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Legha RK, Richards M, Mabeza RM, Gordon-Achebe K, Kataoka S. Teaching the Legacy of Slavery in American Medicine and Psychiatry to Medical Students: Feasibility, Acceptability, Opportunities for Growth. MedEdPORTAL 2023; 19:11349. [PMID: 37766875 PMCID: PMC10520221 DOI: 10.15766/mep_2374-8265.11349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 06/14/2023] [Indexed: 09/29/2023]
Abstract
Introduction Understanding the legacy of slavery in the United States is crucial for engaging in anti-racism that challenges racial health inequities' root causes. However, few medical educational curricula exist to guide this process. We created a workshop illustrating key historical themes pertaining to this legacy and grounded in critical race theory. Methods During a preclinical psychiatry block, a second-year medical school class, divided into three groups of 50-60, attended the workshop, which comprised a 90-minute lecture, 30-minute break, and 60-minute small-group debriefing. Afterwards, participants completed an evaluation assessing self-reported knowledge, attitudes and beliefs, and satisfaction with the workshop. Results One hundred eighty students watched the lecture, 15 attended small-group debriefings, and 132 completed the survey. Seventy-six percent (100) reported receiving no, very little, or some prior exposure to the legacy of slavery in American medicine and psychiatry. Over 80% agreed or strongly agreed that the workshop made them more aware of this legacy and that the artwork, photographs, storytelling, and media (videos) facilitated learning. Qualitative feedback highlighted how the workshop improved students' knowledge about the legacy of slavery's presence in medicine and psychiatry. However, students criticized the lecture's scripted approach and requested more discussion, dialogue, interaction, and connection of this history to anti-racist action they could engage in now. Discussion Though this workshop improved awareness of the legacy of slavery, students criticized its structure and approach. When teaching this legacy, medical schools should consider expanding content, ensuring opportunities for discussion in safe spaces, and connecting it to immediate anti-racist action.
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Affiliation(s)
| | - Misty Richards
- Assistant Clinical Professor and Program Director, Child and Adolescent Psychiatry Fellowship, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine
| | | | - Kimberly Gordon-Achebe
- Assistant Clinical Professor and Program Director, Child and Adolescent Psychiatry Fellowship, Department of Psychiatry, University of Maryland School of Medicine
| | - Sheryl Kataoka
- Professor Emeritus and Associate Program Director, Child and Adolescent Psychiatry Fellowship, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine
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Schreiber J, Richards M. The Hidden Meaning. J Am Acad Child Adolesc Psychiatry 2023; 62:1064. [PMID: 37230285 DOI: 10.1016/j.jaac.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023]
Abstract
In high school English class, I remember teachers telling us to look for the deeper meaning. We learned how to identify symbolism in each page. For example, who do these talking animals really represent, why is someone so intent on catching a whale, and why are we reading about people's view of the future written almost a hundred years ago? This is how we learn to look for the hidden meaning of the text, to open the key to the author's intended message. The reason for the meaning to be hidden can vary. Maybe there is fear of being too blunt due to the political landscape, or perhaps innuendo or euphemisms are more intriguing as they draw people in and encourage deeper thinking. The hard part is we don't always know if this interpretation is the author's intended meaning or if we are overreaching and coming up with our own. Sometimes there are historical conversations with the author that clarify the hidden meaning. At the end of the day, I don't think it matters that we perfectly understand the author's hidden meaning. It is much more fun if we can develop our own meaning and use the stories we read as the context that brings out that meaning. I am sure most authors would love to know that their stories made us stop and think. These reviews think through the hidden meaning within books in unique ways that make us stop and think as child psychiatrists, pondering what we may have missed the first time around.
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Richards M, Schreiber J. August 2023 Book Forum: "The Practice of Holding Space". J Am Acad Child Adolesc Psychiatry 2023:S0890-8567(23)00183-1. [PMID: 37075889 DOI: 10.1016/j.jaac.2023.04.009] [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] [Received: 03/21/2023] [Accepted: 04/10/2023] [Indexed: 04/21/2023]
Abstract
The benefits of savasana are magical. At the end of a rigorous yoga practice, you perform this pose and accept the challenge of relaxing the body while remaining mentally present. It is harder than it looks, and opens the door to the "space between" where thoughts fade away and stillness takes center stage. Admittedly, savasana is my favorite yoga pose. It is where I practice holding space for myself before I hold space for others. And, let's face it, it takes a different skillset than the "handstand scorpion" pose that sounds just as intimidating as it is to attempt (ouch).
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Richards M, Schreiber J. Book Forum: An Introduction to the JAACAP Open Editorial Team. J Am Acad Child Adolesc Psychiatry 2023; 62:472. [PMID: 36587652 DOI: 10.1016/j.jaac.2022.12.011] [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] [Received: 12/03/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022]
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Schreiber J, Richards M, Novins DK, Althoff R, Fortuna L, Fristad MA, Doyle AE, DelBello MP, Middeldorp C. Book Forum: An Introduction to the JAACAP Editorial Team. J Am Acad Child Adolesc Psychiatry 2023; 62:358. [PMID: 36528244 DOI: 10.1016/j.jaac.2022.12.004] [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] [Received: 11/08/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022]
Abstract
Children's books are often our first window into the magic of the written word. As child and adolescent psychiatrists, these books not only lay a foundation for our own introduction into reading, but also are a tool used to connect with the youth and families we serve. We felt there was no better way to continue to introduce some of the new members of JAACAP's Editorial Board than through reading reviews of their favorite children's books. Featured are book reviews from the JAACAP Editor-in-Chief, Associate Editor, and new Deputy Editors. Next month we will highlight children's book reviews from members of JAACAPOpen's inaugural Editorial Board.
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Richards M, Schreiber J. Superheroes. J Am Acad Child Adolesc Psychiatry 2023; 62:699-700. [PMID: 36842546 DOI: 10.1016/j.jaac.2023.02.008] [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] [Received: 01/24/2023] [Accepted: 02/17/2023] [Indexed: 02/28/2023]
Abstract
This framed quote hangs above my 5-year-old son's "costume corner" that overflows with capes, masks, and uncomfortable looking unitards. I am not sure that he truly understands the meaning of this iconic quote, although I am positive that he believes in the power of Spider-Man. Superhero films take place in epic settings under extraordinarily challenging circumstances. The best ones, at their heart, represent a grounded story with an astonishing level of humanity. Beyond the special effects and flashy cinematography, modern-day superheroes cope with the human experience and help viewers connect to the part of themselves that believes in redemption, potential, and a little bit of magic. Heroes have no shortage of traumatic experiences, although what sets them apart, and gives people hope, is the strength of their character that allows them to overcome. Perhaps less flashy but equally important is the fact that behind every superhero is an unwavering source of support and emotional fuel in the form of a caregiver, a mentor, and/or a true believer.
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Kehoe K, Morden E, Jacobs T, Zinyakatira N, Smith M, Heekes A, Murray J, le Roux DM, Wessels T, Richards M, Eley B, Jones HE, Redaniel MT, Davies MA. Comparison of paediatric infectious disease deaths in public sector health facilities using different data sources in the Western Cape, South Africa (2007-2021). BMC Infect Dis 2023; 23:104. [PMID: 36814192 PMCID: PMC9945739 DOI: 10.1186/s12879-023-08012-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/17/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Routinely collected population-wide health data are often used to understand mortality trends including child mortality, as these data are often available more readily or quickly and for lower geographic levels than population-wide mortality data. However, understanding the completeness and accuracy of routine health data sources is essential for their appropriate interpretation and use. This study aims to assess the accuracy of diagnostic coding for public sector in-facility childhood (age < 5 years) infectious disease deaths (lower respiratory tract infections [LRTI], diarrhoea, meningitis, and tuberculous meningitis [TBM]) in routine hospital information systems (RHIS) through comparison with causes of death identified in a child death audit system (Child Healthcare Problem Identification Programme [Child PIP]) and the vital registration system (Death Notification [DN] Surveillance) in the Western Cape, South Africa and to calculate admission mortality rates (number of deaths in admitted patients per 1000 live births) using the best available data from all sources. METHODS The three data sources: RHIS, Child PIP, and DN Surveillance are integrated and linked by the Western Cape Provincial Health Data Centre using a unique patient identifier. We calculated the deduplicated total number of infectious disease deaths and estimated admission mortality rates using all three data sources. We determined the completeness of Child PIP and DN Surveillance in identifying deaths recorded in RHIS and the level of agreement for causes of death between data sources. RESULTS Completeness of recorded in-facility infectious disease deaths in Child PIP (23/05/2007-08/02/2021) and DN Surveillance (2010-2013) was 70% and 69% respectively. The greatest agreement in infectious causes of death were for diarrhoea and LRTI: 92% and 84% respectively between RHIS and Child PIP, and 98% and 83% respectively between RHIS and DN Surveillance. In-facility infectious disease admission mortality rates decreased significantly for the province: 1.60 (95% CI: 1.37-1.85) to 0.73 (95% CI: 0.56-0.93) deaths per 1000 live births from 2007 to 2020. CONCLUSION RHIS had accurate causes of death amongst children dying from infectious diseases, particularly for diarrhoea and LRTI, with declining in-facility admission mortality rates over time. We recommend integrating data sources to ensure the most accurate assessment of child deaths.
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Affiliation(s)
- K. Kehoe
- grid.7836.a0000 0004 1937 1151Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa ,grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK ,Health Intelligence Directorate, Western Cape Government Health, Cape Town, South Africa
| | - E. Morden
- Health Intelligence Directorate, Western Cape Government Health, Cape Town, South Africa ,grid.7836.a0000 0004 1937 1151Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - T. Jacobs
- Health Intelligence Directorate, Western Cape Government Health, Cape Town, South Africa
| | - N. Zinyakatira
- Health Intelligence Directorate, Western Cape Government Health, Cape Town, South Africa ,grid.7836.a0000 0004 1937 1151Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - M. Smith
- grid.7836.a0000 0004 1937 1151Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa ,Health Intelligence Directorate, Western Cape Government Health, Cape Town, South Africa
| | - A. Heekes
- grid.7836.a0000 0004 1937 1151Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa ,Health Intelligence Directorate, Western Cape Government Health, Cape Town, South Africa
| | - J. Murray
- Department of Paediatrics and Neonatology, Paarl Hospital, Cape Town, South Africa
| | - D. M. le Roux
- grid.415742.10000 0001 2296 3850Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
| | - T. Wessels
- grid.11956.3a0000 0001 2214 904XDistrict Paediatrician Cape Town Metro East, Department of Paediatrics and Child Health, Tygerberg Hospital, Stellenbosch University, Stellenbosch, South Africa
| | - M. Richards
- grid.415742.10000 0001 2296 3850Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa ,grid.7836.a0000 0004 1937 1151Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - B. Eley
- grid.415742.10000 0001 2296 3850Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa ,grid.415742.10000 0001 2296 3850Paediatric Infectious Diseases Unit, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| | - H. E. Jones
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - M. T. Redaniel
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK ,grid.410421.20000 0004 0380 7336The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - M. A. Davies
- grid.7836.a0000 0004 1937 1151Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa ,Health Intelligence Directorate, Western Cape Government Health, Cape Town, South Africa ,grid.7836.a0000 0004 1937 1151Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Schreiber J, Richards M. Book Forum: An Introduction to Your New Assistant Editors. J Am Acad Child Adolesc Psychiatry 2023; 62:272-273. [PMID: 36442610 DOI: 10.1016/j.jaac.2022.11.005] [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] [Received: 10/13/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022]
Abstract
Be it books, movies, TV shows, comics, Tik Tok videos, etc, media has influenced us from infancy to today. It draws us in for entertainment, facilitates travel to faraway places, and provides a source of relaxation and fun after those challenging days at work. It weaves together shared experiences and special moments as we introduce children's books and programming to our own children. Media informed our education to becoming child and adolescent psychiatrists from the first text books we opened (in grammar school? Medical school?) to the journal articles we read today to stay up-to-date with the current evidence base. This is why we feel privileged to take over as editors of the Book Forum, to provide a sampling of the media sources that you might want to dive into with your limited free time. We hope to provide this space as a place to explore different types of media and how it can be used for knowledge, as a tool to grow our expertise, as a source of fun, and as a way to connect and empathize with the families with whom we work. As Book Forum editors, our goal is to collaborate with all of you, your families, and your patients to help us identify what should fill these pages. Please reach out to provide feedback on what you want to see, or, better yet, write a review about your favorite media source that needs to be shared. There are millions of books published annually worldwide, not to mention the amount of other new content, so the only way we can curtail this new content is with your guidance. That being said, we won't be able to review and publish every source that is recommended to or sent to us, so we apologize in advance if something doesn't make it to the Book Forum. We also wanted to introduce you to who we are, to help identify some of our influence in the direction of the Book Forum.
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Affiliation(s)
- Justin Schreiber
- Assistant Professor of Psychiatry and Pediatrics, University of Pittsburgh Medica Center, Western Psychiatric Hospital
| | - Misty Richards
- Assistant Professor of Psychiatry and OB-GYN, University of California, Los Angeles
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Schreiber J, Richards M. The Search for Our Identity. J Am Acad Child Adolesc Psychiatry 2023; 62:601. [PMID: 36708922 DOI: 10.1016/j.jaac.2023.01.008] [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] [Received: 12/23/2022] [Accepted: 01/18/2023] [Indexed: 01/27/2023]
Abstract
Identity has been a part of psychiatry from its roots. Sigmund Freud's description of the id, ego, and super ego reflects the various identities that lie within each of us. Carl Jung introduced the development of our identity through the stages of life. We have identity disorders in the DSM. In psychiatry, we diagnose patients, and that diagnosis can meaningfully impact identity formation. It plays a part in the way persons views themselves while also influencing how they are perceived by others. The discussion of identity development through our experiences and how we view our current identity plays an integral role in therapy. This month's Book Forum focuses on 3 books that look at identity through various lenses of experience, diagnosis, and treatment. Although they provide just a snapshot, it is clear from these reviews the significant impact that these books made on the reader.
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Coutrot A, Lazar AS, Richards M, Manley E, Wiener JM, Dalton RC, Hornberger M, Spiers HJ. Reported sleep duration reveals segmentation of the adult life-course into three phases. Nat Commun 2022; 13:7697. [PMID: 36509747 PMCID: PMC9744828 DOI: 10.1038/s41467-022-34624-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 11/01/2022] [Indexed: 12/15/2022] Open
Abstract
Classically the human life-course is characterized by youth, middle age and old age. A wide range of biological, health and cognitive functions vary across this life-course. Here, using reported sleep duration from 730,187 participants across 63 countries, we find three distinct phases in the adult human life-course: early adulthood (19-33yrs), mid-adulthood (34-53yrs), and late adulthood (54+yrs). They appear stable across culture, gender, education and other demographics. During the third phase, where self-reported sleep duration increases with age, cognitive performance, as measured by spatial navigation, was found to have an inverted u-shape relationship with reported sleep duration: optimal performance peaks at 7 hours reported sleep. World-wide self-reported sleep duration patterns are geographically clustered, and are associated with economy, culture, and latitude.
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Affiliation(s)
- A Coutrot
- LIRIS-CNRS-University of Lyon, Lyon, France.
| | - A S Lazar
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - M Richards
- Unit for Lifelong Health and Ageing, University College London, London, UK
| | - E Manley
- School of Geography, University of Leeds, Leeds, UK
| | - J M Wiener
- Department of Psychology, Bournemouth University, Poole, UK
| | - R C Dalton
- School of Architecture, Lancaster University, Lancaster, UK
| | - M Hornberger
- Norwich Medical School, University of East Anglia, Norwich, UK.
| | - H J Spiers
- Institute of Behavioural Neuroscience, University College London, London, UK.
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Topriceanu C, Weber M, Fiona C, Moon JC, Chaturvedi N, Hughes AD, Schott J, Richards M, Captur G. Heterozygous APOE ε4 carriage associates with improved myocardial efficiency in older age. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2243] [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
Carriage of the ancestral APOE ε4 allele confers a risk of developing Alzheimer's and coronary artery disease, but its persistence in human populations also suggests some potential survival advantages. To date it remains unclear whether APOE ε4 carriage independently associates with a better or worse long-term cardiac phenotype.
Purpose
Using data from the 1946 National Survey of Health and Development (NSHD) birth cohort, we investigated whether APOE ε4 carriage associates with adverse or beneficial left ventricular (LV) size and function parameters by echocardiography in older age.
Methods
Based on the presence or absence of APOE ε4, genotypes were divided into: non-APOE ε4 (ε2ε2, ε2ε3, ε3ε3), heterozygous-APOE ε4 (ε2ε4 and ε3ε4) and homozygous-APOE ε4 (ε4ε4). Echocardiographic data at 60–64 years included: left ventricular ejection fraction (LV EF), E/e', systolic and diastolic LV posterior wall and interventricular septal thickness (LVPWTs/d, IVSs/d), and body-surface area indexed LV mass (LVmassi) and myocardial contraction fraction (MCFi). Generalized linear models explored associations between APOE ε4 genotypes as exposures and echocardiographic biomarkers as outcomes. As a combination of gene variants, APOE ε genotype is expected to be an instrumental variable and therefore unconfounded. Thus, Model 1 was unadjusted. To obtain more precise regression estimates, Model 2 was adjusted for factors associated with the outcome, namely sex and socio-economic position (SEP). To explore the mechanistic pathway downstream of APOE ε genotype but upstream of the echocardiographic outcomes, subsequent models were adjusted for mediators as follows: Model 3 for body mass index, Model 4 for the presence of cardiovascular disease (CVD), Model 5 for diabetes, Model 6 for high cholesterol and Model 7 for hypertension.
Results
1464 participants were included. Compared to non-APOE ε4 and homozygous groups, heterozygous-APOE ε4 individuals had similar cardiac phenotypes in terms of EF, E/e', LVPWTs/d, IVSs/d and LVmassi but had a 7% higher MCFi 95% confidence interval [CI]: 1%-13%, p=0.017) which persisted even after adjustment for sex and SEP (95% CI 1%-12%, p=0.026) that was attenuated to 6% after adjustment for CVD (95% CI 0–13% p=0.050) and hypertension (95% CI 1–13% p=0.022).
Conclusion
The heterozygous-APOE ε4 state associates with improved myocardial shortening in older age resulting in greater LV stroke volume generation per 1 mL of myocardium. As we found no association between APOE ε4 carriage and LVPWTs/d, IVSs/d or LVmassi, MCFi enhancement may be mediated by improved myocardial energetics and contractility, with calcium and androgens potentially implicated, rather than through pathological ventricular thickening. Although a dose relationship is normally expected with ε4 carriage, any benefit from increased energetics and contractility is likely to be counterbalances by the higher risk of CVD and cardiovascular risk factors.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): UK Medical Research Council British Heart Foundation
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Affiliation(s)
- C Topriceanu
- University College London, UCL Institute of Cardiovascular Science , London , United Kingdom
| | - M Weber
- University College London, UCL Institute of Cardiovascular Science , London , United Kingdom
| | - C Fiona
- University College London, UCL Institute of Cardiovascular Science , London , United Kingdom
| | - J C Moon
- Barts Heart Centre , London , United Kingdom
| | - N Chaturvedi
- University College London, UCL MRC Unit of Lifelong Health and Ageing , London , United Kingdom
| | - A D Hughes
- University College London, UCL MRC Unit of Lifelong Health and Ageing , London , United Kingdom
| | - J Schott
- University College London, UCL MRC Unit of Lifelong Health and Ageing , London , United Kingdom
| | - M Richards
- University College London, UCL MRC Unit of Lifelong Health and Ageing , London , United Kingdom
| | - G Captur
- University College London, UCL MRC Unit of Lifelong Health and Ageing , London , United Kingdom
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Sobowale K, Richards M, Dixon LB. Perinatal Psychiatry: Improving Access to Perinatal Mental Health Care. Psychiatr Serv 2022; 73:116-117. [PMID: 34974744 DOI: 10.1176/appi.ps.2021.73102] [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: 11/30/2022]
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Richards M, Ferber J, Swor E, Frescholtz T, Li DK, Darrow LA. Intrapartum antibiotics and childhood asthma and allergic rhinitis: a retrospective cohort study. BJOG 2021; 129:722-730. [PMID: 34665922 DOI: 10.1111/1471-0528.16977] [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] [Accepted: 07/24/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to evaluate the association between intrapartum antibiotics (IABX) and asthma and allergic rhinitis among children by ages 6, 8 and 10 years. DESIGN Retrospective cohort. SETTING AND POPULATION Data were collected though Kaiser Permanente Northern California's (KPNC) integrated healthcare system. Children were eligible if they were born in a KPNC hospital between 1997 and 2012 and stayed enrolled through age 6. METHODS Modified Poisson regressions with robust error variances were used to estimate risk ratios for IABX and each outcome at each follow-up age during two separate time periods: 1997-2004 (n = 91 739) and 2005-2012 (n = 108 314). MAIN OUTCOME MEASURES Asthma and allergic rhinitis by ages 6, 8 and 10. RESULTS The proportion of women receiving IABX increased drastically over the study period (from 4% in 1997 to 49% in 2011), while the incidence of asthma (8%) and allergic rhinitis (6%) stayed relatively stable. In adjusted models, risk ratios for the association between IABX and asthma and allergic rhinitis were largely compatible with the null, with some slightly elevated risk ratios observed. For births from 1997 to 2004, risk ratios for asthma were 1.08 (95% CI 1.00-1.17) at age 6, 1.05 (95% CI 0.97-1.15) at age 8, and 1.08 (95% CI 0.99-1.18) at age 10. For births from 2005 to 2012, risk ratios were 1.00 (95% CI 0.95-1.04) at age 6, 1.07 (95% CI 1.01-1.12) at age 8, and 1.11 (95% CI 1.03-1.20) at age 10. CONCLUSIONS Exposure to intrapartum antibiotics is not a strong predictor of childhood asthma or allergic rhinitis risk. TWEETABLE ABSTRACT Exposure to intrapartum antibiotics is not a strong predictor of childhood asthma or allergic rhinitis risk.
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Affiliation(s)
- M Richards
- School of Public Health, University of Nevada, Reno, NV, USA
| | - J Ferber
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - E Swor
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - T Frescholtz
- School of Medicine, University of Nevada, Reno, NV, USA
| | - D-K Li
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - L A Darrow
- School of Public Health, University of Nevada, Reno, NV, USA
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Doudesis D, Lee KK, Anwar M, Astengo F, Newby D, Japp A, Tsanas A, Shah A, Richards M, McMurray J, Mueller C, Januzzi J, Mills N. Machine learning to aid in the diagnosis of acute heart failure in the emergency department. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1040] [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: 11/12/2022] Open
Abstract
Abstract
Background
B-type natriuretic peptide (BNP) and mid-regional pro-atrial natriuretic peptide (MRproANP) testing are recommended to aid in the diagnosis of acute heart failure. However, the application of these biomarkers for optimal diagnostic performance is uncertain.
Methods
We performed a systematic review and harmonised individual patient-level data to evaluate the diagnostic performance of BNP and MRproANP for the diagnosis of acute heart failure using random-effects meta-analysis. We subsequently developed and externally validated a decision-support tool called CoDE-HF for both BNP and MRproANP that combines the natriuretic peptide concentrations with clinical variables using machine learning to report the probability of acute heart failure for an individual patient.
Results
Fourteen studies from 12 countries provided individual patient-level data in 8,493 patients for BNP and 3,847 patients for MRproANP, in whom, 48.3% (4,105/8,493) and 41.3% (1,611/3899) had an adjudicated diagnosis of acute heart failure, respectively. The negative and positive predictive values of guideline-recommended thresholds for BNP (100 pg/mL) and MR-proANP (120 pg/mL) were 93.6% (95% confidence interval 88.4–96.6%) and 68.8% (62.9–74.2%), and 95.6% (92.2–97.6%) and 64.8% (56.3–72.5%), respectively. However, we observed significant heterogeneity in the diagnostic performance across important patient subgroups (Figure 1). In the external validation cohort, CoDE-HF was well calibrated with excellent discrimination in those without prior acute heart failure for both BNP and MRproANP (area under the curve of 0.946 [0.933–0.958] and 0.943 [0.921–0.964], and Brier scores of 0.105 and 0.073, respectively). CoDE-HF performed consistently across all subgroups for both BNP and MRproANP, and identified 30% and 65.7% at low-probability (negative predictive value of 99.1% [98.8–99.3%] and 99.1% [98.8–99.4%]), and 30% and 17.3% at high-probability (positive predictive value of 91.3% [90.7–91.9%] and 70.0% [68.5–71.4%]) in those without prior heart failure, respectively (Figure 2).
Conclusion
In an international collaborative analysis, we observed that guideline-recommended thresholds for BNP and MRproANP to diagnose acute heart failure varied significantly across patient subgroups. A decision-support tool using machine learning to combine natriuretic peptides as a continuous measure and other clinical variables provides a more accurate and individualised approach.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Medical Research Council and British Heart Foundation Figure 1. NPV of BNP threshold (100 pg/mL)Figure 2. NPV of the CoDE-HF rule-out score
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Affiliation(s)
- D Doudesis
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - K K Lee
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - M Anwar
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - F Astengo
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - D Newby
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - A Japp
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - A Tsanas
- University of Edinburgh, Usher Institute, Edinburgh, United Kingdom
| | - A Shah
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - M Richards
- University of Otago, Christchurch Heart Institute, Christchurch, New Zealand
| | - J McMurray
- University of Glasgow, BHF Cardiovascular Research Centre, Glasgow, United Kingdom
| | - C Mueller
- University Hospital Basel, Cardiovascular Research Institute of Basel, Basel, Switzerland
| | - J Januzzi
- Massachusetts General Hospital, Division of Cardiology, Boston, Massachusetts, United States of America
| | - N Mills
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
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15
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Dercon Q, Nicholas J, James SN, Schott J, Richards M. 488 GRIP STRENGTH FROM MIDLIFE AS AN INDICATOR OF LATER-LIFE COGNITION AND BRAIN HEALTH: EVIDENCE FROM A BRITISH BIRTH COHORT. Age Ageing 2021. [DOI: 10.1093/ageing/afab118.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Grip strength is an objective measure of physical function with potential predictive value for health in ageing populations. We aimed to assess whether levels and changes in grip strength from midlife predicted later-life brain health and cognition.
Methods
446 participants in an ongoing British birth cohort study, the MRC National Survey of Health and Development (NSHD), had their maximum grip strength measured at ages 53, 60–64, and 69, and underwent neuroimaging as part of its neuroscience sub-study, Insight 46, at 69–71. A group-based trajectory model identified latent groups of individuals in the whole NSHD cohort with below- and above-average grip strength over time, plus a reference group. Trajectory group membership, plus standardised grip strength levels and change from age 53, were each related to MRI-derived measures of whole-brain volume (WBV) and white-matter hyperintensity volume (WMHV), plus several cognitive tests. Models were adjusted for sex, body size, head size (where appropriate), sociodemographics, and behavioural and vascular risk factors.
Results
Consistently below-average grip strength from midlife was associated with lower WBV and non-verbal reasoning ability at age 69–71 (e.g. low group WBV vs. reference group β = −13.38 cm^3; 95% CI = (−24.12 cm^3, −2.64 cm^3); p = 0.015). There was some accompanying evidence that above-average maximum grip strength showed a positive association with WBV, which was more pronounced in female participants (high group female WBV vs. reference group β = 18.30 cm^3; 95% CI = (1.34 cm^3, 35.29 cm^3); p = 0.034). Steeper than average declines in grip strength between 53 and 69 were additionally weakly associated with an estimated 10% higher WMHV at age 69–71 (β = 1.10, 95% CI = (1.00, 1.22); p = 0.053).
Conclusion
This study provides preliminary evidence that tests of maximum grip strength may have value in predicting brain health. Future work should assess how these observed differences relate to later-life negative health outcomes, and whether changes in grip strength reflect concurrent changes in brain structure and connectivity.
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Affiliation(s)
- Q Dercon
- MRC Cognition & Brain Sciences Unit, University of Cambridge
| | - J Nicholas
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine
| | - S-N James
- MRC Unit for Lifelong Health & Ageing, University College London
| | - J Schott
- Dementia Research Centre, University College London
| | - M Richards
- MRC Unit for Lifelong Health & Ageing, University College London
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16
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Legha RK, Richards M, Kataoka SH. Foundations in Racism: a Novel and Contemporary Curriculum for Child and Adolescent Psychiatry Fellows. Acad Psychiatry 2021; 45:61-66. [PMID: 33575965 PMCID: PMC7929942 DOI: 10.1007/s40596-021-01396-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 01/07/2021] [Indexed: 05/16/2023]
Affiliation(s)
- Rupinder K Legha
- David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, CA, USA.
| | - Misty Richards
- David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Sheryl H Kataoka
- David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, CA, USA
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17
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Holdaway M, Lewis L, Chew-Harris J, Richards M, Pemberton C, Appleby S. Erythroferrone can Diagnose Acute Decompensated Heart Failure in Patients Presenting With Breathlessness. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.05.044] [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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18
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Earle N, Poppe K, Cameron V, Aish S, Choi Y, Wall C, Stewart R, Kerr A, Harrison W, Devlin G, Pera V, Troughton R, Porter G, Gladding P, Rolleston A, Richards M, Legget M, Doughty R. Outcomes Among Patients With First-Time Acute Coronary Syndromes in New Zealand: The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS). Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.05.014] [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: 11/16/2022]
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19
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Abstract
The COVID-19 pandemic has altered many aspects of personal and professional life, including how psychiatry is practiced and how trainees are taught. This Open Forum outlines the challenges faced by psychiatric training directors in adult as well as child and adolescent psychiatry in meeting the educational needs of trainees amid this international crisis. Prioritizing trainee protection and education as well as high-quality treatment for patients, the authors discuss effective communication strategies, rapid telepsychiatry expansion into clinical practice, curricular adjustments, and the importance of well-being. This Open Forum concludes with reflections and considerations for training directors as they prepare for subsequent stages of the COVID-19 pandemic.
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Affiliation(s)
- Misty Richards
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles
| | - Katrina DeBonis
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles
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20
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Ziegler P, Rogers J, Richards M, Nichols A, Ferreira S, Koehler J, Sarkar S. Three year incidence and duration of atrial fibrillation episodes among a large, real-world population of cryptogenic stroke patients with insertable cardiac monitors. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0394] [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: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
The primary goal of monitoring for atrial fibrillation (AF) after cryptogenic stroke (CS) is secondary stroke prevention. Therefore, long-term monitoring of CS patients with insertable cardiac monitors (ICMs) is likely important to ensure appropriate secondary stroke prevention therapy, regardless of when AF is detected after the index event. However, long-term data on the incidence and duration of AF from real-world populations are sparse.
Purpose
To investigate the long-term incidence and duration of AF episodes in real-world clinical practice among a large population of patients with ICMs placed for AF detection following CS.
Methods
We included patients from a large device manufacturer's database who received an ICM for the purpose of AF detection following CS and were monitored for up to 3 years. All detected AF episodes (≥2 minutes) were adjudicated. We quantified the AF detection rate for various episode duration thresholds using Kaplan-Meier survival estimates, analyzed the maximum duration of AF episodes, and measured the time to initial AF detection.
Results
A total of 1247 patients (65.3±13.0 years, 53% male) were included and followed for 763±362 days. AF episodes (n=5456) were detected in 257 patients, resulting in a median frequency of 5 episodes [IQR 2–19] per patient. At 3 years, the AF detection rate for episodes ≥2 minutes was 24.2%. The AF detection rates at 3 years for episodes ≥6 minutes, ≥30 minutes, and ≥1 hour were 22.4%, 20.6%, and 19.1%, respectively. The median duration of the longest detected AF episode was 4.4 [IQR 1.2–13.9] hours and the median time to AF detection was 129 [IQR 45–354] days.
Conclusion
AF episodes were detected via ICMs in approximately one-quarter of CS patients within 3 years of follow-up. More than 75% of patients with AF detected had episodes lasting ≥1 hour and half had episodes lasting ≥4 hours. Detection of the first AF episode typically occurred beyond the range of conventional ambulatory monitors. Long-term surveillance of CS patients is likely important given the appreciable incidence, frequency, and duration of these AF episodes.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P.D Ziegler
- Medtronic, Mounds View, United States of America
| | - J.D Rogers
- Scripps Clinic, La Jolla, United States of America
| | - M Richards
- ProMedica Physicians Cardiology, Toledo, United States of America
| | - A.J Nichols
- OhioHealth Heart & Vascular Physicians, Columbus, United States of America
| | - S.W Ferreira
- SSM Health, Springfield, United States of America
| | - J.L Koehler
- Medtronic, Mounds View, United States of America
| | - S Sarkar
- Medtronic, Mounds View, United States of America
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21
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22
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Cunningham C, Dixon LB, Sawhney R, Robitz R, Richards M, Rodríguez Penney AT, Jordan A, Colon-Rivera H, Goldman ML, Zingman MA, Rolin SA. 2019 Editor's Choice Collections. Psychiatr Serv 2020; 71:105-107. [PMID: 31892287 DOI: 10.1176/appi.ps.71103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Carrie Cunningham
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Lisa B. Dixon
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Rishi Sawhney
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Rachel Robitz
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Misty Richards
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Alan Tomás Rodríguez Penney
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Ayana Jordan
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Héctor Colon-Rivera
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Matthew L. Goldman
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Michael A. Zingman
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
| | - Stephanie A. Rolin
- Early Career Psychiatrist Advisory Committee: Hector Colon-Rivera, M.D., M.R.O., Carrie Cunningham, M.D., M.P.H., Ayana Jordan, M.D., Ph.D., Misty C. Richards, M.D., M.S., Rachel Robitz, M.D., Alan Tomás Rodríguez Penney, M.D., Stephanie A. Rolin, M.D., Rishi Sawhney, M.D. Collections Editors: Carrie Cunningham, M.D., M.P.H., and Matthew L. Goldman, M.D., M.S
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23
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Yandle T, Richards M, Smith M, Charles C, Livesey J, Espiner E. Assay of Endopeptidase-24.11 Activity in Plasma Applied to In Vivo Studies of Endopeptidase Inhibitors. Clin Chem 2019. [DOI: 10.1093/clinchem/38.9.1785] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
We developed a fluorometric assay for endopeptidase-24.11 (EC 3.4.24.11) in human plasma. Substrate [glutaryl-Ala-Ala-Phe-amidomethylcoumarin(AMC)] was incubated with plasma (20 microL, 30 min, pH 7.6) with (control) or without the endopeptidase-24.11 inhibitor phosphoramidon. Further incubation with aminopeptidase M released free AMC. Within-assay CVs were 4.5% and 8.6%, respectively, at 3.31 and 0.27 nmol of AMC released per milliliter per minute. The between-assay CV was 10.4% at 0.31 nmol/mL per minute and the detection limit was 0.05 nmol/mL per minute. A highly skewed distribution of endopeptidase-24.11 in 41 normal samples was found, ranging from 0.12 to 6.84 nmol/mL per minute (median = 0.44). Mean endopeptidase-24.11 concentrations were significantly higher in hypertensive subjects (0.68 nmol/mL per minute) than in normotensive subjects (0.34 nmol/mL per minute; P less than 0.05). Compared with placebo administration, the oral endopeptidase-24.11 inhibitor UK 79300 significantly inhibited the plasma enzyme at doses of 100 mg (twice daily). Although in normotensive subjects the enzyme was unaffected with doses of 25 mg, the same dose (25 mg) inhibited the plasma enzyme in hypertensive subjects. No activity was detected in sheep plasma, but addition of exogenous endopeptidase-24.11 to sheep plasma in vitro allowed in vivo assessment of the effect of infused endopeptidase-24.11 inhibitor SCH 39370.
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Affiliation(s)
- T Yandle
- Department of Endocrinology, Princess Margaret Hospital, Christchurch, New Zealand
| | - M Richards
- Department of Endocrinology, Princess Margaret Hospital, Christchurch, New Zealand
| | - M Smith
- Department of Endocrinology, Princess Margaret Hospital, Christchurch, New Zealand
| | - C Charles
- Department of Endocrinology, Princess Margaret Hospital, Christchurch, New Zealand
| | - J Livesey
- Department of Endocrinology, Princess Margaret Hospital, Christchurch, New Zealand
| | - E Espiner
- Department of Endocrinology, Princess Margaret Hospital, Christchurch, New Zealand
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24
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van de Sandt CE, Clemens EB, Grant EJ, Rowntree LC, Sant S, Halim H, Crowe J, Cheng AC, Kotsimbos TC, Richards M, Miller A, Tong SYC, Rossjohn J, Nguyen THO, Gras S, Chen W, Kedzierska K. Challenging immunodominance of influenza-specific CD8 + T cell responses restricted by the risk-associated HLA-A*68:01 allomorph. Nat Commun 2019; 10:5579. [PMID: 31811120 PMCID: PMC6898063 DOI: 10.1038/s41467-019-13346-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/04/2019] [Indexed: 12/23/2022] Open
Abstract
Although influenza viruses lead to severe illness in high-risk populations, host genetic factors associated with severe disease are largely unknown. As the HLA-A*68:01 allele can be linked to severe pandemic 2009-H1N1 disease, we investigate a potential impairment of HLA-A*68:01-restricted CD8+ T cells to mount robust responses. We elucidate the HLA-A*68:01+CD8+ T cell response directed toward an extended influenza-derived nucleoprotein (NP) peptide and show that only ~35% individuals have immunodominant A68/NP145+CD8+ T cell responses. Dissecting A68/NP145+CD8+ T cells in low vs. medium/high responders reveals that high responding donors have A68/NP145+CD8+ memory T cells with clonally expanded TCRαβs, while low-responders display A68/NP145+CD8+ T cells with predominantly naïve phenotypes and non-expanded TCRαβs. Single-cell index sorting and TCRαβ analyses link expansion of A68/NP145+CD8+ T cells to their memory potential. Our study demonstrates the immunodominance potential of influenza-specific CD8+ T cells presented by a risk HLA-A*68:01 molecule and advocates for priming CD8+ T cell compartments in HLA-A*68:01-expressing individuals for establishment of pre-existing protective memory T cell pools.
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Affiliation(s)
- C E van de Sandt
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute, Melbourne, VIC, 3000, Australia.,Department of Hematopoiesis, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, 1066CX, Amsterdam, Netherlands
| | - E B Clemens
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute, Melbourne, VIC, 3000, Australia
| | - E J Grant
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute, Melbourne, VIC, 3000, Australia.,Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Infection and Immunity Program, Monash University, Clayton, VIC, 3800, Australia
| | - L C Rowntree
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute, Melbourne, VIC, 3000, Australia
| | - S Sant
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute, Melbourne, VIC, 3000, Australia
| | - H Halim
- Infection and Immunity Program and The Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
| | - J Crowe
- Deepdene Surgery, Deepdene, VIC, 3103, Australia
| | - A C Cheng
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.,Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, VIC, 3004, Australia
| | - T C Kotsimbos
- Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, VIC, 3004, Australia.,Department of Medicine, Monash University, Central Clinical School, The Alfred Hospital, Melbourne, VIC, 3004, Australia
| | - M Richards
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Parkville, VIC, 3050, Australia
| | - A Miller
- Indigenous Research Network, Griffith University, Brisbane, QLD, 4222, Australia.,Office of Indigenous Engagement, CQUniversity, Townsvillle, QLD, Australia
| | - S Y C Tong
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Parkville, VIC, 3050, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, NT, 0811, Australia
| | - J Rossjohn
- Infection and Immunity Program and The Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia.,Australian Research Council Centre of Excellence for Advanced Molecular Imaging, Monash University, Clayton, VIC, Australia.,Institute of Infection and Immunity, Cardiff University School of Medicine, Heath Park, Cardiff, CF14 4XN, United Kingdom
| | - T H O Nguyen
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute, Melbourne, VIC, 3000, Australia
| | - S Gras
- Infection and Immunity Program and The Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia.,Australian Research Council Centre of Excellence for Advanced Molecular Imaging, Monash University, Clayton, VIC, Australia
| | - W Chen
- Department of Biochemistry and Genetics, La Trobe Institute of Molecular Science, La Trobe University, Bundoora, VIC, 3086, Australia
| | - K Kedzierska
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute, Melbourne, VIC, 3000, Australia.
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25
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Whalin J, Liu L, Richards M. Lipid Oxidation and Color Stability of Spiced and Unspiced Pork Sausage with a Novel Antioxidant Mixture of Rosemary Extract and Phospholipase A2. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10729] [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: 11/03/2022] Open
Abstract
ObjectivesThe objective of this study was to measure the loss of redness and onset of lipid oxidation in pre-rigor pork sausage containing synthetic antioxidants (Syn) compared to rosemary extract (R), and a combination of R with different concentrations of phospholipase A2 (R+P) over both light display and frozen storage.Materials and MethodsOur work examined pre-rigor spiced and unspiced pork sausage. Tissue from sows for both spiced and unspiced sausage was coarse ground and cooled to 1–3°C with dry ice within 1-h post-exsanguination. Water, treatments and seasonings were added, and the sausage stuffed within 2 h post-exsanguination for spiced sausages. Water and treatments were added 24 h post-exsanguination for the unspiced sausage. Sausages were stored in the dark at –20°C (to 110 and 245 d for unspiced and spiced, respectively) prior to light display. Sausages were sampled for color and lipid oxidation on approximately 40-d intervals of –20°C dark storage and 7–9 d of light display (5°C). In spiced sausage, R (type HT-P) was added at 200 ppm, PLA2 was added at 0.4 ppm. Butylated hydroxyanisole (BHA), propyl gallate (PG) and citric acid (CA) were each added at 0.01% of the estimated fat and collectively formed the Syn treatment. Spices consisted of sucrose, ginger, coriander, nutmeg, white pepper, and MSG. In unspiced sausage R was added at 200 ppm, PLA2 added at 0.4 ppm and 10 ppm, and BHA, CA and PG added at the same levels as in spiced sausage. Color stability was measured based on redness (a*). Peroxide values (PVs) were measured spectrophotometrically, headspace hexanal was measured via gas chromatography (GC) and α tocopherol depletion was measured with HPLC fluorescence detection as markers of lipid oxidation. Total lipids were fractionated to gravimetrically quantify neutral lipids, free fatty acids and polar lipids and to measure PVs in the aforesaid fractions. Unspiced sausages were only stored for 110 d because of rampant lipid oxidation and loss of color.ResultsIn spiced sausage, R and R+P displayed better color stability than both the control (no antioxidant, C) and Syn. Syn displayed the lowest hexanal values. R had the highest PVs and both Syn and R+P were significantly lower. Free fatty acids were the most heavily oxidized fraction on an oil basis, while neutral lipids were the most oxidized lipid on a wet weight basis. Alpha tocopherol did not deplete through 245 d in spiced sausage but was not detected in the unspiced sausage.In unspiced sausage, R+P was examined at two different levels (0.4 ppm and 10 ppm PLA2). R+P (10 ppm) exhibited lower headspace hexanal than R alone and R+P at both levels performed as well as Syn. In addition, R+P at both levels displayed significantly better color stability than R alone and was as good as Syn.ConclusionIn conclusion, R+P decreased lipid oxidation (compared to R) and enhanced color stability (compared to R) and offer an alternative to synthetic antioxidants in pre-rigor pork sausage. Furthermore, spiced pork sausage displayed mean redness values above 9 through 245 d, compared to only 75 d in unspiced sausage.
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Affiliation(s)
- J. Whalin
- University of Wisconsin-Madison Meat Science and Muscle Biology Laboratory, Department of Animal Sciences
| | - L. Liu
- University of Wisconsin-Madison Meat Science and Muscle Biology Laboratory, Department of Animal Sciences
| | - M. Richards
- University of Wisconsin-Madison Meat Science and Muscle Biology Laboratory, Department of Animal Sciences
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Aldous S, Pickering J, Young J, George P, Watson A, Troughton R, Pemberton C, Richards M, Cullen L, Than M. P2674Rapid rule-out of myocardial infarction with a novel high precision point-of-care troponin assay appears safe and effective. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
High sensitivity troponin assays were developed to improve analytical sensitivity and precision at the decision cut-points for the diagnosis and rule out of acute myocardial infarction (AMI). Central laboratory assays have achieved this but point of care assays, which have the ability to accelerate decision making due to much shorter turnaround times, have remained lacking.
Purpose
To ascertain the threshold for decision making and subsequent clinical utility for ruling out AMI on presentation in patients attending the emergency department acutely with chest pain, using a high precision point of care troponin assay (TnI Nx), (i-STAT, Abbott).
Methods
We measured arrival TnI-Nx concentrations in stored plasma samples in adults presenting acutely to the emergency department with chest pain. The primary outcome was an AMI or cardiac death on index admission or within 30 days. We used 2000 bootstrapped data sets to derive and validate a suitable threshold for TnI-Nx before calculating diagnostic test performance. We pre-specified this threshold must have a <1% false negative rate for the primary outcome. We compared this with a core laboratory high sensitivity troponin I (hs-TnI) (Abbott Architect) using the early rule-out cut-point (European Society of Cardiology) at the limit of detection (2 ng/L).
Results
We recruited 1320 patients of whom 192 (14.1%) had the primary outcome. The TnI-Nx threshold was determined to be 8 ng/L with subsequent sensitivity of 99.0% (95% confidence interval: 97.3% to 100%), negative predictive value of 99.7% (99.2% to 100%) and specificity of 59.0% (56.0% to 62.0%). The hs-TnI had a sensitivity of 99.5% (98.2% to 100%), negative predictive value of 99.7% (99.0% to 100%), and specificity of 28.4% (25.8% to 31.2%) at 2ng/L.
Conclusion
A high precision point of care assay, TnI-Nx, with a decision threshold of 8ng/L, has comparable rule out performance compared with a core laboratory high sensitivity assay and therefore could potentially be used for early decision making in the assessment of acute chest pain.
Acknowledgement/Funding
Research grant from Abbott Point of Care. Senior Research Fellowship from ECF, CMRF and CDHB. Clinical Research Fellowship from NZ HRC
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Affiliation(s)
- S Aldous
- Christchurch Hospital, Christchurch, New Zealand
| | - J Pickering
- University of Otago Christchurch, Christchurch Heart Institute, Christchurch, New Zealand
| | - J Young
- University of Otago Christchurch, Christchurch Heart Institute, Christchurch, New Zealand
| | - P George
- Christchurch Hospital, Christchurch, New Zealand
| | - A Watson
- Christchurch Hospital, Christchurch, New Zealand
| | - R Troughton
- Christchurch Hospital, Christchurch, New Zealand
| | - C Pemberton
- University of Otago Christchurch, Christchurch Heart Institute, Christchurch, New Zealand
| | - M Richards
- University of Otago Christchurch, Christchurch Heart Institute, Christchurch, New Zealand
| | - L Cullen
- Royal Brisbane and Women's Hospital, Emergency Department, Brisbane, Australia
| | - M Than
- Christchurch Hospital, Christchurch, New Zealand
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Wong BLH, Chaturvedi N, Tillin T, Richards M, Hughes A, Stewart R, Shibata D, Park C. 6070Association of blood pressure measures with brain structure and function: the Southall and Brent REvisited (SABRE) study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0119] [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: 11/13/2022] Open
Abstract
Abstract
Background
In our rapidly ageing society, dementia and neurocognitive decline are significant global public health problems. Blood pressure (BP), an established cardiovascular risk factor, has been extensively studied with respect to brain structure and function; however, findings across the literature differ depending on the BP component in consideration, and the use of brachial rather than central BP.
Purpose
We set out to assess associations between detailed measures of brain structure and function with comprehensive measures of central and peripheral BP. Furthermore, we performed comprehensive mediation analyses on the associations to investigate potential micro and macro vascular mediatory pathways.
Methods
A community-based sample of 1438 individuals (69.7±6.2 years) from a tri-ethnic cohort. underwent vascular, cognitive and MRI based structural brain measures. BP measures included central (cSBP (Pulsecor)) and peripheral systolic BP (pSBP), diastolic BP (DBP), brachial (bPP) and central pulse pressure (cPP), and mean arterial pressure (MAP). Cognitive assessments comprised tests which explored global/overall function (CSID), executive function and memory. For brain structure, hippocampal brain volume was our key measure. Potential macro- and microvascular mediators included: arterial stiffness (cfPWV), carotid intima-media thickness, retinopathy, white matter hyperintensities and infarcts. Multivariable regression analyses were used to assess associations of BP components with cognitive function scores and brain volumes, adjusted for age, sex and ethnicity as well as macro- and microvascular risk factors. Multiple imputation was performed to account for missing data.
Results
After adjusting for age, sex and ethnicity, both cSBP and pSBP were negatively associated with memory (data are β±SE (z-score) −0.014±0.006, p=0.04), while DBP was positively associated with hippocampal volume (0.006±0.003, p=0.03). cPP was negatively associated with memory (−0.020±0.009, p=0.03), executive function (−0.018±0.006, p=0.002) and hippocampal volume (−0.007±0.003, p=0.005), while bPP was negatively associated with CSID (−0.008±0.004, p=0.04), memory (−0.020±0.008, p=0.02), executive function (−0.016±0.005, p=0.002) and hippocampal volume (−0.006±0.002, p=0.007). There was a stronger association between both PP measures and brain structure and function than with the other BP components, especially MAP. There was little difference in association between cPP and bPP measures with brain structure and function. Furthermore, these associations do not appear to be mediated by either macro- or microvascular disease.
Conclusion
These results suggest that there is a direct association between increased PP and a decline in brain structure and function. This implies that older patients with suboptimal PP control may be at increased risk of developing cognitive impairment and that measuring PP offers mechanistic information above and beyond conventional BP measures.
Acknowledgement/Funding
Wellcome Trust, British Heart Foundation
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Affiliation(s)
- B L H Wong
- University College London, Institute of Cardiovascular Science, London, United Kingdom
| | - N Chaturvedi
- University College London, MRC Unit for Lifelong Health and Ageing; Institute of Cardiovascular Science, London, United Kingdom
| | - T Tillin
- University College London, Institute of Cardiovascular Science, London, United Kingdom
| | - M Richards
- University College London, MRC Unit for Lifelong Health and Ageing, London, United Kingdom
| | - A Hughes
- University College London, Institute of Cardiovascular Science, London, United Kingdom
| | - R Stewart
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - D Shibata
- University of Washington, Department of Radiology, Seattle, United States of America
| | - C Park
- University College London, Institute of Cardiovascular Science, London, United Kingdom
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Tektonidis T, Esser P, Coe S, Maddock J, Buchanan S, Mavrommati F, Schott J, Izadi H, Richards M, Dawes H. MON-LB692: Diet Quality in Late Midlife is Associated with Faster Walking Speed in Later Life in Women, but Not Men: Findings From a British Birth Cohort. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32147-8] [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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Richards M, James SN, Sizer A, Sharma N, Rawle M, Davis DHJ, Kuh D. Identifying the lifetime cognitive and socioeconomic antecedents of cognitive state: seven decades of follow-up in a British birth cohort study. BMJ Open 2019; 9:e024404. [PMID: 31023749 PMCID: PMC6502022 DOI: 10.1136/bmjopen-2018-024404] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The life course determinants of midlife and later life cognitive function have been studied using longitudinal population-based cohort data, but far less is known about whether the pattern of these pathways is similar or distinct for clinically relevant cognitive state. We investigated this for Addenbrooke's Cognitive Examination third edition (ACE-III), used in clinical settings to screen for cognitive impairment and dementia. DESIGN Longitudinal birth cohort study. SETTING Residential addresses in England, Wales and Scotland. PARTICIPANTS 1762 community-dwelling men and women of European heritage, enrolled since birth in the Medical Research Council (MRC) National Survey of Health and Development (the British 1946 birth cohort). PRIMARY OUTCOME ACE-III. RESULTS Path modelling estimated direct and indirect associations between apolipoprotein E (APOE) status, father's social class, childhood cognition, education, midlife occupational complexity, midlife verbal ability (National Adult Reading Test; NART), and the total ACE-III score. Controlling for sex, there was a direct negative association between APOE ε4 and the ACE-III score (β=-0.04 [-0.08 to -0.002], p=0.04), but not between APOE ε4 and childhood cognition (β=0.03 [-0.006 to 0.069], p=0.10) or the NART (β=0.0005 [-0.03 to 0.03], p=0.97). The strongest influences on the ACE-III were from childhood cognition (β=0.20 [0.14 to 0.26], p<0.001) and the NART (β=0.35 [0.29 to 0.41], p<0.001); educational attainment and occupational complexity were modestly and independently associated with the ACE-III (β=0.08 [0.03 to 0.14], p=0.002 and β=0.05 [0.01 to 0.10], p=0.02, respectively). CONCLUSIONS The ACE-III in the general population shows a pattern of life course antecedents that is similar to neuropsychological measures of cognitive function, and may be used to represent normal cognitive ageing as well as a screen for cognitive impairment and dementia.
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Affiliation(s)
- M Richards
- MRC Unit for Lifelong Health and Ageing at UCL, UCL, London, UK
| | | | - Alison Sizer
- Epidemiology and Public Health, University College London, London, UK
| | - Nikhil Sharma
- MRC Unit for Lifelong Health and Ageing at UCL, UCL, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Mark Rawle
- MRC Unit for Lifelong Health and Ageing at UCL, UCL, London, UK
| | | | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, UCL, London, UK
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Affiliation(s)
- Misty Richards
- The Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Adrienne Grzenda
- The Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Evelyn Nelson
- The Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Michael Gitlin
- The Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
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31
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James SN, Jones S, Tillin T, Key D, Hughes A, Richards M, Chaturvedi N. 133DEPRESSIVE SYMPTOMS ARE ASSOCIATED WITH PERCEIVED, NOT OBJECTIVE, EXERTION DURING EXERCISE IN EUROPEAN, INDIAN ASIAN AND AFRICAN-CARIBBEAN GROUPS. Age Ageing 2019. [DOI: 10.1093/ageing/afy207.03] [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: 11/14/2022] Open
Affiliation(s)
- S N James
- MRC Lifelong Health and Ageing, University College London, London, UK
| | - S Jones
- MRC Lifelong Health and Ageing, University College London, London, UK
| | - T Tillin
- MRC Lifelong Health and Ageing, University College London, London, UK
| | - D Key
- MRC Lifelong Health and Ageing, University College London, London, UK
| | - A Hughes
- MRC Lifelong Health and Ageing, University College London, London, UK
| | - M Richards
- MRC Lifelong Health and Ageing, University College London, London, UK
| | - N Chaturvedi
- MRC Lifelong Health and Ageing, University College London, London, UK
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32
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John A, Patel U, Rusted J, Richards M, Gaysina D. Affective problems and decline in cognitive state in older adults: a systematic review and meta-analysis. Psychol Med 2019; 49:353-365. [PMID: 29792244 PMCID: PMC6331688 DOI: 10.1017/s0033291718001137] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 04/05/2018] [Accepted: 04/11/2018] [Indexed: 12/23/2022]
Abstract
Evidence suggests that affective problems, such as depression and anxiety, increase risk for late-life dementia. However, the extent to which affective problems influence cognitive decline, even many years prior to clinical diagnosis of dementia, is not clear. The present study systematically reviews and synthesises the evidence for the association between affective problems and decline in cognitive state (i.e., decline in non-specific cognitive function) in older adults. An electronic search of PubMed, PsycInfo, Cochrane, and ScienceDirect was conducted to identify studies of the association between depression and anxiety separately and decline in cognitive state. Key inclusion criteria were prospective, longitudinal designs with a minimum follow-up period of 1 year. Data extraction and methodological quality assessment using the STROBE checklist were conducted independently by two raters. A total of 34 studies (n = 71 244) met eligibility criteria, with 32 studies measuring depression (n = 68 793), and five measuring anxiety (n = 4698). A multi-level meta-analysis revealed that depression assessed as a binary predictor (OR 1.36, 95% CI 1.05-1.76, p = 0.02) or a continuous predictor (B = -0.008, 95% CI -0.015 to -0.002, p = 0.012; OR 0.992, 95% CI 0.985-0.998) was significantly associated with decline in cognitive state. The number of anxiety studies was insufficient for meta-analysis, and they are described in a narrative review. Results of the present study improve current understanding of the temporal nature of the association between affective problems and decline in cognitive state. They also suggest that cognitive function may need to be monitored closely in individuals with affective disorders, as these individuals may be at particular risk of greater cognitive decline.
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Affiliation(s)
- A. John
- EDGE Lab, School of Psychology, University of Sussex, Brighton, UK
| | - U. Patel
- EDGE Lab, School of Psychology, University of Sussex, Brighton, UK
| | - J. Rusted
- School of Psychology, University of Sussex, Brighton, UK
| | - M. Richards
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - D. Gaysina
- EDGE Lab, School of Psychology, University of Sussex, Brighton, UK
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Whalin J, Liu L, Richards M. Lipid Oxidation and Color Stability of Spiced and Unspiced Pork Sausage with a Novel Antioxidant Mixture of Rosemary Extract and Phospholipase A2. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb2019.0077] [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: 11/03/2022] Open
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34
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Yeo T, Wang M, Grignani R, Koh L, Tan F, Chan G, Lee CH, Richards M. PO548 A Prospective Sports Cardiology Registry of Athletes In Singapore. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.419] [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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35
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Clouston S, Richards M, Smith D, Mukherjee S, Zhang Y, Hou W, Link B. EDUCATION AND THE ONSET OF COGNITIVE PATHOLOGY: A LONGITUDINAL ANALYSIS OF ACCELERATED COGNITIVE DECLINE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - M Richards
- Unit for Lifelong Health and Ageing and University College London
| | | | | | | | | | - B Link
- University of California at Riverside
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36
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Adamson P, Pilbrow A, Pickering J, Poppe K, Mills N, Newby D, Troughton R, Doughty R, Richards M. 1093Prognostic value of convalescent high-sensitivity troponin I concentrations following acute coronary syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P Adamson
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - A Pilbrow
- University of Otago Christchurch, Department of Medicine, Christchurch, New Zealand
| | - J Pickering
- University of Otago Christchurch, Department of Medicine, Christchurch, New Zealand
| | - K Poppe
- The University of Auckland, Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - N Mills
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - D Newby
- University of Edinburgh, Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - R Troughton
- University of Otago Christchurch, Department of Medicine, Christchurch, New Zealand
| | - R Doughty
- The University of Auckland, Faculty of Medical and Health Sciences, Auckland, New Zealand
| | - M Richards
- University of Otago Christchurch, Department of Medicine, Christchurch, New Zealand
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Mathias MC, Collins PW, Palmer BP, Chalmers E, Alamelu J, Richards M, Will A, Hay CRM. The immunogenicity of ReFacto AF (moroctocog alfa AF-CC) in previously untreated patients with haemophilia A in the United Kingdom. Haemophilia 2018; 24:896-901. [DOI: 10.1111/hae.13551] [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] [Accepted: 05/28/2018] [Indexed: 11/29/2022]
Affiliation(s)
- M. C. Mathias
- Great Ormond Street Hospital for Children; NHS Foundation Trust; London UK
| | - P. W. Collins
- Arthur Bloom Haemophilia Centre; School of Medicine; Cardiff University; Cardiff UK
| | - B. P. Palmer
- The UK National Haemophilia Database; Manchester UK
| | | | - J. Alamelu
- The Evelina Children's Hospital; London UK
| | | | - A. Will
- Manchester Children's Hospital; Manchester University NHS Foundation Trust; Manchester UK
| | - C. R. M. Hay
- University Department of Haematology; Manchester University NHS Foundation Trust; Manchester UK
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38
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Affiliation(s)
- M. Richards
- Bass Charrington Ltd., Burton-upon-Trent, England
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39
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Chalmers EA, Alamelu J, Collins PW, Mathias M, Payne J, Richards M, Tunstall O, Williams M, Palmer B, Mumford A. Intracranial haemorrhage in children with inherited bleeding disorders in the UK 2003-2015: A national cohort study. Haemophilia 2018; 24:641-647. [PMID: 29635852 DOI: 10.1111/hae.13461] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Intracranial haemorrhage in children with inherited bleeding disorders is a potentially life-threatening complication and presents a significant therapeutic challenge. AIM To define the characteristics, management and outcomes of intracranial haemorrhage presenting in UK children ≤16 years of age with inherited bleeding disorders from 2003 to 2015. METHOD Retrospective analysis of children treated at UK haemophilia centres. RESULTS Of 66 children presenting with Intracranial haemorrhage (ICH), 82% had haemophilia A or B, 3% VWD and 15% a rare IBD. The IBD was a severe phenotype in 91%. The rates of ICH were 6.4 and 4.2 per 1000 patient years for haemophilia A and B, respectively. Median age at presentation was 4 months (33% neonates; 91% children <2 years of age). In neonates, delivery was spontaneous vaginal (SV) in 11, instrumental in 6, caesarean in 4 and unknown in 1. In children with haemophilia, the risk of ICH after instrumental delivery was 10.6 times greater than after SV delivery. Trauma was more common in children >2 years (67%) than in children 1 month to 2 years (18%; P = .027). Prior to ICH, only 4.5% of children were on prophylaxis. 6% of haemophiliacs had an inhibitor. The median duration of initial replacement therapy was 15 days. Mortality was 13.5%. Neurological sequelae occurred in 39% of survivors, being more common following intracerebral bleeding. In haemophilia survivors, 52% subsequently developed a FVIII inhibitor. CONCLUSION Intracranial haemorrhage occurs most frequently in children with severe IBDs, during the first 2 years of life and in children not receiving prophylaxis. Intracranial haemorrhage often occurs without documented trauma.
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Affiliation(s)
- E A Chalmers
- Department of Haematology, Royal Hospital for Children, Glasgow, UK
| | - J Alamelu
- Department of Paediatric Haematology, Evelina Children's Hospital, London, UK
| | - P W Collins
- School of Medicine, Cardiff University, Cardiff, UK
| | - M Mathias
- Department of Haematology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - J Payne
- Department of Haematology, Sheffield Children's Hospital, Sheffield, UK
| | - M Richards
- Department of Haematology, Leeds Children's Hospital, Leeds, UK
| | - O Tunstall
- Bristol Haemophilia Comprehensive Care Centre, Bristol Royal Hospital for Children, Bristol, UK
| | - M Williams
- Haemophilia Centre, Birmingham Childrens' Hospital, Birmingham, UK
| | - B Palmer
- The National Haemophilia Database, Manchester, UK
| | - A Mumford
- Department of Cellular and Molecular Medicine, University of Bristol, Bristol, UK
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Talaie R, Richards M, Krug H, Dorman C, Noorbaloochi S, Golzarian J. 4:12 PM Abstract No. 209 Neovascularization in knee osteoarthritis: a new mouse model using micro computed tomography to delineate pathological vascular remodeling. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.234] [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: 10/17/2022] Open
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41
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Stampe C, Richards M, Young S. Abstract No. 586 Sclerotherapy for lymphoceles: factors predicting clinical success. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.631] [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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42
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O'Neill HA, Tinder TT, Maher V, Rosenow M, Richards M, Santhanam R, Wei X, Domenyuk V, Miglarese MR, Spetzler D. Abstract P5-08-03: Poly-ligand profiling and target identification from formalin-fixed-paraffin embedded HER2+ breast cancer specimens. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-08-03] [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
We have previously described the ADAPT Biotargeting System™as a novel platform for highly multiplexed poly-ligand profiling of complex phenotypes such as drug response. Here we report extended capabilities of the this platform for target identification directly from formalin-fixed-paraffin embedded (FFPE) tissues using aptamer libraries enriched toward HER2+ breast cancer. Standard mass spectrometry-based biomarker and drug target discovery from FFPE tissues can be challenging due to limited amounts of tissue, harsh conditions of fixation and extraction and the general problem of masking by highly abundant proteins. A single stranded-oligodeoxynucleotide aptamer library was enriched on HER2+ FFPE breast cancer specimens and conjugated with biotin as well as a label transfer reagent, Sulfo-NHS-SS-Diazirine (Sulfo-SDAD). The biotinylated-SDAD conjugated library (B-SDAD-EL) was applied to HER2+ FFPE tissues and photocrosslinked to cognate binding partners within the FFPE sample in order to preserve aptamer-protein interactions under harsh denaturing conditions required for protein extraction and sample preparation. Aptamer-protein complexes were affinity purified and the label was transferred from bound aptamers to their binding partners under reducing conditions that enable proteomic digestion and high resolution mass spectrometry detection. An open database search was performed where the precursor ion tolerance was set to ± 500 Da for database searching, which enabled identification of peptides containing the transferred label as well as additional unknown variable modifications induced by the tissue fixation process. We identified proteins with known roles in HER2+ breast cancer along with several potentially drugable targets not previously associated with HER2 positivity. Differential expression of candidate targets was orthogonally confirmed by immunohistochemistry. By nature of its extreme molecular complexity and its ability to be enriched or “trained,” toward phenotypes of interest, the ADAPT Biotargeting SystemTM can be deployed to advance precision medicine by identifying predictive biomarkers and drug targets with novel associations to complex interactomes.
Citation Format: O'Neill HA, Tinder TT, Maher V, Rosenow M, Richards M, Santhanam R, Wei X, Domenyuk V, Miglarese MR, Spetzler D. Poly-ligand profiling and target identification from formalin-fixed-paraffin embedded HER2+ breast cancer specimens [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-08-03.
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Affiliation(s)
| | | | - V Maher
- Caris Life Sciences, Phoenix, AZ
| | | | | | | | - X Wei
- Caris Life Sciences, Phoenix, AZ
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43
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Nüesch E, Dale C, Palmer TM, White J, Keating BJ, van Iperen EP, Goel A, Padmanabhan S, Asselbergs FW, Verschuren WM, Wijmenga C, Van der Schouw YT, Onland-Moret NC, Lange LA, Hovingh GK, Sivapalaratnam S, Morris RW, Whincup PH, Wannamethe GS, Gaunt TR, Ebrahim S, Steel L, Nair N, Reiner AP, Kooperberg C, Wilson JF, Bolton JL, McLachlan S, Price JF, Strachan MW, Robertson CM, Kleber ME, Delgado G, März W, Melander O, Dominiczak AF, Farrall M, Watkins H, Leusink M, Maitland-van der Zee AH, de Groot MC, Dudbridge F, Hingorani A, Ben-Shlomo Y, Lawlor DA, Amuzu A, Caufield M, Cavadino A, Cooper J, Davies TL, Drenos F, Engmann J, Finan C, Giambartolomei C, Hardy R, Humphries SE, Hypponen E, Kivimaki M, Kuh D, Kumari M, Ong K, Plagnol V, Power C, Richards M, Shah S, Shah T, Sofat R, Talmud PJ, Wareham N, Warren H, Whittaker JC, Wong A, Zabaneh D, Davey Smith G, Wells JC, Leon DA, Holmes MV, Casas JP. Adult height, coronary heart disease and stroke: a multi-locus Mendelian randomization meta-analysis. Int J Epidemiol 2018; 45:1927-1937. [PMID: 25979724 PMCID: PMC5841831 DOI: 10.1093/ije/dyv074] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 11/12/2022] Open
Abstract
Background: We investigated causal effect of completed growth, measured by adult height, on coronary heart disease (CHD), stroke and cardiovascular traits, using instrumental variable (IV) Mendelian randomization meta-analysis. Methods: We developed an allele score based on 69 single nucleotide polymorphisms (SNPs) associated with adult height, identified by the IBCCardioChip, and used it for IV analysis against cardiovascular risk factors and events in 21 studies and 60 028 participants. IV analysis on CHD was supplemented by summary data from 180 height-SNPs from the GIANT consortium and their corresponding CHD estimates derived from CARDIoGRAMplusC4D. Results: IV estimates from IBCCardioChip and GIANT-CARDIoGRAMplusC4D showed that a 6.5-cm increase in height reduced the odds of CHD by 10% [odds ratios 0.90; 95% confidence intervals (CIs): 0.78 to 1.03 and 0.85 to 0.95, respectively],which agrees with the estimate from the Emerging Risk Factors Collaboration (hazard ratio 0.93; 95% CI: 0.91 to 0.94). IV analysis revealed no association with stroke (odds ratio 0.97; 95% CI: 0.79 to 1.19). IV analysis showed that a 6.5-cm increase in height resulted in lower levels of body mass index (P < 0.001), triglycerides (P < 0.001), non high-density (non-HDL) cholesterol (P < 0.001), C-reactive protein (P = 0.042), and systolic blood pressure (P = 0.064) and higher levels of forced expiratory volume in 1 s and forced vital capacity (P < 0.001 for both). Conclusions: Taller individuals have a lower risk of CHD with potential explanations being that taller people have a better lung function and lower levels of body mass index, cholesterol and blood pressure.
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Affiliation(s)
- Eveline Nüesch
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,CTU Bern, Department of Clinical Research and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Caroline Dale
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Tom M Palmer
- Warwick Medical School, University of Warwick, Coventry, UK.,Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
| | - Jon White
- UCL Genetics Institute, Department of Genetics, Evolution and Environment, University College London, London, UK
| | - Brendan J Keating
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Surgery.,Division of Genetics, University of Pennsylvania, Philadelphia
| | - Erik Pa van Iperen
- Department of Biostatistics, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.,Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands
| | - Anuj Goel
- Wellcome Trust Centre for Human Genetics and Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands.,Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands.,Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
| | | | | | | | | | | | - Leslie A Lange
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - G K Hovingh
- Department of Vascular Medicine, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Suthesh Sivapalaratnam
- Department of Vascular Medicine, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Richard W Morris
- Department of Primary Care & Population Health, University College London, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London, UK
| | - Goya S Wannamethe
- Department of Primary Care & Population Health, University College London, London, UK
| | - Tom R Gaunt
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Shah Ebrahim
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Laura Steel
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nikhil Nair
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alexander P Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, USA / Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - James F Wilson
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Jennifer L Bolton
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Stela McLachlan
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Jacqueline F Price
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | | | - Christine M Robertson
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Marcus E Kleber
- Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Graciela Delgado
- Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Winfried März
- Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetolgy, and Rheumatology), Mannheim Medical Faculty, University of Heidelberg, Germany, Synlab Academy, Synlab Services GmbH, Mannheim and Augsburg, Germany, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
| | | | - Anna F Dominiczak
- Institute of Cardiovascular and Medical Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Martin Farrall
- Wellcome Trust Centre for Human Genetics and Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Hugh Watkins
- Wellcome Trust Centre for Human Genetics and Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Maarten Leusink
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anke H Maitland-van der Zee
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Mark Ch de Groot
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank Dudbridge
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Aroon Hingorani
- Department of Epidemiology and Public Health, University College London Medical School, London, UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Debbie A Lawlor
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - D Zabaneh
- UCLEB, London, Edinburgh and Bristol, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jonathan C Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
| | - David A Leon
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Department of Community Medicine, Arctic University of Norway, UiT
| | - Michael V Holmes
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK.,Department of Surgery and Clinical Epidemiology Unit, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Juan P Casas
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
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Koike S, Barnett J, Jones PB, Richards M. Cognitive profiles in childhood and adolescence differ between adult psychotic and affective symptoms: a prospective birth cohort study. Psychol Med 2018; 48:11-22. [PMID: 28988550 PMCID: PMC5729848 DOI: 10.1017/s0033291717000393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 01/25/2017] [Accepted: 01/26/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Differences between verbal and non-verbal cognitive development from childhood to adulthood may differentiate between those with and without psychotic symptoms and affective symptoms in later life. However, there has been no study exploring this in a population-based cohort. METHOD The sample was drawn from the MRC National Survey of Health and Development, and consisted of 2384 study members with self-reported psychotic experiences and affective symptoms at the age of 53 years, and with complete cognitive data at the ages of 8 and 15 years. The association between verbal and non-verbal cognition at age 8 years and relative developmental lag from age 8 to 15 years, and both adult outcomes were tested with the covariates adjusted, and mutually adjusted for verbal and non-verbal cognition. RESULTS Those with psychotic experiences [thought interference (n = 433), strange experience (n = 296), hallucination (n = 88)] had lower cognition at both the ages of 8 and 15 years in both verbal and non-verbal domains. After mutual adjustment, lower verbal cognition at age 8 years and greater verbal developmental lag were associated with higher likelihood of psychotic experiences within individuals, whereas there was no association between non-verbal cognition and any psychotic experience. In contrast, those with case-level affective symptoms (n = 453) had lower non-verbal cognition at age 15 years, and greater developmental lag in the non-verbal domain. After adjustment, lower non-verbal cognition at age 8 years and greater non-verbal developmental lag were associated with higher risk of case-level affective symptoms within individuals. CONCLUSIONS These results suggest that cognitive profiles in childhood and adolescence differentiate psychiatric disease spectra.
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Affiliation(s)
- S. Koike
- MRC Unit for Lifelong Health and Ageing at
UCL, 33 Bedford Place, London WC1B 5JU,
UK
- University of Tokyo Institute for Diversity
& Adaptation of Human Mind (UTIDAHM), 3-8-1 Komaba,
Meguro-ku, Tokyo 153-8902, Japan
- Center for Evolutionary Cognitive
Sciences, Graduate School of Arts and Sciences, The University of
Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902,
Japan
| | - J. Barnett
- Department of Psychiatry,
University of Cambridge, Cambridge CB2
0SZ, UK
- Cambridge Cognition Ltd,
Cambridge CB25 9TU, UK
| | - P. B. Jones
- Department of Psychiatry,
University of Cambridge, Cambridge CB2
0SZ, UK
- CAMEO, Cambridgeshire & Peterborough NHS
Foundation Trust, Cambridge CB21 5EF,
UK
| | - M. Richards
- MRC Unit for Lifelong Health and Ageing at
UCL, 33 Bedford Place, London WC1B 5JU,
UK
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45
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Clouston S, Pietrzak R, Kotov R, Richards M, Spiro A, Mukherjee S, Luft B, Bromet E. POSTTRAUMATIC STRESS AND FLUID COGNITION: LONG-TERM OUTCOMES OF THE WORLD TRADE CENTER DISASTER. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S. Clouston
- Public Health, Stony Brook University, Stony Brook, New York,
| | | | - R. Kotov
- Public Health, Stony Brook University, Stony Brook, New York,
| | - M. Richards
- MRC Unit for Lifelong Health and Ageing at University College London, London, United Kingdom,
| | - A. Spiro
- Boston University, Boston, Massachusetts,
| | - S. Mukherjee
- Florida International University, Miami, Florida
| | - B. Luft
- Public Health, Stony Brook University, Stony Brook, New York,
| | - E. Bromet
- Public Health, Stony Brook University, Stony Brook, New York,
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Collins P, Chalmers E, Alamelu J, Hay C, Liesner R, Makris M, Mathias M, Payne J, Rangarajan S, Richards M, Talks K, Tunstall O, Williams M, Hart DP. First-line immune tolerance induction for children with severe haemophilia A: A protocol from the UK Haemophilia Centre Doctors' Organisation Inhibitor and Paediatric Working Parties. Haemophilia 2017; 23:654-659. [DOI: 10.1111/hae.13264] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2017] [Indexed: 12/29/2022]
Affiliation(s)
- P. Collins
- Arthur Bloom Haemophilia Centre; University Hospital of Wales; Cardiff UK
| | - E. Chalmers
- Haemophilia Centre; Royal Hospital for Children; Glasgow UK
| | - J. Alamelu
- Haemophilia Centre; Evelina London Children's Hospital; London UK
| | - C. Hay
- Haemophilia Centre; University Departmentt of Haematology; Manchester UK
| | - R. Liesner
- Haemophilia Centre; Great Ormond Street Hospital for Children NHS Foundation Trust; London UK
| | - M. Makris
- Sheffield Haemophilia and Thrombosis Centre; Royal Hallamshire Hospital; Sheffield UK
| | - M. Mathias
- Haemophilia Centre; Great Ormond Street Hospital for Children NHS Foundation Trust; London UK
| | - J. Payne
- Departement of Haematology; Sheffield Children's Hospital; Sheffield UK
| | - S. Rangarajan
- Haemophilia Centre; Hampshire Hospitals NHS Foundation Trust; Basingstoke UK
| | - M. Richards
- Haemophilia Centre; Department of Paediatric Haematology; Leeds Children's Hospital; Leeds UK
| | - K. Talks
- Haemophilia Centre; Newcastle upon Tyne Hospitals NHS Foundation Trust (NUTH); Newcastle UK
| | - O. Tunstall
- Department of Paediatric Haematology; Bristol Royal Hospital for Children; Bristol UK
| | - M. Williams
- Department of Haematology; Birmingham Children's Hospital; Birmingham UK
| | - D. P. Hart
- Barts and The London School of Medicine & Dentistry, QMUL; London UK
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Hahne A, Ford J, Richards M, Surkitt L, Slater S, Taylor N. Who benefits most from individualised physiotherapy versus advice for low back disorders: Effect modifier analysis of randomised controlled trial data. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2016.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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48
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Ford J, Hahne A, Surkitt L, Slater S, Richards M, Chan A, Hinman R, Taylor N. Individualised physiotherapy versus advice for people with low back disorders: A 2-year follow-up of a randomised controlled trial. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2016.12.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wieldraaijer T, Duineveld L, van Asselt K, van Geloven A, Bemelman W, van Weert H, Wind J, van Weert H, Wind J, van Asselt K, Duineveld L, Wieldraaijer T, Bemelman W, Courant E, Smits A, Pruim J, van de Ven A, Richards M, Donkervoort S, van Nes M, van Geloven A, Muller M, Govaert M, Koole-Mussche H. Follow-up of colon cancer patients; causes of distress and need for supportive care. Eur J Surg Oncol 2017; 43:118-125. [DOI: 10.1016/j.ejso.2016.08.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/02/2016] [Accepted: 08/18/2016] [Indexed: 12/24/2022] Open
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Lee AT, Chan WC, Chiu HF, Richards M, Hui LY, Ng SP, Chan WM, Lam LC. Physical health and lifestyle predictors for significant cognitive impairment in community-dwelling Chinese older adults in Hong Kong. Hong Kong Med J 2016; 22 Suppl 6:37-39. [PMID: 27807316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Affiliation(s)
- A Tc Lee
- Department of Psychiatry, Tai Po Hospital, Hong Kong
| | - W C Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - H Fk Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - M Richards
- MRC Unit for Lifelong Health and Ageing, UK
| | - L Yf Hui
- Elderly Health Service, Department of Health, Hong Kong
| | - S Ps Ng
- Elderly Health Service, Department of Health, Hong Kong
| | - W M Chan
- Elderly Health Service, Department of Health, Hong Kong
| | - L Cw Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
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