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Zaki P, Apisarnthanarax S, Bowen SR, Grassberger C, Tsai J, Nguyen MH, Ibrahim P, Nyflot M. Liver Regeneration Following Radiation Therapy in Hepatocellular Carcinoma Patients: Insights from Functional Liver Imaging. Int J Radiat Oncol Biol Phys 2023; 117:e743. [PMID: 37786157 DOI: 10.1016/j.ijrobp.2023.06.2279] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A critical need for hepatocellular carcinoma (HCC) patients is understanding how the liver recovers following radiation therapy (RT). While liver regeneration after hepatic resection has been well-studied, liver recovery following RT is less understood. We have previously studied 99mTc-sulphur colloid (SC) single photon emission tomography (SPECT)/CT to spatially and quantitatively analyze liver function. The purpose of this study was to assess both volumetric and functional liver changes following RT. MATERIALS/METHODS Patients with HCC had liver function assessed with SC SPECT/CT before and after definitive RT. Patients received 30-67.5 Gy in 4-15 fractions. Anatomic and functional liver metrics were assessed before and after treatment. The anatomic liver volume (ALV) was drawn on CT imaging. Liver function was measured as the functional volume encompassing 30% of maximum uptake (FLV) and mean liver-to-spleen uptake ratio (L/S). Changes in liver size and function were compared to clinical characteristics, including Child-Pugh (CP) score. Parametric t-tests were used to analyze the data. RESULTS Of 23 evaluable patients (proton RT, n = 16 or photon RT, n = 7), 15 patients had CP-A5/6, 7 had CP-B7/8, and 1 had CP-C10 scores. The mean interval of SC SPECT was 67 days following RT (range, 44 to 113 days). The mean PTV was 272 cc (range 22-802 cc). Regarding baseline liver status, mean pre-treatment ALV was 1584 cc (range 810-2749 cc) with no significant difference in ALV between CP-A and B/C patients (p = 0.285). Pre-treatment mean liver function as assessed with L/S was 1.06 ± 0.43 with significantly greater function in CP-A compared to CP-B/C patients (1.27 vs 0.66, respectively, p<0.001). Mean pre-treatment FLV was 1351 ± 430.8 cc with no significant difference in FLV between CP-A and B/C patients (1422 ± 441 cc vs 1220 ± 436 cc, respectively, p = 0.31). When evaluating change following RT, the mean change in ALV was 0.9% (range, -29% to 23%) with no significant difference between CP-A and CP-B/C patients (-1.5% vs 5.4%, respectively, p = 0.19). In contrast, change in liver function following RT was larger; mean change in FLV was -20% (range, -55% to 33%) and mean change in L/S was -16% (range, -66% to 105%). While change in FLV was not significantly different between CP-A and CP-B/C patients, CP-B/C patients had significantly greater decline in mean liver function (L/S) than CP-A patients (-40 ± 18% vs -3.6 ± 36%, respectively, p = 0.018). There was no association between change in liver volume and change in L/S, p = 0.543. CONCLUSION Functional liver imaging metrics reveal different information about the potential functional reserve of irradiated livers compared to anatomic measurements. These data imply that functional liver imaging may more accurately assess the regenerative potential of irradiated and non-irradiated volumes of liver, which may be useful in clinical scenarios where assessment of the function of future liver remnants become critical.
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Affiliation(s)
- P Zaki
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - S Apisarnthanarax
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - S R Bowen
- University of Washington, Department of Radiation Oncology & Radiology, Seattle, WA
| | - C Grassberger
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - J Tsai
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - M H Nguyen
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - P Ibrahim
- University of Detroit Mercy, Detroit, MI
| | - M Nyflot
- University of Washington, Department of Radiation Oncology & Radiology, Seattle, WA
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Newell K, Ferguson-Steele Z, Shin D, Noh MG, Pipavath S, Gutschenritter T, Tsai J, Kang J. Quantitative and Qualitative Impact of CT-Based Radiotherapy Dose Maps on Radiologists' Interpretation of Post-treatment Thoracic Surveillance Imaging. Int J Radiat Oncol Biol Phys 2023; 117:S96-S97. [PMID: 37784614 DOI: 10.1016/j.ijrobp.2023.06.430] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) For diagnostic radiologists, interpretation of surveillance imaging for oncology patients treated with radiation therapy (RT) can be challenging because (1) the imaging order may not adequately describe the radiation fields and (2) RT treatment effect and progression can appear similar. Volumetric dose visualization used for plan review is often inaccessible to radiologists. We hypothesize that displaying RT dose would improve radiologists' confidence and ability to correctly identify and distinguish irradiated targets and treatment effects. MATERIALS/METHODS CT images were read by a board-certified cardiothoracic radiologist and a diagnostic radiology resident. The readers interpreted pre-RT, treatment planning, and 3-4 month post-RT CT images in anonymized software sessions first without, then-after a 1 month "washout" period-with access to RT dose overlay. Six color-coded isodose lines ranging from 25% to 110% represented in absolute cGy were displayed along with a brief clinical history. RT fractionation schedules ranged in BED10 from 39 to 112.5 Gy. Readers were asked to label the treated lesion(s) and treatment effect(s), and record their confidence using a Likert scale of 1-5 and agreement with statements using yes/no responses. RESULTS Two readersindependently interpreted imaging for 32 patients who received thoracic RT to 1-5 lesion(s) for primary (24) or metastatic (8) cancer. Nineteen patients had 1 lesion and 13 patients had >1 lesion. Correct identification of all treated lesions significantly increased with the addition of dose visualization (61% to 81%; McNemar test, p = 0.00079), with the largest increase noted for cases with >1 lesion (15% to 54%; McNemar test, p = 0.0039). With the addition of dose information, the number of false negatives attributable to missed extranodal targets fell from 52% to 18%. Without dose information, 13% of labeled lesions and treatment effects fell outside of the 25% isodose lines, representing false positives. With the addition of dose information, false positives fell below 2% for both lesions and treatment effects. The readers' confidence that they had identified treated lesion(s) increased from a rating of 4.1 to 4.8 on a scale of 1-5 (Paired two-tail t test; p = 0.000005). CONCLUSION Whendiagnostic radiologists have access to dose visualization, correct identification rate of irradiated lesions and treatment effects, as well as confidence in these identifications significantly increased. The decrease in false negatives could reduce potential missed identification of tumor progression while the decrease in false positives could reduce inaccurate identification of treatment failure in a new or stable lesion. Our results demonstrate that adding volumetric visualization of dose to imaging could improve quality of surveillance care for patients with irradiated thoracic malignancies.
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Affiliation(s)
- K Newell
- University of Washington School of Medicine, Seattle, WA
| | | | - D Shin
- University of Washington, Seattle, WA
| | - M G Noh
- University of Washington, Department of Radiology, Seattle, WA
| | - S Pipavath
- University of Washington, Department of Radiology, Seattle, WA
| | - T Gutschenritter
- Department of Radiation Oncology, University of Washington - Fred Hutchinson Cancer Center, Seattle, WA
| | - J Tsai
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - J Kang
- University of Washington, Department of Radiation Oncology, Seattle, WA
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Koro S, Balagamwala EH, Sahgal A, Chapman D, Schaff EM, Siddiqui F, Lo SS, Wei W, Tseng CL, Tsai J, Schaub SK, Angelov L, Billena C, Bommireddy A, Mayo ZS, Suh JH, Chao ST. Multi-Institutional Validation of the Recursive Partitioning Analysis for Overall Survival in Patients Undergoing Spine Radiosurgery for Spine Metastasis. Int J Radiat Oncol Biol Phys 2023; 117:S59-S60. [PMID: 37784533 DOI: 10.1016/j.ijrobp.2023.06.356] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The recently published spine radiosurgery (sSRS) recursive partitioning analysis (RPA) for overall survival (OS) separated patients into 3 distinct prognostic groups. We sought to externally validate this RPA using 3 separate multi-institutional datasets. MATERIALS/METHODS A total of 444 patients were utilized to develop the recently published sSRS RPA predictive of OS in patients with spine metastases. The RPA identified three distinct prognostic classes. RPA Class 1 was defined as KPS >70 and controlled systemic disease (n = 142); RPA Class 2 was defined as KPS>70 with uncontrolled systemic disease or KPS ≤70, age ≥54 and absence of visceral metastases (n = 207); RPA Class 3 was defined as KPS ≤70 and age <54 years or KPS≤70, age ≥54 years and presence of visceral metastases (n = 95). We utilized data from 3 large tertiary care centers to independently validate this RPA. Data from each institution was utilized independently to validate the RPA to minimize confounding based on institutional differences in patient selection. A total of 1,184 patients (221 patients from institution A, 749 institution B, and 214 from institution C) were in the validation cohort and were divided based on their RPA Class. Kaplan-Meier method was used to estimate OS and log-rank test was used to compare OS between RPA classes. RESULTS In each of the validation cohorts, the median OS was 19.9 months (institution A), 11.0 months (institution B), and 24.4 months (institution C). The patient distribution into RPA classification based on Institution A/B/C was, Class 1 (19.4%, 15.1%, 50.5%), Class 2 (74.7%, 57.7%%, 37.9%), and Class 3 (5.9%, 27.2%%, 11.2%), respectively. The median OS for patients in the validation cohort at Institution A/B/C based on RPA class was Class 1 (54 months, 27.1 months, 50.0 months), Class 2 (15.9 months, 13.0 months, 15.1 months) and Class 3 (6.9 months, 3.5 months, 6.1 months), respectively. Patients in RPA Class 1 had a significantly better OS compared to those in Class 2 of the each of the three external institution validation cohorts (p<0.01). Similarly, patients in RPA Class 2 had a significantly better OS compared to those in Class 3 (p<0.01). CONCLUSION The external datasets from three large institutions independently validated the spine SRS RPA successfully for OS in patients undergoing sSRS for spinal metastases. This is the first RPA for OS to have been externally validated using multiple large datasets. Based on this validation, upfront spine SRS is strongly supported for patients in RPA Class 1 and Class 2 and is also cost effective with median OS >11 months for these patients. Patients in RPA Class 3 would benefit most from upfront conventional radiotherapy given their poor expected survival. Given successful external validation, this RPA helps guide physicians to identify those patients with spinal metastases who most benefit from sSRS.
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Affiliation(s)
- S Koro
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - E H Balagamwala
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - A Sahgal
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | | | - E M Schaff
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - F Siddiqui
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - S S Lo
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | - W Wei
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - C L Tseng
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - J Tsai
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - S K Schaub
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - L Angelov
- Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, OH
| | - C Billena
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - A Bommireddy
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Z S Mayo
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - J H Suh
- Department of Radiation Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH
| | - S T Chao
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
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Balagamwala E, Sahgal A, Chapman D, Schaff E, Siddiqui F, Lo S, Wei W, Campbell M, Tsai J, Schaub S, Angelov L, Mayo Z, Suh J, Hanan J, Chao S. Multi-Institutional Datasets Validate the Recursive Partitioning Analysis for Overall Survival in Patients Undergoing Spine Radiosurgery for Spine Metastasis. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.864] [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: 10/31/2022]
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Raez L, Brice K, Tsai J, Drusbosky L, Dumais K, Lopez-Cohen A, Wietecha D, Daba H, Izquierdo P, Santos E, Powery H. EP16.02-018 Liquid Biopsies First to Make Treatment Decisions in Patients With Metastatic Non-small Cell Lung Cancer (NSCLC). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tsai J, Chien A. 663 Non-sunscreen photoprotection methods are associated with lower serum 25-hydroxyvitamin D, with Asian and Black individuals showing less decrease in 25-hydroxyvitamin D with shade seeking: NHANES 2011-2016. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.674] [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: 11/29/2022]
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Tsai J, Chien A. 053 Epidermal barrier dysfunction is associated with chronic bronchitis in adults: Results from the National Health and Nutrition Examination Survey, 1999-2006. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.055] [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: 11/24/2022]
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Na P, Tsai J, Harpaz-Rotem I, Pietrzak R. Mental health and suicidal ideation in US military veterans with histories of COVID-19 infection. BMJ Mil Health 2021; 168:15-19. [PMID: 34035155 PMCID: PMC8154290 DOI: 10.1136/bmjmilitary-2021-001846] [Citation(s) in RCA: 4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION There have been reports of increased prevalence in psychiatric conditions in non-veteran survivors of COVID-19. To date, however, no known study has examined the prevalence, risk and protective factors of psychiatric conditions among US military veterans who survived COVID-19. METHODS Data were analysed from the 2019 to 2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative, prospective cohort of 3078 US veterans. Prepandemic and 1-year peripandemic risk and protective factors associated with positive screens for peripandemic internalising (major depressive, generalised anxiety and/or posttraumatic stress disorders) and externalising psychiatric disorders (alcohol and/or drug use disorders) and suicidal ideation were examined using bivariate and multivariate logistic regression analyses. RESULTS A total of 233 veterans (8.6%) reported having been infected with COVID-19. Relative to veterans who were not infected, veterans who were infected were more likely to screen positive for internalising disorders (20.5% vs 13.9%, p=0.005), externalising disorders (23.2% vs 14.8%, p=0.001) and current suicidal ideation (12.0% vs 7.6%, p=0.015) at peripandemic. Multivariable analyses revealed that greater prepandemic psychiatric symptom severity and COVID-related stressors were the strongest independent predictors of peripandemic internalising disorders, while prepandemic trauma burden was protective. Prepandemic suicidal ideation, greater loneliness and lower household income were the strongest independent predictors of peripandemic suicidal ideation, whereas prepandemic community integration was protective. CONCLUSION Psychiatric symptoms and suicidal ideation are prevalent in veterans who have survived COVID-19. Veterans with greater prepandemic psychiatric and substance use problems, COVID-related stressors and fewer psychosocial resources may be at increased risk of these outcomes.
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Affiliation(s)
- Peter Na
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - J Tsai
- U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, Florida, USA.,School of Public Health, University of Texas Health Science Center at Houston, San Antonio, Texas, USA
| | - I Harpaz-Rotem
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - R Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.,U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
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9
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Tsai J, Chien A. 249 Increased susceptibility to sunburn occurs during the first three years of hydrochlorothiazide use: Results from the National Health and Nutrition Examination Survey, 2009-2018. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.271] [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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10
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Tsai J, Chien AL, Kang JU, Leung S, Kang S, Garza LA. Hyperspectral measurement of skin reflectance detects differences in the visible and near-infrared regions according to race, gender and body site. J Eur Acad Dermatol Venereol 2020; 35:e330-e333. [PMID: 33290609 DOI: 10.1111/jdv.17076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J Tsai
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J U Kang
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - S Leung
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - S Kang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - L A Garza
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Tsai J, Cerdeña JP, Khazanchi R, Lindo E, Marcelin JR, Rajagopalan A, Sandoval RS, Westby A, Gravlee CC. There is no 'African American Physiology': the fallacy of racial essentialism. J Intern Med 2020; 288:368-370. [PMID: 32808368 DOI: 10.1111/joim.13153] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 11/30/2022]
Affiliation(s)
- J Tsai
- From the, Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - J P Cerdeña
- Department of Anthropology, Yale University, New Haven, CT, USA.,Yale University School of Medicine, New Haven, CT, USA
| | - R Khazanchi
- University of Nebraska Medical Center, Omaha, NE, USA.,University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - E Lindo
- Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - J R Marcelin
- University of Nebraska Medical Center, Omaha, NE, USA
| | - A Rajagopalan
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Veteran Affairs Boston Healthcare System, Boston, MA, USA
| | - R S Sandoval
- Harvard Medical School, Boston, MA, USA.,Harvard Kennedy School, Boston, MA, USA
| | - A Westby
- Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C C Gravlee
- Department of Anthropology, University of Florida, Gainesville, FL, USA
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Abstract
As the demographic characteristics of the US population have changed over the past decade, the characteristics of different homeless populations have changed as well. This study tracked changes in demographic characteristics of homeless adult, veteran, and healthcare service user populations against general adult and veteran populations from 2007-2017. The results showed that changing demographics of homeless populations largely reflected broader trends in the general population, and attention is needed on the clinical needs of aging homeless populations. There may be some unique changes in the demography of some homeless populations, such as younger homeless veterans seeking healthcare services.
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Affiliation(s)
- J Tsai
- U.S. Department of Veterans Affairs, National Center on Homelessness Among Veterans, Tampa, FL, USA
- Department of Psychiatry, Yale University School of Medicine, VACT, 950 Campbell Ave., 151D, West Haven, New Haven, CT 06516, USA
| | - K Mehta
- U.S. Department of Veterans Affairs, National Center on Homelessness among Veterans, Tampa, FL, USA
| | - AE Mongtomery
- U.S. Department of Veterans Affairs, National Center on Homelessness among Veterans, Tampa, FL, USA
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - E Elbogen
- U.S. Department of Veterans Affairs, National Center on Homelessness among Veterans, Tampa, FL, USA
- Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA
| | - D Hooshyar
- U.S. Department of Veterans Affairs, National Center on Homelessness among Veterans, Tampa, FL, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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13
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Guns W, Andrea J, Ma Y, Tsai J, Woodford M, Jones J. Evaluation of cryogenic dewar health using a weight-based monitoring system. Reprod Biomed Online 2019. [DOI: 10.1016/j.rbmo.2019.07.008] [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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14
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Lee H, Tsai J, Chen S, Lai I, Chen C, Ho C, Chiou J, Kuo Y. EP-1355 Oligo-progressive status exhibits unfavorable survival in pulmonary oligo-recurrence treated by SABR. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31775-x] [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: 11/17/2022]
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15
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Iyengar NM, Siegel B, Malik M, Giri DD, Tsai J, Hughes M, Adam A, Williams S, Zhou XK, Rodgers W, Ginter P, Patel A, Yong F, Cherian A, August P, Dannenberg AJ. Abstract P5-07-05: Obesity, adipose inflammation, and race in patients with early stage breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-07-05] [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: 11/16/2022]
Abstract
Abstract
Background: Elevated body mass index (BMI) is associated with increased risk of estrogen receptor-positive postmenopausal breast cancer. Mechanistically, most individuals with elevated BMI have breast white adipose tissue inflammation (WATi) which confers increased breast cancer risk, particularly in those with existing benign breast disease. Individuals with WATi have elevated in-breast expression of aromatase and several systemic changes that increase breast cancer risk, including hyperinsulinemia and higher levels of C-reactive protein. However, women with normal BMI but high levels of body fat are also likely to harbor WATi and are at increased risk of postmenopausal breast cancer. The accuracy of BMI for assessing adiposity and predicting obesity-related disorders, including cancer, varies across race and ethnicity. Whether the association between BMI and WATi varies by race is unknown. Here we aimed to characterize relationships among breast WATi and clinicopathologic features in a racially diverse cohort undergoing mastectomy for breast cancer treatment.
Methods: Non-tumorous breast tissue and fasting blood were collected from women undergoing mastectomy for breast cancer treatment or prevention at a single center serving a racially diverse patient population. Breast WATi was detected by the presence of crown-like structures in the breast (CLS-B), which are composed of a dead/dying adipocyte surrounded by CD68+ macrophages. Clinicopathologic data were abstracted from electronic medical records. Associations among categorical variables were examined using Fisher's exact test. Relationships between continuous variables were examined using the Spearman correlation.
Results: As of May 18, 2018 62 patients have been accrued; median age 55 (range 32 to 84). Self-reported race distribution was: 36 (58%) Asian, 5 African American (8%), 20 (32%) Caucasian, and 1 (2%) unknown. Breast tissue has been analyzed for WATi in 60 cases thus far. Clinicopathologic features stratified by the presence or absence of breast WATi are presented in. Breast WAT inflammation was associated with obesity (P=0.02) and a trend to association was observed with dyslipidemia (P<0.09).
VariableBreast WATi Absent (n=25)Breast WATi Present (n=35)Age, years Median (range)51 (32 to 71)59 (36 to 80)BMI, kg/m2 Median (range)22.5 (18.1 to 35.3)28.0 (19.2 to 38.9)BMI Category Underweight1 (4%)0 (0%)Normal16 (64%)10 (29%)Overweight5 (20%)18 (51%)Obese3 (12%)7 (20%)Race, n (%) Asian15 (60%)19 (54%)African American2 (8%)3 (9%)Caucasian8 (32%)12 (34%)Unknown0 (0%)1 (3%)Menopausal Status, n (%) Pre10 (40%)12 (34%)Post15 (60%)23 (66%)Hypertension, n (%)7 (28%)16 (46%)Diabetes mellitus, n (%)0 (0%)5 (14%)Dyslipidemia, n (%)1 (4%)11 (31%)
Conclusions: Breast adipose inflammation is associated with elevated BMI and possibly metabolic syndrome disorders in a racially diverse population. These findings are consistent with observations from predominantly Caucasian cohorts. Race-specific characteristics will also be examined. Study accrual is ongoing and updated results will be presented.
Citation Format: Iyengar NM, Siegel B, Malik M, Giri DD, Tsai J, Hughes M, Adam A, Williams S, Zhou XK, Rodgers W, Ginter P, Patel A, Yong F, Cherian A, August P, Dannenberg AJ. Obesity, adipose inflammation, and race in patients with early stage breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-07-05.
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Affiliation(s)
- NM Iyengar
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - B Siegel
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - M Malik
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - DD Giri
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - J Tsai
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - M Hughes
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - A Adam
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - S Williams
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - XK Zhou
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - W Rodgers
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - P Ginter
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - A Patel
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - F Yong
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - A Cherian
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - P August
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
| | - AJ Dannenberg
- Memorial Sloan Kettering Cancer Center, New York, NY; New York Presbyterian Hospital Queens, New York, NY; Weill Cornell Medicine, New York, NY
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16
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Tsai J, Gu X. Homelessness among immigrants in the United States: rates, correlates, and differences compared with native-born adults. Public Health 2019; 168:107-116. [PMID: 30739834 DOI: 10.1016/j.puhe.2018.12.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 08/06/2018] [Revised: 11/27/2018] [Accepted: 12/18/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study examines rates of lifetime adult homelessness among foreign-born adults in the United States and how they differ from native-born adults. STUDY DESIGN Cross-sectional data from a nationally representative US sample were analyzed. METHODS A sample of 29,896 native-born (weighted 84.1%) and 6404 foreign-born (weighted 16.0%) US adults participating in the National Epidemiologic Survey on Alcohol and Related Conditions-III were compared on rates of homelessness, controlling for sociodemographic characteristics, mental and substance-use disorders, health insurance, and use of welfare. RESULTS There was no significant difference in rates of lifetime adult homelessness between foreign-born adults and native-born adults (1.0% vs 1.7%). Foreign-born participants were less likely to have various mental and substance-use disorders, less likely to receive welfare, and less likely to have any lifetime incarceration. The number of years foreign-born adults lived in the United States was significantly associated with risk for homelessness. CONCLUSIONS These findings suggest the 'healthy immigrant effect' applies to the mental health and social functioning of US immigrants but may not necessarily apply to homelessness. Long-standing immigration procedures requiring mental health and psychosocial evaluations may contribute to selection effects.
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Affiliation(s)
- J Tsai
- Department of Veterans Affairs (VA) New England Mental Illness Research, Education, Clinical Center (MIRECC), 950 Campbell Ave., 151D, West Haven, CT, 06516, USA; Department of Psychiatry, Yale University School of Medicine, 300 George St., New Haven, CT, 06511, USA.
| | - X Gu
- Department of Biostatistics, Yale School of Public Health, 60 College St., New Haven, CT, 06520, USA
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Perry W, Lacritz L, Roebuck-Spencer T, Silver C, Denney RL, Meyers J, McConnel CE, Pliskin N, Adler D, Alban C, Bondi M, Braun M, Cagigas X, Daven M, Drozdick L, Foster NL, Hwang U, Ivey L, Iverson G, Kramer J, Lantz M, Latts L, Maria Lopez A, Malone M, Martin-Plank L, Maslow K, Melady D, Messer M, Most R, Norris MP, Shafer D, Thomas CM, Thornhill L, Tsai J, Vakharia N, Waters M, Golden T. Population Health Solutions for Assessing Cognitive Impairment in Geriatric Patients. Clin Neuropsychol 2018; 32:1193-1225. [DOI: 10.1080/13854046.2018.1517503] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- William Perry
- National Academy of Neuropsychology (NAN)
- NAN
- University of California, San Diego
| | - Laura Lacritz
- National Academy of Neuropsychology (NAN)
- UT Southwestern Medical Center
| | | | | | - Robert L. Denney
- National Academy of Neuropsychology (NAN)
- Missouri Memory Center, Citizens Memorial Healthcare
| | | | | | | | - Deb Adler
- Senior Vice President Network Strategy, Optum of United Health Group
| | | | - Mark Bondi
- Society for Clinical Neuropsychology (SCN)
| | | | | | | | | | - Norman L. Foster
- American Academy of Neurology (AAN)
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Ula Hwang
- Geriatric EM Section, American College of Emergency Physicians (ACEP)
- Department of Emergency Medicine
- Icahn School of Medicine at Mount Sinai, Geriatric Research Education, and Clinical Center, James J. Peters VAMC Geriatric EM Section
- American College of Emergency Physicians (ACEP)
| | - Laurie Ivey
- Collaborative Family Healthcare Association (CFHA)
| | - Grant Iverson
- National Academy of Neuropsychology (NAN)
- Neuropsychology Outcome Assessment Laboratory and Director, Massachusetts General Hospital for Children Sports Concussion Program, Harvard Medical School
| | - Joel Kramer
- International Neuropsychological Society (INS)
| | | | | | - Ana Maria Lopez
- American College of Physicians (ACP)
- Health Equity and Inclusion, University of Utah Health Sciences Center
- Cancer Health Equity, Huntsman Cancer Institute
- University of Utah School of Medicine
| | - Michael Malone
- American Geriatrics Society
- Aurora Senior Services, Aurora Health Care
| | | | | | - Don Melady
- Schwartz/Reisman Emergency Medicine Institute, Mount Sinai Hospital, University of Toronto
- Canadian Association of Emergency Physicians
- International Federation of Emergency Medicine
| | - Melissa Messer
- Research & Development, Psychological Assessment Resources, Inc. (PAR)
| | - Randi Most
- American Board of Professional Neuropsychology (ABN)
| | | | | | | | | | - Jean Tsai
- American Academy of Neurology (AAN)
- University of Colorado, Denver Health
| | | | - Martin Waters
- Clinical Innovation and Thought Leadership, Beacon Health Options
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Perry W, Lacritz L, Roebuck-Spencer T, Silver C, Denney RL, Meyers J, McConnel CE, Pliskin N, Adler D, Alban C, Bondi M, Braun M, Cagigas X, Daven M, Drozdick L, Foster NL, Hwang U, Ivey L, Iverson G, Kramer J, Lantz M, Latts L, Ling SM, Lopez AM, Malone M, Martin-Plank L, Maslow K, Melady D, Messer M, Most R, Norris MP, Shafer D, Silverberg N, Thomas CM, Thornhill L, Tsai J, Vakharia N, Waters M, Golden T. Population Health Solutions for Assessing Cognitive Impairment in Geriatric Patients. Arch Clin Neuropsychol 2018; 33:655-675. [PMID: 30339202 PMCID: PMC6201735 DOI: 10.1093/arclin/acy052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/08/2018] [Indexed: 12/17/2022] Open
Abstract
SUMMIT PARTICIPANTS ORGANIZATIONS REPRESENTED
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Affiliation(s)
- William Perry
- National Academy of Neuropsychology (NAN)
- NAN
- University of California, San Diego
| | - Laura Lacritz
- National Academy of Neuropsychology (NAN)
- UT Southwestern Medical Center
| | | | | | - Robert L Denney
- National Academy of Neuropsychology (NAN)
- Missouri Memory Center, Citizens Memorial Healthcare
| | | | | | | | - Deb Adler
- Senior Vice President Network Strategy, Optum of United Health Group
| | | | - Mark Bondi
- Society for Clinical Neuropsychology (SCN)
| | | | | | | | | | - Norman L Foster
- American Academy of Neurology (AAN)
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah
| | - Ula Hwang
- Geriatric EM Section, American College of Emergency Physicians (ACEP)
- Department of Emergency Medicine
- Icahn School of Medicine at Mount Sinai, Geriatric Research Education, and Clinical Center, James J. Peters VAMC Geriatric EM Section
- American College of Emergency Physicians (ACEP)
| | - Laurie Ivey
- Collaborative Family Healthcare Association (CFHA)
| | - Grant Iverson
- National Academy of Neuropsychology (NAN)
- Neuropsychology Outcome Assessment Laboratory and Director, Massachusetts General Hospital for Children Sports Concussion Program, Harvard Medical School
| | - Joel Kramer
- International Neuropsychological Society (INS)
| | | | | | - Shari M Ling
- Centers for Medicare and Medicaid Services (CMS)
| | - Ana Maria Lopez
- American College of Physicians (ACP)
- Health Equity and Inclusion, University of Utah Health Sciences Center
- Cancer Health Equity, Huntsman Cancer Institute
- University of Utah School of Medicine
| | - Michael Malone
- American Geriatrics Society
- Aurora Senior Services, Aurora Health Care
| | | | | | - Don Melady
- Schwartz/Reisman Emergency Medicine Institute, Mount Sinai Hospital, University of Toronto
- Canadian Association of Emergency Physicians
- International Federation of Emergency Medicine
| | - Melissa Messer
- Research & Development, Psychological Assessment Resources, Inc. (PAR)
| | - Randi Most
- American Board of Professional Neuropsychology (ABN)
| | | | | | - Nina Silverberg
- Alzheimer's Disease Centers (ADC) Program, National Institute on Aging (NIA)
| | | | | | - Jean Tsai
- American Academy of Neurology (AAN)
- University of Colorado, Denver Health
| | | | - Martin Waters
- Clinical Innovation and Thought Leadership, Beacon Health Options
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Tsai J, Phan D, Lee H, Raza S, Graham J, Levy M, Tucker M. Rate of development of euploid blastocyst affects clinical outcomes of frozen embryo transfer. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.1209] [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]
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Klepitskaya O, Liu Y, Sharma S, Sillau SH, Tsai J, Walters AS. Deep brain stimulation improves restless legs syndrome in patients with Parkinson disease. Neurology 2018; 91:e1013-e1021. [PMID: 30111549 DOI: 10.1212/wnl.0000000000006162] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/14/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To study the effect of subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with Parkinson disease (PD) and moderate to severe restless legs syndrome (RLS) on their RLS symptoms. METHODS Patients undergoing STN DBS surgery for PD completed the International RLS Study Group Rating Scale (IRLS) and RLS Quality of Life (QoL) questionnaires preoperatively and postoperatively at 6 months, 1 year, and 2 years. The primary outcome measure was IRLS sum score and subscales (severity and impact) and the secondary measure was RLS QoL scores. Differences among the mean scores over time were analyzed using mixed model regression. RESULTS Twenty-two patients were enrolled. The preoperative IRLS sum scores were 19.59 ± 6.95, severity subscale 12.91 ± 4.33, impact subscale 4.45 ± 2.72, and transformed RLS QoL score 68.30 ± 20.26. The differences between preoperative and averaged postoperative scores were IRLS sum score -7.80, severity subscale -5.50, impact subscale -1.20, and RLS QoL 4.73. The overall F tests demonstrated differences among the times for the means of the IRLS sum and subscales: p < 0.05. There were no correlations between RLS symptoms improvement and PD motor symptoms improvement or reduction in PD medications. Half of the patients had at least 50% improvement and 27% had resolution of their RLS symptoms (IRLS = 0). CONCLUSIONS STN DBS significantly decreased RLS symptoms in patients with PD despite a decrease in dopaminergic treatment. This improvement was sustained over a 2-year period. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence that for patients with PD and moderate to severe RLS, STN DBS improves RLS symptoms.
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Affiliation(s)
- Olga Klepitskaya
- From the Department of Neurology (O.K., Y.L., S.H.S., J.T.), University of Colorado Denver, Aurora; University of Rochester (S.S.), NY; and Division of Sleep Medicine (A.S.W.), Vanderbilt University School of Medicine, Nashville, TN.
| | - Ying Liu
- From the Department of Neurology (O.K., Y.L., S.H.S., J.T.), University of Colorado Denver, Aurora; University of Rochester (S.S.), NY; and Division of Sleep Medicine (A.S.W.), Vanderbilt University School of Medicine, Nashville, TN
| | - Saloni Sharma
- From the Department of Neurology (O.K., Y.L., S.H.S., J.T.), University of Colorado Denver, Aurora; University of Rochester (S.S.), NY; and Division of Sleep Medicine (A.S.W.), Vanderbilt University School of Medicine, Nashville, TN
| | - Stefan H Sillau
- From the Department of Neurology (O.K., Y.L., S.H.S., J.T.), University of Colorado Denver, Aurora; University of Rochester (S.S.), NY; and Division of Sleep Medicine (A.S.W.), Vanderbilt University School of Medicine, Nashville, TN
| | - Jean Tsai
- From the Department of Neurology (O.K., Y.L., S.H.S., J.T.), University of Colorado Denver, Aurora; University of Rochester (S.S.), NY; and Division of Sleep Medicine (A.S.W.), Vanderbilt University School of Medicine, Nashville, TN
| | - Arthur S Walters
- From the Department of Neurology (O.K., Y.L., S.H.S., J.T.), University of Colorado Denver, Aurora; University of Rochester (S.S.), NY; and Division of Sleep Medicine (A.S.W.), Vanderbilt University School of Medicine, Nashville, TN
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21
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Liang Y, Wei C, Tsai J, Jeng Y, Chen K, Cheng A, Yeh K. Treatment efficacy and survival analysis of extremely elderly (80 years of age or older) patients with metastatic colorectal cancer: Single institute retrospective study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Perry W, Lacritz L, Roebuck-Spencer T, Silver C, Denney RL, Meyers J, McConnel CE, Pliskin N, Adler D, Alban C, Bondi M, Braun M, Cagigas X, Daven M, Drozdick L, Foster NL, Hwang U, Ivey L, Iverson G, Kramer J, Lantz M, Latts L, Ling SM, Maria Lopez A, Malone M, Martin-Plank L, Maslow K, Melady D, Messer M, Most R, Norris MP, Shafer D, Silverberg N, Thomas CM, Thornhill L, Tsai J, Vakharia N, Waters M, Golden T. Population Health Solutions for Assessing Cognitive Impairment in Geriatric Patients. Innov Aging 2018; 2:igy025. [PMID: 30480142 PMCID: PMC6183165 DOI: 10.1093/geroni/igy025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In December 2017, the National Academy of Neuropsychology convened an interorganizational Summit on Population Health Solutions for Assessing Cognitive Impairment in Geriatric Patients in Denver, Colorado. The Summit brought together representatives of a broad range of stakeholders invested in the care of older adults to focus on the topic of cognitive health and aging. Summit participants specifically examined questions of who should be screened for cognitive impairment and how they should be screened in medical settings. This is important in the context of an acute illness given that the presence of cognitive impairment can have significant implications for care and for the management of concomitant diseases as well as pose a major risk factor for dementia. Participants arrived at general principles to guide future screening approaches in medical populations and identified knowledge gaps to direct future research. Key learning points of the summit included: recognizing the importance of educating patients and healthcare providers about the value of assessing current and baseline cognition;emphasizing that any screening tool must be appropriately normalized and validated in the population in which it is used to obtain accurate information, including considerations of language, cultural factors, and education; andrecognizing the great potential, with appropriate caveats, of electronic health records to augment cognitive screening and tracking of changes in cognitive health over time.
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Affiliation(s)
- William Perry
- National Academy of Neuropsychology (NAN)
- University of California, San Diego
| | - Laura Lacritz
- National Academy of Neuropsychology (NAN)
- UT Southwestern Medical Center
| | | | - Cheryl Silver
- National Academy of Neuropsychology (NAN)
- UT Southwestern Medical Center
| | - Robert L Denney
- National Academy of Neuropsychology (NAN)
- Missouri Memory Center, Citizens Memorial Healthcare
| | | | | | | | - Deb Adler
- Senior Vice President Network Strategy, Optum of United Health Group
| | | | - Mark Bondi
- Society for Clinical Neuropsychology (SCN)
| | | | | | | | | | - Norman L Foster
- American Academy of Neurology (AAN)
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah
| | - Ula Hwang
- Geriatric EM Section, American College of Emergency Physicians (ACEP)
- Department of Emergency Medicine
- Icahn School of Medicine at Mount Sinai, Geriatric Research Education, and Clinical Center, James J. Peters VAMC Geriatric EM Section
- American College of Emergency Physicians (ACEP)
| | - Laurie Ivey
- Collaborative Family Healthcare Association (CFHA)
| | - Grant Iverson
- National Academy of Neuropsychology (NAN)
- Neuropsychology Outcome Assessment Laboratory and Director, Massachusetts General Hospital for Children Sports Concussion Program, Harvard Medical School
| | - Joel Kramer
- International Neuropsychological Society (INS)
| | | | | | - Shari M Ling
- Centers for Medicare and Medicaid Services (CMS)
| | - Ana Maria Lopez
- American College of Physicians (ACP)
- Health Equity and Inclusion, University of Utah Health Sciences Center
- Cancer Health Equity, Huntsman Cancer Institute
- University of Utah School of Medicine
| | - Michael Malone
- American Geriatrics Society
- Aurora Senior Services, Aurora Health Care
| | | | | | - Don Melady
- Schwartz/Reisman Emergency Medicine Institute, Mount Sinai Hospital, University of Toronto
- Canadian Association of Emergency Physicians
- International Federation of Emergency Medicine
| | - Melissa Messer
- Research & Development, Psychological Assessment Resources, Inc. (PAR)
| | - Randi Most
- American Board of Professional Neuropsychology (ABN)
| | | | | | - Nina Silverberg
- Alzheimer's Disease Centers (ADC) Program, National Institute on Aging (NIA)
| | | | | | - Jean Tsai
- American Academy of Neurology (AAN)
- University of Colorado, Denver Health
| | | | - Martin Waters
- Clinical Innovation and Thought Leadership, Beacon Health Options
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23
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Tsai J, Pietrzak RH. Trajectories of posttraumatic growth among US military veterans: a 4-year nationally representative, prospective cohort study. Acta Psychiatr Scand 2017; 136:483-492. [PMID: 28846800 DOI: 10.1111/acps.12800] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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] [Accepted: 08/08/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study examined the nature and determinants of predominant trajectories of posttraumatic growth (PTG) over time. METHOD Using data from a prospective, nationally representative survey of 2718 US veterans assessed in 2011, 2013, and 2015, we used latent growth mixture modeling to identify PTG trajectories, and to examine key determinants of PTG trajectories from a comprehensive set of sociodemographic, military, health, and psychosocial variables. RESULTS Three PTG trajectories were identified, labeled as Low and Decreasing PTG (74.0%), Consistently Moderate PTG (12.0%), and High and Increasing PTG (14.0%). Greater severity of posttraumatic stress disorder symptoms, specifically re-experiencing and avoidance symptoms, at baseline predicted Consistently Moderate and High and Increasing PTG trajectories. Compared to the Low and Decreasing PTG trajectory, the High and Increasing PTG trajectory scored higher on baseline measures of gratitude, purpose in life, Spirituality, and social support. CONCLUSION Posttraumatic growth is a dynamic process with divergent trajectories. Developing interventions that target certain psychosocial factors may help trauma survivors maintain PTG over time.
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Affiliation(s)
- J Tsai
- United States Department of Veterans Affairs, New England Mental Illness Research, Education and Clinical Center, West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - R H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, West Haven, CT, USA
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24
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Tekriwal A, Kern DS, Tsai J, Ince NF, Wu J, Thompson JA, Abosch A. REM sleep behaviour disorder: prodromal and mechanistic insights for Parkinson's disease. J Neurol Neurosurg Psychiatry 2017; 88:445-451. [PMID: 27965397 DOI: 10.1136/jnnp-2016-314471] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/15/2016] [Accepted: 11/21/2016] [Indexed: 11/04/2022]
Abstract
Rapid eye movement (REM) sleep behaviour disorder (RBD) is characterised by complex motor enactment of dreams and is a potential prodromal marker of Parkinson's disease (PD). Of note, patients with PD observed during RBD episodes exhibit improved motor function, relative to baseline states during wake periods. Here, we review recent epidemiological and mechanistic findings supporting the prodromal value of RBD for PD, incorporating clinical and electrophysiological studies. Explanations for the improved motor function during RBD episodes are evaluated in light of recent publications. In addition, we present preliminary findings describing changes in the activity of the basal ganglia across the sleep-wake cycle that contribute to our understanding of RBD.
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Affiliation(s)
- Anand Tekriwal
- Department of Neurosurgery, University of Colorado-Anschutz Medical Center, Denver, Colorado, USA
| | - Drew S Kern
- Department of Neurology, University of Colorado-Anschutz Medical Center, Denver, Colorado, USA
| | - Jean Tsai
- Department of Neurology, University of Colorado-Anschutz Medical Center, Denver, Colorado, USA
| | - Nuri F Ince
- Biomedical Engineering, University of Houston, Houston, Texas, USA
| | - Jianping Wu
- Neuromodulation Global Research, Medtronic, Minneapolis, Minnesota, USA
| | - John A Thompson
- Department of Neurosurgery, University of Colorado-Anschutz Medical Center, Denver, Colorado, USA
| | - Aviva Abosch
- Department of Neurosurgery, University of Colorado-Anschutz Medical Center, Denver, Colorado, USA
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Lin T, Man M, Elias P, Tsai C, Sheu H, Tsai J, Chih-Hung L. 431 Epidermal pigmentation regulates cutaneous inflammation. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Peng YKM, Neumeyer CA, Fogarty PJ, Kessel C, Strickler DJ, Rutherford P, Mikkelsen D, Burgess TW, Sabbagh S, Menard J, Gates D, Bell R, LeBlanc B, Mitarai O, Schmidt J, Synakowski E, Tsai J, Grisham L, Nelson BE, Cheng ET, El-Guebaly L. Fusion Engineering and Plasma Science Conditions of Spherical Torus Component Test Facility. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Y.-K. M. Peng
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
- on assignment at Princeton Plasma Physics Laboratory
| | - C. A. Neumeyer
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - P. J. Fogarty
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
| | - C. Kessel
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - D. J. Strickler
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
| | - P. Rutherford
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - D. Mikkelsen
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - T. W. Burgess
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
| | - S Sabbagh
- Columbia University, New York, New York
- on assignment at Princeton Plasma Physics Laboratory
| | - J. Menard
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - D Gates
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - R Bell
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - B LeBlanc
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - O. Mitarai
- Kyushu Tokai University, Kumamoto, Japan
| | - J. Schmidt
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - E. Synakowski
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - J. Tsai
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
| | - L. Grisham
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543
| | - B. E. Nelson
- Oak Ridge National Laboratory – UT Battelle, P.O. Box 2009, Oak Ridge, Tennessee 37831
| | - E. T. Cheng
- TSI Research, Solano Beach, California 92075
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Pikalov A, Goldberg J, Mao Y, Siu C, Tsai J, Calabrese J, Loebel A. Lurasidone for the Treatment of Major Depressive Disorder with Mixed Features: Do Manic Symptoms Moderate Treatment Response? Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.02.018] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BackgroundThis post-hoc analysis evaluated whether the efficacy of lurasidone in major depressive disorder (MDD) with mixed features is moderated by the number and characteristics of manic symptoms present at study baseline.MethodsPatients meeting DSM-IV-TR criteria for MDD who presented with two or three manic symptoms (consistent with the DSM–5 mixed features specifier) were randomly assigned to 6 weeks of double-blind treatment with either lurasidone 20–60 mg/d (n = 109) or placebo (n = 100). Finite mixture models were applied to identify latent class patterns of the 10 baseline manic symptoms.ResultsThree latent class profiles were identified: 105 (50.5%) patients had manic symptom profile 1 (MIX 1) with mean MADRS 33.0, mean YMRS 9.2, mean number of manic symptoms 3.8; 63 (30.3%) patients had manic symptom profile 2 (MIX 2) with similar baseline mean MADRS (32.4) and YMRS (9.3) and lower number of manic symptoms 3.5; 40 patients had manic symptom profile 3 (MIX 3) with significantly higher severity scores in MADRS (35) and YMRS (14.9) and mean number of manic symptoms 4.6. A significant moderating effect on change in YMRS score was observed for the “decreased need for sleep” symptom, with greater lurasidone effect size (vs. Placebo) found in patients without vs. With this symptom (P < 0.05).ConclusionsIn this post-hoc analysis of a placebo-controlled trial involving MDD patients with mixed features, absence of “decreased need for sleep” was found to be significantly associated with improvement in manic and depressive symptoms and to moderate the treatment effect on manic symptoms.Disclosure of interestI am full time employee of Sunovion pharmaceuticals Inc.
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Braekkan SK, Grosse SD, Okoroh EM, Tsai J, Cannegieter SC, Naess IA, Krokstad S, Hansen JB, Skjeldestad FE. Venous thromboembolism and subsequent permanent work-related disability. J Thromb Haemost 2016; 14:1978-1987. [PMID: 27411161 PMCID: PMC5083219 DOI: 10.1111/jth.13411] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 04/21/2016] [Accepted: 06/19/2016] [Indexed: 11/28/2022]
Abstract
Essentials The burden of venous thromboembolism (VTE) related to permanent work-related disability is unknown. In a cohort of 66 005 individuals, the risk of work-related disability after a VTE was assessed. Unprovoked VTE was associated with 52% increased risk of work-related disability. This suggests that indirect costs due to loss of work time may add to the economic burden of VTE. SUMMARY Background The burden of venous thromboembolism (VTE) related to permanent work-related disability has never been assessed among a general population. Therefore, we aimed to estimate the risk of work-related disability in subjects with incident VTE compared with those without VTE in a population-based cohort. Methods From the Tromsø Study and the Nord-Trøndelag Health Study (HUNT), Norway, 66 005 individuals aged 20-65 years were enrolled in 1994-1997 and followed to 31 December 2008. Incident VTE events among the study participants were identified and validated, and information on work-related disability was obtained from the Norwegian National Insurance Administration database. Cox-regression models using age as time-scale and VTE as time-varying exposure were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for sex, body mass index, smoking, education level, marital status, history of cancer, diabetes, cardiovascular disease and self-rated general health. Results During follow-up, 384 subjects had a first VTE and 9862 participants were granted disability pension. The crude incidence rate of work-related disability after VTE was 37.5 (95% CI, 29.7-47.3) per 1000 person-years, vs. 13.5 (13.2-13.7) per 1000 person-years among those without VTE. Subjects with unprovoked VTE had a 52% higher risk of work-related disability than those without VTE (HR, 1.52; 95% CI, 1.09-2.14) after multivariable adjustment, and the association appeared to be driven by deep vein thrombosis. Conclusion VTE was associated with subsequent work-related disability in a cohort recruited from the general working-age population. Our findings suggest that indirect costs because of loss of work time may add to the economic burden of VTE.
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Affiliation(s)
- S K Braekkan
- K.G.Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway.
- Hematological Research Group (HERG), Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway.
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.
| | - S D Grosse
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - E M Okoroh
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J Tsai
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S C Cannegieter
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - I A Naess
- Department of Hematology, Trondheim University Hospital, Trondheim, Norway
| | - S Krokstad
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
| | - J-B Hansen
- K.G.Jebsen Thrombosis Research and Expertise Center (TREC), Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
- Hematological Research Group (HERG), Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - F E Skjeldestad
- Research Group Epidemiology of Chronic Diseases, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
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Thor M, Owosho A, Rosenburg H, Yom S, Oh J, Riaz N, Tsai J, Lee N, Huryn J, Estilo C, Deasy J. WE-AB-207B-08: Exploring and Refining the QUANTEC Guideline to Reduce Severe Hyposalivation Following IMRT for Head and Neck Cancer. Med Phys 2016. [DOI: 10.1118/1.4957789] [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: 11/07/2022] Open
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Cheng H, Pan D, Tsai J. SU-F-T-608: Forward Treatment Planning Techniques On Leksell Gamma Knife for the Normalization Effect Reduction. Med Phys 2016. [DOI: 10.1118/1.4956793] [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: 11/07/2022] Open
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Lasala J, Nick A, Ramirez P, Meyer L, Cain K, Munsell M, Iniesta M, Ifeanyi I, Singh J, Moon Calderon T, Kwater P, Tsai J, Vachhani S, Cata J, Mena G. Decreased intraoperative opioid consumption following institution of enhanced recovery program in open gynecologic surgery. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.155] [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: 10/21/2022]
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Sajatovic M, Forester B, Tsai J, Kroger H, Pikalov A, Cucchiaro J, Loebel A. Efficacy and Tolerability of Lurasidone in Older Adults with Bipolar Depression: Analysis of Two 6-week Double-blind, Placebo-controlled Studies. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30899-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Tsai J, El-Gabalawy R, Sledge WH, Southwick SM, Pietrzak RH. Post-traumatic growth among veterans in the USA: results from the National Health and Resilience in Veterans Study. Psychol Med 2015; 45:165-179. [PMID: 25065450 DOI: 10.1017/s0033291714001202] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is increasing recognition that, in addition to negative psychological consequences of trauma such as post-traumatic stress disorder (PTSD), some individuals may develop post-traumatic growth (PTG) following such experiences. To date, however, data regarding the prevalence, correlates and functional significance of PTG in population-based samples are lacking. METHOD Data were analysed from the National Health and Resilience in Veterans Study, a contemporary, nationally representative survey of 3157 US veterans. Veterans completed a survey containing measures of sociodemographic, military, health and psychosocial characteristics, and the Posttraumatic Growth Inventory-Short Form. RESULTS We found that 50.1% of all veterans and 72.0% of veterans who screened positive for PTSD reported at least 'moderate' PTG in relation to their worst traumatic event. An inverted U-shaped relationship was found to best explain the relationship between PTSD symptoms and PTG. Among veterans with PTSD, those with PTSD reported better mental functioning and general health than those without PTG. Experiencing a life-threatening illness or injury and re-experiencing symptoms were most strongly associated with PTG. In multivariable analysis, greater social connectedness, intrinsic religiosity and purpose in life were independently associated with greater PTG. CONCLUSIONS PTG is prevalent among US veterans, particularly among those who screen positive for PTSD. These results suggest that there may be a 'positive legacy' of trauma that has functional significance for veterans. They further suggest that interventions geared toward helping trauma-exposed US veterans process their re-experiencing symptoms, and to develop greater social connections, sense of purpose and intrinsic religiosity may help promote PTG in this population.
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Affiliation(s)
- J Tsai
- United States Department of Veterans Affairs,New England Mental Illness Research, Education, and Clinical Center,West Haven, CT,USA
| | - R El-Gabalawy
- Department of Psychology,University of Manitoba,Winnipeg, Manitoba,Canada
| | - W H Sledge
- Department of Psychiatry,Yale University School of Medicine,New Haven, CT,USA
| | - S M Southwick
- Department of Psychiatry,Yale University School of Medicine,New Haven, CT,USA
| | - R H Pietrzak
- Department of Psychiatry,Yale University School of Medicine,New Haven, CT,USA
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Tsai J, Occleshaw C, Roberts P, Lydon A, Shannhan C, Edwards K, Oliver G, Harrod M, Cowan B, Young A, Wasywich C. MRI-augmented right heart catheterization: a pilot study. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.078] [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: 10/23/2022]
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Tsai J, Occleshaw C, Liu Y, Cowan B. A comparison of pulmonary blood flow quantification using a novel interleaved MRI sequence measuring flow at multiple sites simultaneously, versus sequential measurements at different sites. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.094] [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]
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Tejani N, Rosenheck R, Tsai J, Kasprow W, McGuire JF. Incarceration histories of homeless veterans and progression through a national supported housing program. Community Ment Health J 2014; 50:514-9. [PMID: 23728839 DOI: 10.1007/s10597-013-9611-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Accepted: 05/19/2013] [Indexed: 11/26/2022]
Abstract
There is increasing concern that adults with a past history of incarceration are at particular disadvantage in exiting homelessness. Supported housing with case management has emerged as the leading service model for assisting homeless adults; however there has been limited examination of the success of adults with past history of incarceration in obtaining housing within this paradigm. Data were examined on 14,557 veterans who entered a national supported housing program for homeless veterans, the Housing and Urban Development-Veterans Affairs Supportive Housing program (HUD-VASH) during 2008 and 2009, to identify characteristics associated with a history of incarceration and to evaluate whether those with a history of incarceration are less likely to obtain housing and/or more likely to experience delays in the housing attainment process. Veterans who reported no past incarceration were compared with veterans with short incarceration histories (≤ 1 year) and those with long incarceration histories (>1 year). A majority of participants reported history of incarceration; 43 % reported short incarceration histories and 22 % reported long incarceration histories. After adjusting for baseline characteristics and site, history of incarceration did not appear to impede therapeutic alliance, progression through the housing process or obtaining housing. Within a national supported housing program, veterans with a history of incarceration were just as successful at obtaining housing in similar time frames when compared to veterans without any past incarceration. Supported housing programs, like HUD-VASH, appear to be able to overcome impediments faced by formerly incarcerated homeless veterans and therefore should be considered a a good model for housing assistance programs.
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Affiliation(s)
- N Tejani
- VA New England Mental Illness, Research, Education and Clinical Center, West Haven, CT, USA,
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Cheng Z, Wang J, Huang T, Li P, Yen N, Tsai J, Zhou Y, Jing L. A Situation-Oriented IoT Middleware for Resolution of Conflict Contexts Based on Combination of Priorities. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/978-94-007-7262-5_51] [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: 02/20/2023]
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Russell AW, Baxter KA, Askew DA, Tsai J, Ware RS, Jackson CL. Model of care for the management of complex Type 2 diabetes managed in the community by primary care physicians with specialist support: an open controlled trial. Diabet Med 2013; 30:1112-21. [PMID: 23758279 DOI: 10.1111/dme.12251] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 03/28/2013] [Accepted: 06/06/2013] [Indexed: 12/23/2022]
Abstract
AIMS To evaluate patient outcomes for a novel integrated primary/specialist model of community care for complex Type 2 diabetes mellitus management compared with outcomes for usual care at a tertiary hospital for diabetes outpatients. METHODS This was a prospective open controlled trial performed in a primary and tertiary care setting in Australia. A total of 330 patients with Type 2 diabetes aged >18 years were allocated to an intervention (n=185) or usual care group (n=145). The intervention arm was a community-based model of care led by a general practitioner with advanced skills and an endocrinologist partnership. Usual care was provided via the hospital diabetes outpatient department. The primary end point was HbA(1c) concentration at 12 months. Secondary end points included serum lipids and blood pressure. RESULTS The mean change in HbA1c concentration in the intervention group was -9 mmol/mol (-0.8%) at 12 months and in the usual care group it was -2 mmol/mol (-0.2%) (95% CI -5,1). The percentage of patients in the intervention group achieving the HbA(1c) target of ≤53 mmol/mol (7%) increased from 21 to 42% (P<0.001); for the usual care group there was a 1% increase to 39% of patients attaining this target (P=0.99). Patients in the intervention group experienced significant improvements in blood pressure and total cholesterol compared with those in the usual care group. The percentage of patients achieving clinical targets was greater in the intervention group for the combined target of HbA(1c) concentration, blood pressure and LDL cholesterol. CONCLUSIONS A community-based, integrated model of complex diabetes care, delivered by general practitioners with advanced skills, produced clinical and process benefits compared with a tertiary diabetes outpatient clinic.
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Affiliation(s)
- A W Russell
- Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Qld, Australia.
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Tsai J, Bert RJ, Gilden D. Zoster paresis: asymptomatic MRI lesions far beyond the site of rash and focal weakness. J Neurol Sci 2013; 330:119-20. [PMID: 23628467 DOI: 10.1016/j.jns.2013.04.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 03/07/2013] [Accepted: 04/10/2013] [Indexed: 11/27/2022]
Abstract
We describe a patient with zoster paresis and an MRI that revealed extensive spinal cord lesions from the upper cervical to the lower thoracic spinal cord. Importantly, the patient reported considerable spontaneous improvement in strength 2-3 weeks after zoster. This report reveals a previously undescribed remarkable preponderance of MRI lesions far beyond the site of zoster rash and focal lower motor neuron weakness.
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Affiliation(s)
- Jean Tsai
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
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Affiliation(s)
- Jean Tsai
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
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Choudhuri K, Llodrá J, Roth EW, Tsai J, Gordo S, Wucherpfennig KW, Kam L, Stokes DL, Dustin ML. Polarized release of TCR‐enriched microvesicles at the center of the T cell immunological synapse. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.553.24] [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]
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Tsai J, Minneci P, Sulkowski J, Cooper J, Deans K. Decreased Sensitivity and Positive Predictive Value of Ultrasound Findings in the Diagnosis of Pediatric Cholecystitis. J Surg Res 2013. [DOI: 10.1016/j.jss.2012.10.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bernstad A, Davidsson A, Tsai J, Persson E, Bissmont M, la Cour Jansen J. Tank-connected food waste disposer systems--current status and potential improvements. Waste Manag 2013; 33:193-203. [PMID: 23122206 DOI: 10.1016/j.wasman.2012.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 09/17/2012] [Accepted: 09/30/2012] [Indexed: 06/01/2023]
Abstract
An unconventional system for separate collection of food waste was investigated through evaluation of three full-scale systems in the city of Malmö, Sweden. Ground food waste is led to a separate settling tank where food waste sludge is collected regularly with a tank-vehicle. These tank-connected systems can be seen as a promising method for separate collection of food waste from both households and restaurants. Ground food waste collected from these systems is rich in fat and has a high methane potential when compared to food waste collected in conventional bag systems. The content of heavy metals is low. The concentrations of N-tot and P-tot in sludge collected from sedimentation tanks were on average 46.2 and 3.9 g/kg TS, equalling an estimated 0.48 and 0.05 kg N-tot and P-tot respectively per year and household connected to the food waste disposer system. Detergents in low concentrations can result in increased degradation rates and biogas production, while higher concentrations can result in temporary inhibition of methane production. Concentrations of COD and fat in effluent from full-scale tanks reached an average of 1068 mg/l and 149 mg/l respectively over the five month long evaluation period. Hydrolysis of the ground material is initiated between sludge collection occasions (30 days). Older food waste sludge increases the degradation rate and the risks of fugitive emissions of methane from tanks between collection occasions. Increased particle size decreases hydrolysis rate and could thus decrease losses of carbon and nutrients in the sewerage system, but further studies in full-scale systems are needed to confirm this.
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Affiliation(s)
- A Bernstad
- Water and Environmental Engineering, Department of Chemical Engineering, Lund University, Sweden.
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Su F, Xu L, Higgings B, Yang H, Packman K, Hilton H, Schostack K, Bollag G, Tsai J, Habets G. 372 Preclinical Characterization of RG7256, a Potent and Selective BRAF Inhibitor with Differentiation From Vemurafenib. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72170-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hartrampf S, Dudakov J, Johnson L, Smith O, Tsai J, Singer N, West M, Hanash A, Liu B, Toth M, Van Den Brink M. The Cns in Acute GVHD: Development and Effects. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.412] [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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Tsai J, Wade A, Norcia A. Dynamics and neural computations underlying visual masking. J Vis 2011. [DOI: 10.1167/11.15.14] [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: 11/24/2022] Open
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Yu H, Chen C, Tsai J, Chung T. Quantifying the Accuracy of Intrafractional Internal Target Volume Margin in Stereotactic Body Radiotherapy for Prostate Cancer Using CyberKnife Tumor Tracking System. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1561] [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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Lee H, Chung T, Ting L, Chen S, Hsiao S, Lai I, Liu E, Chiu J, Tsai J. EGFR Mutations Associated With Superior Intracranial Response and Progression-free Survival After Brain Irradiation in Non-small Cell Lung Cancer With Brain Metastasis. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1119] [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: 10/15/2022]
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Tsai J, Cohrs RJ, Nagel MA, Mahalingam R, Schmid DS, Choe A, Gilden D. Reactivation of type 1 herpes simplex virus and varicella zoster virus in an immunosuppressed patient with acute peripheral facial weakness. J Neurol Sci 2011; 313:193-5. [PMID: 21924743 DOI: 10.1016/j.jns.2011.08.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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: 07/11/2011] [Revised: 08/23/2011] [Accepted: 08/29/2011] [Indexed: 12/29/2022]
Abstract
We describe a 26-year-old man treated with azathioprine for myasthenia gravis who developed acute left-sided peripheral facial weakness. Brain magnetic resonance imaging (MRI) revealed enhancement in the left geniculate ganglion and in the intracanalicular and tympanic segments of the facial nerve. Analysis of cerebrospinal fluid (CSF) and serum revealed intrathecal synthesis of anti-varicella zoster virus (VZV) IgG antibody. Although previous analyses of saliva, blood mononuclear cells, serum antibodies, middle ear fluid, and auricular and geniculate zone skin scrapings have shown that a small but definite proportion of patients with idiopathic peripheral facial palsy ("Bell's palsy") have the Ramsay Hunt syndrome zoster sine herpete (RHS ZSH), this is the first confirmation of RHS ZSH by intrathecal synthesis of anti-VZV IgG antibody. In addition, herpes simplex virus (HSV)-1 DNA was found in saliva of the patient on 3 consecutive days. Simultaneous reactivation of two alphaherpesviruses (HSV-1 and VZV) in our immunosuppressed patient underscores the need to consider opportunistic infection as a cause of facial weakness.
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Affiliation(s)
- Jean Tsai
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
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