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Guertin KA, Repaske DR, Taylor JF, Williams ES, Onengut-Gumuscu S, Chen WM, Boggs SR, Yu L, Allen L, Botteon L, Daniel L, Keating KG, Labergerie MK, Lienhart TS, Gonzalez-Mejia JA, Starnowski MJ, Rich SS. Implementation of type 1 diabetes genetic risk screening in children in diverse communities: the Virginia PrIMeD project. Genome Med 2024; 16:31. [PMID: 38355597 PMCID: PMC10865687 DOI: 10.1186/s13073-024-01305-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 02/08/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Population screening for risk of type 1 diabetes (T1D) has been proposed to identify those with islet autoimmunity (presence of islet autoantibodies). As islet autoantibodies can be transient, screening with a genetic risk score has been proposed as an entry into autoantibody testing. METHODS Children were recruited from eight general pediatric and specialty clinics across Virginia with diverse community settings. Recruiters in each clinic obtained informed consent/assent, a medical history, and a saliva sample for DNA extraction in children with and without a history of T1D. A custom genotyping panel was used to define T1D genetic risk based upon associated SNPs in European- and African-genetic ancestry. Subjects at "high genetic risk" were offered a separate blood collection for screening four islet autoantibodies. A follow-up contact (email, mail, and telephone) in one half of the participants determined interest and occurrence of subsequent T1D. RESULTS A total of 3818 children aged 2-16 years were recruited, with 14.2% (n = 542) having a "high genetic risk." Of children with "high genetic risk" and without pre-existing T1D (n = 494), 7.0% (34/494) consented for autoantibody screening; 82.4% (28/34) who consented also completed the blood collection, and 7.1% (2/28) of them tested positive for multiple autoantibodies. Among children with pre-existing T1D (n = 91), 52% (n = 48) had a "high genetic risk." In the sample of children with existing T1D, there was no relationship between genetic risk and age at T1D onset. A major factor in obtaining islet autoantibody testing was concern over SARS-CoV-2 exposure. CONCLUSIONS Minimally invasive saliva sampling implemented using a genetic risk score can identify children at genetic risk of T1D. Consent for autoantibody screening, however, was limited largely due to the SARS-CoV-2 pandemic and need for blood collection.
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Affiliation(s)
- Kristin A Guertin
- Department of Public Health Sciences, University of Virginia, 1300 Jefferson Park Avenue, 3182 West Complex, Charlottesville, VA, 22903, USA
- Department of Public Health Sciences, UConn School of Medicine, UConn Health, 263 Farmington Avenue, MC 6325, Farmington, CT, 06030, USA
| | - David R Repaske
- Department of Pediatrics, Division of Pediatric Diabetes & Endocrinology, University of Virginia, UVAHealth, 1204 W Main Street, 6th Floor, Charlottesville, VA, 22903, USA
| | - Julia F Taylor
- Department of Pediatrics, Division of Pediatric Diabetes & Endocrinology, University of Virginia, UVAHealth, 1204 W Main Street, 6th Floor, Charlottesville, VA, 22903, USA
| | - Eli S Williams
- Department of Pathology, Division of Medical Genetics, UVAHealth, University of Virginia, 21 Hospital Drive, Charlottesville, VA, 22903, USA
| | - Suna Onengut-Gumuscu
- Department of Public Health Sciences, University of Virginia, 1300 Jefferson Park Avenue, 3182 West Complex, Charlottesville, VA, 22903, USA
- Center for Public Health Genomics, University of Virginia, 1335 Lee Street, 3235 West Complex, Charlottesville, VA, 22903, USA
| | - Wei-Min Chen
- Department of Public Health Sciences, University of Virginia, 1300 Jefferson Park Avenue, 3182 West Complex, Charlottesville, VA, 22903, USA
- Center for Public Health Genomics, University of Virginia, 1335 Lee Street, 3235 West Complex, Charlottesville, VA, 22903, USA
| | - Sarah R Boggs
- Department of Pediatrics, Division of Pediatric Diabetes & Endocrinology, University of Virginia, UVAHealth, 1204 W Main Street, 6th Floor, Charlottesville, VA, 22903, USA
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, 1774 Aurora Court, Suite A140, Aurora, CO, 80045, USA
| | - Luke Allen
- Center for Public Health Genomics, University of Virginia, 1335 Lee Street, 3235 West Complex, Charlottesville, VA, 22903, USA
| | - Lacey Botteon
- Center for Public Health Genomics, University of Virginia, 1335 Lee Street, 3235 West Complex, Charlottesville, VA, 22903, USA
| | - Louis Daniel
- Center for Public Health Genomics, University of Virginia, 1335 Lee Street, 3235 West Complex, Charlottesville, VA, 22903, USA
| | - Katherine G Keating
- Center for Public Health Genomics, University of Virginia, 1335 Lee Street, 3235 West Complex, Charlottesville, VA, 22903, USA
| | - Mika K Labergerie
- Center for Public Health Genomics, University of Virginia, 1335 Lee Street, 3235 West Complex, Charlottesville, VA, 22903, USA
| | - Tyler S Lienhart
- Center for Public Health Genomics, University of Virginia, 1335 Lee Street, 3235 West Complex, Charlottesville, VA, 22903, USA
| | - Jorge A Gonzalez-Mejia
- Center for Public Health Genomics, University of Virginia, 1335 Lee Street, 3235 West Complex, Charlottesville, VA, 22903, USA
| | - Matt J Starnowski
- Center for Public Health Genomics, University of Virginia, 1335 Lee Street, 3235 West Complex, Charlottesville, VA, 22903, USA
| | - Stephen S Rich
- Department of Public Health Sciences, University of Virginia, 1300 Jefferson Park Avenue, 3182 West Complex, Charlottesville, VA, 22903, USA.
- Center for Public Health Genomics, University of Virginia, 1335 Lee Street, 3235 West Complex, Charlottesville, VA, 22903, USA.
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Masterson Creber R, Benda N, Dimagli A, Myers A, Niño de Rivera S, Omollo S, Sharma Y, Goyal P, Turchioe MR. Using Patient Decision Aids for Cardiology Care in Diverse Populations. Curr Cardiol Rep 2023; 25:1543-1553. [PMID: 37943426 PMCID: PMC10914300 DOI: 10.1007/s11886-023-01953-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 11/10/2023]
Abstract
PURPOSE OF REVIEW Patient decision aids (PDAs) are tools that help guide treatment decisions and support shared decision-making when there is equipoise between treatment options. This review focuses on decision aids that are available to support cardiac treatment options for underrepresented groups. RECENT FINDINGS PDAs have been developed to support multiple treatment decisions in cardiology related to coronary artery disease, valvular heart disease, cardiac arrhythmias, heart failure, and cholesterol management. By considering the unique needs and preferences of diverse populations, PDAs can enhance patient engagement and promote equitable healthcare delivery in cardiology. In this review, we examine the benefits, challenges, and current trends in implementing PDAs, with a focus on improving decision-making processes and outcomes for patients from underrepresented racial and ethnic groups. In addition, the article highlights key considerations when implementing PDAs and potential future directions in the field.
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Affiliation(s)
- Ruth Masterson Creber
- Columbia University School of Nursing, Columbia University Irving Medical Center, 560 W 168th St, New York, NY, 10032, USA.
| | - Natalie Benda
- Columbia University School of Nursing, Columbia University Irving Medical Center, 560 W 168th St, New York, NY, 10032, USA
| | - Arnaldo Dimagli
- Columbia University School of Nursing, Columbia University Irving Medical Center, 560 W 168th St, New York, NY, 10032, USA
| | - Annie Myers
- Columbia University School of Nursing, Columbia University Irving Medical Center, 560 W 168th St, New York, NY, 10032, USA
| | - Stephanie Niño de Rivera
- Columbia University School of Nursing, Columbia University Irving Medical Center, 560 W 168th St, New York, NY, 10032, USA
| | - Shalom Omollo
- Columbia University School of Nursing, Columbia University Irving Medical Center, 560 W 168th St, New York, NY, 10032, USA
| | - Yashika Sharma
- Columbia University School of Nursing, Columbia University Irving Medical Center, 560 W 168th St, New York, NY, 10032, USA
| | | | - Meghan Reading Turchioe
- Columbia University School of Nursing, Columbia University Irving Medical Center, 560 W 168th St, New York, NY, 10032, USA
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Slavotinek A, Prasad H, Outram S, Scollon S, Rego S, Yip T, Hoban H, Foreman KM, Kelley W, Finnila C, Berg J, Murali P, Bonini KE, Martin LJ, Hott A. Information-seeking preferences in diverse patients receiving a genetic testing result in the Clinical Sequencing Evidence-Generating Research (CSER) study. Genet Med 2023; 25:100899. [PMID: 37212252 PMCID: PMC10524447 DOI: 10.1016/j.gim.2023.100899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 05/03/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
PURPOSE Accurate and understandable information after genetic testing is critical for patients, family members, and professionals alike. METHODS As part of a cross-site study from the Clinical Sequencing Evidence-Generating Research consortium, we investigated the information-seeking practices among patients and family members at 5 to 7 months after genetic testing results disclosure, assessing the perceived utility of a variety of information sources, such as family and friends, health care providers, support groups, and the internet. RESULTS We found that individuals placed a high value on information obtained from genetics professionals and health care workers, independent of genetic testing result case classifications as positive, inconclusive, or negative. The internet was also highly utilized and ranked. Study participants rated some information sources as more useful for positive results compared with inconclusive or negative outcomes, emphasizing that it may be difficult to identify helpful information for individuals receiving an uncertain or negative result. There were few data from non-English speakers, highlighting the need to develop strategies to reach this population. CONCLUSION Our study emphasizes the need for clinicians to provide accurate and comprehensible information to individuals from diverse populations after genetic testing.
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Affiliation(s)
- Anne Slavotinek
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, San Francisco, CA; Institute for Human Genetics, University of California, San Francisco, San Francisco, CA.
| | - Hannah Prasad
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA
| | - Simon Outram
- Institute for Health & Aging, School of Nursing, University of California San Francisco, San Francisco, CA
| | - Sarah Scollon
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Shannon Rego
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, San Francisco, CA; Institute for Human Genetics, University of California, San Francisco, San Francisco, CA
| | - Tiffany Yip
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, San Francisco, CA; Institute for Human Genetics, University of California, San Francisco, San Francisco, CA
| | - Hannah Hoban
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, San Francisco, CA; Institute for Human Genetics, University of California, San Francisco, San Francisco, CA
| | - Kate M Foreman
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | - Jonathan Berg
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Priyanka Murali
- Department of Medicine (Medical Genetics), University of Washington Medical Center, Seattle, WA
| | - Katherine E Bonini
- Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lisa J Martin
- Division of Human Genetics Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Adam Hott
- HudsonAlpha Institute for Biotechnology, Huntsville, AL
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Sofer T, Kurniansyah N, Granot-Hershkovitz E, Goodman MO, Tarraf W, Broce I, Lipton RB, Daviglus M, Lamar M, Wassertheil-Smoller S, Cai J, DeCarli CS, Gonzalez HM, Fornage M. A polygenic risk score for Alzheimer's disease constructed using APOE-region variants has stronger association than APOE alleles with mild cognitive impairment in Hispanic/Latino adults in the U.S. Alzheimers Res Ther 2023; 15:146. [PMID: 37649099 PMCID: PMC10469805 DOI: 10.1186/s13195-023-01298-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Polygenic Risk Scores (PRSs) are summaries of genetic risk alleles for an outcome. METHODS We used summary statistics from five GWASs of AD to construct PRSs in 4,189 diverse Hispanics/Latinos (mean age 63 years) from the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA). We assessed the PRS associations with MCI in the combined set of people and in diverse subgroups, and when including and excluding the APOE gene region. We also assessed PRS associations with MCI in an independent dataset from the Mass General Brigham Biobank. RESULTS A simple sum of 5 PRSs ("PRSsum"), each constructed based on a different AD GWAS, was associated with MCI (OR = 1.28, 95% CI [1.14, 1.41]) in a model adjusted for counts of the APOE-[Formula: see text] and APOE-[Formula: see text] alleles. Associations of single-GWAS PRSs were weaker. When removing SNPs from the APOE region from the PRSs, the association of PRSsum with MCI was weaker (OR = 1.17, 95% CI [1.04,1.31] with adjustment for APOE alleles). In all association analyses, APOE-[Formula: see text] and APOE-[Formula: see text] alleles were not associated with MCI. DISCUSSION A sum of AD PRSs is associated with MCI in Hispanic/Latino older adults. Despite no association of APOE-[Formula: see text] and APOE-[Formula: see text] alleles with MCI, the association of the AD PRS with MCI is stronger when including the APOE region. Thus, APOE variants different than the classic APOE alleles may be important predictors of MCI in Hispanic/Latino adults.
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Affiliation(s)
- Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Nuzulul Kurniansyah
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Einat Granot-Hershkovitz
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Matthew O Goodman
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Iris Broce
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | | | - Martha Daviglus
- Department of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa Lamar
- Department of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
- Rush Alzheimer's Disease Research Center, Rush University Medical Center, Chicago, IL, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology & Population Health, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles S DeCarli
- Department of Neurology, University of California at Davis, Sacramento, CA, USA
| | - Hector M Gonzalez
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
- Shiley-Marcos Alzheimer's Disease Center, University of California San Diego, La Jolla, CA, USA
| | - Myriam Fornage
- Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Mente A, Dehghan M, Rangarajan S, O'Donnell M, Hu W, Dagenais G, Wielgosz A, Lear SA, Wei L, Diaz R, Avezum A, Lopez-Jaramillo P, Lanas F, Swaminathan S, Kaur M, Vijayakumar K, Mohan V, Gupta R, Szuba A, Iqbal R, Yusuf R, Mohammadifard N, Khatib R, Nasir NM, Karsidag K, Rosengren A, Yusufali A, Wentzel-Viljoen E, Chifamba J, Dans A, Alhabib KF, Yeates K, Teo K, Gerstein HC, Yusuf S. Diet, cardiovascular disease, and mortality in 80 countries. Eur Heart J 2023:ehad269. [PMID: 37414411 PMCID: PMC10361015 DOI: 10.1093/eurheartj/ehad269] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 03/31/2023] [Accepted: 04/25/2023] [Indexed: 07/08/2023] Open
Abstract
AIMS To develop a healthy diet score that is associated with health outcomes and is globally applicable using data from the Prospective Urban Rural Epidemiology (PURE) study and replicate it in five independent studies on a total of 245 000 people from 80 countries. METHODS AND RESULTS A healthy diet score was developed in 147 642 people from the general population, from 21 countries in the PURE study, and the consistency of the associations of the score with events was examined in five large independent studies from 70 countries. The healthy diet score was developed based on six foods each of which has been associated with a significantly lower risk of mortality [i.e. fruit, vegetables, nuts, legumes, fish, and dairy (mainly whole-fat); range of scores, 0-6]. The main outcome measures were all-cause mortality and major cardiovascular events [cardiovascular disease (CVD)]. During a median follow-up of 9.3 years in PURE, compared with a diet score of ≤1 points, a diet score of ≥5 points was associated with a lower risk of mortality [hazard ratio (HR) 0.70; 95% confidence interval (CI) 0.63-0.77)], CVD (HR 0.82; 0.75-0.91), myocardial infarction (HR 0.86; 0.75-0.99), and stroke (HR 0.81; 0.71-0.93). In three independent studies in vascular patients, similar results were found, with a higher diet score being associated with lower mortality (HR 0.73; 0.66-0.81), CVD (HR 0.79; 0.72-0.87), myocardial infarction (HR 0.85; 0.71-0.99), and a non-statistically significant lower risk of stroke (HR 0.87; 0.73-1.03). Additionally, in two case-control studies, a higher diet score was associated with lower first myocardial infarction [odds ratio (OR) 0.72; 0.65-0.80] and stroke (OR 0.57; 0.50-0.65). A higher diet score was associated with a significantly lower risk of death or CVD in regions with lower than with higher gross national incomes (P for heterogeneity <0.0001). The PURE score showed slightly stronger associations with death or CVD than several other common diet scores (P < 0.001 for each comparison). CONCLUSION A diet comprised of higher amounts of fruit, vegetables, nuts, legumes, fish, and whole-fat dairy is associated with lower CVD and mortality in all world regions, especially in countries with lower income where consumption of these foods is low.
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Affiliation(s)
- Andrew Mente
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, 2nd Floor, Room C2-105, 237 Barton St East, Hamilton, Ontario L8L 2X2, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4L8, Canada
| | - Mahshid Dehghan
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, 2nd Floor, Room C2-105, 237 Barton St East, Hamilton, Ontario L8L 2X2, Canada
| | - Sumathy Rangarajan
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, 2nd Floor, Room C2-105, 237 Barton St East, Hamilton, Ontario L8L 2X2, Canada
| | - Martin O'Donnell
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- HRB-Clinical Research Facility, University of Galway, Galway, Connacht, Ireland
| | - Weihong Hu
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, 2nd Floor, Room C2-105, 237 Barton St East, Hamilton, Ontario L8L 2X2, Canada
| | - Gilles Dagenais
- Department of Medicine, Université Laval Institut universitaire de cardiologie et de pneumologie de Québec, Quebec City G1V 4G5, Canada
| | - Andreas Wielgosz
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Scott A Lear
- Faculty of Health Sciences, and Department of Biomedical Physiology & Kinesiology, Simon Fraser University Vancouver, Burnaby, British Columbia, Canada
| | - Li Wei
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, Xicheng District, China
| | - Rafael Diaz
- Estudios Clinicos Latinoamerica ECLA, Universidad Nacional de Rosario, Rosario, Santa Fe, Argentina
| | - Alvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz & UNISA, Sao Paulo, São Paulo estado, SP Brazil
| | - Patricio Lopez-Jaramillo
- Masira Research Institute, Medical School, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia
| | - Fernando Lanas
- Francisco Salazar, Universidad de La Frontera, Temuco, Araucanía, Chile
| | - Sumathi Swaminathan
- Division of Nutrition, St John's Research Institute, Koramangala, Bangalore, Karnataka, India
| | - Manmeet Kaur
- Postgraduate Institute of Medical Education and Research, School of Public Health, Chandigarh, Punjab and Haryana, India
| | - K Vijayakumar
- Health Action by People, Amrita Institute of Medical Sciences, Trivandrum, Kerala, India
| | - Viswanathan Mohan
- Director and Chief of Diabetes Research, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
| | - Andrzej Szuba
- Department of Internal Medicine, Wroclaw Medical University, 4th Military Hospital, Wroclaw, Lower Silesian Voivodeship, Poland
| | - Romaina Iqbal
- Department of Community Health Sciences and Medicine, Aga Khan University, Karachi, Sindh, Pakistan
| | - Rita Yusuf
- Department of Life Sciences, Independent University, Bangladesh, Bashundhara, Dhaka, Dhaka District, Bangladesh
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Isfahan Province, Iran
| | - Rasha Khatib
- Departments of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nafiza Mat Nasir
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Shah Alam, Selangor, Malaysia
| | - Kubilay Karsidag
- Department of Internal Medicine, Division of Endocrinology, Medical Faculty of Istanbul University, Istanbul, Istanbul Province, Turkey
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Västergötland, Sweden
| | - Afzalhussein Yusufali
- Hatta Hospital, Dubai Health Authority, Dubai Medical University, Dubai, United Arab Emirates
| | - Edelweiss Wentzel-Viljoen
- Faculty of Health Sciences, Centre of Excellence for Nutrition, Potchefstroom, North West Province, South Africa
| | - Jephat Chifamba
- College of Health Sciences, Physiology Department, University of Zimbabwe, Harare, Harare Metropolitan Province, Zimbabwe
| | - Antonio Dans
- Department of Medicine, University of the Philippines, Ermita, Manila, Metro Manila, Philippines
| | - Khalid F Alhabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
| | - Karen Yeates
- Department of Medicine, Queen's University, 94 Stuart Street, Etherington Hall, Kingston, Ontario, Canada
| | - Koon Teo
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, 2nd Floor, Room C2-105, 237 Barton St East, Hamilton, Ontario L8L 2X2, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4L8, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Hertzel C Gerstein
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, 2nd Floor, Room C2-105, 237 Barton St East, Hamilton, Ontario L8L 2X2, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4L8, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, 2nd Floor, Room C2-105, 237 Barton St East, Hamilton, Ontario L8L 2X2, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4L8, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Stern CA, LaChappelle ME. Program Considerations and Addressing At-Risk Populations in Active Minds Clubs: A Brief Report. Community Ment Health J 2022;:1-8. [PMID: 36517700 DOI: 10.1007/s10597-022-01067-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022]
Abstract
Active Minds, a national non-profit, was created to combat suicide and mental health stigma among youth and young adults. Research has indicated that Active Minds has been effective in positively changing students' attitudes and behaviors towards mental health. This study seeks to understand what else Active Minds can do to address mental health barriers and help-seeking within student populations and how Active Minds can better support at-risk populations in their wellness. This study consisted of four focus groups, and 13 participants completed a Brief Questionnaire and answered open-ended questions from a semi-structured interview guide. The narrative was coded and categorized, and thematic analysis was utilized. Eight themes were identified: (a) creating shared safe spaces (b) mental health stigma among Native American and Hispanic/Latinx students (c) the vulnerability of LGBTQ + student populations (d) addressing special populations in Active Minds programming (e) the role of gender and religion in mental health (f) cultural education and resources (g) normalizing mental health through education and family conversation, and (h) promotion of Active Minds and accessibility of counseling. Because the sample size only consisted of 13 participants the results cannot be generalized to students, but the results are transferable to student populations. The researchers recommend that Active Minds use a peer support model and develop curriculums that address mental health stigma and cultural education in diverse populations. Future research is needed to uncover those strategies that might engage males in mental health education.
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Ge T, Irvin MR, Patki A, Srinivasasainagendra V, Lin YF, Tiwari HK, Armstrong ND, Benoit B, Chen CY, Choi KW, Cimino JJ, Davis BH, Dikilitas O, Etheridge B, Feng YCA, Gainer V, Huang H, Jarvik GP, Kachulis C, Kenny EE, Khan A, Kiryluk K, Kottyan L, Kullo IJ, Lange C, Lennon N, Leong A, Malolepsza E, Miles AD, Murphy S, Namjou B, Narayan R, O'Connor MJ, Pacheco JA, Perez E, Rasmussen-Torvik LJ, Rosenthal EA, Schaid D, Stamou M, Udler MS, Wei WQ, Weiss ST, Ng MCY, Smoller JW, Lebo MS, Meigs JB, Limdi NA, Karlson EW. Development and validation of a trans-ancestry polygenic risk score for type 2 diabetes in diverse populations. Genome Med 2022; 14:70. [PMID: 35765100 PMCID: PMC9241245 DOI: 10.1186/s13073-022-01074-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 06/16/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) is a worldwide scourge caused by both genetic and environmental risk factors that disproportionately afflicts communities of color. Leveraging existing large-scale genome-wide association studies (GWAS), polygenic risk scores (PRS) have shown promise to complement established clinical risk factors and intervention paradigms, and improve early diagnosis and prevention of T2D. However, to date, T2D PRS have been most widely developed and validated in individuals of European descent. Comprehensive assessment of T2D PRS in non-European populations is critical for equitable deployment of PRS to clinical practice that benefits global populations. METHODS We integrated T2D GWAS in European, African, and East Asian populations to construct a trans-ancestry T2D PRS using a newly developed Bayesian polygenic modeling method, and assessed the prediction accuracy of the PRS in the multi-ethnic Electronic Medical Records and Genomics (eMERGE) study (11,945 cases; 57,694 controls), four Black cohorts (5137 cases; 9657 controls), and the Taiwan Biobank (4570 cases; 84,996 controls). We additionally evaluated a post hoc ancestry adjustment method that can express the polygenic risk on the same scale across ancestrally diverse individuals and facilitate the clinical implementation of the PRS in prospective cohorts. RESULTS The trans-ancestry PRS was significantly associated with T2D status across the ancestral groups examined. The top 2% of the PRS distribution can identify individuals with an approximately 2.5-4.5-fold of increase in T2D risk, which corresponds to the increased risk of T2D for first-degree relatives. The post hoc ancestry adjustment method eliminated major distributional differences in the PRS across ancestries without compromising its predictive performance. CONCLUSIONS By integrating T2D GWAS from multiple populations, we developed and validated a trans-ancestry PRS, and demonstrated its potential as a meaningful index of risk among diverse patients in clinical settings. Our efforts represent the first step towards the implementation of the T2D PRS into routine healthcare.
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Affiliation(s)
- Tian Ge
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
- Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| | - Marguerite R Irvin
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amit Patki
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Vinodh Srinivasasainagendra
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yen-Feng Lin
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
- Department of Public Health & Medical Humanities, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hemant K Tiwari
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nicole D Armstrong
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Barbara Benoit
- Mass General Brigham Research Information Science & Computing, Boston, MA, USA
| | - Chia-Yen Chen
- Translational Biology, Biogen Inc., Cambridge, MA, USA
| | - Karmel W Choi
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - James J Cimino
- Informatics Institute, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brittney H Davis
- Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ozan Dikilitas
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Internal Medicine, Mayo Clinician-Investigator Training Program, Mayo Clinic, Rochester, MN, USA
| | - Bethany Etheridge
- Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yen-Chen Anne Feng
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Vivian Gainer
- Mass General Brigham Research Information Science & Computing, Boston, MA, USA
| | - Hailiang Huang
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Gail P Jarvik
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Eimear E Kenny
- Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Atlas Khan
- Division of Nephrology, Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University, New York, USA
| | - Krzysztof Kiryluk
- Division of Nephrology, Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University, New York, USA
| | - Leah Kottyan
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Iftikhar J Kullo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Christoph Lange
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Niall Lennon
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Aaron Leong
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | | | - Ayme D Miles
- Informatics Institute, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shawn Murphy
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Bahram Namjou
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Renuka Narayan
- Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Jennifer A Pacheco
- Center for Genetic Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Emma Perez
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Mass General Brigham Personalized Medicine, Boston, MA, USA
| | - Laura J Rasmussen-Torvik
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Elisabeth A Rosenthal
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Daniel Schaid
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Maria Stamou
- Division of Endocrinology, Massachusetts General Hospital, Boston, MA, USA
| | - Miriam S Udler
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Wei-Qi Wei
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Scott T Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Maggie C Y Ng
- Vanderbilt Genetics Institute, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jordan W Smoller
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Matthew S Lebo
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Mass General Brigham Personalized Medicine, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - James B Meigs
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Nita A Limdi
- Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Elizabeth W Karlson
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Mass General Brigham Personalized Medicine, Boston, MA, USA
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8
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Suckiel SA, Braganza GT, Aguiñiga KL, Odgis JA, Bonini KE, Kenny EE, Hamilton JG, Abul-Husn NS. Perspectives of diverse Spanish- and English-speaking patients on the clinical use of polygenic risk scores. Genet Med 2022; 24:1217-1226. [PMID: 35380538 PMCID: PMC10066541 DOI: 10.1016/j.gim.2022.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/05/2022] [Accepted: 03/08/2022] [Indexed: 02/01/2023] Open
Abstract
PURPOSE As polygenic risk scores (PRS) emerge as promising tools to inform clinical care, there is a pressing need for patient-centered evidence to guide their implementation, particularly in diverse populations. Here, we conducted in-depth interviews of diverse Spanish- and English-speaking patients to explore their perspectives on clinical PRS. METHODS We enrolled 30 biobank participants aged 35-50 years through a purposive sampling strategy, ensuring that >75% self-reported as African/African American or Hispanic/Latinx and half were Spanish-speaking. Semistructured interviews in Spanish or English explored attitudes toward PRS, barriers to adoption, and communication preferences. Data were analyzed using an inductive thematic analysis approach. RESULTS Perceived utility of clinical PRS focused on the potential for personal health benefits, and most participants stated that high-risk results would prompt physician consultations and health behavior changes. There was little concern among participants about the limited predictive power of PRS for non-European populations. Barriers to uptake of PRS testing and adoption of PRS-related recommendations included socioeconomic factors, insurance status, race, ethnicity, language, and inadequate understanding of PRS. Participants favored in-person PRS result disclosure by their physician. CONCLUSION Findings provide valuable insight into diverse patients' attitudes and potential barriers related to clinical PRS, guiding future research and patient-centered clinical implementation.
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Affiliation(s)
- Sabrina A Suckiel
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Giovanna T Braganza
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Karla López Aguiñiga
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jacqueline A Odgis
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Katherine E Bonini
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Eimear E Kenny
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jada G Hamilton
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell Medical College, New York, NY
| | - Noura S Abul-Husn
- The Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY.
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9
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Young KA, Hokanson JE. Commentary on Chenoweth et al.: Assessing response to interventions for smoking cessation in diverse populations. Addiction 2022; 117:1725-1726. [PMID: 35301772 DOI: 10.1111/add.15865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Kendra A Young
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John E Hokanson
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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10
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Buckey TM, Morales KH, Apter AJ. Understanding Autonomy in Patients with Moderate to Severe Asthma. J Allergy Clin Immunol Pract 2022; 10:525-33. [PMID: 34785390 DOI: 10.1016/j.jaip.2021.10.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 10/24/2021] [Accepted: 10/29/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Autonomy is the ability of patients to make informed medical decisions. Autonomy is rooted in disease state understanding. Medical ethics, especially the principle of autonomy, plays an important role in health care delivery when caring for diverse populations. OBJECTIVE To identify patient characteristics that influence autonomy. METHODS A total of 295 adults with moderate to severe asthma completed 2 surveys at the beginning of a 1-year randomized clinical trial. The Navigating Ability 2 and Inhaled Corticosteroids Knowledge questionnaires were combined to create a 21-question assessment of autonomy with possible scores ranging from 10 to 105. Linear regression was performed on the derived autonomy score predicted by patient baseline characteristics. RESULTS Comparison revealed statistically significant differences in baseline autonomy scores in patients who reported Spanish as their primary language (P = .01), patients with diabetes (P = .01), and those with depressive symptoms (P = .03) at -11.4 (95% CI, -20.5 to -2.3), -4.8 (95% CI, -8.3 to -1.3), and -3.1 (95% CI, -5.9 to -0.3) points, respectively. Non-Hispanic White participants on average were found to have 8.2 (95% CI, 4.5 to 12.0) points higher autonomy scores compared with non-Hispanic Black participants (Bonferroni-adjusted P < .01). Patients with higher functional health literacy had higher autonomy scores (coefficient = 0.24; 95% CI, 0.1 to 0.4; P < .01). CONCLUSIONS Autonomy is associated with comorbidities, demographics, and literacy. These results may reflect differences in social, educational, and economic opportunities encountered by patients. Further investigation is needed to assess and understand how socioeconomic and educational factors influence autonomy. By identifying differences in autonomy based on baseline patient characteristics, this project serves as an initial step in adjusting current and developing new treatment guidelines and interventions to improve patient autonomy.
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11
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Hou SJ, Tsai SJ, Kuo PH, Lin WY, Liu YL, Yang AC, Lin E, Lan TH. An association study in the Taiwan Biobank elicits the GABAA receptor genes GABRB3, GABRA5, and GABRG3 as candidate loci for sleep duration in the Taiwanese population. BMC Med Genomics 2021; 14:223. [PMID: 34530807 PMCID: PMC8447520 DOI: 10.1186/s12920-021-01083-x] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background Gamma-aminobutyric acid type A (GABAA) receptors mainly mediate the effects of gamma-aminobutyric acid, which is the primary inhibitory neurotransmitter in the central nervous system. Abundant evidence suggests that GABAA receptors play a key role in sleep-regulating processes. No genetic association study has explored the relationships between GABAA receptor genes and sleep duration, sleep quality, and sleep timing in humans. Methods We determined the association between single-nucleotide polymorphisms (SNPs) in the GABAA receptor genes GABRA1, GABRA2, GABRB3, GABRA5, and GABRG3 and sleep duration, sleep quality, and sleep timing in the Taiwan Biobank with a sample of 10,127 Taiwanese subjects. There were 10,142 subjects in the original study cohort. We excluded 15 subjects with a medication history of sedative-hypnotics. Results Our data revealed an association of the GABRB3-GABRA5-GABRG3 gene cluster with sleep duration, which has not been previously identified: rs79333046 (beta = − 0.07; P = 1.21 × 10–3) in GABRB3, rs189790076 (beta = 0.92; P = 1.04 × 10–3) in GABRA5, and rs147619342 (beta = − 0.72; P = 3.97 × 10–3) in GABRG3. The association between rs189790076 in GABRA5 and sleep duration remained significant after Bonferroni correction. A variant (rs12438141) in GABRB3 was also found to act as a potential expression quantitative trait locus. Additionally, we discovered interactions between variants in the GABRB3-GABRA5-GABRG3 gene cluster and lifestyle factors, such as tea and coffee consumption, smoking, and physical activity, that influenced sleep duration, although some interactions became nonsignificant after Bonferroni correction. We also found interactions among GABRB3, GABRA5, and GABRG3 that affected sleep duration. Furthermore, we identified an association of rs7165524 (beta = − 0.06; P = 2.20 × 10–3) in GABRA5 with sleep quality and an association of rs79465949 (beta = − 0.12; P = 3.95 × 10–3) in GABRB3 with sleep timing, although these associations became nonsignificant after Bonferroni correction. However, we detected no evidence of an association of individual SNPs in GABRA1 and GABRA2. Conclusions Our results indicate that rs189790076 in GABRA5 and gene–gene interactions among GABRB3, GABRA5, and GABRG3 may contribute to sleep duration in the Taiwanese population. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-021-01083-x.
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Affiliation(s)
- Sheue-Jane Hou
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Department of Public Health, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Wan-Yu Lin
- Department of Public Health, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Li Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Albert C Yang
- Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Eugene Lin
- Department of Biostatistics, University of Washington, 3980 15th Avenue NE, Box 351617, Seattle, WA, 98195, USA. .,Department of Electrical and Computer Engineering, University of Washington, Seattle, WA, 98195, USA. .,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.
| | - Tsuo-Hung Lan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan.
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12
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Frost CJ, Johnson EP, Witte B, Stark L, Botkin J, Rothwell E. Electronic informed consent information for residual newborn specimen research: findings from focus groups with diverse populations. J Community Genet 2021; 12:199-203. [PMID: 33481187 DOI: 10.1007/s12687-020-00496-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022] Open
Abstract
We developed a video and an app for obtaining consent about allowing newborn blood spots (NBS) to be used as biospecimen resources for biobanking. Newborn screening programs test for treatable diseases and leave residual biospecimens that can be used in future research activities. We conducted focus groups and interviews with three diverse communities to determine (a) how well the consent tools worked and (b) participant familiarity with NBS. Participants preferred the video and noted that they were unaware that NBS could be used for future research. Providing information about how biospecimens could be used was a key issue.
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13
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Rosenbrock GJ, Mire SS, Kim HJ, Aguirre-Munoz Z. Exploring sociodemographic predictors of parents' perceptions about their children's autism and their families' adjustment. Res Dev Disabil 2021; 108:103811. [PMID: 33242748 DOI: 10.1016/j.ridd.2020.103811] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/19/2020] [Accepted: 11/05/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Diagnostic and treatment disparities exist among sociodemographically diverse families with autism spectrum disorder (ASD). These disparities may be partially explained by the lack of information researchers and providers have regarding the unique experiences of diverse populations. AIMS This study aimed to explore sociodemographic predictors of parents' perceptions about their children's ASD and families' adjustment. METHODS Hierarchical linear regression analyses were conducted to explore whether sociodemographic factors predicted aspects of parent's perceptions and family adjustment among 363 parents of children and adolescents with ASD. RESULTS Parents' race/ethnicity, education level, and annual household income predicted their beliefs that they or treatment could be helpful in controlling their children's ASD symptoms; their understanding of ASD; their experiences of emotional distress; their involvement in resources of support; and their families' ability to manage stress. CONCLUSION Our results demonstrate the importance of considering the complexity of families' demographic characteristics when working to support families with ASD. Parents' unique characteristics and experiences influence their perceptions about their children's ASD diagnosis and their families' ability to adjust to life raising children with ASD. Research extending this work is a critical step in dismantling ASD diagnostic and treatment disparities.
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Affiliation(s)
- Georgina J Rosenbrock
- Department of Psychological, Health, and Learning Sciences, University of Houston, United States.
| | - Sarah S Mire
- Department of Psychological, Health, and Learning Sciences, University of Houston, United States
| | - Han Joe Kim
- Department of Psychological, Health, and Learning Sciences, University of Houston, United States
| | - Zenaida Aguirre-Munoz
- Department of Psychological, Health, and Learning Sciences, University of Houston, United States
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14
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Hou SJ, Tsai SJ, Kuo PH, Liu YL, Yang AC, Lin E, Lan TH. An association study in the Taiwan Biobank reveals RORA as a novel locus for sleep duration in the Taiwanese Population. Sleep Med 2020; 73:70-75. [PMID: 32791442 DOI: 10.1016/j.sleep.2020.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/26/2020] [Accepted: 04/13/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Sleep is a key factor for health-related quality of life since sleep disturbances are a significant and common problem for patients with various human diseases such as psychiatric disorders. While single nucleotide polymorphisms (SNPs) in circadian clock genes have been indicated to be associated with sleep duration, most of the association studies have been investigated in populations with European ancestry. It is believed that no studies have been conducted to investigate a link between sleep duration and the circadian clock genes RORA and RORB, which play a key role, with NR1D1, in an additional feedback loop for the circadian rhythm machinery. METHODS In this study, we assessed the relationships between sleep duration and SNPs in the circadian clock genes NR1D1, RORA, and RORB in the Taiwan Biobank with a sample of 10,112 Taiwanese subjects. RESULTS From our data, we revealed a novel significant association in sleep duration with the rs75981965 SNP (P = 9.93 × 10-5) in the RORA gene that has not been previously identified. The association of sleep duration with this SNP remained significant after performing Bonferroni correction. RORA is a potential candidate for sleep duration as RORA has been suggested to play a key role in the regulation of sleep disorders. Additionally, we pinpointed the effects of interactions between RORA rs75981965 and environmental factors such as tea consumption (P = 0.0015), coffee consumption (P = 0.0029), physical activity (P = 0.011), alcohol consumption (P = 0.0146), and smoking (P = 0.0223) in influencing sleep duration. We also found interactions between RORA and NR1D1 (P = 0.0023) as well as between RORA and RORB (P = 0.0061) in affecting sleep duration. CONCLUSIONS Our results indicate that the circadian clock gene RORA may contribute to sleep duration independently as well as through gene-gene and gene-environment interactions in the Taiwanese population.
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Affiliation(s)
- Sheue-Jane Hou
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Department of Public Health, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Li Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Albert C Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, 02215, USA
| | - Eugene Lin
- Department of Biostatistics, University of Washington, Seattle, WA, 98195, USA; Department of Electrical & Computer Engineering, University of Washington, Seattle, WA, 98195, USA; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.
| | - Tsuo-Hung Lan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan.
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15
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Goudsmit M, van Campen J, Schilt T, Hinnen C, Franzen S, Schmand B. One Size Does Not Fit All: Comparative Diagnostic Accuracy of the Rowland Universal Dementia Assessment Scale and the Mini Mental State Examination in a Memory Clinic Population with Very Low Education. Dement Geriatr Cogn Dis Extra 2018; 8:290-305. [PMID: 30323830 PMCID: PMC6180264 DOI: 10.1159/000490174] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 05/17/2018] [Indexed: 11/19/2022] Open
Abstract
Background Diagnosing dementia in elderly immigrants is often difficult due to language and cultural barriers, low education, and illiteracy. We compared the diagnostic accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) to that of the Mini Mental State Examination (MMSE). Methods A total of 144 patients (42 with intact cognition, 44 with mild cognitive impairment [MCI], and 58 with dementia) were administered both instruments and were diagnosed by specialists blinded for MMSE and RUDAS results. Results Areas under the curve for discriminating intact cognition from MCI and dementia were comparable for RUDAS (0.81; 95% confidence interval 0.74–0.88) and MMSE (0.75; 95% confidence interval 0.69–0.85). Education and literacy were not correlated with the RUDAS but had a medium-large correlation with the MMSE (rho = 0.39). Conclusions The study provides additional evidence for the usefulness of the RUDAS in a highly illiterate, culturally diverse geriatric outpatient population.
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Affiliation(s)
- Miriam Goudsmit
- Department of Medical Psychology/Hospital Psychiatry, Medical Centre Slotervaart, Amsterdam, the Netherlands
| | - Jos van Campen
- Department of Geriatrics, Medical Centre Slotervaart, Amsterdam, the Netherlands
| | - Thelma Schilt
- Department of Medical Psychology/Hospital Psychiatry, Medical Centre Slotervaart, Amsterdam, the Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Chris Hinnen
- Department of Medical Psychology/Hospital Psychiatry, Medical Centre Slotervaart, Amsterdam, the Netherlands
| | - Sanne Franzen
- Department of Neurology, Erasmus MC - University Medical Center, Rotterdam, the Netherlands
| | - Ben Schmand
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
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Bailey KA, Gammage KL, van Ingen C. How do you define body image? Exploring conceptual gaps in understandings of body image at an exercise facility. Body Image 2017; 23:69-79. [PMID: 28886392 DOI: 10.1016/j.bodyim.2017.08.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 08/03/2017] [Accepted: 08/15/2017] [Indexed: 12/13/2022]
Abstract
The definition of body image has evolved within research; however, less is known about the layperson's understanding of the construct. This study explored how members and student trainees of an exercise facility (designed for older adults, people with physical disability, and those with cardiac complications) defined body image. Nineteen participants completed a one-on-one interview, and seven of those participants took part in six additional focus group meetings. The following main themes were found: stereotypical assumptions about body image (e.g., it is solely a person's weight or merely a woman's issue), body image continua for positive and negative body image, degree of complexity of body image dimensions, broad considerations of body image (e.g., it is self-esteem), and limited knowledge about body image. These findings suggest a need for knowledge translation between researchers and the general public which informs future body image program design.
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Affiliation(s)
- K Alysse Bailey
- Faculty of Applied Health Sciences, Brock University, Canada; Brock-Niagara Centre for Health and Well-Being, Brock University, Canada.
| | - Kimberley L Gammage
- Department of Kinesiology, Brock University, Canada; Brock-Niagara Centre for Health and Well-Being, Brock University, Canada
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Price P, Tacey M, Koufariotis V, Stramandinoli D, Vincent R, Grigg L, Zentner D. A Contemporary Phone-Based Cardiac Coaching Program: Evolution and Cross Cultural Utility. Heart Lung Circ 2017; 27:804-811. [PMID: 28923394 DOI: 10.1016/j.hlc.2017.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/23/2017] [Accepted: 07/26/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Hospital Admission Risk Program (HARP) Cardiac Coach Program at Royal Melbourne Hospital has evolved to include a Greek and Italian service, developed in response to the diverse local community and supported by evidence that Culturally and Linguistically Diverse (CALD) groups both perceive health and respond to health care services and information, differently. This paper aims to evaluate if a phone-based cardiac coaching program can be adapted to the Greek and Italian populations using the English cohort as a comparator. METHODS We retrospectively analysed cardiovascular risk profiles at recruitment into and at discharge from the program. Patients (n=383) were recruited after an acute coronary event or intervention between June 2011 and June 2013. Recruitment was into the English (n=301 patients (79%)) Greek (40 (10%)) or Italian (42 (11%)) model. Data was collected on demographic information and risk factor status at entry and discharge from the program: waist circumference, weight, height, lipid profile, HbA1c, smoking status and physical activity. A comparison of the proportion of patients meeting the defined targets across the English, Italian and Greek cohorts was performed, with multivariate logistic regression analysis applied to adjust for differences in baseline variables. RESULTS There were baseline differences in age, smoking history, total cholesterol and cholesterol fractions, diastolic blood pressure, weight and physical activity between the cohorts. At discharge, the proportion of patients meeting targets within each cohort were similar. CONCLUSION A phone-based integrated disease management program can be adapted to CALD patients, achieving comparable outcomes as compared with an English-speaking cohort. Health services need to respond to their local needs and be flexible in program delivery in order to benefit as many patients as possible.
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Affiliation(s)
- Peita Price
- HARP-Merri Health, Melbourne, Vic, Australia; Royal Melbourne Hospital, Melbourne, Vic, Australia.
| | - Mark Tacey
- Royal Melbourne Hospital, Melbourne, Vic, Australia; Melbourne EpiCentre, Department of Medicine, University of Melbourne, Melbourne, Vic, Australia
| | | | | | - Ruth Vincent
- Royal Melbourne Hospital, Melbourne, Vic, Australia
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Napoles A, Cook E, Ginossar T, Knight KD, Ford ME. Applying a Conceptual Framework to Maximize the Participation of Diverse Populations in Cancer Clinical Trials. Adv Cancer Res 2016; 133:77-94. [PMID: 28052822 DOI: 10.1016/bs.acr.2016.08.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The underrepresentation of ethnically diverse populations in cancer clinical trials results in the inequitable distribution of the risks and benefits of this research. Using a case study approach, we apply a conceptual framework of factors associated with the participation of diverse population groups in cancer clinical trials developed by Dr. Jean Ford and colleagues to increase understanding of the specific strategies, and barriers and promoters addressed by these strategies, that resulted in marked success in accrual of racially and ethnically diverse populations in cancer clinical research. Results indicate that the studies presented were able to successfully engage minority participants due to the creation and implementation of multilevel, multifaceted strategies that included: culturally and linguistically appropriate outreach, education, and research studies that were accessible in local communities; infrastructure to support engagement of key stakeholders, clinicians, and organizations serving minority communities; testimonials by ethnically diverse cancer survivors; availability of medical interpretation services; and providing infrastructure that facilitated the engagement in clinical research of clinicians who care for minority patient populations. These strategic efforts were effective in addressing limited awareness of trials, lack of opportunities to participate, and acceptance of engagement in cancer clinical trials. Careful attention to the context and population characteristics in which cancer clinical trials are conducted will be necessary to address disparities in research participation and cancer outcomes. These studies illustrate that progress on minority accrual into clinical research requires intentional efforts to overcome barriers at all three stages of the accrual process: awareness, opportunity, and acceptance of participation.
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Affiliation(s)
- A Napoles
- University of California, San Francisco, CA, United States
| | - E Cook
- University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - T Ginossar
- University of New Mexico, Albuquerque, NM, United States
| | - K D Knight
- Medical University of South Carolina, Charleston, SC, United States
| | - M E Ford
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, United States.
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Hay JL, Ramos M, Li Y, Holland S, Brennessel D, Kemeny MM. Deliberative and intuitive risk perceptions as predictors of colorectal cancer screening over time. J Behav Med 2016; 39:65-74. [PMID: 26280754 PMCID: PMC4724274 DOI: 10.1007/s10865-015-9667-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/31/2015] [Indexed: 02/05/2023]
Abstract
Cancer risk perceptions may involve intuitions-including both affect as well as gut-level thoughts about risk-and deliberative risk magnitudes. Yet, little research has examined the potentially diverse relations between risk perceptions and behavior across time. A highly diverse primary care sample (N = 544, aged ≥50) was utilized to compare how deliberative and intuitive perceptions of risk relate to chart-confirmed colorectal cancer screening at cross-sectional and prospective time points. At baseline, deliberative and intuitive risk perceptions were negatively associated with chart-confirmed colorectal cancer screening adherence in bivariable but not multivariable analyses. Among those who were non-adherent with colorectal cancer screening at baseline, deliberative and intuitive risk perceptions were positively associated with prospective uptake of chart-confirmed colorectal cancer screening adherence at 12-months in bivariable analyses; only deliberative risk perceptions remained significant in the multivariable model. This study indicates that diverse risk perceptions are differentially important for screening at different time points.
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Affiliation(s)
- Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA.
| | - Marcel Ramos
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA
| | - Susan Holland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA
| | - Debra Brennessel
- Mount Sinai Medical Center, Queens Hospital Center, New York, NY, 11432, USA
| | - M Margaret Kemeny
- Mount Sinai Medical Center, Queens Hospital Center, New York, NY, 11432, USA
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