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Norbury R, Grant I, Woodhead A, Hughes L, Tallent J, Patterson SD. Acute hypoalgesic, neurophysiological and perceptual responses to low-load blood flow restriction exercise and high-load resistance exercise. Exp Physiol 2024; 109:672-688. [PMID: 38578259 PMCID: PMC11061633 DOI: 10.1113/ep091705] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/13/2024] [Indexed: 04/06/2024]
Abstract
This study compared the acute hypoalgesic and neurophysiological responses to low-load resistance exercise with and without blood flow restriction (BFR), and free-flow, high-load exercise. Participants performed four experimental conditions where they completed baseline measures of pain pressure threshold (PPT), maximum voluntary force (MVF) with peripheral nerve stimulation to determine central and peripheral fatigue. Corticospinal excitability (CSE), corticospinal inhibition and short interval intracortical inhibition (SICI) were estimated with transcranial magnetic stimulation. Participants then performed low-load leg press exercise at 30% of one-repetition maximum (LL); low-load leg press with BFR at 40% (BFR40) or 80% (BFR80) of limb occlusion pressure; or high-load leg press of four sets of 10 repetitions at 70% one-repetition maximum (HL). Measurements were repeated at 5, 45 min and 24 h post-exercise. There were no differences in CSE or SICI between conditions (all P > 0.05); however, corticospinal inhibition was reduced to a greater extent (11%-14%) in all low-load conditions compared to HL (P < 0.005). PPTs were 12%-16% greater at 5 min post-exercise in BFR40, BFR80 and HL compared to LL (P ≤ 0.016). Neuromuscular fatigue displayed no clear difference in the magnitude or time course between conditions (all P > 0.05). In summary, low-load BFR resistance exercise does not induce different acute neurophysiological responses to low-load, free-flow exercise but it does promote a greater degree of hypoalgesia and reduces corticospinal inhibition more than high-load exercise, making it a useful rehabilitation tool. The changes in neurophysiology following exercise were not related to changes in PPT.
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Affiliation(s)
- Ryan Norbury
- Faculty of Sport, Technology and Health SciencesSt Mary's UniversityTwickenhamUK
| | - Ian Grant
- Faculty of Sport, Technology and Health SciencesSt Mary's UniversityTwickenhamUK
| | - Alex Woodhead
- Faculty of Sport, Technology and Health SciencesSt Mary's UniversityTwickenhamUK
| | - Luke Hughes
- Department of Sport, Exercise and RehabilitationNorthumbria UniversityNewcastle‐Upon TyneUK
| | - Jamie Tallent
- School of Sport, Rehabilitation and Exercise SciencesUniversity of EssexColchesterUK
- Monash Exercise Neuroplasticity Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health ScienceMonash UniversityMelbourneVAAustralia
| | - Stephen D. Patterson
- Faculty of Sport, Technology and Health SciencesSt Mary's UniversityTwickenhamUK
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2
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Epanomeritakis IE, Li L, Treharne L, Grant I. Congenital brachial artery occlusion causing neonatal forearm compartment syndrome. J Hand Surg Eur Vol 2024; 49:275-277. [PMID: 37728888 DOI: 10.1177/17531934231200530] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Congenital brachial artery occlusion is rare. We report four patients who presented at birth with absent wrist pulses. We propose management recommendations that include anti-coagulation, duplex ultrasound assessment and fasciotomy surgery as early as is safe and possible.
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Affiliation(s)
| | - Lily Li
- Department of Plastic Surgery, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK
| | - Linda Treharne
- Department of Plastic Surgery, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK
| | - Ian Grant
- Department of Plastic Surgery, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK
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3
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Norbury R, Dickens L, Grant I, Emery A, Patterson SD. Remote ischaemic preconditioning increase tolerance to experimentally induced cold pain. Eur J Sport Sci 2023; 23:2435-2442. [PMID: 37746841 DOI: 10.1080/17461391.2023.2241831] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Ischaemic preconditioning (IPC) applied locally and remotely has been shown to reduce pain which may underpin its ergogenic effect on exercise performance, however, it is unclear how many IPC cycles are needed to induce hypoalgesia. Therefore the purpose of this study was to examine the number of cycles of IPC on experimental pain perception. Sixteen healthy participants underwent four, randomised, experimental sessions where they either underwent a sham protocol (1 × 5 min at 20 mmHg), and 1, 2 or 3 cycles × 5 min of remote IPC at 105% of limb occlusion pressure. Ten minutes post-intervention, participants underwent a cold-pressor test where pain threshold, pain tolerance and pain intensity were examined and compared between conditions with a one-way repeated measure analysis of variance. Pain threshold was not different between conditions (P = 0.065); but pain tolerance was increased by ∼30% in the 1 × 5 condition, 2 × 5 condition, and 3 × 5 condition compared to the sham condition. No differences in pain tolerance were seen between the different numbers of cycles (all P > 0.05). There was also no difference in the perception of pain 30 s into the cold pressor test (P = 0.279). Remote IPC appears to significantly improve tolerance to pain which may have significant implications for endurance performance and exercise rehabilitation, but this warrants further investigation.
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Affiliation(s)
- Ryan Norbury
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
| | - Lieben Dickens
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
| | - Ian Grant
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
| | - Alison Emery
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
| | - Stephen D Patterson
- Faculty of Sport, Allied Health and Performance Science, St Mary's University, Twickenham, UK
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4
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Habeeb A, Roszpopa J, Arnaout A, Grant I, Latimer M. Multiple Distal Femoral Osteochondromas Encasing Popliteal Neurovascular Bundle. Cureus 2023; 15:e46396. [PMID: 37927696 PMCID: PMC10620753 DOI: 10.7759/cureus.46396] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Multiple hereditary exostosis syndrome is a rare diagnosis with approximately 1:50000 incidence prevailing in males. The exostoses or osteochondromas are benign but have the potential for malignant transformation in 1-5%. There is a strong genetic component, with exostosis (EXT) signaling pathways being an underlying cause. They can be symptomatic, with pain and functional deficit as the main complaints. We present a case of a 17-year-old male who presented with pain and anatomical deformity in his left lower femur. Magnetic resonance imaging revealed multiple osteochondromas compressing the popliteal neurovascular bundle. Excision of the osteochondromas was performed to decompress the neurovascular bundle in a multidisciplinary approach. Histological examination demonstrated no evidence of malignancy. Currently, there is no consensus for patients diagnosed with multiple osteochondromas regarding further investigation and/or screening for malignant transformation.
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Affiliation(s)
- Amir Habeeb
- Otolaryngology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, GBR
| | - Jaroszlav Roszpopa
- Plastic Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, GBR
| | - Ali Arnaout
- Plastic Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, GBR
| | - Ian Grant
- Plastic Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, GBR
| | - Mark Latimer
- Orthopedics, University of Leicester Medical School, Leicester, GBR
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Wyper GM, Assuncao R, Fletcher E, Gourley M, Grant I, Haagsma JA, Hilderink H, Idavain J, Lesnik T, von der Lippe E, Majdan M, Mccartney G, Santric-Milicevic M, Pallari E, Pires SM, Plass D, Porst M, Santos JV, de Haro Moro MT, Stockton DL, Devleesschauwer B. The increasing significance of disease severity in a burden of disease framework. Scand J Public Health 2023; 51:296-300. [PMID: 34213383 PMCID: PMC9969303 DOI: 10.1177/14034948211024478] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Indexed: 11/15/2022]
Abstract
Recent estimates have reiterated that non-fatal causes of disease, such as low back pain, headaches and depressive disorders, are amongst the leading causes of disability-adjusted life years (DALYs). For these causes, the contribution of years lived with disability (YLD) - put simply, ill-health - is what drives DALYs, not mortality. Being able to monitor trends in YLD closely is particularly relevant for countries that sit high on the socio-demographic spectrum of development, as it contributes more than half of all DALYs. There is a paucity of data on how the population-level occurrence of disease is distributed according to severity, and as such, the majority of global and national efforts in monitoring YLD lack the ability to differentiate changes in severity across time and location. This raises uncertainties in interpreting these findings without triangulation with other relevant data sources. Our commentary aims to bring this issue to the forefront for users of burden of disease estimates, as its impact is often easily overlooked as part of the fundamental process of generating DALY estimates. Moreover, the wider health harms of the COVID-19 pandemic have underlined the likelihood of latent and delayed demand in accessing vital health and care services that will ultimately lead to exacerbated disease severity and health outcomes. This places increased importance on attempts to be able to differentiate by both the occurrence and severity of disease.
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Affiliation(s)
- Grant M.A. Wyper
- Place and Wellbeing Directorate, Public
Health Scotland, UK,Grant MA Wyper, Public Health Scotland,
Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE, UK.
| | | | - Eilidh Fletcher
- Data Driven Innovation Directorate,
Public Health Scotland, UK
| | - Michelle Gourley
- Burden of Disease and Mortality Unit,
Australian Institute of Health and Welfare, Australia
| | - Ian Grant
- Data Driven Innovation Directorate,
Public Health Scotland, UK
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus
MC, University Medical Centre Rotterdam, The Netherlands
| | - Henk Hilderink
- National Institute for Public Health
and the Environment (RIVM), The Netherlands
| | - Jane Idavain
- National Institute for Health
Development, Estonia
| | - Tina Lesnik
- National Institute of Public Health,
Slovenia
| | - Elena von der Lippe
- Department of Epidemiology and Health
Monitoring, Robert Koch Institute, Germany
| | - Marek Majdan
- Faculty of Health Sciences and Social
Work, Trnava University, Slovakia
| | | | - Milena Santric-Milicevic
- Institute of Social Medicine, Centre
School of Public Health and Health Management, Faculty of Medicine University of
Belgrade, Serbia
| | - Elena Pallari
- MRC Clinical Trials and Methodology
Unit, University College London, UK
| | - Sara M. Pires
- National Food Institute, Technical
University of Denmark, Denmark
| | - Dietrich Plass
- Section Exposure Assessment and
Environmental Health Indicators, German Environment Agency, Germany
| | - Michael Porst
- Department of Epidemiology and Health
Monitoring, Robert Koch Institute, Germany
| | - João V. Santos
- MEDCIDS, Department of Community
Medicine, Information and Health Decision Sciences, Faculty of Medicine, University
of Porto, Portugal,CINTESIS, Centre for Health
Technology and Services Research, Portugal,Public Health Unit, ACES Grande Porto
VIII – Espinho/Gaia, ARS Norte, Portugal
| | | | - Diane L. Stockton
- Clinical and Protecting Health
Directorate, Public Health Scotland, UK
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public
Health, Sciensano, Belgium,Department of Veterinary Public
Health and Food Safety, Faculty of Veterinary Medicine, Ghent University,
Belgium
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6
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Ljubenkov PA, Staffaroni AM, Rojas JC, VandeVrede L, Koestler M, Sulse TA, Moreton J, Horiki S, Heuer HW, Grant I, Irwin DJ, Boeve BF, Rosen HJ, Knopman DS, Bowser R, Grossman M, Qureshi I, Boxer AL. Introduction to Veri‐T: A Phase 1 Randomized, Double‐Blind, Placebo‐Controlled, Multicenter Trial of Verdiperstat in Patients with svPPA Due to FTLD‐TDP. Alzheimers Dement 2022. [DOI: 10.1002/alz.067255] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Peter A. Ljubenkov
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Adam M. Staffaroni
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Julio C. Rojas
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Lawren VandeVrede
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Mary Koestler
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Tayler A Sulse
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Julia Moreton
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Sheena Horiki
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Hilary W. Heuer
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Ian Grant
- Northwestern University Chicago IL USA
| | - David J. Irwin
- Penn FTD Center Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | | | - Howard J. Rosen
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | | | - Robert Bowser
- Barrow Neurological Institute & St. Joseph’s Hospital and Medical Center Phoenix AZ USA
| | - Murray Grossman
- Penn FTD Center Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | | | - Adam L. Boxer
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
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Fletcher E, Grant I, Wyper G, McCartney G, Thrower M, Stockton D. Redistribution of ill-defined deaths: the Scottish Burden of Disease approach. Eur J Public Health 2022. [PMCID: PMC9619906 DOI: 10.1093/eurpub/ckac129.620] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Burden of disease (BoD) studies are an established method of quantifying health loss across - and within - a population. They aim to combine the impact of living with, and dying from, various health conditions to allow for comparability of conditions in an equitable manner. A key component of this is the calculation of the loss of years of life arising from premature death (Years of Life Lost (YLL)). Most high-income nations have robust death registration systems which ensure that deaths are routinely recorded, the causes are medically certified and the age at death is accurate. However, even in these situations the recording of ill-defined death (IDD) causes remains widespread and to some extent unavoidable, in that it is not always appropriate to undertake extensive investigation to establish an exact cause of death or the cause of death recorded does not map directly to disease groupings used routinely in BoD studies. The Scottish Burden of Disease (SBoD) uses cause of death data from the National Records of Scotland. These patient-level records include one underlying cause of death and up to 10 supplementary causes of death, all coded using ICD classifications. Around 12% of these deaths do not map directly to a BoD cause group and could therefore be considered ill-defined. The SBoD study have developed a 9-step hierarchical methodology for the redistribution of ill-defined deaths, utilising uses a mix of fixed and proportional redistribution and focusses on exploiting the data recorded on the death certificate at both an individual and population level. In this presentation we will describe the methodology used to redistribute ill-defined deaths in the Scottish study - the development, the application and the strengths and weaknesses of our approach. We will also discuss the example of COVID-19 and how competition between the underlying cause of death is likely to impact how we need to approach IDDs in the future.
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Affiliation(s)
- E Fletcher
- Data Driven Innovation Directorate, Public Health Scotland , Edinburgh, UK
| | - I Grant
- Data Driven Innovation Directorate, Public Health Scotland , Edinburgh, UK
| | - G Wyper
- Place and Wellbeing Directorate, Public Health Scotland , Glasgow, UK
| | - G McCartney
- College of Social Sciences, University of Glasgow , Glasgow, UK
| | - M Thrower
- Data Driven Innovation Directorate, Public Health Scotland , Edinburgh, UK
| | - D Stockton
- Clinical and Protecting Health Directorate, Public Health Scotland , Glasgow, UK
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8
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Devleesschauwer B, Haagsma JA, Charalampous P, Assunção R, Bari CD, Gorasso V, Grant I, Hilderink H, Idavain J, Lesnik T, Majdan M, Santric-Milicevic M, Pallari E, Pires SM, Plass D, Wyper GMA, Von der Lippe E. Reporting guidelines for burden of disease studies: why and how? Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.097] [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
The Disability Adjusted Life Year (DALY) is a frequently used metric to assess burden of disease (BoD). Many independent BoD studies have been performed across Europe, showing wide variations and inconsistencies in the application and reporting of DALY specific methods. The European Burden of Disease Network (burden-eu) aims to develop guidelines for reporting DALY calculation studies which may enhance transparency and comparability of BoD estimates across Europe and beyond.
Methods
A burden-eu working group of experts generated a list of potential reporting items based on existing literature, guidance for developing guidelines and consultations with BoD experts. To pilot the drafted product, we asked BoD experts and non-experts to apply it to existing BoD studies. We received feedback and we revised the guidelines accordingly.
Results
The guide for DALY calculation studies comprises about 25 items that should be reported in BoD studies. We included information about the study setting, data input sources including methods for data corrections, DALY-specific methods (e.g., YLL life table, YLD approach, disability weights etc), data analyses, and data limitations. We also included information on how users can compare their new estimates with previously available BoD estimates.
Conclusions
We introduced a reporting instrument for DALY calculations that can be used to document input data and methodological design choices in BoD studies. The application of such guidelines will enhance usability of BoD estimates for decision-makers as well as global, regional, and national health experts.
Key messages
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Affiliation(s)
| | - JA Haagsma
- European Burden of Disease Network, COST Action CA18218
| | | | - R Assunção
- European Burden of Disease Network, COST Action CA18218
| | - C Di Bari
- European Burden of Disease Network, COST Action CA18218
| | - V Gorasso
- European Burden of Disease Network, COST Action CA18218
| | - I Grant
- European Burden of Disease Network, COST Action CA18218
| | - H Hilderink
- European Burden of Disease Network, COST Action CA18218
| | - J Idavain
- European Burden of Disease Network, COST Action CA18218
| | - T Lesnik
- European Burden of Disease Network, COST Action CA18218
| | - M Majdan
- European Burden of Disease Network, COST Action CA18218
| | | | - E Pallari
- European Burden of Disease Network, COST Action CA18218
| | - SM Pires
- European Burden of Disease Network, COST Action CA18218
| | - D Plass
- European Burden of Disease Network, COST Action CA18218
| | - GMA Wyper
- European Burden of Disease Network, COST Action CA18218
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Grant I, Fletcher E, McCartney G, Thrower M, Wyper G, Stockton D. Inequalities in the disease burden in Scotland: an area level analysis. Eur J Public Health 2022. [PMCID: PMC9593838 DOI: 10.1093/eurpub/ckac129.401] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In the context of increasing demand for evidence-based policy, attempts to address or mitigate the effects of disadvantage have been usefully informed by comprehensive indices of multiple deprivation. These indices combine indicators on a range of dimensions of deprivation to classify neighborhoods or localities. Through combining information on fatal and non-fatal health loss, burden of disease studies allow planners and policy-makers to have a better understanding of the contribution of different diseases and injuries to the total burden of disease. These estimates can be augmented through studies, stratified by investigating inequalities in the burden of disease due to area-based deprivation. Doing so, helps contribute to discussions about where prevention and service activity should be focused to address health inequalities. The Scottish Burden of Disease study uses the Scottish Index of Multiple Deprivation (SIMD) as means to report on of the extent of inequality in the burden of disease in Scotland between people living in the areas of greatest, and of least, multiple deprivation. The SIMD quantifies deprivation based on data zones, a geographical unit comparable to a postcode. Using pooled and weighted data from seven domains (employment, income, crime, housing, health, education and geographic access), each data zone is given a composite rank out of 6,505 data zones. The composite rank was then converted to a decile, with 1 assigned to the 10% most deprived data zones and 10 to the 10% least deprived. In this presentation we will show the key steps involved in undertaking an area-based analysis of health inequalities in the burden of disease in Scotland using results from the Scottish Burden of Disease 2019 study, and from our monitoring of COVID-19 disability-adjusted life years.
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Affiliation(s)
- I Grant
- Data Driven Innovation Directorate, Public Health Scotland , Edinburgh, UK
| | - E Fletcher
- Data Driven Innovation Directorate, Public Health Scotland , Edinburgh, UK
| | - G McCartney
- College of Social Sciences, University of Glasgow , Glasgow, UK
| | - M Thrower
- Data Driven Innovation Directorate, Public Health Scotland , Edinburgh, UK
| | - G Wyper
- Place and Wellbeing Directorate, Public Health Scotland , Glasgow, UK
| | - D Stockton
- Clinical and Protecting Health Directorate, Public Health Scotland , Glasgow, UK
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10
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Fletcher E, Grant I. Monitoring the burden of disease in Scotland and the contribution of risk factors. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.760] [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
The Scottish Burden of Disease (SBoD) Study monitors the contribution of over 100 diseases and injuries to the population health in Scotland, in the context of disability-adjusted life years (DALYs). Providing robust estimates of burden is the first step in identifying areas of prevention which could have the biggest impact on health; including identification of modifiable risk factors and changes in the underlying risk factor prevalence. Our aim was to estimate DALYs for 2019, to describe the current burden in Scotland and as a baseline for future burden scenarios.
Methods
The SBoD 2016 study estimated the burden using routine data and patient-level record linkage. For this update, years lived with disability were estimated using 2016 age-sex-deprivation specific rates, assuming no change in disease prevalence from 2016, but taking account of changes to the population structure. Years of life lost were calculated from 2019 observed deaths and the application of the Global Burden of Disease (GBD) aspirational life table. Population attributable fractions (PAFs) were sourced from the GBD 2019 and risk factor prevalence from the Scottish Health Survey.
Results
In 2019 the leading causes of burden were ischaemic heart disease (IHD), Alzheimer's/other dementias, lung cancer, drug-use disorders and cerebrovascular disease, representing over a quarter (27%) of the total DALYs in Scotland. Application of PAFs shows that a proportion of the burden for each of these causes can be attributed to modifiable risk factors.
Conclusions
IHD continues to be the leading cause of health burden in Scotland in 2019. However recent years show an increase in burden of social causes and diseases affecting the ageing population. Application of PAFs demonstrate the importance of continuing to monitor both the burden of disease in Scotland and the prevalence of risk factors, to provide robust evidence for planning of local and national services.
Key messages
• The Scottish Burden of Disease continues to monitor the population health landscape of Scotland.
• Ischaemic heart disease continues to be the leading cause of burden in Scotland.
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Affiliation(s)
- E Fletcher
- Data Driven Innovation Directorate, Public Health Scotland , Edinburgh, UK
| | - I Grant
- Data Driven Innovation Directorate, Public Health Scotland , Edinburgh, UK
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11
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Tipton PW, Deutschlaender AB, Savica R, Heckman MG, Brushaber DE, Dickerson BC, Gavrilova RH, Geschwind DH, Ghoshal N, Graff-Radford J, Graff-Radford NR, Grossman M, Hsiung GYR, Huey ED, Irwin DJ, Jones DT, Knopman DS, McGinnis SM, Rademakers R, Ramos EM, Forsberg LK, Heuer HW, Onyike C, Tartaglia C, Domoto-Reilly K, Roberson ED, Mendez MF, Litvan I, Appleby BS, Grant I, Kaufer D, Boxer AL, Rosen HJ, Boeve BF, Wszolek ZK. Differences in Motor Features of C9orf72, MAPT, or GRN Variant Carriers With Familial Frontotemporal Lobar Degeneration. Neurology 2022; 99:e1154-e1167. [PMID: 35790423 PMCID: PMC9536745 DOI: 10.1212/wnl.0000000000200860] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 05/02/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Familial frontotemporal lobar degeneration (f-FTLD) is a phenotypically heterogeneous spectrum of neurodegenerative disorders most often caused by variants within chromosome 9 open reading frame 72 (C9orf72), microtubule-associated protein tau (MAPT), or granulin (GRN). The phenotypic association with each of these genes is incompletely understood. We hypothesized that the frequency of specific clinical features would correspond with different genes. METHODS We screened the Advancing Research and Treatment in Frontotemporal Lobar Degeneration (ARTFL)/Longitudinal Evaluation of Familial Frontotemporal Dementia Subjects (LEFFTDS)/ARTFL LEFFTDS Longitudinal Frontotemporal Lobar Degeneration Consortium for symptomatic carriers of pathogenic variants in C9orf72, MAPT, or GRN. We assessed for clinical differences among these 3 groups based on data recorded as part of a detailed neurologic examination, the Progressive Supranuclear Palsy Rating Scale, Progressive Supranuclear Palsy-Quality of Life Rating Scale, Unified Parkinson's Disease Rating Scale Part III (motor items), and the Amyotrophic Lateral Sclerosis Functional Rating Scale, revised version. Data were analyzed using Kruskal-Wallis and Wilcoxon rank-sum tests and Fisher exact test. RESULTS We identified 184 symptomatic participants who had a single pathogenic variant in C9orf72 (n = 88), MAPT (n = 53), or GRN (n = 43). Motor symptom age at onset was earliest in the MAPT participants followed by C9orf72, whereas the GRN pathogenic variant carriers developed symptoms later. C9orf72 participants more often had fasciculations, muscle atrophy, and weakness, whereas parkinsonism was less frequent. Vertical oculomotor abnormalities were more common in the MAPT cohort, whereas apraxia and focal limb dystonia occurred more often in participants with GRN variants. DISCUSSION We present a large comparative study of motor features in C9orf72, MAPT, and GRN pathogenic variant carriers with symptomatic f-FTLD. Our findings demonstrate characteristic phenotypic differences corresponding with specific gene variants that increase our understanding of the genotype-phenotype relationship in this complex spectrum of neurodegenerative disorders. TRIAL REGISTRATION INFORMATION NCT02365922, NCT02372773, and NCT04363684.
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Affiliation(s)
- Philip Wade Tipton
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill.
| | - Angela B Deutschlaender
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Rodolfo Savica
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Michael G Heckman
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Danielle E Brushaber
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Bradford C Dickerson
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Ralitza H Gavrilova
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Daniel H Geschwind
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Nupur Ghoshal
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Jonathan Graff-Radford
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Neill R Graff-Radford
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Murray Grossman
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Ging-Yuek R Hsiung
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Edward D Huey
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - David John Irwin
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - David T Jones
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - David S Knopman
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Scott M McGinnis
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Rosa Rademakers
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Eliana Marisa Ramos
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Leah K Forsberg
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Hilary W Heuer
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Chiadi Onyike
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Carmela Tartaglia
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Kimiko Domoto-Reilly
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Erik D Roberson
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Mario F Mendez
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Irene Litvan
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Brian S Appleby
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Ian Grant
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Daniel Kaufer
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Adam L Boxer
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Howard J Rosen
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Brad F Boeve
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
| | - Zbigniew K Wszolek
- From the Department of Neurology (P.W.T., A.B.D., N.R.G.-R., Z.K.W.), Mayo Clinic, Jacksonville, FL; Department of Neurology (R.S., D.E.B., R.H.G., J.G.-R., D.T.J., D.S.K., L.K.F., B.F.B.), Mayo Clinic, Rochester, MN; Division of Clinical Trials and Biostatistics (M.G.H.), Mayo Clinic, Jacksonville, FL; Massachusetts General Hospital (B.C.D., S.M.M.), Harvard University, Boston; University of California, Los Angeles (UCLA) (D.H.G., E.M.R., M.F.M.); Washington University (N.G.), St. Louis, MO; University of Pennsylvania (M.G., D.J.I.), Philadelphia; University of British Columbia (G.-Y.R.H.), Vancouver, Canada; Columbia University (E.D.H.), New York; Department of Neuroscience (R.R.), Mayo Clinic, Jacksonville, FL; University of California, San Francisco (UCSF) (H.W.H., A.L.B., H.J.R.); Johns Hopkins University School of Medicine (C.O.), Baltimore, MD; University of Toronto (C.T.), Ontario, Canada; University of Washington (K.D.-R.), Seattle; University of Alabama at Birmingham (E.D.R.); University of California, San Diego (UCSD) (I.L.); Case Western Reserve University (B.S.A.), Cleveland, OH; Northwestern University (I.G.), Evanston, IL; and University of North Carolina (D.K.), Chapel Hill
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Marton A, Ahmed S, Jarvis GE, Brassett C, Grant I, Gaunt ME. The Berrettini palmar neural communicating branch: a study of 27 cadaveric specimens and determination of a high-risk surgical zone. J Hand Surg Eur Vol 2022; 47:851-856. [PMID: 35473393 DOI: 10.1177/17531934221095401] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In this cadaveric study, we analysed digital images of dissected palms to define the location and length of superficial connections between the median and the ulnar nerves (Berrettini communicating branches). We found the connections present in 12 of 27 hands. We used a coordinate model to define their location relative to seven specified landmarks. The model revealed that the Berrettini communicating branches were positioned consistently, and we defined a high-risk zone in the palm that fully contained seven of the 12 connections, while others had minor projections outside the zone. We conclude that awareness of this high-risk zone in the palm can be of some help to reduce the risk of iatrogenic nerve injury, however, any operation in the palm must always be done with great care to visualize and protect any possible anatomically unusual structures.
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Affiliation(s)
- Akos Marton
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Shahzaib Ahmed
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Gavin E Jarvis
- School of Medicine, University of Sunderland, Sunderland, UK
| | - Cecilia Brassett
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Ian Grant
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.,Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, Cambridge, UK
| | - Michael E Gaunt
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
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Wyper GMA, Fletcher E, Grant I, Harding O, de Haro Moro MT, Stockton DL, McCartney G. Correction: Inequalities in population health loss by multiple deprivation: COVID-19 and pre-pandemic all-cause disability-adjusted life years (DALYs) in Scotland. Int J Equity Health 2022; 21:117. [PMID: 36008861 PMCID: PMC9406257 DOI: 10.1186/s12939-022-01714-4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Grant M A Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland.
| | - Eilidh Fletcher
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, Scotland
| | - Ian Grant
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, Scotland
| | - Oliver Harding
- Directorate of Public Health, NHS Forth Valley, Stirling, Scotland
| | | | - Diane L Stockton
- Clinical and Protecting Health Directorate, Public Health Scotland, Edinburgh, Scotland
| | - Gerry McCartney
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland
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Wyper GMA, Fletcher E, Grant I, Harding O, de Haro Moro MT, McCartney G, Stockton DL. Widening of inequalities in COVID-19 years of life lost from 2020 to 2021: a Scottish Burden of Disease Study. J Epidemiol Community Health 2022; 76:jech-2022-219090. [PMID: 35613856 DOI: 10.1136/jech-2022-219090] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/21/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Previous studies have highlighted the large extent of inequality in adverse COVID-19 health outcomes. Our aim was to monitor changes in overall, and inequalities in, COVID-19 years of life lost to premature mortality (YLL) in Scotland from 2020 and 2021. METHODS Cause-specific COVID-19 mortality counts were derived at age group and area deprivation level using Scottish death registrations for 2020 and 2021. YLL was estimated by multiplying mortality counts by age-conditional life expectancy from the Global Burden of Disease 2019 reference life table. Various measures of absolute and relative inequality were estimated for triangulation purposes. RESULTS There were marked inequalities in COVID-19 YLL by area deprivation in 2020, which were further exacerbated in 2021; confirmed across all measures of absolute and relative inequality. Half (51%) of COVID-19 YLL was attributable to inequalities in area deprivation in 2021, an increase from 41% in 2020. CONCLUSION Despite a highly impactful vaccination programme in preventing mortality, COVID-19 continues to represent a substantial area of fatal population health loss for which inequalities have widened. Tackling systemic inequalities with effective interventions is required to mitigate further unjust health loss in the Scottish population from COVID-19 and other causes of ill-health and mortality.
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Affiliation(s)
- Grant M A Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
| | - Eilidh Fletcher
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, UK
| | - Ian Grant
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, UK
| | - Oliver Harding
- Directorate of Public Health, NHS Forth Valley, Stirling, UK
| | | | - Gerry McCartney
- College of Social Sciences, University of Glasgow, Glasgow, UK
- Clinical and Protecting Health Directorate, Public Health Scotland, Edinburgh, UK
| | - Diane L Stockton
- Clinical and Protecting Health Directorate, Public Health Scotland, Edinburgh, UK
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Macdonald IR, Cora EA, Grant I, Volders D. Practical use and underlying physics of the BENCHMARK™ BMX™ 96 for large-bore aspiration thrombectomy: Case report of initial institutional experience. Neuroradiol J 2022; 35:250-254. [PMID: 34342548 PMCID: PMC8958568 DOI: 10.1177/19714009211036691] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Endovascular thrombectomy (EVT) is part of first-line intervention for acute ischemic stroke management. Recent technological advances have demonstrated that large-bore catheters are an attractive approach for EVT. A multitude of approaches such as A Direct Aspiration first Pass Technique (ADAPT) or in conjunction with stent retrieval (Solumbra technique) have been developed with increasingly large-bore catheters, demonstrating safety and efficacy. Furthermore, these techniques have demonstrated promise for the intervention of cerebral venous thrombosis as well as posterior circulation ischemic events. Recently, advances in neurointerventional catheters have focused on improved maneuverability to navigate the neurovasculature, as well as larger inner diameters for improved procedural versatility, including aspiration. We describe a case report highlighting our early institutional experience with the recently developed large-bore catheter, the BENCHMARK™ BMX™ 96. The case report entails near complete occlusion of the internal carotid artery from acute thrombus and the utility of the BMX™ 96 catheter for treatment of such extensive clot burden. The applicability of large-bore aspiration catheters, with an emphasis on recent advances, for mechanical thrombectomy in arterial as well as venous systems is discussed. To our knowledge, this is the first reported case of use of the BENCHMARK™ BMX™ 96 access system for EVT in acute ischemic stroke. Such new-generation large-bore catheters are a promising advance in neurointervention, and our early institution experience highlights the ease of use and versatility for neurointerventional procedures such as EVT.
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Affiliation(s)
- Ian R Macdonald
- Division of Neuroradiology, Department of
Diagnostic Radiology, Dalhousie University, Canada
| | - Elena A Cora
- Division of Neuroradiology, Department of
Diagnostic Radiology, Dalhousie University, Canada
| | - Ian Grant
- Division of Neurology, Department of
Medicine, Dalhousie University, Canada
| | - David Volders
- Division of Neuroradiology, Department of
Diagnostic Radiology, Dalhousie University, Canada
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16
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Gorasso V, Silversmit G, Arbyn M, Cornez A, De Pauw R, De Smedt D, Grant I, Wyper GMA, Devleesschauwer B, Speybroeck N. The non-fatal burden of cancer in Belgium, 2004-2019: a nationwide registry-based study. BMC Cancer 2022; 22:58. [PMID: 35026995 PMCID: PMC8756629 DOI: 10.1186/s12885-021-09109-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/06/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The importance of assessing and monitoring the health status of a population has grown in the last decades. Consistent and high quality data on the morbidity and mortality impact of a disease represent the key element for this assessment. Being increasingly used in global and national burden of diseases (BoD) studies, the Disability-Adjusted Life Year (DALY) is an indicator that combines healthy life years lost due to living with disease (Years Lived with Disability; YLD) and due to dying prematurely (Years of Life Lost; YLL). As a step towards a comprehensive national burden of disease study, this study aims to estimate the non-fatal burden of cancer in Belgium using national data. METHODS We estimated the Belgian cancer burden from 2004 to 2019 in terms of YLD, using national population-based cancer registry data and international disease models. We developed a microsimulation model to translate incidence- into prevalence-based estimates, and used expert elicitation to integrate the long-term impact of increased disability due to surgical treatment. RESULTS The age-standardized non-fatal burden of cancer increased from 2004 to 2019 by 6 and 3% respectively for incidence- and prevalence-based YLDs. In 2019, in Belgium, breast cancer had the highest morbidity impact among women, followed by colorectal and non-melanoma skin cancer. Among men, prostate cancer had the highest morbidity impact, followed by colorectal and non-melanoma skin cancer. Between 2004 and 2019, non-melanoma skin cancer significantly increased for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 49 to 111 for men and from 15 to 44 for women. Important decreases were seen for colorectal cancer for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 105 to 84 for men and from 66 to 58 for women. CONCLUSIONS Breast and prostate cancers represent the greatest proportion of cancer morbidity, while for both sexes the morbidity burden of skin cancer has shown an important increase from 2004 onwards. Integrating the current study in the Belgian national burden of disease study will allow monitoring of the burden of cancer over time, highlighting new trends and assessing the impact of public health policies.
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Affiliation(s)
- Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium.
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | | | - Marc Arbyn
- Department of Epidemiology and Public Health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Astrid Cornez
- Department of Epidemiology and Public Health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium
| | - Robby De Pauw
- Department of Epidemiology and Public Health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Ian Grant
- Public Health Scotland, Edinburgh, Scotland
| | | | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Catholic University of Louvain, Brussels, Belgium
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17
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Rojas JC, Heuer HW, Chen W, Czerkowicz J, Graham D, Forsberg LK, Brushaber D, Appleby B, Ramos EM, Coppolla G, Bordelon YM, Botha H, Dickerson BC, Dickson DW, Domoto‐Reilly K, Fagan AM, Fields JA, Fong JC, Foroud TM, Galasko DR, Gavrilova RH, Geschwind DH, Ghoshal N, Goldman J, Graff‐Radford NR, Graff‐Radford J, Grant I, Grossman M, Hsiung GR, Huang EJ, Huey ED, Irwin DJ, Jones DT, Kantarci K, Knopman DS, Kornak J, Kremers WK, Lapid MI, Leger GC, Litvan I, Ljubenkov PA, Lucente DE, Mackenzie IR, Masdeu JC, McMillan CT, Mendez MF, Miller BL, Miyagawa T, Onyike CU, Pascual B, Pedraza O, Petrucelli L, Rademakers R, Rankin KP, Rascovsky K, Rexach JE, Ritter A, Roberson ED, Savica R, Seeley WW, Staffaroni AM, Tartaglia MC, Toga AW, Weintraub S, Wong B, Wszolek Z, Vandevrede L, Boeve BF, Rosen HJ, Boxer AL. Clinical value of CSF tau, p‐tau181, neurogranin and neurofilaments in familial frontotemporal lobar degeneration. Alzheimers Dement 2021. [DOI: 10.1002/alz.052993] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Julio C. Rojas
- University of California San Francisco San Francisco CA USA
| | | | | | | | | | | | | | | | | | - Giovanni Coppolla
- University of California Los Angeles School of Medicine Los Angeles CA USA
| | | | | | | | | | | | | | | | | | - Tatiana M. Foroud
- National Cell Repository for Alzheimer's Disease (NCRAD) Indianapolis IN USA
| | | | | | | | - Nupur Ghoshal
- Washington University School of Medicine St. Louis MO USA
| | | | | | | | - Ian Grant
- Northwestern University Chicago IL USA
| | - Murray Grossman
- Penn FTD Center University of Pennsylvania Philadelphia PA USA
| | | | - Eric J. Huang
- Department of Pathology University of California San Francisco San Francisco CA USA
| | | | - David J. Irwin
- Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | | | | | | | - John Kornak
- University of California San Francisco San Francisco CA USA
| | | | | | | | - Irene Litvan
- University of California San Diego San Diego CA USA
| | | | | | | | | | | | | | - Bruce L. Miller
- University of California San Francisco (UCSF) San Francisco CA USA
| | | | | | - Belen Pascual
- Houston Methodist Neurological Institute Houston TX USA
| | | | | | - Rosa Rademakers
- VIB‐U Antwerp Center for Molecular Neurology Antwerp Belgium
| | - Katherine P. Rankin
- Memory and Aging Center University of California San Francisco San Francisco CA USA
| | - Katya Rascovsky
- Penn FTD Center, Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | - Jessica E. Rexach
- University of California Los Angeles School of Medicine Los Angeles CA USA
| | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas NV USA
| | | | | | - William W. Seeley
- Weill Institute for Neurosciences and Memory and Aging Center Department of Neurology University of California San Francisco CA USA
| | | | | | - Arthur W. Toga
- Laboratory of Neuro Imaging Stevens Neuroimaging and Informatics Institute Keck School of Medicine University of Southern California Los Angeles CA USA
| | - Sandra Weintraub
- Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Bonnie Wong
- Massachusetts General Hospital/Harvard Medical School Boston MA USA
| | | | | | | | | | - Adam L. Boxer
- University of California San Francisco San Francisco CA USA
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18
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Rojas JC, Vandevrede L, Heuer HW, Toller G, Thijssen EH, Proctor N, Forsberg LK, Brushaber D, Ramos EM, Coppola G, Appleby B, Bordelon YM, Botha H, Dickerson BC, Dickson DW, Domoto‐Reilly K, Fagan AM, Fields JA, Fong JC, Foroud TM, Galasko DR, Gavrilova RH, Geschwind DH, Ghoshal N, Goldman J, Graff‐Radford NR, Graff‐Radford J, Grant I, Grossman M, Hsiung GR, Huang EJ, Huey ED, Irwin DJ, Jones DT, Kantarci K, Knopman DS, Kornak J, Kremers WK, Lapid MI, Leger GC, Litvan I, Ljubenkov PA, Lucente DE, Mackenzie IR, Masdeu JC, McMillan CT, Mendez M, Miller BL, Miyagawa T, Onyike CU, Pascual B, Pedraza O, Petrucelli L, Rademakers R, Rankin KP, Rascovsky K, Rexach JE, Ritter A, Roberson ED, Savica R, Seeley WW, Staffaroni AM, Trataglia MC, Toga AW, Weintraub S, Wong B, Wszolek Z, Dage JL, Boeve BF, Rosen HJ, Boxer AL. Diagnostic value of plasma P‐tau217 in frontotemporal dementia spectrum disorders. Alzheimers Dement 2021. [DOI: 10.1002/alz.055763] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Julio C. Rojas
- University of California San Francisco San Francisco CA USA
| | | | | | - Gianina Toller
- Memory and Aging Center University of California San Francisco San Francisco CA USA
- Kantonsspital St. Gallen Switzerland
| | - Elisabeth H. Thijssen
- Neurochemistry Laboratory Department of Clinical Chemistry Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Tatiana M. Foroud
- National Centralized Repository for Alzheimer's Disease and Related Dementias (NCRAD) Indianapolis IN USA
| | | | | | | | | | | | | | | | - Ian Grant
- Northwestern University Chicago IL USA
| | | | | | - Eric J. Huang
- Department of Pathology University of California San Francisco San Francisco CA USA
| | | | - David J. Irwin
- Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | | | | | | | - John Kornak
- University of California San Francisco San Francisco CA USA
| | | | | | | | - Irene Litvan
- University of California San Diego San Diego CA USA
| | | | | | | | | | | | - Mario Mendez
- University of California Los Angeles Los Angeles CA USA
| | | | - Toji Miyagawa
- Mayo Clinic Rochester MN USA
- The University of Tokyo Tokyo Japan
| | | | - Belen Pascual
- Houston Methodist Neurological Institute Houston TX USA
| | | | | | - Rosa Rademakers
- VIB‐U Antwerp Center for Molecular Neurology Antwerp Belgium
| | | | | | | | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas NV USA
| | | | | | - William W. Seeley
- Weill Institute for Neurosciences and Memory and Aging Center Department of Neurology University of California San Francisco CA USA
| | | | | | - Arthur W. Toga
- University of Southern California Laboratory of Neuroimaging (LONI) Los Angeles CA USA
| | - Sandra Weintraub
- Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Bonnie Wong
- Massachusetts General Hospital/Harvard Medical School Boston MA USA
| | | | | | | | | | - Adam L. Boxer
- University of California San Francisco San Francisco CA USA
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19
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Bajorek LP, Kiekhofer R, Hall M, Taylor J, Lucente DE, Brushaber D, Appleby B, Coppolla G, Bordelon YM, Botha H, Dickerson BC, Dickson DW, Domoto‐Reilly K, Fagan AM, Fields JA, Fong JC, Foroud TM, Forsberg LK, Galasko DR, Gavrilova RH, Geschwind DH, Ghoshal N, Goldman J, Graff‐Radford NR, Graff‐Radford J, Grant I, Grossman M, Heuer HW, Hsiung GR, Huang EJ, Huey ED, Irwin DJ, Jones DT, Kantarci K, Kornak J, Kremers WK, Lapid MI, Leger GC, Litvan I, Ljubenkov PA, Mackenzie IR, Masdeu JC, McMillan C, Mendez M, Miller BL, Miyagawa T, Onyike CU, Pascual B, Pedraza O, Petrucelli L, Rademakers R, Ramos EM, Rankin KP, Rascovsky K, Rexach JE, Ritter A, Roberson ED, Savica R, Rojas JC, Seeley WW, Tartaglia MC, Toga AW, Weintraub S, Wong B, Wszolek Z, Vandevrede L, Boeve BF, Boxer AL, Rosen HJ, Staffaroni AM. Demographic and psychosocial factors associated with the decision to learn mutation status in familial frontotemporal dementia and the impact of disclosure on mood. Alzheimers Dement 2021. [DOI: 10.1002/alz.050692] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Lynn P. Bajorek
- University of California, San Francisco San Francisco CA USA
| | | | - Matthew Hall
- University of California, San Francisco San Francisco CA USA
| | - Joanne Taylor
- University of California, San Francisco San Francisco CA USA
| | | | | | | | - Giovanni Coppolla
- University of California, Los Angeles School of Medicine Los Angeles CA USA
| | | | | | | | | | | | - Anne M Fagan
- Washington University in St. Louis St. Louis MO USA
| | | | | | - Tatiana M Foroud
- National Centralized Repository for Alzheimer's Disease and Related Dementias (NCRAD) Indianapolis IN USA
| | | | | | | | | | - Nupur Ghoshal
- Washington University School of Medicine St. Louis MO USA
| | - Jill Goldman
- Columbia University Medical Center New York NY USA
| | | | | | - Ian Grant
- Northwestern University Chicago IL USA
| | | | - Hilary W Heuer
- University of California, San Francisco San Francisco CA USA
| | | | - Eric J Huang
- Department of Pathology, University of California, San Francisco San Francisco CA USA
| | | | - David J Irwin
- Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA
| | | | | | - John Kornak
- University of California, San Francisco San Francisco CA USA
| | | | | | | | - Irene Litvan
- University of California, San Diego San Diego CA USA
| | | | | | | | | | - Mario Mendez
- University of California, Los Angeles Los Angeles CA USA
| | - Bruce L Miller
- University of California, San Francisco (UCSF) San Francisco CA USA
| | | | - Chiadi U Onyike
- Johns Hopkins University School of Medicine Baltimore MD USA
| | - Belen Pascual
- Houston Methodist Neurological Institute Houston TX USA
| | | | | | | | | | | | | | | | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas NV USA
| | | | | | - Julio C Rojas
- University of California, San Francisco San Francisco CA USA
| | - William W Seeley
- Weill Institute for Neurosciences and Memory and Aging Center, Department of Neurology, University of California San Francisco CA USA
| | | | - Arthur W Toga
- University of Southern California Los Angeles CA USA
| | - Sandra Weintraub
- Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Bonnie Wong
- Massachusetts General Hospital/Harvard Medical School Boston MA USA
| | | | | | | | - Adam L Boxer
- University of California, San Francisco San Francisco CA USA
| | - Howard J Rosen
- University of California, San Francisco San Francisco CA USA
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20
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Banga YB, Lai Y, Kim P, Boeve BF, Boxer AL, Rosen HJ, Forsberg LK, Heuer HW, Brushaber D, Appleby B, Biernacka JM, Bordelon YM, Botha H, Bozoki AC, Brannelly P, Dickerson BC, Dickinson S, Dickson DW, Domoto‐Reilly K, Faber K, Fagan AM, Fields JA, Fishman A, Foroud TM, Galasko DR, Gavrilova RH, Gendron TF, Geschwind DH, Ghoshal N, Goldman J, Graff‐Radford J, Graff‐Radford NR, Grant I, Grossman M, Hsiung GR, Huang EJ, Huey ED, Irwin DJ, Jones DT, Kantarci K, Karydas AM, Kaufer D, Knopman DS, Kramer JH, Kremers WK, Kornak J, Kukull WA, Lagone E, Leger GC, Litvan I, Ljubenkov PA, Lucente DE, Mackenzie IR, Manoochehri M, Masdeu JC, McGinnis S, Mendez MF, Miller BL, Miyagawa T, Nelson KM, Onyike CU, Pantelyat A, Pascual B, Pearlman R, Petrucelli L, Pottier CP, Rademakers R, Ramos EM, Rankin KP, Rascovsky K, Rexach JE, Ritter A, Roberson ED, Rojas JC, Sabbagh MN, Salmon DP, Savica R, Seeley WW, Staffaroni AM, Syrjanen JA, Tartaglia MC, Tatton N, Taylor JC, Toga AW, Weintraub S, Wheaton D, Wong B, Wszolek Z. Gearing up for the future: Exploring facilitators and barriers to inform clinical trial design in frontotemporal lobar degeneration. Alzheimers Dement 2021. [DOI: 10.1002/alz.052495] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Yasmin B Banga
- Heritage University Toppenish WA USA
- Pacific Northwest University of Health Sciences Yakima WA USA
| | - Yujung Lai
- Heritage University Toppenish WA USA
- Pacific Northwest University of Health Sciences Yakima WA USA
| | - Priscilla Kim
- Heritage University Toppenish WA USA
- Pacific Northwest University of Health Sciences Yakima WA USA
| | | | - Adam L Boxer
- University of California, San Francisco San Francisco CA USA
| | - Howard J Rosen
- University of California, San Francisco San Francisco CA USA
| | | | - Hilary W Heuer
- University of California, San Francisco San Francisco CA USA
| | | | | | | | | | | | | | | | | | | | | | | | - Kelley Faber
- Indiana University School of Medicine Indianapolis IN USA
| | - Anne M Fagan
- Washington University School of Medicine Saint Louis MO USA
| | | | | | | | | | | | | | - Daniel H Geschwind
- University of California, Los Angeles School of Medicine Los Angeles CA USA
| | | | | | | | | | - Ian Grant
- Northwestern University Chicago IL USA
| | - Murray Grossman
- Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA
| | - Ging‐Yuek Robin Hsiung
- Djavad Mowafaghian Centre for Brain Health, University of British Colombia Vancouver BC Canada
| | - Eric J Huang
- Department of Pathology, University of California, San Francisco San Francisco CA USA
| | - Edward D Huey
- Gertrude H. Sergievsky Center at Columbia University New York NY USA
| | - David J Irwin
- Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA
| | | | | | - Anna M Karydas
- University of California, San Francisco San Francisco CA USA
| | | | | | - Joel H Kramer
- University of California, San Francisco San Francisco CA USA
| | | | - John Kornak
- University of California, San Francisco San Francisco CA USA
| | - Walter A Kukull
- National Alzheimer's Coordinating Center, University of Washington Seattle WA USA
| | | | | | - Irene Litvan
- University of California San Diego San Diego CA USA
| | | | | | | | | | | | | | - Mario F Mendez
- David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Bruce L Miller
- University of California, San Francisco (UCSF) San Francisco CA USA
| | | | | | - Chiadi U Onyike
- Johns Hopkins University School of Medicine Baltimore MD USA
| | - Alex Pantelyat
- Johns Hopkins University School of Medicine Baltimore MD USA
| | - Belen Pascual
- Houston Methodist Neurological Institute Houston TX USA
| | | | | | | | | | | | - Katherine P Rankin
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco San Francisco CA USA
| | - Katya Rascovsky
- Penn FTD Center, Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA
| | - Jessica E Rexach
- University of California, Los Angeles School of Medicine Los Angeles CA USA
| | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas NV USA
| | | | - Julio C Rojas
- University of California, San Francisco San Francisco CA USA
| | - Marwan N Sabbagh
- Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas NV USA
| | - David P Salmon
- Shiley‐Marcos Alzheimer's Disease Research Center La Jolla CA USA
| | | | - William W Seeley
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco San Francisco CA USA
| | | | | | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto Toronto ON Canada
| | | | - Jack C Taylor
- University of California, San Francisco San Francisco CA USA
| | - Arthur W Toga
- Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California Los Angeles CA USA
| | - Sandra Weintraub
- Northwestern University Feinberg School of Medicine Chicago IL USA
| | | | - Benjamin Wong
- National Neuroscience Institute, Tan Tock Seng Hospital Singapore Singapore
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21
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Hughes L, Grant I, Patterson SD. Aerobic exercise with blood flow restriction causes local and systemic hypoalgesia and increases circulating opioid and endocannabinoid levels. J Appl Physiol (1985) 2021; 131:1460-1468. [PMID: 34498944 DOI: 10.1152/japplphysiol.00543.2021] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
This study examined the effect of aerobic exercise with and without blood flow restriction (BFR) on exercise-induced hypoalgesia and endogenous opioid and endocannabinoid systems. In a randomized crossover design, pain-free individuals performed 20 min of cycling in four experimental trials: 1) low-intensity aerobic exercise (LI-AE) at 40% V̇o2max; 2) LI-AE with low-pressure BFR (BFR40); 3) LI-AE with high-pressure BFR (BFR80); and 4) high-intensity aerobic exercise (HI-AE) at 70% V̇o2max. Pressure pain thresholds (PPTs) were assessed before and 5 min postexercise. Circulating concentrations of beta-endorphin and 2-arachidonoylglycerol were assessed before and 10 min postexercise. In the exercising legs, postexercise PPTs were increased following BFR40 and BFR80 compared with LI-AE (23-32% vs. 1-2% increase, respectively). The increase in PPTs was comparable to HI-AE (17-20% increase) with BFR40 and greater with BFR80 (30-32% increase). Both BFR80 and HI-AE increased PPTs in remote areas of the body (increase of 26-28% vs. 19-21%, respectively). Postexercise circulating beta-endorphin concentration was increased following BFR40 (11%) and HI-AE (14%), with the greatest change observed following BFR80 (29%). Postexercise circulating 2-arachidonoylglycerol concentration was increased following BFR40 (22%) and BFR80 (20%), with the greatest change observed following HI-AE (57%). Addition of BFR to LI-AE can trigger both local and systemic hypoalgesia that is not observed follow LI-AE alone and activate endogenous opioid and endocannabinoid systems of pain inhibition. Compared with HI-AE, local and systemic hypoalgesia following LI-AE with high-pressure BFR is greater and comparable, respectively. LI-AE with BFR may help pain management in load-compromised individuals.NEW & NOTEWORTHY We have shown that performing blood flow restriction (BFR) during low-intensity aerobic exercise can trigger local and systemic hypoalgesia, which is not typically observed with this intensity of exercise. High-pressure BFR triggers greater and comparable hypoalgesia than high-intensity aerobic exercise in the exercising limbs and remote areas of the body, respectively. Performing BFR during low-intensity aerobic exercise activates the opioid and endocannabinoid systems, providing novel insight into potential mechanisms of hypoalgesia with BFR exercise.
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Affiliation(s)
- Luke Hughes
- Centre for Applied Performance Sciences, Faculty of Sport, Allied Health, and Performance Sciences, St. Mary's University, London, United Kingdom
| | - Ian Grant
- Centre for Applied Performance Sciences, Faculty of Sport, Allied Health, and Performance Sciences, St. Mary's University, London, United Kingdom
| | - Stephen David Patterson
- Centre for Applied Performance Sciences, Faculty of Sport, Allied Health, and Performance Sciences, St. Mary's University, London, United Kingdom
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22
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Santos JV, Gorasso V, Souza J, Wyper GMA, Grant I, Pinheiro V, Viana J, Ricciardi W, Haagsma JA, Devleesschauwer B, Plass D, Freitas A. Risk factors and their contribution to population health in the European Union (EU-28) countries in 2007 and 2017. Eur J Public Health 2021; 31:958-967. [PMID: 34468766 DOI: 10.1093/eurpub/ckab145] [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
BACKGROUND The Global Burden of Disease (GBD) study has generated a wealth of data on death and disability outcomes in Europe. It is important to identify the disease burden that is attributable to risk factors and, therefore, amenable to interventions. This paper reports the burden attributable to risk factors, in deaths and disability-adjusted life years (DALYs), in the 28 European Union (EU) countries, comparing exposure to risks between them, from 2007 to 2017. METHODS Retrospective descriptive study, using secondary data from the GBD 2017 Results Tool. For the EU-28 and each country, attributable (all-cause) age-standardized death and DALY rates, and summary exposure values are reported. RESULTS In 2017, behavioural and metabolic risk factors showed a higher attributable burden compared with environmental risks, with tobacco, dietary risks and high systolic blood pressure standing out. While tobacco and air quality improved significantly between 2007 and 2017 in both exposure and attributable burden, others such as childhood maltreatment, drug use or alcohol use did not. Despite significant heterogeneity between EU countries, the EU-28 burden attributable to risk factors decreased in this period. CONCLUSION Accompanying the improvement of population health in the EU-28, a comparable trend is visible for attributable burden due to risk factors. Besides opportunities for mutual learning across countries with different disease/risk factors patterns, good practices (i.e. tobacco control in Sweden, air pollution mitigation in Finland) might be followed. On the opposite side, some concerning cases must be highlighted (i.e. tobacco in Bulgaria, Latvia and Estonia or drug use in Czech Republic).
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Affiliation(s)
- João Vasco Santos
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal.,Public Health Unit, ACES Grande Porto VIII, ARS Norte, Espinho/Gaia, Portugal
| | - Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Júlio Souza
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | | | | | - Vera Pinheiro
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal.,Public Health Unit, ULS Baixo Alentejo, ARS Alentejo, Beja, Portugal
| | - João Viana
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - Walter Ricciardi
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico 'A. Gemelli' IRCCS, Rome, Italy
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Dietrich Plass
- German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Berlin, Germany
| | - Alberto Freitas
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
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23
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Fletcher E, Wyper GMA, Grant I, de Haro Moro MT, McCartney G, Stockton DL. Quantifying the burden of disease in Scotland in 2018: a Scottish Burden of Disease study. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.265] [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
Background
The Scottish Burden of Disease (SBoD) Study monitors the contribution of over 100 diseases and injuries to the population health in Scotland. Providing robust estimates of the burden is important as recent evidence has highlighted stalling life expectancy and worsening trends in self-assessed general health and understanding the burden of disease is the first step in identifying areas of prevention which could have the biggest impact on health. Our aim was to estimate disability-adjusted life years (DALYs) for 2018, for all causes of disease and injury.
Methods
The SBoD 2016 study estimated the burden for 132 causes of injury and disease using routine data and patient-level record linkage. For this update, years lived with disability were estimated using 2016 age-sex-deprivation specific rates, assuming no change in disease prevalence from 2016, but taking account of changes to the population structure. Years of life lost were calculated from 2018 observed deaths and the application of the Global Burden of Disease aspirational life table.
Results
In 2018 the leading causes of burden were ischaemic heart disease, Alzheimer's/other dementias, lung cancer, drug-use disorders and cerebrovascular disease, representing over a quarter (27%) of the total DALYs in Scotland. Of the 10 leading causes of disease burden, four are wholly attributable to ill-health, demonstrating the added-value of considering DALYs in conjunction with traditional measures of mortality and morbidity.
Conclusions
Ischaemic heart disease continues to be the leading cause of burden of disease in Scotland, however recent years show an increase in burden of social causes and diseases primarily affecting the ageing population. These changes in leading causes demonstrate the importance of continuing to monitor the burden of disease in Scotland, to provide robust evidence for planning of local and national services.
Key messages
The study demonstrates the added-value of considering the burden of disease, in conjunction with traditional measures of morbidity and mortality. Ischaemic heart disease continues to be the leading cause of burden of disease in Scotland.
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Affiliation(s)
- E Fletcher
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, UK
| | - GMA Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
| | - I Grant
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, UK
| | - MT de Haro Moro
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, UK
| | - G McCartney
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
| | - DL Stockton
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
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Wyper G, Grant I, Fletcher E, De Haro Moro MT, McCartney G, Stockton DL. Scottish Burden of Disease (SBOD) study: a population health surveillance system for meaningful action. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
In 2012, planning began to launch the Scottish Burden of Disease (SBOD) study. The aim was to create a population health surveillance system to assess the impact of over 100 causes of disease and injury, and risks, measured by disability-adjusted life years (DALYs). The study has become a mainstay over the last five years as a tool to aid strategic and proportionate decision-making. In 2017, its scope expanded to highlight the extent of inequalities in DALYs by socioeconomic status. Additionally, it now provides comprehensive estimates for 14 regional Health Boards, which are responsible for protecting and improving the health of their local populations. It also provides estimates for 32 local government regions, which provide services related to the broader determinants of health, such as: education, social care and housing. To help turn findings from the SBOD study into action, push, pull and integrated efforts are used. Push efforts involve working together with publishing and communications leads to share key findings. These are commonly in the form of plain English and academic reports, summary briefings, social media messages and infographics. Key messages are also shared through television, radio and newsprint. Pull efforts have recently been improved to house estimates within interactive R Shiny dashboards, which contain user-friendly charts and easy to download data. Integrated approaches involve working with relevant national and local stakeholders, to help shape national and local priority setting. Findings from the study are being used by national and local government and health institutions. Third sector organisations are also key users of SBOD findings, particularly for health conditions that generate high-levels of ill-health, rather than mortality. In 2021, the study will publish an update, and increase capacity on integrated efforts to further embed the SBOD in national and local strategic planning.
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Affiliation(s)
- G Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
| | - I Grant
- Data Driven Innovation Directorate, Public Health Scotland, Glasgow, UK
| | - E Fletcher
- Data Driven Innovation Directorate, Public Health Scotland, Glasgow, UK
| | - MT De Haro Moro
- Data Driven Innovation Directorate, Public Health Scotland, Glasgow, UK
| | - G McCartney
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
| | - DL Stockton
- Board Clinical and Protecting Health Directorate, Public Health Scotland, Glasgow, UK
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Wyper GMA, Fletcher E, Grant I, McCartney G, Harding O, de Haro Moro MT, Stockton DL. Socioeconomic inequalities in COVID-19 DALYs in Scotland, 2020. Eur J Public Health 2021. [PMCID: PMC8574791 DOI: 10.1093/eurpub/ckab164.210] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Aim
Our aim was to estimate the overall, and inequalities in the, population health impact of COVID-19 in Scotland, measured by disability-adjusted life years (DALYs) in 2020.
Methods
National deaths and daily case data were input into the consensus model outlined by the European Burden of Disease Network, to estimate DALYs. Total Years of Life Lost (YLL) were estimated, and for each deprivation quintile of the Scottish population. Years Lived with Disability (2% of all DALYs) were proportionately distributed to deprivation quintiles, based on YLL estimates. Socioeconomic inequalities were measured by the Relative Index of Inequality (RII), Slope Index of Inequality (SII), and attributable DALYs were estimated by using the least deprived quintile as a reference. Results were presented as a range, using a sensitivity based on YLL estimates using: cause-specific; and COVID-19 related deaths.
Results
COVID-19 DALYs ranged from 96,500 to 108,200 in 2020, representing the second leading cause of disease/injury in Scotland, in 2020. Marked socioeconomic inequalities were observed across several measures. The difference between the most and least deprived areas, measured by SII, was 2,048 to 2,289 DALYs per 100,000. The RII was 1.16, meaning that the rate in the most deprived areas was around 58% higher than the mean rate of the population. DALYs attributable to differences in socioeconomic status accounted for 40% of total COVID-19 DALYs.
Conclusions
The direct population health impact of COVID-19 in 2020 was substantial. Despite unprecedented mitigation efforts, in Scotland, a single case in early 2020 developed to having an impact second only to ischaemic heart disease. This impact was not shared equally, and socioeconomically deprived areas were hit hardest, a result confirmed across all measures of inequality. DALY estimation on both the ongoing direct, and indirect, pandemic harms will evidence the extent of impact on overall, and inequalities in, population health.
Key messages
The population impact of COVID-19 has been highly damaging. When measured by DALYs, the population health impact of COVID-19 in Scotland, during 2020, was second only to ischaemic heart disease. The population health impact of COVID-19 has not been shared equally, a result confirmed across all measures of socioeconomic inequality.
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Affiliation(s)
- GMA Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
| | - E Fletcher
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, UK
| | - I Grant
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, UK
| | - G McCartney
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UK
| | - O Harding
- Directorate of Public Health, NHS Forth Valley, Stirling, UK
| | - MT de Haro Moro
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, UK
| | - DL Stockton
- Clinical and Protecting Health Directorate, Public Health Scotland, Edinburgh, UK
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Hodgkinson-Brechenmacher V, Lounsberry J, Abrahao A, Benstead T, Breiner A, Briemberg H, Genge A, Grant I, Kalra S, Marrero A, Massie R, Matte G, O'Connell C, Pfeffer G, Schellenberg K, Shoesmith C, Taylor S, Izenberg A, Johnston W, Korngut L. MOTOR NEURON DISORDERS AND NEUROPATHIES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.268] [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: 10/20/2022]
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27
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Wyper GMA, Fletcher E, Grant I, Harding O, de Haro Moro MT, Stockton DL, McCartney G. Inequalities in population health loss by multiple deprivation: COVID-19 and pre-pandemic all-cause disability-adjusted life years (DALYs) in Scotland. Int J Equity Health 2021; 20:214. [PMID: 34565406 PMCID: PMC8474788 DOI: 10.1186/s12939-021-01547-7] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/11/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND COVID-19 has caused almost unprecedented change across health, education, the economy and social interaction. It is widely understood that the existing mechanisms which shape health inequalities have resulted in COVID-19 outcomes following this same, familiar, pattern. Our aim was to estimate inequalities in the population health impact of COVID-19 in Scotland, measured by disability-adjusted life years (DALYs) in 2020. Our secondary aim was to scale overall, and inequalities in, COVID-19 DALYs against the level of pre-pandemic inequalities in all-cause DALYs, derived from the Scottish Burden of Disease (SBoD) study. METHODS National deaths and daily case data were input into the European Burden of Disease Network consensus model to estimate DALYs. Total Years of Life Lost (YLL) were estimated for each area-based deprivation quintile of the Scottish population. Years Lived with Disability were proportionately distributed to deprivation quintiles, based on YLL estimates. Inequalities were measured by: the range, Relative Index of Inequality (RII), Slope Index of Inequality (SII), and attributable DALYs were estimated by using the least deprived quintile as a reference. RESULTS Marked inequalities were observed across several measures. The SII range was 2048 to 2289 COVID-19 DALYs per 100,000 population. The rate in the most deprived areas was around 58% higher than the mean population rate (RII = 1.16), with 40% of COVID-19 DALYs attributed to differences in area-based deprivation. Overall DALYs due to COVID-19 ranged from 7 to 20% of the annual pre-pandemic impact of inequalities in health loss combined across all causes. CONCLUSION The substantial population health impact of COVID-19 in Scotland was not shared equally across areas experiencing different levels of deprivation. The extent of inequality due to COVID-19 was similar to averting all annual DALYs due to diabetes. In the wider context of population health loss, overall ill-health and mortality due to COVID-19 was, at most, a fifth of the annual population health loss due to inequalities in multiple deprivation. Implementing effective policy interventions to reduce health inequalities must be at the forefront of plans to recover and improve population health.
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Affiliation(s)
- Grant M A Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland.
| | - Eilidh Fletcher
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, Scotland
| | - Ian Grant
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, Scotland
| | - Oliver Harding
- Directorate of Public Health, NHS Forth Valley, Stirling, Scotland
| | | | - Diane L Stockton
- Clinical and Protecting Health Directorate, Public Health Scotland, Edinburgh, Scotland
| | - Gerry McCartney
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland
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28
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Boudreau C, Corkum J, Grant I, Tang DT. A Comparative Study Using Electromyography to Assess Hand Exercises For Rehabilitation After Ulnar Nerve Decompression. J Plast Reconstr Aesthet Surg 2021; 75:307-313. [PMID: 34642062 DOI: 10.1016/j.bjps.2021.08.042] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 07/10/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022]
Abstract
Ulnar nerve (UN) entrapment is a common peripheral neuropathy and can lead to dysfunction of both sensory and motor function of the hand. Surgical release is the mainstay of treatment, but post-operative rehabilitation of UN innervated intrinsic muscles is lacking evidence. This cohort study utilized surface electromyography (EMG) and assessed the activation of UN innervated intrinsic and extrinsic hand muscles during four exercises in healthy participants. Exercises included rotating baoding balls, squeezing a stress ball or grip device every second, and repetitive finger abduction against a rubber band. Normalized percent activation of each muscle was calculated for each exercise. It was demonstrated that rubber band resistance (RBR) finger abduction showed significantly increased activation in both intrinsic muscles tested, while minimizing activation of the one tested UN innervated extrinsic muscle. Thus, to best target the intrinsic hand muscles without fatiguing extrinsic muscles, the inexpensive and practical RBR exercise is beneficial in post-UN release rehabilitation.
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Affiliation(s)
- Colton Boudreau
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joseph Corkum
- Division of Plastic Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ian Grant
- Division of Neurology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - David T Tang
- Division of Plastic Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
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29
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Bickerton S, Grant I. Tenosynovial giant cell tumour mimicking ulnar collateral ligament rupture at the thumb metacarpophalangeal joint. J Hand Surg Eur Vol 2021; 46:789-790. [PMID: 33794690 DOI: 10.1177/17531934211004437] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Shixin Bickerton
- The Department of Plastic & Reconstructive Surgery, Addenbrooke's Hospital, Cambridge UK
| | - Ian Grant
- The Department of Plastic & Reconstructive Surgery, Addenbrooke's Hospital, Cambridge UK.,The Spire Cambridge Lea Hospital, Impington, UK
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30
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Haneef R, Schmidt J, Gallay A, Devleesschauwer B, Grant I, Rommel A, Wyper GM, Van Oyen H, Hilderink H, Ziese T, Newton J. Recommendations to plan a national burden of disease study. ACTA ACUST UNITED AC 2021; 79:126. [PMID: 34233754 PMCID: PMC8262070 DOI: 10.1186/s13690-021-00652-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/27/2021] [Indexed: 11/17/2022]
Abstract
Background The InfAct (Information for Action) project is a European Commission Joint Action on Health Information which has promoted the potential role of burden of disease (BoD) approaches to improve the current European Union-Health Information System (EU-HIS). It has done so by raising awareness of the concept, the methods used to calculate estimates and their potential implications and uses in policymaking. The BoD approach is a systematic and scientific effort to quantify and compare the magnitude of health loss due to different diseases, injuries, and risk factors with estimates produced by demographic characteristics and geographies for specific points in time. Not all countries have the resources to undertake such work, and may therefore start with a more restricted objective, e.g., a limited number of diseases, or the use of simple measures of population health such as disease prevalence or life expectancy. The main objective to develop these recommendations was to facilitate those countries planning to start a national burden of disease study. Results These recommendations could be considered as minimum requirements for those countries planning to start a BoD study and includes following elements: (1) Define the objectives of a burden of disease study within the context of your country, (2) Identify, communicate and secure the benefits of performing national burden of disease studies, (3) Secure access to the minimum required data sources, (4) Ensure the minimum required capacity and capability is available to carry out burden of disease study, (5) Establish a clear governance structure for the burden of disease study and stakeholder engagement/involvement, (6) Choose the appropriate methodological approaches and (7) Knowledge translation. These were guided by the results from our survey performed to identify the needs of European countries for BoD studies, a narrative overview from four European countries (Belgium, Germany, The Netherlands and Scotland) and the summary of a comparative study of country health profiles with national health statistics. Conclusions These recommendations as minimum requirements would facilitate efforts by those European countries who intend to perform national BoD studies. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00652-x.
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Affiliation(s)
- Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Osne, 94415, Saint-Maurice Cedex, France.
| | | | - Anne Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Osne, 94415, Saint-Maurice Cedex, France
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Ian Grant
- Public Health Scotland, Edinburgh, Scotland, UK
| | - Alexander Rommel
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | | | - Herman Van Oyen
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Henk Hilderink
- Centre for Public Health Forecasting, National Institute for Public Health and the Environment (RIVM), Bilthoven Utrecht, Utrecht, The Netherlands
| | - Thomas Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - John Newton
- Health Improvement, Public Health England, London, UK
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Hubbard JA, Hoffman MA, Ellis SE, Sobolesky PM, Smith BE, Suhandynata RT, Sones EG, Sanford SK, Umlauf A, Huestis MA, Grelotti DJ, Grant I, Marcotte TD, Fitzgerald RL. Biomarkers of Recent Cannabis Use in Blood, Oral Fluid and Breath. J Anal Toxicol 2021; 45:820-828. [PMID: 34185831 DOI: 10.1093/jat/bkab080] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/15/2021] [Accepted: 07/07/2021] [Indexed: 12/25/2022] Open
Abstract
Proving driving under the influence of cannabis (DUIC) is difficult. Establishing a biomarker of recent use to supplement behavioral observations may be a useful alternative strategy. We determined whether cannabinoid concentrations in blood, oral fluid (OF), or breath could identify use within 3h, likely the period of greatest impairment. In a randomized trial, 191 frequent (≥4/week) and occasional (<4/week) cannabis users smoked one cannabis (placebo [0.02%], 5.9% or 13.4% THC) cigarette ad libitum. Blood, OF and breath samples were collected prior to and up to 6h after smoking. Samples were analyzed for 10 cannabinoids in OF, 8 in blood, and THC in breath. Frequent users had more residual THC in blood and were categorized as "recently used" prior to smoking; this did not occur in OF. Per se limits ranging from undetectable to 5 ng/mL THC in blood offered limited usefulness as biomarkers of recent use. Cannabinol (CBN, cutoff=1 ng/mL) in blood offered 100% specificity but only 31.4% sensitivity, resulting in 100% PPV and 94.0% NPV at 4.3% prevalence; but CBN may vary by cannabis chemovar. A 10 ng/mL THC cutoff in OF exhibited the overall highest performance to detect use within 3h (99.7% specificity, 82.4% sensitivity, 92.5% PPV, 99.2% NPV) but was still detectable in 23.2% of participants ~4.4h post smoking limiting specificity at later time points. OF THC may be a helpful indicator of recent cannabis intake, but this does not equate to impairment. Behavioral assessment of impairment is still required to determine DUIC. This study only involved cannabis inhalation and additional research evaluating alternative routes of ingestion (i.e., oral) is needed.
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Affiliation(s)
- J A Hubbard
- Department of Pathology, University of California, San Diego, 10300 Campus Point Drive, Suite 150, San Diego, CA 92121 USA
| | - M A Hoffman
- Department of Pathology, University of California, San Diego, 10300 Campus Point Drive, Suite 150, San Diego, CA 92121 USA
| | - S E Ellis
- Department of Cognitive Science, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92092 USA.,Halıcıoğlu Data Science Institute, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92092 USA
| | - P M Sobolesky
- Department of Pathology, University of California, San Diego, 10300 Campus Point Drive, Suite 150, San Diego, CA 92121 USA
| | - B E Smith
- Department of Pathology, University of California, San Diego, 10300 Campus Point Drive, Suite 150, San Diego, CA 92121 USA
| | - R T Suhandynata
- Department of Pathology, University of California, San Diego, 10300 Campus Point Drive, Suite 150, San Diego, CA 92121 USA
| | - E G Sones
- Department of Psychiatry, University of California, San Diego, 220 Dickinson, MC #8231, San Diego, CA 92103 USA
| | - S K Sanford
- Department of Psychiatry, University of California, San Diego, 220 Dickinson, MC #8231, San Diego, CA 92103 USA
| | - A Umlauf
- Department of Psychiatry, University of California, San Diego, 220 Dickinson, MC #8231, San Diego, CA 92103 USA
| | - M A Huestis
- Institute for Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA 19107 USA
| | - D J Grelotti
- Department of Psychiatry, University of California, San Diego, 220 Dickinson, MC #8231, San Diego, CA 92103 USA
| | - I Grant
- Department of Psychiatry, University of California, San Diego, 220 Dickinson, MC #8231, San Diego, CA 92103 USA
| | - T D Marcotte
- Department of Psychiatry, University of California, San Diego, 220 Dickinson, MC #8231, San Diego, CA 92103 USA
| | - R L Fitzgerald
- Department of Pathology, University of California, San Diego, 10300 Campus Point Drive, Suite 150, San Diego, CA 92121 USA
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32
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Patel MIA, Laing T, Grant I. Amniotic constriction band in infants conceived by in vitro fertilization: a report of two consecutive cases. J Hand Surg Eur Vol 2021; 46:548-549. [PMID: 33423584 DOI: 10.1177/1753193420979227] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Manal I A Patel
- School of Clinical Medicine, University of Cambridge, Cambridge, UK.,Department of Plastic & Reconstructive Surgery, Addenbrooke's Hospital, Cambridge, UK
| | - Tereze Laing
- School of Clinical Medicine, University of Cambridge, Cambridge, UK.,Department of Plastic & Reconstructive Surgery, Addenbrooke's Hospital, Cambridge, UK
| | - Ian Grant
- School of Clinical Medicine, University of Cambridge, Cambridge, UK.,Department of Plastic & Reconstructive Surgery, Addenbrooke's Hospital, Cambridge, UK
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33
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Wyper GMA, Assunção RMA, Colzani E, Grant I, Haagsma JA, Lagerweij G, Von der Lippe E, McDonald SA, Pires SM, Porst M, Speybroeck N, Devleesschauwer B. Burden of Disease Methods: A Guide to Calculate COVID-19 Disability-Adjusted Life Years. Int J Public Health 2021; 66:619011. [PMID: 34744580 PMCID: PMC8565264 DOI: 10.3389/ijph.2021.619011] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/12/2021] [Indexed: 12/21/2022] Open
Affiliation(s)
- Grant M. A. Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland
- *Correspondence: Grant M. A. Wyper,
| | - Ricardo M. A. Assunção
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Edoardo Colzani
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Ian Grant
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, Scotland
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Giske Lagerweij
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Elena Von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Scott A. McDonald
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Sara M. Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Michael Porst
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Niko Speybroeck
- Research Institute of Health and Society, Catholic University of Louvain, Brussels, Belgium
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
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Hodgkinson V, Lounsberry J, M'Dahoma S, Russell A, Jewett G, Benstead T, Brais B, Campbell C, Johnston W, Lochmüller H, McCormick A, Nguyen CT, O'Ferrall E, Oskoui M, Abrahao A, Briemberg H, Bourque PR, Botez S, Cashman N, Chapman K, Chrestian N, Crone M, Dobrowolski P, Dojeiji S, Dowling JJ, Dupré N, Genge A, Gonorazky H, Grant I, Hasal S, Izenberg A, Kalra S, Katzberg H, Krieger C, Leung E, Linassi G, Mackenzie A, Mah JK, Marrero A, Massie R, Matte G, McAdam L, McMillan H, Melanson M, Mezei MM, O'Connell C, Pfeffer G, Phan C, Plamondon S, Poulin C, Rodrigue X, Schellenberg K, Selby K, Sheriko J, Shoesmith C, Smith RG, Taillon M, Taylor S, Venance S, Warman-Chardon J, Worley S, Zinman L, Korngut L. The Canadian Neuromuscular Disease Registry 2010-2019: A Decade of Facilitating Clinical Research Througha Nationwide, Pan-NeuromuscularDisease Registry. J Neuromuscul Dis 2021; 8:53-61. [PMID: 32925088 PMCID: PMC7902956 DOI: 10.3233/jnd-200538] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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] [Indexed: 12/11/2022]
Abstract
We report the recruitment activities and outcomes of a multi-disease neuromuscular patient registry in Canada. The Canadian Neuromuscular Disease Registry (CNDR) registers individuals across Canada with a confirmed diagnosis of a neuromuscular disease. Diagnosis and contact information are collected across all diseases and detailed prospective data is collected for 5 specific diseases: Amyotrophic Lateral Sclerosis (ALS), Duchenne Muscular Dystrophy (DMD), Myotonic Dystrophy (DM), Limb Girdle Muscular Dystrophy (LGMD), and Spinal Muscular Atrophy (SMA). Since 2010, the CNDR has registered 4306 patients (1154 pediatric and 3148 adult) with 91 different neuromuscular diagnoses and has facilitated 125 projects (73 academic, 3 not-for-profit, 3 government, and 46 commercial) using registry data. In conclusion, the CNDR is an effective and productive pan-neuromuscular registry that has successfully facilitated a substantial number of studies over the past 10 years.
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Affiliation(s)
- V Hodgkinson
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - J Lounsberry
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - S M'Dahoma
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - A Russell
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - G Jewett
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - T Benstead
- Division of Neurology, Dalhousie University, Halifax, Canada
| | - B Brais
- Montreal Neurological Institute and Hospital, Montreal, Canada
| | - C Campbell
- Department of Pediatrics, Children's Health Research Institute, London Health Sciences Centre, Western University, London, Canada
| | - W Johnston
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - H Lochmüller
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.,Department of Medicine, The Ottawa Hospital and Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - A McCormick
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - C T Nguyen
- CHU Sainte-Justine, Université de Montréal, Montréal, Canada
| | - E O'Ferrall
- Montreal Neurological Institute and Hospital, Montreal, Canada.,Department of Neurosciences, McGill University, Montréal, Canada
| | - M Oskoui
- Department of Neurosciences, McGill University, Montréal, Canada.,Departments of Pediatrics, Montreal Children's Hospital, McGill University, Montréal, Canada
| | - A Abrahao
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - H Briemberg
- GF Strong Rehabilitation Centre, University of British Columbia, Vancouver, Canada.,Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - P R Bourque
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Ottawa, Ottawa, Canada
| | - S Botez
- Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Canada
| | - N Cashman
- GF Strong Rehabilitation Centre, University of British Columbia, Vancouver, Canada.,Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - K Chapman
- Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - N Chrestian
- Department of Medicine, Université Laval, Quebec City, Canada, Neuroscience axis, CHU de Québec-Université Laval
| | - M Crone
- Division of Pediatric Neurology, Department of Neurology, University of Saskatchewan, Saskatoon, Canada
| | - P Dobrowolski
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - S Dojeiji
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Ottawa, Ottawa, Canada
| | - J J Dowling
- Department of Pediatrics, Sick Kids Hospital, University of Toronto, Toronto, Canada
| | - N Dupré
- Department of Medicine, Laval University, Québec City, Canada
| | - A Genge
- Department of Neurosciences, McGill University, Montréal, Canada
| | - H Gonorazky
- Department of Pediatrics, Sick Kids Hospital, University of Toronto, Toronto, Canada
| | - I Grant
- Division of Neurology, Dalhousie University, Halifax, Canada
| | - S Hasal
- Division of Pediatric Neurology, Department of Neurology, University of Saskatchewan, Saskatoon, Canada
| | - A Izenberg
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - S Kalra
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - H Katzberg
- University Health Network, University of Toronto, Toronto, Canada
| | - C Krieger
- GF Strong Rehabilitation Centre, University of British Columbia, Vancouver, Canada.,Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - E Leung
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - G Linassi
- Department of Physical Medicine and Rehabilitation University of Saskatchewan, Saskatoon, Canada
| | - A Mackenzie
- Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - J K Mah
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.,Department of Pediatrics, University of Calgary, Calgary, Canada
| | - A Marrero
- CHU Dr. Georges-L-Dumont, Université de Sherbrooke, Moncton, Canada
| | - R Massie
- Montreal Neurological Institute and Hospital, Montreal, Canada.,Department of Neurosciences, McGill University, Montréal, Canada
| | - G Matte
- Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, Canada
| | - L McAdam
- Department of Pediatrics, Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, University of Toronto, Toronto, Canada
| | - H McMillan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - M Melanson
- Department of Physical Medicine and Rehabilitation, Queen's University, Kingston, Canada
| | - M M Mezei
- Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
| | - C O'Connell
- Stan Cassidy Centre for Rehabilitation, Fredericton, Canada.,Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - G Pfeffer
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.,Department of Medical Genetics, and Alberta Child Health Research Institute, University of Calgary, Calgary, Canada
| | - C Phan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - S Plamondon
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - C Poulin
- Departments of Pediatrics, Montreal Children's Hospital, McGill University, Montréal, Canada
| | - X Rodrigue
- Department of Medicine, Laval University, Québec City, Canada
| | - K Schellenberg
- Department of Physical Medicine and Rehabilitation University of Saskatchewan, Saskatoon, Canada
| | - K Selby
- Division of Neurology, Department of Pediatrics, BC Children's Hospital, University of Vancouver, Vancouver, Canada
| | - J Sheriko
- Division of Neurology, Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - C Shoesmith
- Division of Neurology, Clinical Neurological Sciences, Western University, London, Canada
| | - R G Smith
- Department of Pediatrics, KidsInclusive Centre for Child & Youth Development, Hotel Dieu Hospital, Queen's University, Kingston, Canada
| | - M Taillon
- Stan Cassidy Centre for Rehabilitation, Fredericton, Canada.,Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - S Taylor
- Division of Neurology, Dalhousie University, Halifax, Canada
| | - S Venance
- Division of Neurology, Clinical Neurological Sciences, Western University, London, Canada
| | - J Warman-Chardon
- Department of Medicine, The Ottawa Hospital and Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - S Worley
- Stan Cassidy Centre for Rehabilitation, Fredericton, Canada.,Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - L Zinman
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - L Korngut
- Department of Clinical Neurosciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
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von der Lippe E, Devleesschauwer B, Gourley M, Haagsma J, Hilderink H, Porst M, Wengler A, Wyper G, Grant I. Reflections on key methodological decisions in national burden of disease assessments. Arch Public Health 2020; 78:137. [PMID: 33384020 PMCID: PMC7774238 DOI: 10.1186/s13690-020-00519-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/08/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Summary measures of population health are increasingly used in different public health reporting systems for setting priorities for health care and social service delivery and planning. Disability-adjusted life years (DALYs) are one of the most commonly used health gap summary measures in the field of public health and have become the key metric for quantifying burden of disease (BoD). BoD methodology is, however, complex and highly data demanding, requiring a substantial capacity to apply, which has led to major disparities across researchers and nations in their resources to perform themselves BoD studies and interpret the soundness of available estimates produced by the Global Burden of Disease Study. METHODS BoD researchers from the COST Action European Burden of Disease network reflect on the most important methodological choices to be made when estimating DALYs. The paper provides an overview of eleven methodological decisions and challenges drawing on the experiences of countries working with BoD methodology in their own national studies. Each of these steps are briefly described and, where appropriate, some examples are provided from different BoD studies across the world. RESULTS In this review article we have identified some of the key methodological choices and challenges that are important to understand when calculating BoD metrics. We have provided examples from different BoD studies that have developed their own strategies in data usage and implementation of statistical methods in the production of BoD estimates. CONCLUSIONS With the increase in national BoD studies developing their own strategies in data usage and implementation of statistical methods in the production of BoD estimates, there is a pressing need for equitable capacity building on the one hand, and harmonization of methods on the other hand. In response to these issues, several BoD networks have emerged in the European region that bring together expertise across different domains and professional backgrounds. An intensive exchange in the experience of the researchers in the different countries will enable the understanding of the methods and the interpretation of the results from the local authorities who can effectively integrate the BoD estimates in public health policies, intervention and prevention programs.
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Affiliation(s)
- Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | | | - Michelle Gourley
- Indigenous Data Analysis and Reporting Unit, Australian Institute of Health and Welfare, Canberra, Australia
| | - Juanita Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henk Hilderink
- Centre for Public Health Forecasting, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Michael Porst
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Annelene Wengler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Grant Wyper
- Public Health Scotland, Edinburgh, Scotland, UK
| | - Ian Grant
- Public Health Scotland, Edinburgh, Scotland, UK
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Heuer HW, Rojas JC, Toller G, Rankin K, Brushaber D, Appleby B, Bordelon YM, Dickerson BC, Kimiko D, Faber K, Foroud TM, Forsberg LK, Ghoshal N, Grant I, Graff‐Radford NR, Grossman M, Hsiung GR, Huey ED, Karydas AM, Kaufer D, Kerwin DR, Lagone E, Litvan I, Ljubenkov PA, Mackenzie IR, Mendez MF, Miller BL, Onyike CU, Ramos EM, Rascovsky K, Roberson ED, Tartaglia C, Weintraub S, Boeve BF, Rosen HJ, Boxer AL. Plasma neurofilament light chain levels reflect caregiver burden and social cognition measures in familial frontotemporal lobar degeneration (FTLD). Alzheimers Dement 2020. [DOI: 10.1002/alz.046247] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Gianina Toller
- Memory and Aging Center University of California San Francisco San Francisco CA USA
| | - Katherine Rankin
- Memory and Aging Center, UCSF Weill Institute for Neurosciences University of California San Francisco CA USA
| | | | | | | | | | | | - Kelley Faber
- Indiana University School of Indianapolis IN USA
| | | | | | - Nupur Ghoshal
- Washington University School of Medicine St. Louis MO USA
| | - Ian Grant
- Northwestern University Chicago IL USA
| | | | - Murray Grossman
- Penn FTD Center University of Pennsylvania Philadelphia PA USA
| | | | - Edward D. Huey
- Gertrude H. Sergievsky Center at Columbia University New York NY USA
| | | | | | | | | | - Irene Litvan
- University of California San Diego San Diego CA USA
| | | | | | | | | | | | | | - Katya Rascovsky
- Penn FTD Center, Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | | | | | | | | | | | - Adam L. Boxer
- University of California San Francisco San Francisco CA USA
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Wyper GMA, Grant I, Fletcher E, Chalmers N, McCartney G, Stockton DL. Correction to: Prioritising the development of severity distributions in burden of disease studies for countries in the European region. Arch Public Health 2020; 78:29. [PMID: 32266068 PMCID: PMC7115076 DOI: 10.1186/s13690-020-00412-3] [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: 11/30/2022] Open
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38
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Grant I, Plass D, von der Lippe E, Lesnik T, Idavain J. Fostering methodological advances and technical capacity building. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1379] [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
Countries all over the world, and especially in Europe, are increasingly using the burden of disease approach to assess the health status of populations and to identify the main drivers of ill health. Thus, there is an increasing need for equitable capacity building on the one hand (including an improved understanding of the complex methods behind global and national burden estimates), and harmonization of methods on the other hand to keep the results comparable. Furthermore, involved researchers also strive for a platform to exchange experiences and foster collaboration.
To address the current challenges in burden of disease research, our COST Action CA18218-European Burden of Disease Network will build strongly on the COST mechanisms, such as short-term scientific missions and training schools to foster and increase capacity building activities across Europe. Our Action will also serve as a technical platform where knowledge and expertise can be shared among experienced and less experienced researchers. Collaboratively, the technical platform will provide unique opportunities for developing a joint research agenda in the domain of burden of disease, for fostering methodological developments, and for developing new collaborative research.
With this presentation, we aim to show how the COST Action is fostering methodological advances and technical capacity building, focusing on 1) the role and aim of short-term scientific missions including real case examples; 2) the concept and structure of the Action's training schools; and 3) examples of specific methodological activities underway as part of the Action. The session will conclude with an interaction with the audience during which the needs and expectations of the attendees will be elicited.
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Affiliation(s)
- I Grant
- Public Health Scotland, Edinburgh, UK
| | - D Plass
- Department for Environmental Hygiene, German Environment Agency, Berlin, Germany
| | - E von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - T Lesnik
- National Institute of Public Health, Ljubljana, Slovenia
| | - J Idavain
- Department of Health Statistics, National Institute for Health Development, Tallinn, Estonia
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Wyper GMA, Fletcher E, Grant I, McCartney G, Stockton DL. Forecasting the extent of future public health challenges using the Scottish Burden of Disease study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.046] [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
Over the next 25 years in Scotland there is expected to be negative natural change in population growth in a rapidly ageing population. Recent evidence has highlighted the slowing of life expectancy gains and worsening trends in self-assessed general health. We have adapted the Scottish Burden of Disease study to forecast how demographic and health trends will shape future public health challenges. This is important in order to inform policy, service and workforce planning to meet anticipated needs.
Methods
For a baseline period of 2014-16 Disability-Adjusted Life Years (DALYs) were estimated for 132 causes of burden using routine data sources and patient-level record linkage techniques. Disability weights and disease models used to calculate Years Lived with Disability (YLD) were largely based on those from the Global Burden of Disease study, with life tables used to facilitate calculations of Years of Life Lost (YLL). The leading 20 causes were identified and trends in the occurrence of morbidity and mortality are currently being estimated up until 2019, and forecast to 2040, using age-period-cohort modelling. Crude and age-standardised rates will be used to monitor changes due to demography and exposure to the wider social determinants of health.
Results
In 2014-16, the leading causes of burden were ischaemic heart disease, neck and low back pain, depression, lung cancer and cerebrovascular disease. The leading 20 causes represented 68% of all-cause DALYs with ill-health and disability causing almost half of the burden.
Conclusions
Insights of the future trajectory of population health equip us with strong evidence to influence the need for a strong policy response on prevention. Estimates of the future occurrence of morbidities can be embedded in planning to ensure that services and the care workforce are proportionately designed to meet the increasing needs of a vulnerable ageing population.
Key messages
The most recent assessment highlighted that non-fatal and fatal health states approximately contribute equally to the overall disease burden in Scotland. Evidencing how future demographic and population health trends interact allows us to ensure that policy responses, care services and the care workforce can be designed based on anticipated needs.
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Affiliation(s)
| | | | - I Grant
- Public Health Scotland, Glasgow, UK
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Cornez A, Silversmit G, Gorasso V, Grant I, Wyper GMA, De Smedt D, Devleesschauwer B, Speybroeck N. The burden of cancer in Belgium, 2004-2017. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Monitoring the health status of a population requires consistent and comparable data on the morbidity and mortality impacts of a disease. The Disability-Adjusted Life Year (DALY) is an increasingly used disease burden indicator, combining healthy life years lost due to living with disease (Years Lived with Disability; YLDs) and due to dying prematurely (Years of Life Lost; YLLs). In Belgium, as in many other developed countries, cancer is a major contributor to the overall burden of disease. To date, however, local estimates of the burden of cancer are lacking.
Methods
We estimated the burden of 48 cancers in Belgium from 2004 to 2017 in terms of DALYs, using national population-based cancer registry data and international disease models. We developed a microsimulation model to translate incidence- into prevalence-based estimates, and used expert elicitation to integrate the long-term impact of surgical treatment.
Results
In 2017, in Belgium, breast cancer was the cancer with the highest disease burden among women, followed by lung cancer and colorectal cancer. Among men, lung cancer had the highest disease burden, followed by colorectal cancer and prostate cancer. Between 2004 and 2017, the burden of lung cancer increased by more than 50% in women, while in both sexes, significant increases were observed in melanoma and skin cancer burden. The majority of the cancer burden remained linked to premature mortality.
Conclusions
Cancer maintains a major impact on the health of the Belgian population. Current resources allocated for their prevention and treatment will need to be maintained to further reduce the cancer burden. Lung cancer remains a crucial challenge, among both men and women, calling for strengthened tobacco control policies. Integrating the current study in the Belgian national burden of disease study (BeBOD) will allow monitoring the burden of cancer over time, highlighting new trends and assessing the impact of public health policies.
Key messages
Burden of disease studies allow assessing and monitoring the impact of diseases and risk factors in a comparable way. Cancer maintains a major impact on the health of the Belgian population; lung cancer in particular remains a crucial challenge.
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Affiliation(s)
- A Cornez
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - G Silversmit
- Research Department, Belgian Cancer Registry, Brussels, Belgium
| | - V Gorasso
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - I Grant
- Public Health Scotland, Edinburgh, UK
| | | | - D De Smedt
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - B Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - N Speybroeck
- Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
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von der Lippe E, Grant I, Devleesschauwer B. Data inputs and assumptions in calculating the fatal burden in burden of disease studies. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1439] [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
Years of Life Lost (YLL) is a measure of premature mortality used in the calculation of the Disability-Adjusted Life Year (DALY), as well as stand-alone measure in itself. The concept of years of life lost is to estimate the length of time a person is expected to have lived had they not died prematurely. The YLL is based on comparing the age of death to an external standard life expectancy curve, and can incorporate time discounting and age weighting. Furthermore, YLL can be calculated for specific causes of death. In this way the indicator can be used to compare the relative importance of different causes of premature death within a particular population. Thus, it can be used by health planners to define priorities for the prevention interventions.
The process of calculating a YLL involves several components and this presentation will provide a sequential walk through each step in the YLL calculation, including causes of death statisticsdefinition of ill-defined deathsmethods of redistribution of ill-defined deathsthe use of life tablessocial weighting
The aim of this presentation is to outline a simple step by step guide on the key components in the YLL calculation. Using the real-life example of cerebrovascular disease, the presentation will outline the key choices and assumptions that underline each data inputs in the YLL calculation. Participants in this session will also be provided with links to resources to help facilitate this decision making process. The workshop will end with an interactive session where the presenters will discuss the implications of the different methodological choices with the audience.
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Affiliation(s)
| | - I Grant
- Public Health Scotland, Edinburgh, UK
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Grant I, Wyper GMA, Fletcher E, McCartney G, Stockton D. The power of administrative data in national studies: experiences from the Scottish Burden of Disease study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.263] [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
In 2013, the Scottish Burden of Disease Study (SBoD) study set out with an ambitious aim of comprehensively estimating the burden of 132 causes of ill-health and mortality. The study utilised the rich and widespread data which is recorded as a by-product of individual encounters across the universally available and free at point-of-contact healthcare services in Scotland, and other long-standing survey initiatives. It was carried out as an independent national burden of disease study, but used Global Burden of Disease methodology for disability weights. In 2017, our first report outlined the contribution of causes of disease and injury of DALYs. This was followed up in a 2018, with a further report highlighting the effect of socioeconomic inequalities in DALYs.
In this presentation we will show the key steps involved in undertaking the SBoD study drawing on available data sources in Scotland. From the Scottish experience we will highlight important issues in knowledge translation for national burden of diseases studies to consider when specific choices are made on the methodological inputs into calculations for both YLL and YLD, specifically: (i) the differential impact between different life tables; (ii) the impact of differences in severity distributions; and (iii) the impact of using different standard populations when directly standardising rates.
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Affiliation(s)
- I Grant
- Public Health Scotland, Edinburgh, UK
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43
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Grant I, Soria R, Julian CG, Vargas E, Moore LG, Aiken CE, Giussani DA. Parental ancestry and risk of early pregnancy loss at high altitude. FASEB J 2020; 34:13741-13749. [PMID: 32856356 DOI: 10.1096/fj.202001257r] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 05/27/2020] [Revised: 07/20/2020] [Accepted: 07/31/2020] [Indexed: 11/11/2022]
Abstract
High altitude pregnancy is associated with increased frequency of low birth weight infants and neonatal complications, the risks of which are higher in women of low-altitude ancestry. Does ancestry also influence the risk of miscarriage (pregnancy loss <20 weeks) in high-altitude pregnancy? To answer this, 5386 women from La Paz, Bolivia (3300-4150 m) with ≥1 live-born infant were identified. Data were extracted from medical records including maternal and paternal ancestry, demographic factors, and reproductive history. The risk of miscarriage by ancestry was assessed using multivariate logistic regression, adjusting for parity, and maternal age. Andean women experienced first live-births younger than Mestizo or European women (21.7 ± 4.6 vs 23.4 ± 8.0 vs 24.1 ± 5.1, P < .001). Andeans experienced more pregnancies per year of reproductive life (P < .001) and had significantly higher ratios of live-births to miscarriages than women of Mestizo or European ancestry (P < .001). Andean women were 24% less likely to have ever experienced a miscarriage compared to European women (OR:0.76; CI:0.62-0.90, P < .001). The woman's partner's ancestry wasn't a significant independent predictor of miscarriage. In conclusion, the risk of miscarriage at high altitude is lower in Andean women. The lack of a paternal ancestry effect suggests underlying mechanisms relate more to differential maternal adaptation in early pregnancy than fetal genetics.
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Affiliation(s)
- I Grant
- Department of Obstetrics and Gynaecology, NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - R Soria
- Instituto Boliviano de Biología de Altura, La Paz, Bolivia
| | - C G Julian
- Department of Medicine, University of Colorado, Denver, CO, USA
| | - E Vargas
- Instituto Boliviano de Biología de Altura, La Paz, Bolivia
| | - L G Moore
- Department of Obstetrics/Gynecology, University of Colorado, Denver, CO, USA
| | - C E Aiken
- Department of Obstetrics and Gynaecology, NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - D A Giussani
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
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Wyper GMA, Assunção R, Cuschieri S, Devleesschauwer B, Fletcher E, Haagsma JA, Hilderink HBM, Idavain J, Lesnik T, Von der Lippe E, Majdan M, Milicevic MS, Pallari E, Peñalvo JL, Pires SM, Plaß D, Santos JV, Stockton DL, Thomsen ST, Grant I. Correction to: Population vulnerability to COVID-19 in Europe: a burden of disease analysis. ACTA ACUST UNITED AC 2020; 78:57. [PMID: 32566224 PMCID: PMC7299839 DOI: 10.1186/s13690-020-00437-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Grant M A Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland, UK
| | - Ricardo Assunção
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, ida, Malta
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Eilidh Fletcher
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, Scotland, UK
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henk B M Hilderink
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jane Idavain
- National Institute for Health Development, Tallinn, Estonia
| | - Tina Lesnik
- National Institute of Public Health, Ljubljana, Slovenia
| | - Elena Von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Marek Majdan
- Department of Public Health, Institute for Global Health and Epidemiology, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
| | | | - Elena Pallari
- MRC Clinical Trials and Methodology Unit, University College London, London, UK
| | - José L Peñalvo
- Unit of Noncommunicable Diseases, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sara M Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Dietrich Plaß
- Exposure Assessment and Environmental Health Indicators, German Environment Agency, Berlin, Germany
| | - João V Santos
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS, Centre for Health Technology and Services Research, Porto, Portugal.,Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Porto, Portugal
| | - Diane L Stockton
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland, UK
| | | | - Ian Grant
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, Scotland, UK
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45
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Wyper GMA, Assunção R, Cuschieri S, Devleeschauwer B, Fletcher E, Haagsma JA, Hilderink HBM, Idavain J, Lesnik T, Von der Lippe E, Majdan M, Milicevic MS, Pallari E, Peñalvo JL, Pires SM, Plaß D, Santos JV, Stockton DL, Thomsen ST, Grant I. Population vulnerability to COVID-19 in Europe: a burden of disease analysis. Arch Public Health 2020; 78:47. [PMID: 32501409 PMCID: PMC7256342 DOI: 10.1186/s13690-020-00433-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 05/04/2020] [Accepted: 05/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Evidence has emerged showing that elderly people and those with pre-existing chronic health conditions may be at higher risk of developing severe health consequences from COVID-19. In Europe, this is of particular relevance with ageing populations living with non-communicable diseases, multi-morbidity and frailty. Published estimates of Years Lived with Disability (YLD) from the Global Burden of Disease (GBD) study help to characterise the extent of these effects. Our aim was to identify the countries across Europe that have populations at highest risk from COVID-19 by using estimates of population age structure and YLD for health conditions linked to severe illness from COVID-19. METHODS Population and YLD estimates from GBD 2017 were extracted for 45 countries in Europe. YLD was restricted to a list of specific health conditions associated with being at risk of developing severe consequences from COVID-19 based on guidance from the United Kingdom Government. This guidance also identified individuals aged 70 years and above as being at higher risk of developing severe health consequences. Study outcomes were defined as: (i) proportion of population aged 70 years and above; and (ii) rate of YLD for COVID-19 vulnerable health conditions across all ages. Bivariate groupings were established for each outcome and combined to establish overall population-level vulnerability. RESULTS Countries with the highest proportions of elderly residents were Italy, Greece, Germany, Portugal and Finland. When assessments of population-level YLD rates for COVID-19 vulnerable health conditions were made, the highest rates were observed for Bulgaria, Czechia, Croatia, Hungary and Bosnia and Herzegovina. A bivariate analysis indicated that the countries at high-risk across both measures of vulnerability were: Bulgaria; Portugal; Latvia; Lithuania; Greece; Germany; Estonia; and Sweden. CONCLUSION Routine estimates of population structures and non-fatal burden of disease measures can be usefully combined to create composite indicators of vulnerability for rapid assessments, in this case to severe health consequences from COVID-19. Countries with available results for sub-national regions within their country, or national burden of disease studies that also use sub-national levels for burden quantifications, should consider using non-fatal burden of disease estimates to estimate geographical vulnerability to COVID-19.
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Affiliation(s)
- Grant M. A. Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland, UK
| | - Ricardo Assunção
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Brecht Devleeschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Eilidh Fletcher
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, Scotland, UK
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henk B. M. Hilderink
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jane Idavain
- National Institute for Health Development, Tallinn, Estonia
| | - Tina Lesnik
- National Institute of Public Health, Ljubljana, Slovenia
| | - Elena Von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Marek Majdan
- Department of Public Health, Institute for Global Health and Epidemiology, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
| | | | - Elena Pallari
- MRC Clinical Trials and Methodology Unit, University College London, London, UK
| | - José L. Peñalvo
- Unit of Noncommunicable Diseases, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sara M. Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Dietrich Plaß
- Exposure Assessment and Environmental Health Indicators, German Environment Agency, Berlin, Germany
| | - João V. Santos
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS, Centre for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Porto, Portugal
| | - Diane L. Stockton
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland, UK
| | | | - Ian Grant
- Data Driven Innovation Directorate, Public Health Scotland, Edinburgh, Scotland, UK
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46
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Timmers PRHJ, Kerssens JJ, Minton J, Grant I, Wilson JF, Campbell H, Fischbacher CM, Joshi PK. Trends in disease incidence and survival and their effect on mortality in Scotland: nationwide cohort study of linked hospital admission and death records 2001-2016. BMJ Open 2020; 10:e034299. [PMID: 32217562 PMCID: PMC7170664 DOI: 10.1136/bmjopen-2019-034299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/05/2020] [Accepted: 02/24/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Identify causes and future trends underpinning Scottish mortality improvements and quantify the relative contributions of disease incidence and survival. DESIGN Population-based study. SETTING Linked secondary care and mortality records across Scotland. PARTICIPANTS 1 967 130 individuals born between 1905 and 1965 and resident in Scotland from 2001 to 2016. MAIN OUTCOME MEASURES Hospital admission rates and survival within 5 years postadmission for 28 diseases, stratified by sex and socioeconomic status. RESULTS 'Influenza and pneumonia', 'Symptoms and signs involving circulatory and respiratory systems' and 'Malignant neoplasm of respiratory and intrathoracic organs' were the hospital diagnosis groupings associated with most excess deaths, being both common and linked to high postadmission mortality. Using disease trends, we modelled a mean mortality HR of 0.737 (95% CI 0.730 to 0.745) from one decade of birth to the next, equivalent to a life extension of ~3 years per decade. This improvement was 61% (30%-93%) accounted for by improved disease survival after hospitalisation (principally cancer) with the remainder accounted for by lowered hospitalisation incidence (principally heart disease and cancer). In contrast, deteriorations in infectious disease incidence and survival increased mortality by 9% (~3.3 months per decade). Disease-driven mortality improvements were slightly greater for men than women (due to greater falls in disease incidence), and generally similar across socioeconomic deciles. We project mortality improvements will continue over the next decade but slow by 21% because much progress in disease survival has already been achieved. CONCLUSION Morbidity improvements broadly explain observed mortality improvements, with progress on prevention and treatment of heart disease and cancer contributing the most. The male-female health gaps are closing, but those between socioeconomic groups are not. Slowing improvements in morbidity may explain recent stalling in improvements of UK period life expectancies. However, these could be offset if we accelerate improvements in the diseases accounting for most deaths and counteract recent deteriorations in infectious disease.
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Affiliation(s)
- Paul R H J Timmers
- Centre for Global Health Research, The University of Edinburgh Usher Institute, Edinburgh, UK
| | - Joannes J Kerssens
- Information Services Division, NHS National Services Scotland, Edinburgh, UK
| | - Jon Minton
- Public Health Observatory, NHS Health Scotland, Glasgow, UK
| | - Ian Grant
- Information Services Division, NHS National Services Scotland, Edinburgh, UK
| | - James F Wilson
- Centre for Global Health Research, The University of Edinburgh Usher Institute, Edinburgh, UK
- MRC Human Genetics Unit, The University of Edinburgh MRC Institute of Genetics and Molecular Medicine, Edinburgh, UK
| | - Harry Campbell
- Centre for Global Health Research, The University of Edinburgh Usher Institute, Edinburgh, UK
| | - Colin M Fischbacher
- Information Services Division, NHS National Services Scotland, Edinburgh, UK
| | - Peter K Joshi
- Centre for Global Health Research, The University of Edinburgh Usher Institute, Edinburgh, UK
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47
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Oikonomou G, Addis MF, Chassard C, Nader-Macias MEF, Grant I, Delbès C, Bogni CI, Le Loir Y, Even S. Milk Microbiota: What Are We Exactly Talking About? Front Microbiol 2020; 11:60. [PMID: 32117107 PMCID: PMC7034295 DOI: 10.3389/fmicb.2020.00060] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [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: 09/11/2019] [Accepted: 01/13/2020] [Indexed: 12/17/2022] Open
Abstract
The development of powerful sequencing techniques has allowed, albeit with some biases, the identification and inventory of complex microbial communities that inhabit different body sites or body fluids, some of which were previously considered sterile. Notably, milk is now considered to host a complex microbial community with great diversity. Milk microbiota is now well documented in various hosts. Based on the growing literature on this microbial community, we address here the question of what milk microbiota is. We summarize and compare the microbial composition of milk in humans and in ruminants and address the existence of a putative core milk microbiota. We discuss the factors that contribute to shape the milk microbiota or affect its composition, including host and environmental factors as well as methodological factors, such as the sampling and sequencing techniques, which likely introduce distortion in milk microbiota analysis. The roles that milk microbiota are likely to play in the mother and offspring physiology and health are presented together with recent data on the hypothesis of an enteromammary pathway. At last, this fascinating field raises a series of questions, which are listed and commented here and which open new research avenues.
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Affiliation(s)
- Georgios Oikonomou
- Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom
| | - Maria Filippa Addis
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | | | | | - I Grant
- Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom
| | - Celine Delbès
- Université Clermont Auvergne, INRAE, UMRF, Aurillac, France
| | - Cristina Inés Bogni
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Exactas, Físico-Químicas y Naturales, Universidad Nacional de Río Cuarto, Río Cuarto, Argentina
| | - Yves Le Loir
- STLO, UMR 1253, INRAE, Agrocampus Ouest, Rennes, France
| | - Sergine Even
- STLO, UMR 1253, INRAE, Agrocampus Ouest, Rennes, France
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48
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Wyper GMA, Grant I, Fletcher E, Chalmers N, McCartney G, Stockton DL. Prioritising the development of severity distributions in burden of disease studies for countries in the European region. ACTA ACUST UNITED AC 2020; 78:3. [PMID: 31921418 PMCID: PMC6950931 DOI: 10.1186/s13690-019-0385-6] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 12/20/2019] [Indexed: 11/24/2022]
Abstract
Severity distributions are a means of summarising the range of health loss suffered to disease which enables estimates of disease occurrence to be paired with disability weights to estimate Years Lost to Disability (YLD) in burden of disease studies. There is a lack of current data exploring severity distributions, which has led to the Global Burden of Disease (GBD) study relying on using the same severity distributions across countries and regions across the world. This is also largely true for some national studies, although there are exceptions. Recent evidence has raised concerns that severity distributions are unlikely to be generalisable as major differences arise when using country-specific data to develop severity distributions. These issues raise uncertainties over interpreting YLD estimates, particularly if they are being used to develop and influence policies and to determine priorities across diseases and populations. It is clear that GBD researchers and those carrying out national studies need to work towards ensuring that estimates are based upon country-specific data, and, if possible, that the impact of assumptions are fully tested and understood. There is a lack of strategy about if, where, and how, this could be achieved, particularly around how efforts should be prioritised. This commentary advocates and presents a possible strategic approach to better understanding how efforts may be best placed.
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Affiliation(s)
- Grant M A Wyper
- Public Health Science Directorate, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland G2 6QE
| | - Ian Grant
- 2Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, Scotland EH12 9EB
| | - Eilidh Fletcher
- 2Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, Scotland EH12 9EB
| | - Neil Chalmers
- Public Health Science Directorate, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland G2 6QE
| | - Gerry McCartney
- Public Health Science Directorate, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland G2 6QE
| | - Diane L Stockton
- Public Health Science Directorate, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland G2 6QE
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49
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Olney NT, Ong E, Goh SYM, Bajorek L, Dever R, Staffaroni AM, Cobigo Y, Bock M, Chiang K, Ljubenkov P, Kornak J, Heuer HW, Wang P, Rascovsky K, Wolf A, Appleby B, Bove J, Bordelon Y, Brannelly P, Brushaber D, Caso C, Coppola G, Dickerson BC, Dickinson S, Domoto-Reilly K, Faber K, Ferrall J, Fields J, Fishman A, Fong J, Foroud T, Forsberg LK, Gearhart DJ, Ghazanfari B, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford NR, Grant I, Grossman M, Haley D, Hsiung G, Huey ED, Irwin DJ, Jones DT, Kantarci K, Karydas AM, Kaufer D, Kerwin D, Knopman DS, Kramer JH, Kraft R, Kremers W, Kukull W, Lapid MI, Litvan I, Mackenzie IR, Maldonado M, Manoochehri M, McGinnis SM, McKinley EC, Mendez MF, Miller BL, Onyike C, Pantelyat A, Pearlman R, Petrucelli L, Potter M, Rademakers R, Ramos EM, Rankin KP, Roberson ED, Rogalski E, Sengdy P, Shaw LM, Syrjanen J, Tartaglia MC, Tatton N, Taylor J, Toga A, Trojanowski JQ, Weintraub S, Wong B, Wszolek Z, Boxer AL, Boeve BF, Rosen HJ. Clinical and volumetric changes with increasing functional impairment in familial frontotemporal lobar degeneration. Alzheimers Dement 2020; 16:49-59. [PMID: 31784375 PMCID: PMC6988137 DOI: 10.1016/j.jalz.2019.08.196] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: The Advancing Research and Treatment in Frontotemporal Lobar Degeneration and Longitudinal Evaluation of Familial Frontotemporal Dementia Subjects longitudinal studies were designed to describe the natural history of familial-frontotemporal lobar degeneration due to autosomal dominant mutations. Methods: We examined cognitive performance, behavioral ratings, and brain volumes from the first time point in 320 MAPT, GRN, and C9orf72 family members, including 102 non–mutation carriers, 103 asymptomatic carriers, 43 mildly/questionably symptomatic carriers, and 72 carriers with dementia. Results: Asymptomatic carriers showed similar scores on all clinical measures compared with noncarriers but reduced frontal and temporal volumes. Those with mild/questionable impairment showed decreased verbal recall, fluency, and Trail Making Test performance and impaired mood and self-monitoring. Dementia was associated with impairment in all measures. All MAPT carriers with dementia showed temporal atrophy, but otherwise, there was no single cognitive test or brain region that was abnormal in all subjects. Discussion: Imaging changes appear to precede clinical changes in familial-frontotemporal lobar degeneration, but specific early clinical and imaging changes vary across individuals.
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Affiliation(s)
- Nicholas T. Olney
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Elise Ong
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Sheng-Yang M. Goh
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Lynn Bajorek
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Reilly Dever
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Meredith Bock
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Kevin Chiang
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Peter Ljubenkov
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - John Kornak
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Hilary W. Heuer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Ping Wang
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Katya Rascovsky
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amelia Wolf
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Brian Appleby
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Jessica Bove
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yvette Bordelon
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Patrick Brannelly
- Tau Consortium, Rainwater Charitable Foundation, Fort Worth, TX, USA
| | | | - Christine Caso
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Giovanni Coppola
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bradford C. Dickerson
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | - Susan Dickinson
- Association for Frontotemporal Degeneration, Radnor, PA, USA
| | | | - Kelly Faber
- National Centralized Repository for Alzheimer’s Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, IN, USA
| | - Jessica Ferrall
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Julie Fields
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Ann Fishman
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jamie Fong
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Tatiana Foroud
- National Centralized Repository for Alzheimer’s Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, IN, USA
| | | | | | - Behnaz Ghazanfari
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nupur Ghoshal
- Department of Psychiatry, Washington University, St. Louis, MO, USA
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Jill Goldman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | | | | | - Ian Grant
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dana Haley
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Gingyuek Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edward D. Huey
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David T. Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Kejal Kantarci
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Anna M. Karydas
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Kaufer
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Diana Kerwin
- Department of Neurology and Neurotherapeutics, Center for Alzheimer’s and Neurodegenerative Diseases, The University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA
- Department of Internal Medicine, The University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA
| | | | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Ruth Kraft
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Walter Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Walter Kukull
- National Alzheimer Coordinating Center (NACC), University of Washington, Seattle, WA, USA
| | - Maria I. Lapid
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Irene Litvan
- Department of Neurosciences, Parkinson and Other Movement Disorders Center, University of California, San Diego, San Diego, CA, USA
| | - Ian R. Mackenzie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Miranda Maldonado
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Masood Manoochehri
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Scott M. McGinnis
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | - Emily C. McKinley
- Department of Neurology, Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mario F. Mendez
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bruce L. Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Chiadi Onyike
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Alex Pantelyat
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Len Petrucelli
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Madeleine Potter
- National Centralized Repository for Alzheimer’s Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, IN, USA
| | | | - Eliana M. Ramos
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine P. Rankin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Erik D. Roberson
- Department of Neurology, Alzheimer’s Disease Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emily Rogalski
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pheth Sengdy
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie M. Shaw
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeremy Syrjanen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - M. Carmela Tartaglia
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Nadine Tatton
- Association for Frontotemporal Degeneration, Radnor, PA, USA
| | - Joanne Taylor
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Arthur Toga
- Laboratory of Neuroimaging (LONI), University of Southern California, Los Angeles, CA, USA
| | - John Q. Trojanowski
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sandra Weintraub
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Bonnie Wong
- Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | | | - Adam L. Boxer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Brad F. Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
- Corresponding author. Tel.: 1 415 476 5567; Fax: 1 415 476 1816.,
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Wyper GMA, Grant I, Fletcher E, McCartney G, Fischbacher C, Stockton DL. How do world and European standard populations impact burden of disease studies? A case study of disability-adjusted life years (DALYs) in Scotland. ACTA ACUST UNITED AC 2020; 78:1. [PMID: 31908777 PMCID: PMC6941317 DOI: 10.1186/s13690-019-0383-8] [Citation(s) in RCA: 61] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 12/13/2019] [Indexed: 11/10/2022]
Abstract
Background Disability-Adjusted Life Years (DALYs) are an established method for quantifying population health needs and guiding prioritisation decisions. Global Burden of Disease (GBD) estimates aim to ensure comparability between countries and over time by using age-standardised rates (ASR) to account for differences in the age structure of different populations. Different standard populations are used for this purpose but it is not widely appreciated that the choice of standard may affect not only the resulting rates but also the rankings of causes of DALYs. We aimed to evaluate the impact of the choice of standard, using the example of Scotland. Methods DALY estimates were derived from the 2016 Scottish Burden of Disease (SBoD) study for an abridged list of 68 causes of disease/injury, representing a three-year annual average across 2014-16. Crude DALY rates were calculated using Scottish national population estimates. DALY ASRs standardised using the GBD World Standard Population (GBD WSP) were compared to those using the 2013 European Standard Population (ESP2013). Differences in ASR and in rank order within the cause list were summarised for all-cause and for each individual cause. Results The ranking of causes by DALYs were similar using crude rates or ASR (ESP2013). All-cause DALY rates using ASR (GBD WSP) were around 26% lower. Overall 58 out of 68 causes had a lower ASR using GBD WSP compared with ESP2013, with the largest falls occurring for leading causes of mortality observed in older ages. Gains in ASR were much smaller in absolute scale and largely affected causes that operated early in life. These differences were associated with a substantial change to the ranking of causes when GBD WSP was used compared with ESP2013. Conclusion Disease rankings based on DALY ASRs are strongly influenced by the choice of standard population. While GBD WSP offers international comparability, within-country analyses based on DALY ASRs should reflect local age structures. For European countries, including Scotland, ESP2013 may better guide local priority setting by avoiding large disparities occurring between crude and age-standardised results sets, which could potentially confuse non-technical audiences.
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Affiliation(s)
- Grant M A Wyper
- Public Health Science Directorate, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE Scotland
| | - Ian Grant
- 2Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB Scotland
| | - Eilidh Fletcher
- 2Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB Scotland
| | - Gerry McCartney
- Public Health Science Directorate, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE Scotland
| | - Colin Fischbacher
- 2Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB Scotland
| | - Diane L Stockton
- Public Health Science Directorate, NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE Scotland
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