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Canton I, Guzman J, Soto Y, Selzer Ninomiya AL, Morales D, Aguiñaga S. Isotemporal Substitution of Sedentary Time With Physical Activity Among Middle-Aged and Older Latinos: Effects on Episodic Memory. Am J Health Promot 2024; 38:607-614. [PMID: 38352993 DOI: 10.1177/08901171241233404] [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] [Indexed: 04/23/2024]
Abstract
PURPOSE To examine the estimated effects of substituting 30 min of sedentary time with low-light physical activity (LLPA) and high-light physical activity (HLPA) on episodic memory, executive functioning, and working memory among middle-aged and older Latinos. DESIGN A cross-sectional study. SETTING Chicago and Chicagoland suburbs. SUBJECTS Middle-aged and older Latinos (n = 61). MEASURES Accelerometer-assessed physical activity. A cognitive battery was administered to assess episodic memory, executive function, and working memory. ANALYSIS Isotemporal substitution analyses were conducted, where unstandardized coefficients from linear regression models were used to examine the substitution effect of replacing sedentary time with LLPA and HLPA. RESULTS Substitution of sedentary time with LLPA was associated with better episodic memory (Immediate recall, B = .947, P = .008; Delayed recall, B = .857, P = .013). No other significant substitution effects were present. CONCLUSION Middle-aged and older Latinos who replace sedentary time with LLPA may have better episodic memory. Future studies may target light physical activity to address cognition disparities and can inform the development of physical activity interventions that are appealing and accessible for Latinos.
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Affiliation(s)
- Imani Canton
- Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Champaign, IL, USA
| | | | - Yuliana Soto
- Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Ana Laura Selzer Ninomiya
- Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Diana Morales
- Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Susan Aguiñaga
- Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Champaign, IL, USA
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Moayedi Y, Truby LK, Foroutan F, Han J, Guzman J, Angleitner P, Sabatino M, Felius J, van Zyl JS, Rodenas-Alesina E, Fan CP, DeVore AD, Miller R, Potena L, Zuckermann A, Farrero M, Chih S, Farr M, Hall S, Ross HJ, Khush KK. The International Consortium on Primary Graft Dysfunction: Redefining Clinical Risk Factors in the Contemporary Era of Heart Transplantation. J Card Fail 2023:S1071-9164(23)00382-2. [PMID: 37907150 DOI: 10.1016/j.cardfail.2023.09.018] [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: 06/29/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND Primary Graft Dysfunction (PGD) is the leading cause of morbidity and mortality early after heart transplant (HT). The International Consortium on PGD is a multicenter collaboration dedicated to identifying the clinical risk factors for PGD in the contemporary era of HT. The objectives of the current report were to 1) assess the incidence of severe PGD in an international cohort, 2) evaluate the performance of the most validated PGD risk tool, the RADIAL score, in a contemporary cohort, and 3) redefine clinical risk factors for severe PGD in the current era of HT. METHODS This is a retrospective, observational study of consecutive adult HT recipients between 2010 and 2020 in 10 centers in the United States, Canada, and Europe. Patients with severe PGD were compared to those without severe PGD (comprising those with no, mild and moderate PGD). The RADIAL score was calculated for each transplant recipient. The discriminatory power of the RADIAL score was evaluated using receiver operating characteristic (ROC) analysis and its calibration was assessed by plotting the percentage of PGD predicted versus observed. To identify clinical risk factors associated with severe PGD, we performed multivariable mixed-effects logistic regression modeling to account for among-center variability. RESULTS A total of 2,746 patients have been enrolled in the registry to date, including 2,015 (73.4%) from North America, and 731 (26.6%) from Europe. 215 participants (7.8%) met the criteria for severe PGD. There was an increase in the incidence of severe PGD over the study period (p-value for trend by difference sign test = 0.004). The Kaplan Meier estimate for 1-year survival was 75.7% [95%CI 69.4-80.9%] in patients with severe PGD as compared to 94.4% [95% CI 93.5-95.2%] in those without severe PGD (log-rank p-value <0.001). The RADIAL score performed poorly in our contemporary cohort and was not associated with severe PGD with an AUC of 0.53 (95%CI 0.48-0.58). In the multivariable regression model, acute preoperative dialysis (OR 2.41, 95% CI 1.31 - 4.43), durable LVAD support (OR 1.77, 95% CI 1.13 - 2.77), and total ischemic time (OR 1.20 for each additional hour, 95% CI 1.02 - 1.41) were associated with an increased risk of severe PGD. CONCLUSIONS Our consortium has identified an increasing incidence of PGD in the modern transplant era. We identified contemporary risk factors for this early post-transplant complication, which confers a high mortality risk. These results may enable the identification of patients at high risk for developing severe PGD in order to inform peri-transplant donor and recipient management practices.
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Affiliation(s)
- Y Moayedi
- Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Canada
| | - L K Truby
- UT Southwestern Medical Center, Dallas, USA
| | - F Foroutan
- Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Canada
| | - J Han
- University of Chicago, Chicago, USA
| | - J Guzman
- Hospital Clinic, Barcelona, Spain
| | | | | | - J Felius
- Baylor Medical Center, Dallas, USA
| | | | - E Rodenas-Alesina
- Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Canada
| | - C-P Fan
- Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Canada
| | - A D DeVore
- Duke University Medical Center, Durham, USA
| | - R Miller
- University of Calgary, Calgary, Canada
| | - L Potena
- University of Bologna, Bologna, Italy
| | | | | | - S Chih
- Ottawa Heart, Ottawa, Canada
| | - M Farr
- UT Southwestern Medical Center, Dallas, USA
| | - S Hall
- Baylor Medical Center, Dallas, USA
| | - H J Ross
- UT Southwestern Medical Center, Dallas, USA
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Aguiñaga S, Guzman J, Soto Y, Marquez DX. Self-rated health as a predictor of cognition among middle-aged and older Latinos. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2023; 30:388-401. [PMID: 35174775 PMCID: PMC9381643 DOI: 10.1080/13825585.2022.2038070] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 01/31/2022] [Indexed: 10/19/2022]
Abstract
Self-rated health (SRH) has been used to predict cognitive decline in various populations; however, this relationship has not been examined in Latinos. This study examines the relationship between SRH and cognition among middle-aged and older Latinos. A cross-sectional analysis was conducted among Latinos (n = 425, Mage = 64.13 ± 7.65, 82% female). Participants rated their health as poor/fair, good, and excellent and completed cognitive performance tests. Analyses of covariance (ANCOVA) examined differences in cognition between SRH categories. ANCOVAs showed significant differences in SRH categories for working memory (F [2, 357] = 3.63, p = .028) and global cognition (F [2, 348] = 3.074, p = .047), such that those who self-rated their health as good had better scores compared to participants in the poor/fair category. Findings show that SRH is associated with cognition among middle-aged and older Latinos. SRH may serve as an indicator of early signs of cognitive decline.
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Affiliation(s)
- Susan Aguiñaga
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, 906 S. Goodwin Ave., Urbana, IL 61801, United States
| | - Jacqueline Guzman
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, 906 S. Goodwin Ave., Urbana, IL 61801, United States
| | - Yuliana Soto
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, 906 S. Goodwin Ave., Urbana, IL 61801, United States
| | - David X. Marquez
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 1919 W. Taylor Street, Chicago, IL 60612, United States
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Ojo A, Johnson S, Erfani P, Guo R, Garmilla A, Saini A, Benitez B, Salinas KE, Plana D, Pena Perez A, Guzman J, So-Armah C, Gottlieb B. A high-touch outreach model to re-engage patients in mammogram screening. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e18555] [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: 11/20/2022] Open
Abstract
e18555 Background: Disparities in cancer screening have been well documented during the Covid-19 pandemic. However, there are limited patient-reported data describing the prevalence and drivers of patient hesitancy towards cancer screening and willingness to resume screening. As health systems continue to experience pandemic-related capacity strain, there is an urgent need for innovative models of re-engaging patients in preventive screening. To address this issue, we developed a medical student-led, high-touch outreach model to re-engage primary care patients at Brookside Community Health Center in cancer screening. Methods: We iteratively optimized semi-structured call scripts and surveys in English and Spanish to contact patients overdue for mammography screening. Student callers included medical and pre-medical students with native Spanish fluency. Using the call script, students identified patient-reported barriers and facilitated mammogram scheduling for consenting patients. For consenting patients, student callers placed a telephone encounter with a pended screening mammogram order in the electronic medical record. PCP confirmation of the order triggered outreach by the radiology department for mammogram scheduling. Patients also received reminder calls from students the week of their appointment. Primary outcomes include screening consent rates, mammogram scheduling and completion rates, and screening results. Patient survey responses were securely recorded using the REDCap survey platform. Results: 198 patients were eligible for the intervention. 60% are primarily Spanish-speaking and 81% are insured by Medicaid. 145 patients (73%) have successfully been contacted, of which 129 (89%) consented for mammogram screening. 74 (57%) of the consenting patients have scheduled their mammogram and 38 (29%) have completed their mammogram. 36% of consenting Spanish-speaking patients with active mammogram orders did not have a mammogram scheduled, compared to 9% of consenting English-speaking. To date, 6 patients had abnormal mammograms requiring subsequent diagnostic imaging, and 1 patient was diagnosed with ductal carcinoma in situ requiring oncologic care. Qualitative analysis of patient surveys found that primary barriers to screening included factors associated with the Covid-19 pandemic (32.9% of contacted patients), lack of awareness of overdue status (25.9%) and patient unavailability (e.g. outside of country) (20%). Conclusions: In this single-center quality improvement study, we found that patients had a high willingness to engage in cancer screening during the pandemic and that trainees can play a vital role in re-engaging patients in preventative care. The disparity between Spanish and English-speaking patients’ ability to schedule a mammogram after the consent process suggests that patients with limited English proficiency face additional challenges in accessing screenings.
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Affiliation(s)
| | | | | | - Ruby Guo
- Harvard Medical School, Boston, MA
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Moayedi Y, Foroutan F, Truby L, Han J, Angleitner P, Guzman J, Sabatino M, Felius J, Zafar H, Law D, Van Zyl J, Tremblay-Gravel M, Segovia J, Devore A, Kim G, Lasarte MR, Knezevic I, Noly P, Farr M, Zuckermann A, Potena L, Ferrero M, Miller R, Fan S, Chih S, Hall S, Khush K, Ross H. Using Machine Learning to Develop a Contemporary Primary Graft Dysfunction Prediction Model: The International Consortium on PGD. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.022] [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: 10/18/2022] Open
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Truby L, Moayedi Y, Foroutan F, Han J, Guzman J, Farrero M, Zafar H, Felius J, van Zyl J, Hall S, Law D, Chih S, Angleitner P, Sabatino M, DeVore A, Miller R, Potena L, Zuckermann A, Ross H, Khush K, Farr M. Bridge to Transplant with Durable Left Ventricular Assist Device is Associated with Primary Graft Dysfunction Following Heart Transplantation: A Report from the International Consortium on Primary Graft Dysfunction. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.232] [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: 10/18/2022] Open
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Soto Y, Guzman J, Aguiñaga S. Cross‐sectional comparison of psychosocial and executive function outcomes between low and high adherers of the MIND diet in a sample of middle‐aged Latinos. Alzheimers Dement 2021. [DOI: 10.1002/alz.054143] [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)
- Yuliana Soto
- University of Illinois at Urbana‐Champaign Urbana IL USA
| | | | - Susan Aguiñaga
- University of Illinois at Urbana‐Champaign Urbana IL USA
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Guzman J, Rocha JS, Soto Y, Aguiñaga S. The preliminary efficacy of Caring of Caregivers Organically (CoCO) health education program on the health of Latina caregivers of persons with Alzheimer’s disease and related dementias. Alzheimers Dement 2021. [DOI: 10.1002/alz.054289] [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)
| | | | - Yuliana Soto
- University of Illinois at Urbana‐Champaign Urbana IL USA
| | - Susan Aguiñaga
- University of Illinois at Urbana‐Champaign Urbana IL USA
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9
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Guzman J, Aguiñaga S, Balbim GM, Lamar M, Marques IG, Marquez DX. The effects of the BAILAMOS Dance Program on hippocampal volume in older Latinos: a randomized controlled pilot study. Transl Behav Med 2021; 11:1857-1862. [PMID: 33734418 DOI: 10.1093/tbm/ibab009] [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] [Indexed: 11/14/2022] Open
Abstract
Hippocampal atrophy is associated with cognitive decline. Physical activity (PA) can reverse the hippocampal loss. This study investigated the effects of the 4 month BAILAMOS dance program on hippocampal volume and self-reported PA in Latinos. Participants were randomized to the BAILAMOS dance program or waitlist control group (N = 14, n = 10 intervention, n = 4 waitlist, 67 ± 6.1 years old, 70% female). Hippocampal volumes were derived from Magnetic Resonance Imaging whole-brain T1-weighted images. Participants self-reported PA through the Community Healthy Activities Model Program for Seniors Physical Activity Questionnaire for older adults. There were no statistically significant changes in hippocampal volume preintervention to postintervention (F[1, 8] = .077, p = .79, d = .05) and no associations between PA change and hippocampal volume (F[4, 13] = .71, p = .61). However, dance participants self-reported more PA (d = .54) compared to the control. These findings demonstrate that the BAILAMOS dance program did not decrease hippocampal atrophy; however, it increased self-reported PA. Future studies should include longer and more cognitively demanding interventions to determine whether dance can reduce cognitive decline through hippocampal changes.
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Affiliation(s)
- Jacqueline Guzman
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Susan Aguiñaga
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Guilherme M Balbim
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Melissa Lamar
- Department of Behavioral Sciences, Rush Medical College, Chicago, IL 60612, USA
| | - Isabela G Marques
- Faculty of Medicine, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - David X Marquez
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60612, USA
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Eschenbach LK, Bauer S, Bauernschmitt R, Guzman J, Von Hodenberg E, Sodian R. Transcarotid Approach for Transcatheter Aortic Valve Replacement: First Results of an Alternative Access. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725826] [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: 10/21/2022]
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11
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Soto Y, Aguinaga S, Guzman J. Physical Activity Programming and Physical Function of Older Adults in Adult Day Centers: A Mixed-Methods Approach. Innov Aging 2020. [PMCID: PMC7741873 DOI: 10.1093/geroni/igaa057.962] [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
With increased prevalence of Alzheimer’s disease, there is a need for long-term care services (e.g., Adult Day Centers (ADCs)) to provide physical activity (PA) programs to maintain physical function of older adults. ADCs report offering PA programs; however, information on PA programs and physical function of participants attending ADCs is limited. The study aims to a) explore perspectives of ADC directors on PA programming; b) examine physical function in older adults attending ADCs. A cross-sectional mixed-methods study was conducted among ADC directors and attending participants. Interviews were conducted with ADC directors to assess barriers and facilitators of PA programming. Physical function was assessed among ADC participants via the Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG). Five director interviews were conducted and three major themes emerged; 1) current PA programming limited by fear of falls, 2) staff training and retention, and 3) diversifying PA programming. Twenty-nine ADC participants enrolled in the study, Mage= 74.5±8.2 years; BMI= 29.2 ±7.4 kg/m2; MMSE= 25.6 ±3.3; 51.7% (n=15) African American; 79.3% (n=23) males. ADC participants scored 6.7±3.1 on the SPPB and 15.4±5.3 seconds on the TUG. Directors expressed the importance of PA; however, mentioned current programming was limited due to risk of falls and untrained staff in PA. Findings indicate that older adults attending ADCs have physical function scores indicative of high fall risk. Future PA programming may consider including alternative forms of PA while embedding falls prevention strategies to reduce risk of falls and improve physical function among ADC participants.
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Affiliation(s)
- Yuliana Soto
- University of Illinois--Urbana-Champaign, champaign, Illinois, United States
| | - Susan Aguinaga
- University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
| | - Jacqueline Guzman
- University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
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Guzman J, Soto Y, Marquez D, Aguinaga S. Self-Rated Health Status as a Predictor of Executive Function in Older Latinos. Innov Aging 2020. [PMCID: PMC7742145 DOI: 10.1093/geroni/igaa057.1063] [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
Abstract
Latinos have high risk of Alzheimer’s disease and related dementias (ADRD). Self-rated health (SRH) has been used to predict cognitive decline. Early detection of executive function changes may help identify those at higher risk of cognitive decline. The purpose of this study was to examine the relationship between SRH and executive function in Latinos. Latinos (N=333, 84.4% female, Mage= 64.9 ± 7.08) from the BAILA randomized controlled trial self-rated their health as 1) poor/fair, 2) good, and 3) very good/excellent. Executive function was assessed by the Trail-making B, Verbal Fluency, Stroop C & CW, and the Digit Modality tests and stratified by SRH. One-way analysis of variance showed that the effect of SRH was significant for Trails B, F(2,298)=4.01, p=.019 and Stroop CW, F(2,298)=3.07, p=.048. Tukey’s test indicated that participants who rated their health as fair/poor took longer to complete Trails B (M=196.78±83.0 seconds) compared to those who rated their health as good (M=185.25 ± 85.1 seconds) and very good/excellent (M=149.25±95.3 seconds). Stroop CW results demonstrated that those in the fair/poor health category scored lower (M=17.22±6.6) than those in good (M=19.70±8.5 words/minutes) and very good/excellent health categories (M=18.73±8.2 words/minute). In sum, the results suggest SRH is related to executive function such that lower categories of SRH are indicative of poorer executive function. SRH might be used as a proxy for executive function and as a tool that community leaders can use to identify individuals at high risk of ADRD in need of behavioral interventions.
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Affiliation(s)
- Jacqueline Guzman
- University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
| | - Yuliana Soto
- University of Illinois–Urbana-Champaign, champaign, Illinois, United States
| | - David Marquez
- University of Illinois at Chicago, Chicago, Illinois, United States
| | - Susan Aguinaga
- University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
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Calvo M, Guzman J, Perez P, Ortega L, Mendieta G, Lorenzatti D, Perez N, Gavara J, Marcos Garces V, Brugaletta S, Sabate M, Bodi V, Ortiz Perez J. Complete revascularization of non-culprit lesions in stemi is associated with improved myocardial salvage and reduced microvascular obstruction: a cardiac magnetic resonance study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1769] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The COMPLETE trial showed that routine and complete Percutaneous Coronary Intervention (PCI) of non-infarct related artery (non-IRA) lesions in STEMI was associated with a significant reduction in the rates of death or new myocardial infarction. However, whether this benefit is related to improved myocardial salvage and left ventricular (LV) function is unknown.
Methods
We prospectively included 465 patients with first STEMI reperfused by primary PCI. Late gadolinium-enhanced Cardiac Magnetic Resonance (CMR) was obtained during admission to measure the area at risk (AAR), IRA-infarct size (IS) as % LV mass, and myocardial salvage index (MSI) as % of AAR. The study was repeated in 392 of them at 6 months follow-up to compute LV volumes and ejection fraction (EF).
Results
Patients with three-vessel disease had larger IS than those with two or single vessel disease (25.4±14.5% vs 19.0±13.1% vs 19.0±12.8% LV mass respectively, p<0.05), despite no differences in AAR (33±11% LV mass for all). Accordingly, MSI decreased progressively for one, two or three-vessel disease (42.4±31.4 vs 41.5±30.6 vs 25.1±31.3% AAR respectively, p<0.01). The number of myocardial segments with microvascular obstruction (MVO) was also higher for three-vessel disease (1.9±1.9) than for two (1.1±1.7) or single-vessel disease (1.2±1.8), p<0.05. Mean follow-up EF also decreased progressively with the number of vessels involved (50.7±9.4, 49.1±11.4 and, 44.4±11.2% respectively, p<0.01). A total of 183 patients had multivessel disease. Among them, those with complete revascularization (n=51) had larger MSI (46.4±35.2 vs 34.5±29.3% AAR, p<0.04) and were less likely to have MVO phenomenon (28.6 vs 49.2%, p<0.05). However, no significant differences in the change in EF was observed between both groups (ΔEF:+4.4±6.2 vs +4.3±6.2%, p=0.985 for the interaction).
Conclusion
The presence and extent of multivessel disease influence myocardial salvage and MVO following primary PCI in STEMI. Improvement in myocardial salvage in the IRA territory and a reduction in microvascular obstruction may mediate the beneficial effects of complete revascularization.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Fundaciό La Marato TV3 2015303132, FIS PI15/00531. Partially funded with FEDER funds.
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Affiliation(s)
- M Calvo
- Clinic Cardiovascular Institute, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - J Guzman
- Clinic Cardiovascular Institute, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - P Perez
- Clinic Cardiovascular Institute, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - L.G Ortega
- Clinic Cardiovascular Institute, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - G Mendieta
- Clinic Cardiovascular Institute, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - D Lorenzatti
- Clinic Cardiovascular Institute, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - N Perez
- Instituto de Investigacion Sanitaria INCLIVA, Valencia, Spain
| | - J Gavara
- Instituto de Investigacion Sanitaria INCLIVA, Valencia, Spain
| | - V Marcos Garces
- Instituto de Investigacion Sanitaria INCLIVA, Valencia, Spain
| | - S Brugaletta
- Clinic Cardiovascular Institute, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - M Sabate
- Clinic Cardiovascular Institute, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - V Bodi
- Instituto de Investigacion Sanitaria INCLIVA, Valencia, Spain
| | - J.T Ortiz Perez
- Clinic Cardiovascular Institute, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
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Balbim GM, Magallanes M, Marques IG, Ciruelas K, Aguiñaga S, Guzman J, Marquez DX. Sources of Caregiving Burden in Middle-Aged and Older Latino Caregivers. J Geriatr Psychiatry Neurol 2020; 33:185-194. [PMID: 31510848 DOI: 10.1177/0891988719874119] [Citation(s) in RCA: 9] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE We aimed to identify sources of caregiver burden in middle-aged and older Latino caregivers of people with Alzheimer disease and related dementia (ADRD). METHODS Participants were recruited through an agreement with the Rush Alzheimer's Disease Center Clinic Data Repository. We conducted semistructured interviews with 16 middle-aged and older Latinos who were the primary caregiver for a family member diagnosed with ADRD. The interview guide consisted of questions and probes to capture participants' perceptions of family caregiving. Direct content analysis was performed. RESULTS Participants were aged 50 to 75 years (n = 16) and a majority female (n = 12). The sources of burden identified were (1) caregiver responsibilities, (2) caregiving-related health decline, (3) lack of support, (4) financial status, (5) vigilance, and (6) concerns about the future. CONCLUSIONS The influence of gender roles seemed to play a role in caregivers' perceptions of sources of burden, especially on caregiver responsibilities and perceptions of lack of support. Latinos cultural values such as familismo and marianismo likely reinforced gender disparities in family caregiving.
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Affiliation(s)
- Guilherme Moraes Balbim
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, IL, USA
| | | | - Isabela Gouveia Marques
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Karen Ciruelas
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, IL, USA
| | - Susan Aguiñaga
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jacqueline Guzman
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - David Xavier Marquez
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, IL, USA
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Son MB, Kimura Y, Aalto K, Berntson L, Dallas J, Duffy C, Glerup M, Guzman J, Herlin T, Hovi P, Hyrich K, Klotsche J, Magnusson B, Mcityre V, Nordal E, Özen S, Santos MJ, Sözeri B, Beukelman T. OP0197 THE INITIAL TREATMENT OF SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS: AN INTERNATIONAL COLLABORATION AMONG 10 REGISTRIES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The introduction of biologics has transformed care for children with systemic juvenile idiopathic arthritis (SJIA). Differences in treatment approaches between countries and how they have changed over time are not well studied.Objectives:We contrast the initial features, treatment and 12-month outcome in SJIA across 10 JIA registers in Europe and North America.Methods:Data were extracted locally from 10 Registers including manifestations at diagnosis, medication use over first year and outcomes (Physician Global Assessment (PGA), active joint count (AJC)) at 12 months. Data was compared before/after 2012 to assess change over time. Weighted (w) means were used to adjust for varying number of patients/Register.Results:1,149 patients; 553 had medication data for 2012-2018; primarily female and Caucasian; median age at diagnosis 5.3-8 years. Median duration of symptoms prior to first visit varied (0-3.3 months). Glucocorticoid (GC) use was common in the first year (w_average 72% (range 33-96%)). Biologic use included IL-1, IL-6 and TNF inhibitors. The proportion of patients treated with biologics, primarily anakinra, increased after 2012 (Table 1). W_mean PGA and AJC at the 12±3 month visit were 1.55 and 1.57, respectively (Table 2). At one year, the proportion of patients prescribed GC varied (w_mean 40%, range 26-60%).Conclusion:Analysis of SJIA patients across 10 countries show that time to first rheumatology visit was highly variable. Although local factors influence treatment decisions, biologic use increased after 2011; anakinra most common. Nearly 75% of patients were prescribed steroids within the first year but seemed to decrease after 1 year. More study is needed on long-term outcomes in SJIA patients within this modern era.1: Medication Usage within First Year (pre/post 2012 where available)Glucocorticoids (IV+PO)%Methotrexate%Biologic%Anti-IL-1%Anakinra%Tocilizumab%USA2010-2011n=922563333330USA2012-2018n=91501771705717Canada2005-2010n=8876601710100UK2001-2011n=69787110330UK2012-2018n=31485829191919Portugal2008-2011n=7342364330Portugal2012-2018n=19744732161621Sweden2009-2015n=50964662302830Denmark1997-2011n=83864013662Denmark2012-2018n=325012.575636319Turkey2000-2011n=71937758423720Turkey2012-2018n=11498524032289Germany2000-2011n=27173621376<1Germany2012-2018n=249574727191020Norway1997-2011n=26816212448Norway2012-2018n=510060100202080Finland2006-2011n=12424217008Finland2012-2018n=1225880082: Clinical Outcomes at 12 Months -all yearsAJCMedian [IQR]PGAMedian [IQR]GC Use, %USA0 [0, 0]0 [0,0]47Canada0 [0, 2]0.1 [0, 2.7]41UK0 [0, 0]0.5 [0, 1.7]53Portugal0 [0, 0]0.3 [0, 1]53Sweden0 [0, 0.5]0 [0, 0.5]31Denmark0 [0, 0]-26Turkey4 [2, 7]4 [3, 7]60Germany0 [0, 1]0 [0,2]36Norway0 [0, 0]0.5 [0, 2]45Finland0 [0, 0]0 [0, 0]33Disclosure of Interests:Mary Beth Son: None declared, Yukiko Kimura Consultant of: Genetech, Kristiina Aalto: None declared, Lillemor Berntson: None declared, Johnathan Dallas: None declared, Ciaran Duffy: None declared, Mia Glerup: None declared, Jaime Guzman: None declared, Troels Herlin: None declared, Petteri Hovi: None declared, Kimme Hyrich Grant/research support from: Pfizer, UCB, BMS, Speakers bureau: Abbvie, Jens Klotsche: None declared, Bo Magnusson: None declared, Vanessa McItyre: None declared, Ellen Nordal: None declared, Seza Özen: None declared, Maria Jose Santos Speakers bureau: Novartis and Pfizer, Betül Sözeri: None declared, Timothy Beukelman Consultant of: UCB, Novartis
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Lakshmipathy U, Guzman J, Landon M. A sensitive epigenetic immune cell counting assay for identity and purity testing of cellular therapies. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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MacArthur C, Hernandez M, Landon M, Switalski S, Pradhan S, Guzman J, Lakshmipathy U. Efficient generation of CD4 & CD8 T cell derived iPSC for potential use in allogeneic cellular therapies. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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18
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Guzman J, Bauernschmitt R, Grunebaum JP, Sodian R. Transfemoral Self-Expanding TAVI to Treat Severe AI after Valve-Sparing David Operation. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705479] [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: 10/24/2022]
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Guzman J, Bauernschmitt R, Grunebaum JP, Sodian R. MANTA—The First Percutaneous Closure System Meeting Surgical Claims. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705434] [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: 10/24/2022]
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20
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Balbim GM, Aguinaga S, Marques IG, Guzman J, Marquez DX, Vasquez P. MIDDLE-AGED AND OLDER LATINOS’ SATISFACTION OF BAILAMOS LATIN DANCE PROGRAM. Innov Aging 2019. [PMCID: PMC6841236 DOI: 10.1093/geroni/igz038.2620] [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: 11/30/2022] Open
Abstract
Older Latinos engage in low levels of leisure-time physical activity (LTPA). Dance is a culturally appropriate activity which can be used to increase LTPA levels. We examined middle-aged and older Latinos’ satisfaction with the revised BAILAMOS Latin dance program. Healthy and low actives middle-aged and older Latinos (Mage = 64.89±7.08) were randomized to a 4-month dance program (n=167) or health education (n=166). The dance program consisted of four Latin dance styles (Merengue, Bachata, Cha Cha Cha, and Salsa). Classes were held twice a week for one hour. A total of 113 participants completed the program. Participants completed a program evaluation about the 4-months program regarding time, duration, settings, instructor, and overall satisfaction. Items were evaluated on a 1 (strongly disagree/very bad) to 4 (strongly agree/excellent) Likert agreement scale. A total of 73 participants evaluated the 4-month dance program. Participants evaluated the program adequacy agreeing or strongly agreeing as far: time, duration and setting (96-98%); instructor’s enthusiasm, quality of instructions, and eager to help (96-100%); dance program’s progression and enjoyment (93-96%); difficulty level (59%). Participants reported they intended to keep dancing by themselves (93%) and would recommend the program to friends and family (98%). Many participants (88%) reported feeling physically excellent or good as a result of the program, 95% found the program excellent or good, and 100% thought the program was worth their time. Overall, the BAILAMOS program evaluation demonstrated high participants’ acceptability and satisfaction. Those results can promote sustained LTPA and provide initial evidence to translation into community settings.
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Affiliation(s)
| | - Susan Aguinaga
- University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
| | | | - Jacqueline Guzman
- University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois, United States
| | - David X Marquez
- University of Illinois at Chicago, Chicago, Illinois, United States
| | - Priscilla Vasquez
- University of California San Diego, California, San Diego, California, United States
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Carrillo F, Sader G, Guzman J, Echevarria E. Correction of whistle deformity using the myomucosal vertical Z-plasty technique. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.020] [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: 10/26/2022]
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22
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Lakshmipathy U, Pradhan S, Dargitz C, Guzman J. Identification and quantification of immune cell types using PCR-based PureQuant methylation assay. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.343] [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: 10/26/2022]
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23
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Guzman J, Magaña S, Rocha JS, Torres MG, Morales M, Marquez DX. Physical Activity in Latina Caregivers of Children with Developmental Disabilities. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000538286.44771.47] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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24
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Bonella F, Sennekamp J, Joest M, Rolke M, Guzman J, Costabel U. Antinukleare Antikörper bei Patienten mit exogen allergischer Alveolitis (EAA): Untersuchung der klinischen Relevanz in einem Einzelzentrum. Pneumologie 2018. [DOI: 10.1055/s-0037-1619249] [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: 10/28/2022]
Affiliation(s)
- F Bonella
- Schwerpunkt Interstitielle und Seltene Lungenerkrankungen, Ruhrlandklinik, Universitätsmedizin Essen
| | | | - M Joest
- Malteser Lungen- und Allergiezentrum, Bonn
| | - M Rolke
- Gemeinschaftspraxis Drs. M. Rolke und P. Rückert, Aschaffenburg
| | - J Guzman
- Allgemeine und Experimentelle Pathologie, Ruhr Universität, Bochum
| | - U Costabel
- Schwerpunkt Interstitielle und Seltene Lungenerkrankungen, Ruhrlandklinik, Universitätsmedizin Essen
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Bonella F, Lyu Y, Börner E, Wessendorf T, Theegarten D, Guzman J, Taube C, Costabel U. IL-9 und IL-9 Rezeptor (IL-9r) Expression durch BAL Lymphozyten bei Patienten mit interstitiellen Lungenerkrankungen (ILD). Pneumologie 2018. [DOI: 10.1055/s-0037-1619395] [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: 10/28/2022]
Affiliation(s)
- F Bonella
- Schwerpunkt Interstitielle und Seltene Lungenerkrankungen, Ruhrlandklinik, Universitätsmedizin Essen
| | - Y Lyu
- Schwerpunkt Interstitielle und Seltene Lungenerkrankungen, Ruhrlandklinik, Universitätsmedizin Essen
| | - E Börner
- Schwerpunkt Interstitielle und Seltene Lungenerkrankungen, Ruhrlandklinik, Universitätsmedizin Essen
| | - T Wessendorf
- Schwerpunkt Interstitielle und Seltene Lungenerkrankungen, Ruhrlandklinik, Universitätsmedizin Essen
| | - D Theegarten
- Institut für Pathologie, Universitätsklinikum Essen
| | - J Guzman
- Allgemeine und Experimentelle Pathologie, Ruhr Universität, Bochum
| | - C Taube
- Klinik für Pneumologie, Ruhrlandklinik, Universitätsmedizin Essen
| | - U Costabel
- Schwerpunkt Interstitielle und Seltene Lungenerkrankungen, Ruhrlandklinik, Universitätsmedizin Essen
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Guzman J, Bauernschmitt R, Bauer S, Grunebaum J, von Hodenberg E, Schnell C, Sodian R. Anterior Mitral Leaflet (AML) Endocarditis and Perforation after Self-expanding TAVI. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628110] [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: 10/28/2022]
Affiliation(s)
- J. Guzman
- Cardiac Surgery, Lahr Heart Center, Lahr, Germany
| | | | - S. Bauer
- Cardiac Surgery, Lahr Heart Center, Lahr, Germany
| | | | | | - C. Schnell
- Cardiology, Lahr Heart Center, Lahr, Germany
| | - R. Sodian
- Cardiac Surgery, Lahr Heart Center, Lahr, Germany
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Olvera O, Powell JR, de la Rosa ME, Salceda VM, Gaso MI, Guzman J, Anderson WW, Levine L. POPULATION GENETICS OF MEXICAN DROSOPHILA
VI. CYTOGENETIC ASPECTS OF THE INVERSION POLYMORPHISM IN DROSOPHILA PSEUDOOBSCURA. Evolution 2017; 33:381-395. [DOI: 10.1111/j.1558-5646.1979.tb04691.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/1978] [Revised: 09/14/1978] [Indexed: 11/30/2022]
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Bonella F, Lyu Y, Theegarten D, Boerner E, Wessendorf TE, Guzman J, Costabel U, Kreuter M. Potential utility of anti-DFS70 antibodies to exclude systemic autoimmune rheumatic disease (SARD) in patients with interstitial lung disease (ILD). Pneumologie 2017. [DOI: 10.1055/s-0037-1598280] [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: 10/20/2022]
Affiliation(s)
- F Bonella
- Interstitial and Rare Lung Disease Unit, Ruhrlandklinik University Hospital, University Duisburg-Essen
| | - Y Lyu
- Interstitial and Rare Lung Disease Unit, Ruhrlandklinik University Hospital, University Duisburg-Essen
| | - D Theegarten
- Institute of Pathology, University Hospital, University Duisburg-Essen
| | - E Boerner
- Interstitial and Rare Lung Disease Unit, Ruhrlandklinik University Hospital, University Duisburg-Essen
| | - TE Wessendorf
- Interstitial and Rare Lung Disease Unit, Ruhrlandklinik University Hospital, University Duisburg-Essen
| | - J Guzman
- General and Experimental Pathology, Ruhr University
| | - U Costabel
- Interstitial and Rare Lung Disease Unit, Ruhrlandklinik University Hospital, University Duisburg-Essen
| | - M Kreuter
- Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg und Translationales Zentrum für Lungenforschung Heidelberg (Tlrc), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
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Bonella F, Long X, Theegarten D, Boerner E, Wessendorf T, Guzman J, Costabel U. Einfluss von Nintedanib auf die Freisetzung von angiogenetischen/angiostatischen Zytokinen von Alveolarmakrophagen (AMs) bei interstitiellen Lungenerkrankungen (ILD). Pneumologie 2016. [DOI: 10.1055/s-0036-1572293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cheng J, Au J, Morillo C, Guzman J, MacDonald M. CHARACTERIZATION OF ARTERIAL STIFFNESS IN PATIENTS WITH POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME AND EHLERS-DANLOS SYNDROME JOINT HYPERMOBILITY SYNDROME TYPE III. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Deif B, Kang S, Ismail A, Vanniyasingam T, Guzman J, Morillo C. APPLYING SYNCOPE GUIDELINES TO AN EMERGENCY DEPARTMENT POPULATION IS NOT ASSOCIATED WITH A REDUCTION IN ADMISSION RATES: A RETROSPECTIVE COHORT STUDY. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Guzman J, Tompa E, Koehoorn M, de Boer H, Macdonald S, Alamgir H. Economic evaluation of occupational health and safety programmes in health care. Occup Med (Lond) 2015; 65:590-7. [PMID: 26290408 DOI: 10.1093/occmed/kqv114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Evidence-based resource allocation in the public health care sector requires reliable economic evaluations that are different from those needed in the commercial sector. AIMS To describe a framework for conducting economic evaluations of occupational health and safety (OHS) programmes in health care developed with sector stakeholders. To define key resources and outcomes to be considered in economic evaluations of OHS programmes and to integrate these into a comprehensive framework. METHODS Participatory action research supported by mixed qualitative and quantitative methods, including a multi-stakeholder working group, 25 key informant interviews, a 41-member Delphi panel and structured nominal group discussions. RESULTS We found three resources had top priority: OHS staff time, training the workers and programme planning, promotion and evaluation. Similarly, five outcomes had top priority: number of injuries, safety climate, job satisfaction, quality of care and work days lost. The resulting framework was built around seven principles of good practice that stakeholders can use to assist them in conducting economic evaluations of OHS programmes. CONCLUSIONS Use of a framework resulting from this participatory action research approach may increase the quality of economic evaluations of OHS programmes and facilitate programme comparisons for evidence-based resource allocation decisions. The principles may be applicable to other service sectors funded from general taxes and more broadly to economic evaluations of OHS programmes in general.
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Affiliation(s)
- J Guzman
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - E Tompa
- Institute for Work and Health, Toronto, Ontario, Canada
| | - M Koehoorn
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - H de Boer
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - S Macdonald
- Institute for Work and Health, Toronto, Ontario, Canada
| | - H Alamgir
- Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, San Antonio, TX, USA.
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Guzman J, Kerr T, Ward L, Ma J, Oen K, Boire G, Feldman B, Scuccimarri R, Houghton K, Bruns A, Dancey P, Rosenberg A, Tucker L. SAT0507 Growth and Weight Gain in Children with Juvenile Idiopathic Arthritis: Results from the Reacch-Out Cohort. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Guzman J, Loughin T, Henrey A, Berard R, Shiff N, Jurencak R, Benseler S, Tucker L. FRI0499 Using Patient-Relevant Variables to Describe the Disease Course in Children with Juvenile Idiopathic Arthritis: Results from the Reacch-Out Cohort: Table1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Beukelman T, Berntson L, Duffy C, Guzman J, Kimura Y, Klotsche J, Magnusson B, Minden K, Nordal E, Santos M, Thomson W, Zilhao C, Hyrich K. THU0531 The Initial Treatment of Systemic Juvenile Idiopathic Arthritis: An International Collaboration Among 7 Registries:. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bonella F, Sixt S, Thomassen J, Schmidt M, Cai M, Mori T, Guzman J, Costabel U. Extracellular 20S proteasome in BAL and serum of patients with alveolar proteinosis. Immunobiology 2015; 220:382-8. [DOI: 10.1016/j.imbio.2014.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 09/17/2014] [Accepted: 10/12/2014] [Indexed: 10/24/2022]
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Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJEM, Ostelo RWJG, Guzman J, van Tulder MW. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ 2015; 350:h444. [PMID: 25694111 PMCID: PMC4353283 DOI: 10.1136/bmj.h444] [Citation(s) in RCA: 549] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess the long term effects of multidisciplinary biopsychosocial rehabilitation for patients with chronic low back pain. DESIGN Systematic review and random effects meta-analysis of randomised controlled trials. DATA SOURCES Electronic searches of Cochrane Back Review Group Trials Register, CENTRAL, Medline, Embase, PsycINFO, and CINAHL databases up to February 2014, supplemented by hand searching of reference lists and forward citation tracking of included trials. STUDY SELECTION CRITERIA Trials published in full; participants with low back pain for more than three months; multidisciplinary rehabilitation involved a physical component and one or both of a psychological component or a social or work targeted component; multidisciplinary rehabilitation was delivered by healthcare professionals from at least two different professional backgrounds; multidisciplinary rehabilitation was compared with a non- multidisciplinary intervention. RESULTS Forty one trials included a total of 6858 participants with a mean duration of pain of more than one year who often had failed previous treatment. Sixteen trials provided moderate quality evidence that multidisciplinary rehabilitation decreased pain (standardised mean difference 0.21, 95% confidence interval 0.04 to 0.37; equivalent to 0.5 points in a 10 point pain scale) and disability (0.23, 0.06 to 0.40; equivalent to 1.5 points in a 24 point Roland-Morris index) compared with usual care. Nineteen trials provided low quality evidence that multidisciplinary rehabilitation decreased pain (standardised mean difference 0.51, -0.01 to 1.04) and disability (0.68, 0.16 to 1.19) compared with physical treatments, but significant statistical heterogeneity across trials was present. Eight trials provided moderate quality evidence that multidisciplinary rehabilitation improves the odds of being at work one year after intervention (odds ratio 1.87, 95% confidence interval 1.39 to 2.53) compared with physical treatments. Seven trials provided moderate quality evidence that multidisciplinary rehabilitation does not improve the odds of being at work (odds ratio 1.04, 0.73 to 1.47) compared with usual care. Two trials that compared multidisciplinary rehabilitation with surgery found little difference in outcomes and an increased risk of adverse events with surgery. CONCLUSIONS Multidisciplinary biopsychosocial rehabilitation interventions were more effective than usual care (moderate quality evidence) and physical treatments (low quality evidence) in decreasing pain and disability in people with chronic low back pain. For work outcomes, multidisciplinary rehabilitation seems to be more effective than physical treatment but not more effective than usual care.
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Affiliation(s)
- Steven J Kamper
- Musculoskeletal Division, George Institute, University of Sydney, Sydney 2050, NSW, Australia Department of Epidemiology and Biostatistics and the EMGO+ Institute, VU University Medical Centre, Amsterdam 1081BT, Netherlands
| | - A T Apeldoorn
- Department of Epidemiology and Biostatistics and the EMGO+ Institute, VU University Medical Centre, Amsterdam 1081BT, Netherlands
| | - A Chiarotto
- Department of Epidemiology and Biostatistics and the EMGO+ Institute, VU University Medical Centre, Amsterdam 1081BT, Netherlands
| | - R J E M Smeets
- Rehabilitation Medicine Department, Maastricht University Medical Centre, Maastricht 6200MD, Netherlands
| | - R W J G Ostelo
- Department of Epidemiology and Biostatistics and the EMGO+ Institute, VU University Medical Centre, Amsterdam 1081BT, Netherlands Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam 1081HV, Netherlands
| | - J Guzman
- University of British Columbia, Vancouver, Canada V6T 1Z3
| | - M W van Tulder
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam 1081HV, Netherlands
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Long X, Costabel U, He X, Guzman J, Theegarten D, Bonella F. Serum YKL-40 as a candidate biomarker for hypersensitivity pneumonitis. Pneumologie 2015. [DOI: 10.1055/s-0035-1544609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Börner E, Bonella F, Theegarten D, Wessendorf T, Guzman J, Costabel U. Pleuroparenchymal fibroelastosis – a new diagnostic and therapeutic challenge for pneumologists. Pneumologie 2014. [DOI: 10.1055/s-0034-1367971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Product Development Partnerships (PDPs) are playing an increasingly important role in the development of new medicines for neglected diseases of the developing world; however, there has been limited information on their funding and expenditure patterns. This paper analyses funding for the 14 PDPs working on neglected disease research and development (R&D) by using unpublished data from the Global Funding of Innovation for Neglected Diseases (G-FINDER) project, which surveyed 2007 global investments into R&D of products for neglected diseases. PDPs captured US$469 million or 23% of 'external' R&D funding for neglected diseases, i.e. funding granted by donors to research organisations, as opposed to internal investments by donors. PDP's funding sources were highly concentrated with the Gates Foundation providing nearly half of PDPs' combined income (49%) and four public funders (the US Agency for International Development (USAID), the UK Department for International Development (DFID), the Dutch government and Irish Aid) providing 28%. PDPs collectively spent US$262 million on R&D activities in 2007, with 88% of this expenditure going to academic institutions, contract research organisations and companies in the developed world. Our analysis confirms the central role played by PDPs in R&D for neglected diseases, but highlights the need to diversify their funding sources.
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Affiliation(s)
- M Moran
- The George Institute - Health Policy Division, PO Box M201, Missenden Rd, NSW 2050, Australia
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Affiliation(s)
- J. Guzman
- Division of Clinical Chemistry, Department of Pediatrics, University of Zürich, CH-8032 Zürich, Switzerland
| | - N. Blau
- Division of Clinical Chemistry, Department of Pediatrics, University of Zürich, CH-8032 Zürich, Switzerland
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Bonella F, Theegarten D, Worm K, Wessendorf T, Guzman J, Costabel U. Beeinflussung der Serum YKL-40 Konzentration bei Patienten mit Alveolarproteinose durch Chitinase 3-like 1 Genpolymorphismen. Pneumologie 2013. [DOI: 10.1055/s-0033-1334685] [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: 10/27/2022]
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Chin A, Velasco A, Guzman J, Morillo C. 603 The Efficacy and Safety of Vernakalant - A Meta-Analysis of Randomised Clinical Trials. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Cai M, Bonella F, Dai H, Guzman J, Costabel U. Macrolides inhibit cytokine production by alveolar macrophages in bronchiolitis obliterans organizing pneumonia. Pneumologie 2012. [DOI: 10.1055/s-0032-1302796] [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: 10/28/2022]
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Bonella F, Cai M, Ohshimo S, Guzman J, Costabel U. Serum YKL-40 als prädiktiver Biomarker der Krankheitsprogression bei Patienten mit Alveolarproteinose. Pneumologie 2012. [DOI: 10.1055/s-0032-1302795] [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: 10/28/2022]
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Guzman J, Silvanto J, Seemungal B. PTMS64 Motion adaptation increases the susceptibility of the motion selective-area V5/MT to phosphene induction by transcranial magnetic stimulation. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60717-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Seemungal B, Guzman J, Arshad Q, Walsh V, Bronstein A. PTMS61 Vestibular activation differentially affects excitability in human visual cortex areas V1 and V5/MT. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60714-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cai M, Sixt S, Bonella F, Anlasik T, Mori T, Guzman J, Costabel U. Up-regulated expression of immunoproteasome subunit LMP7 in alveolar macrophages of hypersensitivity pneumonitis. Pneumologie 2011. [DOI: 10.1055/s-0031-1271995] [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: 10/18/2022]
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50
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Bonella F, Sixt S, Anlasik T, Bauer P, Guzman J, Costabel U. Extrazelluläres Proteasom in der BAL von Patienten mit Alveolarproteinose. Pneumologie 2011. [DOI: 10.1055/s-0031-1272154] [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: 10/18/2022]
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