatory disease with fever (SJIAsyst) or polyarticular disease (SJIApoly). A discovery cohort of n=10 patients per SJIA group, plus n=10 with infection, was subjected to unbiased label-free liquid chromatography mass spectrometry (LC-MS/MS) and immunoassay screens. In a separate verification cohort (SJIAsyst, n=45; SJIApoly, n=29; infection, n=32), candidate biomarkers were measured by multiple reaction monitoring MS (MRM-MS) and targeted immunoassays.ResultsSignatures differentiating the two phenotypes of SJIA could be identified. LC-MS/MS in the discovery cohort differentiated SJIAsyst from SJIApoly well, but less effectively from infection. Targeted MRM verified the discovery data and, combined with targeted immunoassays, correctly identified 91% (SJIAsyst vs SJIApoly) and 77% (SJIAsyst vs infection) of all cases.ConclusionsMolecular signatures differentiating two phenotypes of SJIA were identified suggesting shifts in underlying immunological processes in this biphasic disease. Biomarker signatures separating SJIA in its initial autoinflammatory phase from the main differential diagnosis (ie, infection) could aid early-stage diagnostic decisions, while markers of a phenotype switch could inform treat-to-target strategies.
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Whelan D, Delahunt E, O'Reilly M, Hernandez B, Caulfield B. Determining Interrater and Intrarater Levels of Agreement in Students and Clinicians When Visually Evaluating Movement Proficiency During Screening Assessments. Phys Ther 2019; 99:478-486. [PMID: 30657981 DOI: 10.1093/ptj/pzz004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 08/31/2018] [Indexed: 11/13/2022]
Abstract
BACKGROUND Biomechanical screening assessments are used to provide useful information about an athlete's movement proficiency. Clinically, movement proficiency is typically evaluated visually. This can result in low levels of agreement, leading to difficulties in ensuring consistent athlete assessment. OBJECTIVE The objective was to determine levels of agreement within and between physical therapists and physical therapist students when visually evaluating athletes' movement proficiency during biomechanical screening assessments. DESIGN This was an observational study. METHODS Twenty-seven physical therapists and 20 physical therapist students assessed 100 video recordings of athletes performing 4 lower-extremity biomechanical screening assessments: squat, lunge, single leg squat, and deadlift. Analysis was completed on conditioned and unconditioned data. In the conditioned data, technique deviations were induced purposefully by the athletes. In the unconditioned data, deviations occurred naturally due to increased weight or movement complexity. In order to determine levels of agreement in the assessments, participants were required to classify the athletes' movement as acceptable or aberrant. Each participant assessed the same video recordings on 2 separate occasions at least 30 days apart. Agreement levels were determined using Cohen κ and Fleiss κ. RESULTS Kappa scores at an interrater level ranged from 0.18 to 0.53, and intrarater agreement ranged from 0.38 to 0.62. Levels of agreement were higher in the conditioned data compared with the unconditioned data. Overall, the lunge and squat produced higher levels of agreement than the deadlift and single-leg squat. Students and physical therapists demonstrated similar levels of agreement. LIMITATIONS Screening assessments were evaluated through the use of video analysis. CONCLUSIONS Greater efforts are needed to ensure standardization of movement analysis.
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Affiliation(s)
- Darragh Whelan
- Insight Centre for Data Analytics, University College Dublin; and School of Public Health, Physiotherapy and Sports Science, University College Dublin, Science Centre East, Belfield, Dublin, Ireland
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin
| | - Martin O'Reilly
- Insight Centre for Data Analytics; and School of Public Health, Physiotherapy and Sports Science, University College Dublin
| | | | - Brian Caulfield
- Insight Centre for Data Analytics; and School of Public Health, Physiotherapy and Sports Science, University College Dublin
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Hernandez B, Herrero P, Rawson T, Moore LP, Toumazou C, Holmes A, Georgiou P. Enhancing antimicrobial surveillance: an automated, dynamic and interactive approach. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Goldstein-Piekarski AN, O’Hora K, Buchanan A, Lee C, Hernandez B, Zeitzer JM, Friedman L, Kushida C, Yesavage J. 0406 The Effects Of Cbt-i On Cognitive Functioning In Individuals With Insomnia And Mild Cognitive Impairment. Sleep 2018. [DOI: 10.1093/sleep/zsy061.405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A N Goldstein-Piekarski
- Stanford University, Stanford, CA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA
| | - K O’Hora
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA
| | - A Buchanan
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA
| | - C Lee
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA
| | - B Hernandez
- Stanford University, Stanford, CA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA
| | - J M Zeitzer
- Stanford University, Stanford, CA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA
| | - L Friedman
- Stanford University, Stanford, CA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA
| | | | - J Yesavage
- Stanford University, Stanford, CA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA
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Jamison JM, Fourie E, Siper PM, Trelles MP, George-Jones J, Buxbaum Grice A, Krata J, Holl E, Shaoul J, Hernandez B, Mitchell L, McKay MM, Buxbaum JD, Kolevzon A. Examining the Efficacy of a Family Peer Advocate Model for Black and Hispanic Caregivers of Children with Autism Spectrum Disorder. J Autism Dev Disord 2017; 47:1314-1322. [PMID: 28168677 DOI: 10.1007/s10803-017-3045-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Autism spectrum disorder (ASD) affects individuals across all racial and ethnic groups, yet rates of diagnosis are disproportionately higher for Black and Hispanic children. Caregivers of children with ASD experience significant stressors, which have been associated with parental strain, inadequate utilization of mental health services and lower quality of life. The family peer advocate (FPA) model has been utilized across service delivery systems to provide family-to-family support, facilitate engagement, and increase access to care. This study used a randomized controlled design to examine the efficacy of FPAs in a racially and ethnically diverse sample. Results demonstrate significantly increased knowledge of ASD and reduced levels of stress for caregivers who received the FPA intervention as compared to treatment as usual.
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Affiliation(s)
- J M Jamison
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - E Fourie
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - P M Siper
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M P Trelles
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julia George-Jones
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - A Buxbaum Grice
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - J Krata
- Private Practice, New York, NY, USA
| | - E Holl
- Saint Paul College, 235 Marshall Avenue, St. Paul, MN, 55102, USA
| | - J Shaoul
- NYC Human Resources Administration, 150 Greenwich St., New York, NY, 10007, USA
| | - B Hernandez
- Young Adult Institute (YAI) Autism Center, 460 W. 34th St., New York, NY, 10001, USA
| | - L Mitchell
- Young Adult Institute (YAI) Autism Center, 460 W. 34th St., New York, NY, 10001, USA
| | - M M McKay
- McSilver Institute for Poverty Policy and Research, New York University Silver School of Social Work, 1 Washington Square North, G03, New York, NY, 10003, USA
| | - J D Buxbaum
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA. .,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Caorsi R, Penco F, Grossi A, Insalaco A, Alessio M, Conti G, Marchetti F, Tommasini A, Martino S, Gallizzi R, Salis A, Schena F, Caroli F, Martini A, Damonte G, Ceccherini I, Gattorno M, Frémond ML, Uggenti C, Van Eyck L, Melki I, Duffy D, Bondet V, Rose Y, Neven B, Crow Y, Rodero MP, Kusche Y, Roth J, Barczyk-Kahlert K, Ferrara G, Chiocchetti A, Polizzi S, Vuch J, Vozzi D, Mondino A, Valencic E, Pastore S, Taddio A, Faletra F, Dianzani U, Ramenghi U, Tommasini A, Zhou Q, Yu X, Demirkaya E, Deuitch N, Stone D, Tsai W, Ombrello A, Romeo T, Remmers EF, Chae J, Gadina M, Welch S, Ozen S, Topaloglu R, Abinun M, Kastner DL, Aksentijevich I, Vairo D, Ferraro RM, Zani G, Galli J, De Simone M, Cattalini M, Fazzi E, Giliani S, Omoyinmi E, Standing A, Rowczenio D, Keylock A, Gomes SM, Price-Kuehne F, Nanthapisal S, Murphy C, Cullup T, Jenkins L, Gilmour K, Eleftheriou D, Lachmann H, Hawkins P, Klein N, Brogan P, Nikolayenko VB, Şahin K, Karaaslan Y, Civino A, Alighieri G, Davì S, Rondelli R, Martino S, Filocamo G, Magnolato A, Dhanrajani A, Ricci F, Gallizzi R, Olivieri A, Gerloni V, Lattanzi B, Soscia F, De Fanti A, Manzoni SM, Citiso S, Quartulli L, Chan M, La Torre F, Rigante D, Maggio MC, Marsili M, Pelagatti MA, Conter V, Fagioli F, Lepore L, Pession A, Ravelli A, Pau S, Consolaro A, Ruperto N, Garrone M, Rinaldi M, De Inocencio J, Demirkaya E, Garay S, Foell D, Lovell DJ, Lazar C, Ellsworth J, Nielsen S, Flato B, Martini A, Ravelli A, Marasco E, Aquilani A, Cascioli S, Caiello I, Moneta GM, Pires-Marafón D, Guzman J, Magni-Manzoni S, Carsetti R, De Benedetti F, Robinson E, Albani S, Beresford MW, de Jager W, de Roock S, Duong T, Ellis J, Aeschlimann FA, Hyrich K, Jervis L, Lovell D, Marshall L, Mellins ED, Minden K, Munro J, Nigrovic PA, Palman J, Roth J, Twilt M, Ruperto N, Sampath S, Schanberg LE, Thompson SD, Thomson W, Vesely R, Wallace C, Williams C, Wu Q, Wulffraat N, Eng SW, Yeung RSM, Prakken B, Wedderburn LR, Horneff G, Seyger MB, Arikan D, Kalabic J, Anderson JK, Lazar A, Williams DA, Sheikh S, Wang C, Tarzynski-Potempa R, Hymans JS, Simonini G, Scoccimarro E, Pontikaki I, Ferrara G, Giani T, Ventura A, Meroni PL, Laxer RM, Cimaz R, Minnone G, Soligo M, Caiello I, Prencipe G, Marafon DP, Magni-Manzoni S, Manni L, De Benedetti F, Laudiero LB, Hebert D, Groot N, Grein I, Wulffraat NM, Schepp R, Berbers G, de Souza CCBS, Ferriani VPL, Pileggi G, de Roock S, Grein IHR, Noone D, Scala S, Patrone E, Schoemaker C, Costello W, Wulffraat N, Parsons S, McDonagh J, Thomson W, Cohen JD, Bentayou D, Pagnoux C, Brunel MAB, Trope S, Klotsche J, Listing M, Niewerth M, Horneff G, Thon A, Huppertz HI, Mönkemöller K, Foeldvari I, Benseler SM, Föll D, Minden K, Marino A, Stagi S, Carli N, Bertini F, Giani T, Simonini G, Cimaz R, Díaz-Maldonado AS, Yeung RS, Pino S, Guarnizo P, Torres-Jimenez AR, Sanchez-Jara B, Solis-Vallejo E, Cespedes-Cruz AI, Zeferino-Cruz M, Ramirez-Miramontes JV, Kumar A, Gupta A, Kessel C, Suri D, Rawat A, Kakkar N, Singh S, Makay B, Gücenmez ÖA, Ünsal E, Magnusson B, Mördrup K, Vermé A, Lippitz K, Peterson C, Freychet C, Stephan JL, Hofer M, Belot A, Harkness CE, Rooney M, Foster L, Henry E, Taggart P, Weinhage T, Simsek D, Ozkececi CF, Kurt E, Basbozkurt G, Gok F, Demirkaya E, Gorczyca D, Postępski J, Czajkowska A, Szponar B, Hinze C, Paściak M, Gruenpeter A, Lachór-Motyka I, Augustyniak D, Olesińska E, Asuka ES, Golovko T, Aliejim SU, Clemente EI, Jimenez EI, Wittkowski H, Hernandez JC, Fernandez SB, Roca CG, Romo DM, Nieva NR, Angarita JMM, Lopez JA, Nuñez-Cuadros E, Diaz-Cordovés G, Galindo-Zavala R, Holzinger D, Urda-Cardona A, Fernández-Nebro A, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Gallo MM, Borrell RP, Barril SM, Sánchez AMM, Caballero CM, Grün N, Merlin E, Breton S, Fraitag S, Stephan JL, Wouters C, Bodemer C, Bader-Meunier B, Baldo F, Annoni F, Di Landro G, Föll D, Torreggiani S, Torcoletti M, Petaccia A, Corona F, Filocamo G, Tiller G, Buckle J, Munro J, Cox A, Gowdie P, Van Dijkhuizen P, Allen RC, Akikusa JD, Hernández-Huirache HG, Rodea-Montero ER, Cohen JD, Belot A, Fahy W, Quartier P, Sordet C, Trope S, Del Chierico F, Berggren KB, Kembe JT, Bos J, Armbrust W, Wulffraat N, van Brussel M, Cappon J, Dijkstra P, Geertzen J, Legger E, Malattia C, van Rossum M, Sauer P, Lelieveld O, Ozturk K, Buluc L, Akansel G, Muezzinoglu B, Ekinci Z, Rychkova L, Knyazeva T, Russo A, Pogodina A, Belova T, Mandzyak T, Kulesh E, Cafarotti A, Marsili M, Giannini C, Salvatore R, Lapergola G, Di Battista C, Marafon DP, Marcovecchio ML, Basilico R, Pelliccia P, Chiarelli F, Breda L, Almeida B, Tansley S, Simou S, Gunawardena H, McHugh N, ter Haar NM, Wedderburn L, Aouizerate J, Bader-Meunier B, De Antonio M, Bodemer C, Barnerias C, Bassez G, Desguerre I, Quartier P, Gherardi R, Magni-Manzoni S, Charuel JL, Authier FJ, Gitiaux C, Spencer CH, Aziz RA, Yu CY, Adler B, Bout-Tabaku S, Lintner K, Moore-Clingenpeel M, Vastert SJ, Boros C, McCann L, Ambrose N, Cortina-Borja M, Simou S, Pilkington C, Wedderburn L, Hinze C, Oommen PT, Speth F, Dallapiccola B, Haas JP, Hinze C, Oommen PT, Speth F, Haas JP, Speth F, Haas JP, Hinze C, Lavarello C, Giancane G, Prakken B, Pistorio A, Rider L, Aggarwal R, Oliveira SK, Cuttica R, Fischbach M, Sterba G, Brochard K, Dressler F, Barone P, Martini A, Burgos-Vargas R, Chalom EC, Desjonqueres M, Espada G, Fasth A, Garay SM, Herbigneaux RM, Hoyoux C, Deslandre CJ, Miller FW, De Benedetti F, Vencovsky J, Ravelli A, Martini A, Ruperto N, Sag E, Ozen S, Kale G, Topaloglu H, Talim B, Giancane G, Putignani L, Lavarello C, Pistorio A, Zulian F, Magnusson B, Avcin T, Corona F, Gerloni V, Pastore S, Marini R, Martino S, Fidanci BE, Pagnier A, Rodiere M, Soler C, Stanevicha V, Ten Cate R, Uziel Y, Vojinovic J, Ravelli A, Martini A, Ruperto N, Barut K, Villarreal AV, Acevedo N, Diaz T, Ramirez Y, Faugier E, Maldonado R, Arabshahi B, Lee JH, Leibowitz I, Okong’o LO, Arıcı S, Wilmshurst J, Esser M, Scott C, Batu ED, Emiroglu N, Sonmez HE, Tugcu GD, Arici ZS, Yalcin E, Dogru D, Simsek D, Ozcelik U, Bilginer Y, Haliloglu M, Kiper N, Ozen S, Yashiro M, Yamada M, Yabuuchi T, Kikkawa T, Nosaka N, Cakan M, Fujii Y, Saito Y, Tsukahara H, Al-Mayouf SM, AlMutiari N, Muzaffer M, shehata R, Al-Wahadneh A, Abdwani R, Al-Abrawi S, Batu ED, Abu-shukair M, El-Habahbeh Z, Alsonbul A, Szabat A, Chęć M, Opoka-Winiarska V, Kumar A, Gupta A, Rawat A, Saikia B, Şahin S, Minz RW, Suri D, Singh S, Arango C, Malagon C, Gomez MDP, Mosquera AC, Yepez R, Gonzalez T, Vargas C, Kısaarslan A, Zulian F, Balzarin M, Castaldi B, Reffo E, Sperotto F, Martini G, Meneghel A, Milanesi O, Foeldvari I, Klotsche J, Yilmaz E, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Sifuentes-Giraldo WA, Basaran Ö, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Kallinich T, Demir F, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Foeldvari I, Baildem E, Blakley M, Boros C, Ozturk K, Fligelstone K, Kienast A, Nemcova D, Pain C, Saracino A, Simoni G, Torok K, Weibel L, Helmus N, Foeldvari I, Gunduz Z, Klotsche J, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Sozeri B, Sifuentes-Giraldo WA, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Makay B, Kallinich T, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Osminina MK, Geppe NA, Niconorova OV, Ayaz N, Karashtina OV, Abbyasova OV, Shpitonkova OV, Adrovic A, Sahin S, Barut K, Durmus S, Uzun H, Kasapcopur O, Foeldvari I, Yavascan O, Klotsche J, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Aydog O, Sifuentes-Giraldo WA, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Bilginer Y, Kallinich T, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Mauro A, Fanti E, Voller F, Ekinci Z, Rusconi F, Cimaz R, Garcia-Rodriguez F, Villarreal-Treviño AV, Flores-Pineda AJ, Lara-Herrea PB, Salinas-Encinas DR, Diaz-Prieto T, Maldonado-Velazquez MR, Moreno-Espinosa S, Yıldız D, Faugier-Fuentes E, Gallizzi R, Finetti M, Crapanzano M, Cantarini L, Cattalini M, Filocamo G, Insalaco A, Mauro A, Rigante D, Gök F, Zulian F, Alessio M, Parissenti I, Ruperto N, Gattorno M, Cimaz R, Parihar MS, Singh S, Vignesh P, Gupta A, Erguven M, Rohit M, Gopalan K, Singh S, Vignesh P, Gupta A, Rohit M, Attri SV, Hong Y, Eleftheriou D, Nanthapisal S, Unsal E, Salama A, Jayne D, Little M, Brogan P, Kostina Y, Lyskina G, Shpitonkova O, Torbyak A, Lyskina G, Shirinsky O, Kasapcopur O, Mauro A, Gicchino MF, Smaldone MC, Diplomatico M, Olivieri AN, Spencer CH, Aziz RA, McClead R, Bout-Tabaku S, Patel H, Ozen S, Yu CY, Ozkececi CF, Basbozkurt G, Simsek D, Kurt E, Gok F, Demirkaya E, Cebecauerová D, Dallos T, Kabíčková E, Demirkaya E, Kynčl M, Chroustová D, Hoza J, Němcová D, Tesař V, Doležalová P, Batu ED, Sonmez HE, Hazirolan T, Ozaltin F, Sönmez HE, Bilginer Y, Ozen S, Almeida F, de Paula IHF, Sampaio MM, Arita FN, Alves AG, Santos MC, Okuda EM, Sacchetti SB, Batu ED, Falcini F, Francesca M, Stagi S, Rigante D, Lepri G, Matucci-Cerinic M, Brandi ML, Di Landro G, Torreggiani S, Petaccia A, Sözeri B, Torcoletti M, Corona F, Filocamo G, Kisaoglu H, Misir S, Demir S, Aliyazicioglu Y, Kalyoncu M, de Paula IHF, Ramalho CE, Butbul Y, Almeida FD, Alves AG, Santos MC, Sacchetti SB, Okuda EM, Calzada-Hernández J, Bou R, Iglesias E, Sánchez-Manubens J, Martínez FHP, Bilginer Y, Roca CG, Fernández SB, Angarita JMM, Anton J, Bohm M, Mahmood K, Leone V, Wood M, Yamaguchi KI, Fujikawa S, Özen S, Kim KY, Kim DY, Kim DS, Ioseliani M, Chkhaidze I, Lekishvili M, Tskhakaia N, Tvalabeishvili S, Kajrishvili A, Takakura M, Bracaglia C, Shimizu M, Inoue N, Mizuta M, Yachie A, Alizzi C, Corsello G, Maggio MC, Piram M, Maldini C, Biscardi S, Prencipe G, Desuremain N, Orzechowski C, Georget E, Regnard D, Kone-Paut I, Mahr A, Sparchez M, Damian L, Sparchez Z, Silva NA, Pardeo M, Treviño AVV, Loyola YR, Prieto TD, Fuentes EF, Velazquez MDRM, Perez P, Mosquera AC, Malagon C, Bhattad S, Rawat A, Lapeyre G, Saikia B, Minz R, Shandilya J, Singh S, Parihar MS, Singh S, Vignesh P, Gupta A, Rohit M, Maldonado R, Marasco E, Faugier E, Villarreal A, Acevedo N, Ramírez Y, Diaz T, Kostina Y, Lyskina G, Shpitonkova O, Ozturk K, Ekinci Z, Insalaco A, Özçakar ZB, Fitoz S, Yalcinkaya F, Horne A, Minoia F, Bovis F, Davi S, Pal P, Anton J, Stein K, Ferlin W, Enciso S, Kasapcopur O, Jeng M, Maritsi D, Cron RC, Ravelli A, Thorwarth A, von Stuckrad SL, Rösen-Wolff A, Luksch H, Nelson R, Hundsdoerfer P, Minden K, Krawitz P, Kallinich T, Sozeri B, Ayaz NA, Batu ED, Makay B, Şahin S, Simsek D, de Min C, Kılıc ŞS, Ozturk K, Sonmez E, Kisaarslan AP, Gucenmez OA, Cakan M, Arıcı ZS, Adrovic A, Kelesoglu F, Bilginer Y, De Benedetti F, Demirkaya E, Ekinci ZE, Dusunsel R, Unsal E, Kasapcopur O, Ozen S, Lerkvaleekul B, Vilaiyuk S, Miranda-Garcia M, Pretzer C, Ruperto N, Huppertz HI, Horneff G, Haas JP, Ganser G, Kuemmerle-Deschner J, Wittkowski H, Frosch M, Roth J, Foell D, Holzinger D, Brunner HI, Gohar F, McArdle A, Callan N, Hernandez B, Lavric M, Kessel C, Holzinger D, FitzGerald O, Pennington SR, Foell D, Quartier P, Horneff G, Peitz J, Kekow J, Klein A, Horneff G, Schulz AC, Minden K, Weller-Heinemann F, Hospach A, Haas JP, Constantin T, Put K, Vandenhaute J, Avau A, van Nieuwenhuijze A, Brisse E, Dierckx T, Rutgeerts O, Garcia-Perez JE, Toelen J, Waer M, Alexeeva E, Leclercq G, Goris A, Van Weyenbergh J, Liston A, De Somer L, Matthys P, Wouters CH, Mizuta M, Shimizu M, Inoue N, Kone-Paut I, Nakagishi Y, Yachie A, Shimizu M, Inoue N, Mizuta M, Yachie A, Ombrello MJ, Arthur V, Remmers EF, Hinks A, Marzan K, Kastner DL, Woo P, Thomson W, Stanimirovic B, Djurdjevic-Banjac B, Ljuboja O, Hugle B, Speth F, Haas JP, Maritsi D, Wulffraat N, Onoufriou MA, Vougiouka O, Eleftheriou D, Horneff G, Peitz J, Kekow J, Foell D, Bouayed K, El Hani S, Hafid I, Schneider R, Mikou N, Ioseliani M, Lekishvili M, Shelia N, Tvalabeishvili S, Kajrishvili A, Laan M, Ilisson J, Pruunsild C, Padeh S, Chasnyk V, Wouters C, Kuemmerle-Deschner JB, Kallinich T, Lauwerys B, Haddad E, Nasonov E, Trachana M, Vougiouka O, Leon K, Vritzali E, Lheritier K, Martini A, Lovell D, Schena F, Volpi S, Caorsi R, Penco F, Pastorino C, Kalli F, Omenetti A, Chiesa S, Bertoni A, Picco P, Filaci G, Aksentijevich I, Grossi A, Ceccherini I, Martini A, Traggiai E, Gattorno M, Melki I, Rose Y, Uggenti C, Fremond ML, Van Eyck L, Kitabayashi N, Gattorno M, Volpi S, Sacco O, Meyts I, Morren MA, Wouters C, Legius E, Callebaut I, Bodemer C, Rieux-Laucat F, Rodero M, Crow Y, Frémond ML, Rodero MP, Jeremiah N, Belot A, Jeziorski E, Duffy D, Bessis D, Cros G, Rice GI, Charbit B, Hulin A, Khoudour N, Caballero CM, Bodemer C, Fabre M, Berteloot L, Le Bourgeois M, Reix P, Walzer T, Moshous D, Blanche S, Fischer A, Bader-Meunier B, Rieux-Laucat F, Crow Y, Neven B, Annink K, ter Haar N, Al-Mayouf S, Amaryan G, Anton J, Barron K, Benseler S, Brogan P, Cantarini L, Cattalini M, Cochino A, De Benedetti F, Dedeoglu F, De Jesus A, Dellacasa O, Demirkaya E, Dolezalova P, Durrant K, Fabio G, Gallizzi R, Goldbach-Mansky R, Hachulla E, Hentgen V, Herlin T, Hofer M, Hoffman H, Insalaco A, Jansson A, Kallinich T, Koné-Paut I, Kozlova A, Kuemmerle-Deschner J, Lachmann H, Laxer R, Martini A, Nielsen S, Nikishina I, Ombrello A, Ozen S, Papadopoulou-Alataki E, Quartier P, Ravelli A, Rigante D, Russo R, Simon A, Trachana M, Uziel Y, Gattorno M, Frenkel J, ter Haar N, Jeyaratnam J, Lachmann H, Simon A, Brogan P, Doglio M, Cattalini M, Anton J, Modesto C, Quartier P, Hoppenreijs E, Martino S, Insalaco A, Cantarini L, Lepore L, Alessio M, Penades IC, Boros C, Consolini R, Rigante D, Russo R, Schmid JP, Lane T, Martini A, Ruperto N, Frenkel J, Gattorno M, Passarelli C, Pisaneschi E, Messia V, Pardeo M, Novelli A, Debenedetti F, Insalaco A, Brogan PA, Hofer M, Kuemmerle-Deschner JB, Lauwerys B, Speziale A, Wei X, Laxer R, Insalaco A, Marafon DP, Finetti M, Pardeo M, Martino S, Cattalini M, Alessio M, Orlando F, Taddio A, Pastore S, Cortis E, Miniaci A, Ruperto N, Martini A, De Benedetti F, Gattorno M, Eijkelboom C, ter Haar N, Cantarini L, Finetti M, Brogan P, Dolezalova P, Koné-Paut I, Insalaco A, Jelusic-Drazic M, Bezrodnik L, Pinedo MC, Stanevicha V, van Gijn M, Federici S, Ruperto N, Frenkel J, Gattorno M, Girschick H, Finetti M, Orlando F, Insalaco A, Ganser G, Nielsen S, Herlin T, Koné-Paut I, Martino S, Cattalini M, Anton J, Al-Mayouf SM, Hofer M, Quartier P, Boros C, Kuemmerle-Deschner J, Schalm S, Alessio M, Ruperto N, Martini A, Jansson A, Gattorno M, Finetti M, Marchi M, Marini C, Doglio M, Malattia C, Ravelli A, Martini A, Garaventa A, Gattorno M, Bertoni A, Carta S, Balza E, Castellani P, Pellecchia C, Penco F, Schena F, Borghini S, Trotta ML, Pastorino C, Ceccherini I, Martini A, Gattorno M, Rubartelli A, Chiesa S, Guzman J, Henrey A, Loughin T, Berard R, Shiff N, Jurencak R, Benseler S, Tucker L, Papadopoulou C, Hong Y, Krol P, Ioannou Y, Pilkington C, Chaplin H, Simou S, Charakida M, Wedderburn L, Brogan P, Eleftheriou D, Spiegel LR, Kohut SA, Stinson J, Forgeron P, Kaufman M, Luca N, Amaria K, Bell M, Swart J, Boris F, Castagnola E, Groll A, Giancane G, Horneff G, Huppertz HI, Lovell D, Wolfs T, Hofer M, Alekseeva E, Panaviene V, Nielsen S, Anton J, Uettwiller F, Stanevicha V, Trachana M, De Benedetti F, Ailioaie LM, Tsitami E, Kamphuis S, Herlin T, Dolezalova P, Susic G, Sztajnbok F, Flato B, Pistorio A, Martini A, Wulffraat N, Ruperto N, Shoop SJW, Verstappen SMM, McDonagh JE, Thomson W, Hyrich KL, Tarkiainen M, Tynjala P, Lahdenne P, Martikainen J, Wilkinson M, Piper C, Otto G, Deakin CT, Dowle S, Simou S, Kelberman D, Ioannou Y, Mauri C, Jury E, Isenberg D, Wedderburn LR, Nistala K, Foeldvari I, Ruperto N, Lovell DJ, Horneff G, Huppertz HI, Quartier P, Simonini G, Bereswill M, Kalabic J, Martini A, Brunner HI, Oen K, Guzman J, Feldman BM, Dufault B, Lee J, Shiff N, Duffy KW, Tucker L, Duffy C, Ruperto N, Lovell DJ, Tzaribachev N, Vega-Cornejo G, Louw I, Berman A, Calvo I, Cuttica R, Horneff G, Avila-Zapata F, Anton J, Cimaz R, Solau-Gervais E, Joos R, Espada G, Li X, Nys M, Wong R, Banerjee S, Martini A, Brunner HI, Nicolai R, Marafon DP, Verardo M, D’Amico A, Bracci-Laudiero L, De Benedetti F, Moneta GM, Belot A, Rice G, Mathieu AL, Omarjee SO, Bader-Meunier B, Walzer T, Briggs TA, O’Sullivan J, Williams S, Cimaz R, Smith E, Beresford MW, Crow YJ, Rooney M, Bishop N, davidson J, pilkington C, Beresford M, Clinch J, Satyapal R, Foster H, Medwin JG, McDonagh J, Wyatt S, Modignani VL, Baldo F, Lanni S, Consolaro A, Ravelli A, Filocamo G, Omenetti A, Frenkel J, Lachmann HJ, Ozen S, Ruperto N, Gattorno M, Insalaco A, Moneta G, Pardeo M, Passarelli C, Celani C, Messia V, De Benedetti F, Cherqaoui B, Rossi-Semerano L, Dusser P, Hentgen V, Koné-Paut I, Grimwood C, Dusser P, Rossi L, Paut IK, Hentgen V, Lasigliè D, Ferrera D, Amico G, Di Duca M, Caorsi R, Lepore L, Insalaco A, Cattalini M, Obici L, Consolini R, Ravazzolo R, Martini A, Ceccherini I, Nishikomori R, Arostegui J, Gattorno M, Borghini S, Penco F, Petretto A, Lavarello C, Inglese E, Omenetti A, Finetti M, Pastorino C, Bertoni A, Gattorno M, Vanoni F, Federici S, Ozen S, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Hofer M, Kuemmerle-Deschner JB, Hoffman HM, Hawkins PN, van der Poll T, Walker UA, Speziale A, Joubert Y, Tilson HH, Kuemmerle-Deschner J, Ozen S, Tyrrell PN, Koné-Paut I, Goldbach-Mansky R, Lachmann H, Blank N, Hoffman HM, Weissbarth-Riedel E, Huegle B, Kallinich T, Gattorno M, Gul A, ter Haar NM, Oswald M, Dedeoglu F, Benseler SM, Hanaya A, Miyamae T, Kawamoto M, Tani Y, Hara T, Kawaguchi Y, Nagata S, Yamanaka H, Ćosićkić A, Skokić F, Čolić B, Suljendić S, Kozlova A, Mersiyanova I, Panina M, Hachtryan L, Burlakov V, Raikina E, Maschan A, Shcherbina A, Acar B, Albayrak M, Sozeri B, Sahin S, Barut K, Adrovic A, Inan N, Sevgi S, Kasapcopur O, Andreasen CM, Jurik AG, Glerup MB, Høst C, Mahler BT, Hauge EM, Herlin T, Lazea C, Damian L, Lazar C, Manasia R, Stephenson CM, Prajapati V, Miettunen PM, Yılmaz D, Tokgöz Y, Bulut Y, Çakmak H, Sönmez F, Comak E, Aksoy GK, Koyun M, Akman S, Arıkan Y, Terzioğlu E, Özdeş ON, Keser İ, Koçak H, Bingöl A, Yılmaz A, Artan R, De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Xu X, Mehregan FF, Ziaee V, Moradinejad MH, Ferrara G, Pastore S, Insalaco A, Pardeo M, Tommasini A, La Torre F, Alizzi C, Cimaz R, Finetti M, Gattorno M, D’Adamo P, Taddio A, Lachmann H, Simon A, Anton J, Gattorno M, Kone-Paut I, Ozen S, Frenkel J, Ben-Chetrit E, Hoffman H, Zeft A, Joubert Y, Lheritier K, Speziale A, Junge G, Gregson J, De Benedetti F, Sargsyan H, Sargsyan H, Zengin H, Fidanci BE, Kaymakamgil C, Konukbay D, Simsek D, Batu ED, Yildiz D, Gok F, Ozen S, Demirkaya E, Stoler I, Freytag J, Orak B, Seib C, Esmann L, Seipelt E, Gohar F, Foell D, Wittkowski H, Kallinich T, Dursun I, Tulpar S, Yel S, Kartal D, Borlu M, Bastug F, Poyrazoglu H, Gunduz Z, Kose K, Yuksel ME, Calıskan A, Cekgeloglu AB, Dusunsel R, Bouchalova K, Franova J, Schuller M, Macku M, Theodoropoulou K, Carlomagno R, von Scheven-Gête A, Poloni C, Hofer M, Damian LO, Cosma D, Radulescu A, Vasilescu D, Rogojan L, Lazar C, Rednic S, Lupse M, De Somer L, Moens P, Wouters C, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Forno ID, Pieropan S, Viapiana O, Gatti D, Dallagiacoma G, Caramaschi P, Biasi D, Windschall D, Trauzeddel R, Lehmann H, Ganser G, Berendes R, Haller M, Krumrey-Langkammerer M, Nimtz-Talaska A, Schoof P, Trauzeddel RF, Nirschl C, Quesada-Masachs E, Blancafort CA, Barril SM, Caballero CM, Aguiar F, Fonseca R, Alves D, Vieira A, Vieira A, Dias JA, Brito I, Susic G, Milic V, Radunovic G, Boricic I, Marteau P, Adamsbaum C, Rossi-Semerano L, De Bandt M, Lemelle I, Deslandre C, Tran TA, Lohse A, Solau-Gervais E, Pillet P, Bader-Meunier B, Wipff J, Gaujoux-Viala C, Breton S, Devauchelle-Pensec V, Gran S, Fehler O, Zenker S, Schäfers M, Roth J, Vogl T, Czitrom SG, Foell D, Holzinger D, Lanni S, Van Dijkhuizen EHP, Manzoni SM, Marafon DP, Magnaguagno F, de Horatio LT, Ter Haar NM, Littooij AS, Vastert SJ, De Benedetti F, Ravelli A, Martini A, Malattia C, Teixeira VA, Campanilho-Marques R, Mourão AF, Ramos FO, Costa M, Madan WA, Killeen OG, Vidal AR, Delgado DS, Fernandez MIG, Montesinos BL, Penades IC, Kozhevnikov A, Pozdeeva N, Konev M, Melchenko E, Kenis V, Novik G, Sozeri B, Kısaarslan AP, Gunduz Z, Poyrazoglu H, Dusunsel R, Lerkvaleekul B, Jaovisidha S, Sungkarat W, Chitrapazt N, Fuangfa P, Ruangchaijatuporn T, Vilaiyuk S, Pradsgaard DØ, Hørlyck A, Spannow AH, Heuck CW, Herlin T, Diaz T, Garcia F, De La Cruz L, Rubio N, Świdrowska-Jaros J, Smolewska E, Lamot M, Lamot L, Vidovic M, Bosak EP, Rados I, Harjacek M, Tzaribachev N, Louka P, Hagoug R, Trentin C, Kubassova O, Hinton M, Boesen M, Oshlianska OA, Chaikovsky IA, Mjasnikov G, Kazmirchyk A, Garagiola U, Borzani I, Cressoni P, Corona F, Dzsida E, Farronato G, Garagiola U, Cressoni P, Corona F, Petaccia A, Dzsida E, Farronato G, Gagro A, Pasini AM, Roic G, Vrdoljak O, Lujic L, Zutelija-Fattorini M, Esser MM, Abraham DR, Kinnear C, Durrheim G, Urban M, Hoal E, Crow Y, Oshlianska OA. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part one. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461530 DOI: 10.1186/s12969-017-0141-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Friedman L, Hernandez B, Buchanan A, Dinh M, Cooper B, Hou D, Posner D, Kushida C, Yesavage J, Zeitzer JM. 0346 COGNITIVE AROUSAL IN OLDER INDIVIDUALS WITH INSOMNIA COMPLAINTS AROUSAL IN OLDER INDIVIDUALS WITH INSOMNIA COMPLAINTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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McNellan C, Dansereau E, Colombara D, Palmisano E, Wallace M, Johanns C, Schaefer A, Ríos-Zertuche D, Zúñiga-Brenes P, Hernandez B, Iriarte E, Mokdad A. Uptake of Antenatal Care, and its Relationship with Participation in
Health Services and Behaviors: An Analysis of the Poorest Regions of Four
Mesoamerican Countries. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Rawson TM, Moore LSP, Hernandez B, Charani E, Castro-Sanchez E, Herrero P, Hayhoe B, Hope W, Georgiou P, Holmes AH. A systematic review of clinical decision support systems for antimicrobial management: are we failing to investigate these interventions appropriately? Clin Microbiol Infect 2017; 23:524-532. [PMID: 28268133 DOI: 10.1016/j.cmi.2017.02.028] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 02/23/2017] [Accepted: 02/25/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Clinical decision support systems (CDSS) for antimicrobial management can support clinicians to optimize antimicrobial therapy. We reviewed all original literature (qualitative and quantitative) to understand the current scope of CDSS for antimicrobial management and analyse existing methods used to evaluate and report such systems. METHOD PRISMA guidelines were followed. Medline, EMBASE, HMIC Health and Management and Global Health databases were searched from 1 January 1980 to 31 October 2015. All primary research studies describing CDSS for antimicrobial management in adults in primary or secondary care were included. For qualitative studies, thematic synthesis was performed. Quality was assessed using Integrated quality Criteria for the Review Of Multiple Study designs (ICROMS) criteria. CDSS reporting was assessed against a reporting framework for behaviour change intervention implementation. RESULTS Fifty-eight original articles were included describing 38 independent CDSS. The majority of systems target antimicrobial prescribing (29/38;76%), are platforms integrated with electronic medical records (28/38;74%), and have a rules-based infrastructure providing decision support (29/38;76%). On evaluation against the intervention reporting framework, CDSS studies fail to report consideration of the non-expert, end-user workflow. They have narrow focus, such as antimicrobial selection, and use proxy outcome measures. Engagement with CDSS by clinicians was poor. CONCLUSION Greater consideration of the factors that drive non-expert decision making must be considered when designing CDSS interventions. Future work must aim to expand CDSS beyond simply selecting appropriate antimicrobials with clear and systematic reporting frameworks for CDSS interventions developed to address current gaps identified in the reporting of evidence.
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Affiliation(s)
- T M Rawson
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College, London, UK.
| | - L S P Moore
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College, London, UK
| | - B Hernandez
- Department of Electrical and Electronic Engineering, Imperial College, London, UK
| | - E Charani
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College, London, UK
| | - E Castro-Sanchez
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College, London, UK
| | - P Herrero
- Department of Electrical and Electronic Engineering, Imperial College, London, UK
| | - B Hayhoe
- School of Public Health, Imperial College, London, UK
| | - W Hope
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - P Georgiou
- Department of Electrical and Electronic Engineering, Imperial College, London, UK
| | - A H Holmes
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College, London, UK
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Duval D, Cronise K, Hernandez B, Klippenstein L, Dailey D, Gustafson D. Targeting activated mutant BRAF in canine transitional cell carcinomas of the bladder. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32817-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Román M, Lopez I, Zubiri L, Sanchez R, Salas D, Gardeazabal I, Baraibar I, Santisteban M, Vicent S, Gil-Aldea I, Aguillo MM, Hernandez B, Lopez-Picazo J, Gurpide A, Guruceaga E, Perez-Gracia J, Collantes M, Ecay M, Gil-Bazo I. Id1 and Id3 genes confer poor prognosis in KRAS-mutant (KM) lung adenocarcinoma (LA) patients. Gene silencing reduces metastatic rate to the liver and increases survival. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mc Ardle A, Szentpetery A, De Rook S, De Ganck A, Hernandez B, FitzGerlad O, Pennington S. FRI0444 Early Detection of Psoriatic Arthritis: A Multi-Omic Approach To Developing A New Blood Test. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ide N, Fitzpatrick AL, Flaxman AD, Koju R, Tamrakar D, Hernandez B. Estimation of Causes of Death in Suburban Nepal Using Verbal Autopsy. Kathmandu Univ Med J (KUMJ) 2016; 14:112-119. [PMID: 28166065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Background Nepal is in the midst of a disease transition, including a rapid increase of noncommunicable diseases. In order for health policy makers and planners to make informed programmatic and funding decisions, they need up to date and accurate data regarding cause of death throughout the country. Methods of improving cause of death reporting in Nepal are urgently required. Objective We sought to validate SmartVA-Analyze, an application which computer certifies verbal autopsies, to evaluate it as a method for collecting mortality data in Nepal. Method We conducted a medical record review of mortality cases at Dhulikhel Hospital, Kathmandu University Hospital. Cases with a verifiable underlying cause of death were used as gold standard reference cases. Verbal autopsies were conducted with caregivers of 48 gold standard cases. Result Of the 66 adult gold standard mortality cases reviewed, 76% were caused by cancer, cirrhosis, cardiovascular disease, COPD or injury. When assessing concordance between cause of death from verbal autopsy vs. gold standards, we found an overall agreement (Kappa) of 0.50. Kappa based on broader ICD-10 categories was 0.69. Cause-Specific Mortality Fraction Accuracy was 0.625, and disease specific measures of concordance varied widely, with sensitivities ranging from 0-100%. Conclusion Ongoing, countrywide mortality data collection is crucial for evidence-based priority setting in Nepal. Though not valid for all causes, we found SmartVA-Analyze to provide useful general cause of death data, particularly in settings where death certification is unavailable.
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Affiliation(s)
- N Ide
- Department of Global Health, University of Washington, Box 357965 Seattle, WA 98195 USA
| | - A L Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global Health, Box 354696 Seattle, WA 98195 USA
| | - A D Flaxman
- Institute for Health Metrics and Evaluation, 2301 5th Ave. Suite 600, Seattle, WA 98121, USA
| | - R Koju
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - D Tamrakar
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - B Hernandez
- Institute for Health Metrics and Evaluation, 2301 5th Ave. Suite 600, Seattle, WA 98121, USA
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Perez-Janices N, Blanco-Luquin I, Tuñón MT, Barba-Ramos E, Ibáñez B, Zazpe-Cenoz I, Martinez-Aguillo M, Hernandez B, Martínez-Lopez E, Fernández AF, Mercado MR, Cabada T, Escors D, Megias D, Guerrero-Setas D. EPB41L3, TSP-1 and RASSF2 as new clinically relevant prognostic biomarkers in diffuse gliomas. Oncotarget 2016; 6:368-80. [PMID: 25621889 PMCID: PMC4381601 DOI: 10.18632/oncotarget.2745] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 11/12/2014] [Indexed: 12/17/2022] Open
Abstract
Hypermethylation of tumor suppressor genes is one of the hallmarks in the progression of brain tumors. Our objectives were to analyze the presence of the hypermethylation of EPB41L3, RASSF2 and TSP-1 genes in 132 diffuse gliomas (astrocytic and oligodendroglial tumors) and in 10 cases of normal brain, and to establish their association with the patients’ clinicopathological characteristics. Gene hypermethylation was analyzed by methylation-specific-PCR and confirmed by pyrosequencing (for EPB41L3 and TSP-1) and bisulfite-sequencing (for RASSF2). EPB41L3, RASSF2 and TSP-1 genes were hypermethylated only in tumors (29%, 10.6%, and 50%, respectively), confirming their cancer-specific role. Treatment of cells with the DNA-demethylating-agent 5-aza-2′-deoxycytidine restores their transcription, as confirmed by quantitative-reverse-transcription-PCR and immunofluorescence. Immunohistochemistry for EPB41L3, RASSF2 and TSP-1 was performed to analyze protein expression; p53, ki-67, and CD31 expression and 1p/19q co-deletion were considered to better characterize the tumors. EPB41L3 and TSP-1 hypermethylation was associated with worse (p = 0.047) and better (p = 0.037) prognosis, respectively. This observation was confirmed after adjusting the results for age and tumor grade, the role of TSP-1 being most pronounced in oligodendrogliomas (p = 0.001). We conclude that EPB41L3, RASSF2 and TSP-1 genes are involved in the pathogenesis of diffuse gliomas, and that EPB41L3 and TSP-1 hypermethylation are of prognostic significance.
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Affiliation(s)
- N Perez-Janices
- Cancer Epigenetics Group, Navarrabiomed-Fundación Miguel Servet, Navarra, Spain
| | - I Blanco-Luquin
- Cancer Epigenetics Group, Navarrabiomed-Fundación Miguel Servet, Navarra, Spain
| | - M T Tuñón
- Department of Pathology Section A, Complejo Hospitalario de Navarra, Navarra Health Service, Navarra, Spain
| | - E Barba-Ramos
- Department of Pathology Section A, Complejo Hospitalario de Navarra, Navarra Health Service, Navarra, Spain
| | - B Ibáñez
- Navarrabiomed-Fundación Miguel Servet, Navarra, Spain. Red de Evaluación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Navarra, Spain
| | - I Zazpe-Cenoz
- Department of Neurosurgery, Complejo Hospitalario de Navarra, Navarra Health Service, Navarra, Spain
| | - M Martinez-Aguillo
- Department of Medical Oncology, Complejo Hospitalario de Navarra, Navarra Health Service, Navarra, Spain
| | - B Hernandez
- Department of Medical Oncology, Complejo Hospitalario de Navarra, Navarra Health Service, Navarra, Spain
| | - E Martínez-Lopez
- Department of Radiation Oncology, Complejo Hospitalario de Navarra, Navarra Health Service, Navarra, Spain
| | - A F Fernández
- Cancer Epigenetics Laboratory, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), HUCA, Universidad de Oviedo, Asturias, Spain
| | - M R Mercado
- Department of Pathology Section A, Complejo Hospitalario de Navarra, Navarra Health Service, Navarra, Spain
| | - T Cabada
- Department of Radiology, Complejo Hospitalario de Navarra, Navarra Health Service, Navarra, Spain
| | - D Escors
- Navarrabiomed-Fundación Miguel Servet, Navarra, Spain
| | - D Megias
- Confocal Microscopy Core Unit, Spanish National Cancer Research Centre, Madrid, Spain
| | - D Guerrero-Setas
- Cancer Epigenetics Group, Navarrabiomed-Fundación Miguel Servet, Navarra, Spain
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Posecion L, Goodale G, La D, Funtanilla E, Hernandez B, Noda A, Cheng J, Lee T, Yesavage J, Kinoshita L. A-18Posttraumatic Stress Disorder and Obstructive Sleep Disorder Effects on Auditory Learning and Memory in Older Veterans. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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