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Ashford MT, Aaronson A, Kwang W, Eichenbaum J, Gummadi S, Jin C, Cashdollar N, Thorp E, Wragg E, Zavitz KH, Cormack F, Banh T, Neuhaus JM, Ulbricht A, Camacho MR, Fockler J, Flenniken D, Truran D, Mackin RS, Weiner MW, Nosheny RL. Unsupervised Online Paired Associates Learning Task from the Cambridge Neuropsychological Test Automated Battery (CANTAB®) in the Brain Health Registry. J Prev Alzheimers Dis 2024; 11:514-524. [PMID: 38374758 PMCID: PMC10879687 DOI: 10.14283/jpad.2023.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND Unsupervised online cognitive assessments have demonstrated promise as an efficient and scalable approach for evaluating cognition in aging, and Alzheimer's disease and related dementias. OBJECTIVES The aim of this study was to evaluate the feasibility, usability, and construct validity of the Paired Associates Learning task from the Cambridge Neuropsychological Test Automated Battery® in adults enrolled in the Brain Health Registry. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS The Paired Associates Learning task was administered to Brain Health Registry participants in a remote, unsupervised, online setting. In this cross-sectional analysis, we 1) evaluated construct validity by analyzing associations between Paired Associates Learning performance and additional participant registry data, including demographics, self- and study partner-reported subjective cognitive change (Everyday Cognition scale), self-reported memory concern, and depressive symptom severity (Patient Health Questionnaire-9) using multivariable linear regression models; 2) determined the predictive value of Paired Associates Learning and other registry variables for identifying participants who self-report Mild Cognitive Impairment by employing multivariable binomial logistic regressions and calculating the area under the receiver operator curve; 3) investigated feasibility by looking at task completion rates and statistically comparing characteristics of task completers and non-completers; and 4) evaluated usability in terms of participant requests for support from BHR related to the assessment. RESULTS In terms of construct validity, in participants who took the Paired Associates Learning for the first time (N=14,528), worse performance was associated with being older, being male, lower educational attainment, higher levels of self- and study partner-reported decline, more self-reported memory concerns, greater depressive symptom severity, and self-report of Mild Cognitive Impairment. Paired Associates Learning performance and Brain Health Registry variables together identified those with self-reported Mild Cognitive Impairment with moderate accuracy (areas under the curve: 0.66-0.68). In terms of feasibility, in a sub-sample of 29,176 participants who had the opportunity to complete Paired Associates Learning for the first time in the registry, 14,417 started the task. 11,647 (80.9% of those who started) completed the task. Compared to those who did not complete the task at their first opportunity, those who completed were older, had more years of education, more likely to self-identify as White, less likely to self-identify as Latino, less likely to have a subjective memory concern, and more likely to report a family history of Alzheimer's disease. In terms of usability, out of 8,395 received requests for support from BHR staff via email, 4.4% (n=374) were related to PAL. Of those, 82% were related to technical difficulties. CONCLUSIONS Our findings support moderate feasibility, good usability, and construct validity of cross-sectional Paired Associates Learning in an unsupervised online registry, but also highlight the need to make the assessment more inclusive and accessible to individuals from ethnoculturally and socioeconomically diverse communities. A future, improved version could be a scalable, efficient method to assess cognition in many different settings, including clinical trials, observational studies, healthcare, and public health.
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Affiliation(s)
- M T Ashford
- Miriam Ashford, 4150 Clement St, San Francisco, CA 94121, , Phone: +16502089267
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Banh T, Jin C, Neuhaus J, Mackin RS, Maruff P, Stricker N, Weiner MW, Nosheny RL. Unsupervised Performance of the CogState Brief Battery in the Brain Health Registry: Implications for Detecting Cognitive Decline. J Prev Alzheimers Dis 2021; 9:262-268. [PMID: 35542999 PMCID: PMC9101916 DOI: 10.14283/jpad.2021.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION: The feasibility and validity of unsupervised, longitudinal brief computerized cognitive batteries is unknown. METHODS: Participants aged 56–90 (N = 19476) from the Brain Health Registry (BHR) completed the CogState Brief Battery (CBB) at 6-month intervals over a period of 5 years. We used linear mixed-effects models to assess whether cross-sectional and longitudinal performance on CBB within BHR was associated with demographic and cognitive characteristics. We also defined a group of CBB decliners based on subject-specific slopes and estimated associations between decliner status and participant characteristics. RESULTS: We found weak associations between longitudinal change in CBB and participant characteristics. Cross-sectional CBB scores were significantly associated with participant characteristics such as age, gender, ethnicity, self-reported disease status, and memory concern. CBB decliners were more likely to self-report mild cognitive impairment (MCI) and memory concerns. DISCUSSION: Cross-sectional, remote CBB shows evidence of construct validity, but our results suggest that longitudinal assessment may not provide additional value for identifying those at risk for and with cognitive impairment.
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Affiliation(s)
- T Banh
- Tim Banh, University of California San Francisco, USA,
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Williams C, Borges K, Banh T, Vasilevska-Ristovska J, Chanchlani R, Ng VL, Dipchand AI, Solomon M, Hebert D, Kim SJ, Astor BC, Parekh RS. Patterns of kidney injury in pediatric nonkidney solid organ transplant recipients. Am J Transplant 2018; 18:1481-1488. [PMID: 29286569 DOI: 10.1111/ajt.14638] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 10/31/2017] [Accepted: 12/10/2017] [Indexed: 01/25/2023]
Abstract
The incidence of acute kidney injury (AKI) and its impact on chronic kidney disease (CKD) following pediatric nonkidney solid organ transplantation is unknown. We aimed to determine the incidence of AKI and CKD and examine their relationship among children who received a heart, lung, liver, or multiorgan transplant at the Hospital for Sick Children between 2002 and 2011. AKI was assessed in the first year posttransplant. Among 303 children, perioperative AKI (within the first week) occurred in 67% of children, and AKI after the first week occurred in 36%, with the highest incidence among lung and multiorgan recipients. Twenty-three children (8%) developed CKD after a median follow-up of 3.4 years. Less than 5 children developed end-stage renal disease, all within 65 days posttransplant. Those with 1 AKI episode by 3 months posttransplant had significantly greater risk for developing CKD after adjusting for age, sex, and estimated glomerular filtration rate at transplant (hazard ratio: 2.77, 95% confidence interval, 1.13-6.80, P trend = .008). AKI is common in the first year posttransplant and associated with significantly greater risk of developing CKD. Close monitoring for kidney disease may allow for earlier implementation of kidney-sparing strategies to decrease risk for progression to CKD.
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Affiliation(s)
- C Williams
- Department of Medicine, University of Toronto, Toronto, Canada.,Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Canada
| | - K Borges
- Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Canada
| | - T Banh
- Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Canada
| | - J Vasilevska-Ristovska
- Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Canada
| | - R Chanchlani
- Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Canada.,Division of Nephrology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, Canada.,Division of Pediatric Nephrology, Hospital for Sick Children, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - V L Ng
- Department of Medicine, University of Toronto, Toronto, Canada.,Division of Pediatric Gastroenterology Hepatology and Nutrition, Hospital for Sick Children, Toronto, Canada.,Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, Canada
| | - A I Dipchand
- Department of Medicine, University of Toronto, Toronto, Canada.,Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, Canada.,Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Canada
| | - M Solomon
- Department of Medicine, University of Toronto, Toronto, Canada.,Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, Canada.,Division of Pediatric Respiratory Medicine, Hospital for Sick Children, Toronto, Canada
| | - D Hebert
- Department of Medicine, University of Toronto, Toronto, Canada.,Division of Pediatric Nephrology, Hospital for Sick Children, Toronto, Canada.,Transplant and Regenerative Medicine Centre, Hospital for Sick Children, Toronto, Canada
| | - S J Kim
- Department of Medicine, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Department of Medicine, University Health Network, Toronto, Canada
| | - B C Astor
- Departments of Medicine and Population Health Sciences, University of Wisconsin, Madison, WI, USA
| | - R S Parekh
- Department of Medicine, University of Toronto, Toronto, Canada.,Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Canada.,Division of Pediatric Nephrology, Hospital for Sick Children, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Department of Medicine, University Health Network, Toronto, Canada
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Song W, Wagle NM, Banh T, Whiteford CC, Ulug E, Pierce SK. Wortmannin, a phosphatidylinositol 3-kinase inhibitor, blocks the assembly of peptide-MHC class II complexes. Int Immunol 1997; 9:1709-22. [PMID: 9418132 DOI: 10.1093/intimm/9.11.1709] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Peptide-class II complexes are assembled in endocytic, lysosome-like compartments where newly synthesized class II molecules are targeted from the trans-Golgi network (TGN). Recent studies have implicated phosphatidylinositol 3-kinase (PI3-kinase) as an essential component in membrane trafficking from the TGN to lysosomes. Here, using subcellular fractionation, we show PI3-kinase activity associated with subcellular fractions which contain the class II peptide-loading compartment (IIPLC) in B cells. At concentrations required for inhibition of PI3-kinase activity in vivo, wortmannin blocked the processing and presentation of antigen by B cells to T cells. Treatment of B cells with wortmannin significantly limited the proteolytic degradation of invariant chain and the formation of peptide-class II complexes. Subcellular fractionation coupled with pulse-chase analyses showed that invariant chain and class II molecules trafficked to the IIPLC in wortmannin-treated cells. However, wortmannin prevented the maturation and correct targeting to the IIPLC of cathepsin D, a protease necessary for the degradation of invariant chain and assembly of processed antigen-class II complexes. These results suggest that li-class II complexes traffic to the IIPLC via a pathway that is relatively insensitive to wortmannin, but suggest a role for PI3-kinases in the trafficking of other components necessary for the assembly of processed antigen class II complexes to the IIPLC.
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Affiliation(s)
- W Song
- Department of Biochemistry, Molecular Biology and Cell Biology, Northwestern University, Evanston, IL 60208, USA
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