1,718 results on '"Stanford Prevention Research Center"'
Search Results
2. Stronger: Muscle Strengthening for Menopause
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Marily Ann Oppezzo, Instructor, Med/Stanford Prevention Research Center
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- 2024
3. First-in-Human Study of Utomilumab, a 4-1BB/CD137 Agonist, in Combination with Rituximab in Patients with Follicular and Other CD20+ Non-Hodgkin Lymphomas
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Craig Davis, Nancy L. Bartlett, Roch Houot, Aron Thall, Ronald Levy, Keith A. Ching, Leslie Popplewell, Sandip Pravin Patel, Adrian Woolfson, Bo Huang, Ying Chen, Xinmeng J. Mu, Ajay K. Gopal, Caron A. Jacobson, Kolette D. Fly, Shibing Deng, University of Washington [Seattle], Stanford Prevention Research Center, Stanford Medicine, Stanford University-Stanford University, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Etablissement français du sang [Rennes] (EFS Bretagne), Microenvironment, Cell Differentiation, Immunology and Cancer (MICMAC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Moores Cancer Center [La Jolla], UC San Diego School of Medicine, City of Hope National Medical Center, Dana-Farber Cancer Institute [Boston], Pfizer Oncology, Washington University School of Medicine in St. Louis, Washington University in Saint Louis (WUSTL), N.A., Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), School of Medicine [Univ California San Diego] (UC San Diego), University of California [San Diego] (UC San Diego), University of California (UC)-University of California (UC)-University of California [San Diego] (UC San Diego), and University of California (UC)-University of California (UC)
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0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Pharmacokinetics ,immune system diseases ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Adverse effect ,CD20 ,biology ,business.industry ,medicine.disease ,3. Good health ,Lymphoma ,030104 developmental biology ,Oncology ,Tolerability ,030220 oncology & carcinogenesis ,Pharmacodynamics ,biology.protein ,Rituximab ,Refractory Follicular Lymphoma ,business ,medicine.drug - Abstract
Purpose: In this phase I study (NCT01307267), we evaluated safety, pharmacokinetics, clinical activity, and pharmacodynamics of treatment with utomilumab plus rituximab in patients with relapsed/refractory follicular lymphoma (FL) and other CD20+ non-Hodgkin lymphomas (NHL). Patients and Methods: Primary objectives were to assess treatment safety and tolerability for estimating the MTD, using a modified time-to-event continual reassessment method, and selecting the recommended phase II dose (RP2D). Results: Sixty-seven patients received utomilumab (0.03–10.0 mg/kg every 4 weeks) and rituximab (375 mg/m2 weekly) in the dose-escalation groups or utomilumab (1.2 mg/kg every 4 weeks) plus rituximab in the dose-expansion cohort. No patient experienced dose-limiting toxicity. The MTD for utomilumab in combination with rituximab was not reached and estimated to be ≥10 mg/kg every 4 weeks. The majority of the utomilumab treatment-related adverse events (AE) were grade 1 to 2; the most common AE was fatigue (16.4%). The pharmacokinetics of utomilumab in combination with rituximab was linear in the 0.03 to 10 mg/kg dose range. A low incidence (1.5%) of treatment-induced antidrug antibodies against utomilumab was observed. The objective response rate was 21.2% (95% CI, 12.1%–33.0%) in all patients with NHL, including four complete and 10 partial responses. Analysis of paired biopsies from a relapsed/refractory FL patient with complete response showed increased T-cell infiltration and cytotoxic activity in tumors. Biomarker correlations with outcomes suggested that clinical benefit may be contingent on patient immune function. Conclusions: Utomilumab in combination with rituximab demonstrated clinical activity and a favorable safety profile in patients with CD20+ NHLs.
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- 2020
4. Sustainable Diets for Cardiovascular Disease Prevention and Management
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Matthew J. Landry, Anthony Crimarco, Claire Bladier, Andrea S. Mendoza-Vasconez, Christopher D. Gardner, Stanford Prevention Research Center, Stanford Medicine, Stanford University-Stanford University, Direction de l'Evaluation des Risques (DER), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), and This work was supported by a training grant from the National Heart, Lung, and Blood Institute [T32 HL007034].
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Healthy eating pattern ,MESH: Food Supply ,Natural resource economics ,Biodiversity ,Context (language use) ,Cardiovascular disease prevention ,030204 cardiovascular system & hematology ,Food Supply ,03 medical and health sciences ,0302 clinical medicine ,MESH: Diet ,Economic cost ,Health care ,Food choice ,Humans ,Medicine ,030212 general & internal medicine ,Dietary patterns ,2. Zero hunger ,MESH: Humans ,Land use ,business.industry ,MESH: Cardiovascular Diseases ,MESH: Diet, Healthy ,15. Life on land ,Diet ,Plant-based diets ,3. Good health ,Sustainability ,Cardiovascular Diseases ,13. Climate action ,Agriculture ,Diet, Healthy ,Cardiology and Cardiovascular Medicine ,business ,[SDV.AEN]Life Sciences [q-bio]/Food and Nutrition - Abstract
Healthy dietary patterns are recommended for prevention of cardiovascular disease, which remains the leading cause of morbidity and mortality globally. In this review, we discuss dietary patterns that are not only optimal for CVD prevention and management but also sustainable in maximizing health, environmental, and economic benefits. The growing literature on sustainable diets in the context of environmental sustainability includes subtopics of climate change, land use, biodiversity loss, freshwater use, and reactive nitrogen emissions. Similarly, economic sustainability, beyond the retail cost of food, extends to healthcare costs and the economic costs of environmental destruction related to current agricultural practices and food choices. Dietary patterns that are high in plant foods and low in animal foods could maximize health, environmental, and economic benefits; however, questions remain about how to best promote these patterns to achieve wider adoption in an environmentally and economically sustainable way.
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- 2021
5. Dietary Protein and Amino Acids in Vegetarian Diets-A Review
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François Mariotti, Christopher D. Gardner, Physiologie de la Nutrition et du Comportement Alimentaire (PNCA), AgroParisTech-Institut National de la Recherche Agronomique (INRA), Stanford University [Stanford], Institut National de la Recherche Agronomique (INRA)-AgroParisTech, Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine [CA, USA]-Stanford University School of Medicine [CA, USA], and Stanford University
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0301 basic medicine ,Amino acid deficiency ,High energy ,vegetarian diet ,lcsh:TX341-641 ,030209 endocrinology & metabolism ,Review ,Biology ,Vegetarian diets ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,adults ,Humans ,2. Zero hunger ,chemistry.chemical_classification ,adequacy ,amino acids ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Health professionals ,Diet, Vegetarian ,Nutritional Requirements ,Vegan Diet ,Nutritional status ,protein requirement ,vegan diet ,protein intake ,3. Good health ,Amino acid ,Dietary protein ,chemistry ,Dietary Proteins ,protein ,lcsh:Nutrition. Foods and food supply ,[SDV.AEN]Life Sciences [q-bio]/Food and Nutrition ,Food Science - Abstract
International audience; While animal products are rich in protein, the adequacy of dietary protein intake from vegetarian/vegan diets has long been controversial. In this review, we examine the protein and amino acid intakes from vegetarian diets followed by adults in western countries and gather information in terms of adequacy for protein and amino acids requirements, using indirect and direct data to estimate nutritional status. We point out that protein-rich foods, such as traditional legumes, nuts and seeds, are sufficient to achieve full protein adequacy in adults consuming vegetarian/vegan diets, while the question of any amino acid deficiency has been substantially overstated. Our review addresses the adequacy in changes to protein patterns in people newly transitioning to vegetarian diets. We also specifically address this in older adults, where the issues linked to the protein adequacy of vegetarian diets are more complex. This contrasts with the situation in children where there are no specific concerns regarding protein adequacy because of their very high energy requirements compared to those of protein. Given the growing shifts in recommendations from nutrition health professionals for people to transition to more plant-based, whole-food diets, additional scientific evidence-based communications confirming the protein adequacy of vegetarian and vegan diets is warranted.
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- 2019
6. Classification and Evolution of Human Papillomavirus Genome Variants: Alpha-5 (HPV26, 51, 69, 82), Alpha-6 (HPV30, 53, 56, 66), Alpha-11 (HPV34, 73), Alpha-13 (HPV54) and Alpha-3 (HPV61)
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Ann W. Hsing, Mark Schiffman, Kathryn Anastos, Paul K.S. Chan, Patti E. Gravitt, Robert D. Burk, Michel Segondy, Vikrant V. Sahasrabuddhe, Rolando Herrero, Zigui Chen, Rob DeSalle, Department of Microbiology, the University of Hong Kong, The University of Hong Kong (HKU), National Cancer Institute [Bethesda] (NCI-NIH), National Institutes of Health [Bethesda] (NIH), Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, San José, Costa Rica, Prevention and Implementation Group, International Agency for Research on Cancer, World Health Organization, France, The Sackler Institute of Comparative Genomics, American Museum of Natural History, Albert Einstein College of Medicine [New York], Pathogénèse et contrôle des infections chroniques (PCCI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier )-Université de Montpellier (UM), Milken Institute School of Public Health, The George Washington University (GW), Stanford Prevention Research Center, Stanford Medicine, and Stanford University-Stanford University
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0301 basic medicine ,food.ingredient ,Alpha (ethology) ,Genome, Viral ,Alphapapillomavirus ,Biology ,Genome ,Article ,Evolution, Molecular ,03 medical and health sciences ,food ,Phylogenetics ,Virology ,Genetic variation ,Humans ,Human papillomavirus ,Phylogeny ,Genetics ,Phylogenetic tree ,Papillomavirus Infections ,Genetic Variation ,030104 developmental biology ,Capsid ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Female - Abstract
International audience; HPV variants from the same type can be classified into lineages and sublineages based on the complete genome differences and the phylogenetic topologies. We examined nucleotide variations of twelve HPV types within the species Alpha-5 (HPV26, 51, 69, 82), Alpha-6 (HPV30, 53, 56, 66), Alpha-11 (HPV34, 73), Alpha-13 (HPV54) and Alpha-3 (HPV61) by analyzing 1432 partial sequences and 181 complete genomes from multiple geographic populations. The inter-lineage and inter-sublineage mean differences of HPV variants ranged between 0.9-7.3% and 0.3-0.9%, respectively. The heterogeneity and phylogenies of HPV isolates indicate an independent evolutionary history for each type. The noncoding regions were the most variable regions whereas the capsid proteins were relatively conserved. Certain variant lineages and/or sublineages were geographically-associated. These data provide the basis to further classify HPV variants and should foster future studies on the evolution of HPV genomes and the associations of HPV variants with cancer risk.
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- 2018
7. A meta-analysis of genome-wide association studies identifies novel variants associated with osteoarthritis of the hip
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William E R Ollier, Gillian A. Wallis, Unnur Styrkarsdottir, Nicholas G. Martin, P. Eline Slagboom, Mike R. Reed, Helgi Jonsson, J. Mark Wilkinson, John P. A. Ioannidis, Aime Keis, Yolande F. M. Ramos, Daniel S. Evans, Penelope A. Lind, Stuart H. Ralston, Thorvaldur Ingvarsson, Andrew McCaskie, Konstantinos K. Tsilidis, Evangelos Evangelou, Kay Chapman, Tim D. Spector, Aaron G. Day-Williams, L. Stefan Lohmander, Aspasia Tsezou, Ashok Rai, Rob G H H Nelissen, Kari Stefansson, Cristina Rodriguez-Fontenla, Sarah Metrustry, Andres Metspalu, Kalliope Panoutsopoulou, Albert Hofman, Hanneke J. M. Kerkhof, John Loughlin, Panos Deloukas, Joyce B. J. van Meurs, Ana M. Valdes, Evangelia E. Ntzani, Lorraine Southam, José A. Riancho, J. Christiaan Keurentjes, Francisco J. Blanco, Gudmar Thorleifsson, Peter M. Nilsson, Ingrid Meulenbelt, Lili Milani, Fernando Rivadeneira, Michael C. Nevitt, Nicholas Bellamy, Nancy E Lane, Unnur Thorsteinsdottir, Grant W. Montgomery, Michael Doherty, Tõnu Esko, Ingileif Jonsdottir, Nigel K Arden, Hafdis T. Helgadottir, André G. Uitterlinden, Antonio Gonzalez, Steffan D. Bos, Margreet Kloppenburg, Andrew Carr, Eleftheria Zeggini, Gunnar Engström, N Aslam, Fraser Birrell, Neeta Parimi, Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece Department of Twin Research & Genetic Epidemiology, King's College London, London, UK. 2Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. 3Department of Population Genetics, deCODE Genetics, Reykjavik, Iceland. 4Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece. 5Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands Netherlands Consortium for Healthy Ageing, The Netherlands. 6Estonian Genome Center, University of Tartu, Tartu, Estonia Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia. 7California Pacific Medical Center Research Institute, San Francisco, USA. 8Department of Twin Research & Genetic Epidemiology, King's College London, London, UK. 9Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, UK. 10Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands. 11NIHR Biomedical Research Unit and ARUK Centre of excellence for Sport, Exercise and Osteoarthritis, University of Oxford, Oxford, UK MRC Epidemiology Resource Centre, University of Southampton, Southampton, UK. 12Worcestershire Royal Hospital, Worcestershire Acute Hospitals NHS Trust, Worcester, UK. 13Centre of National Research on Disability and Rehabilitation Medicine, The University of Queensland, Brisbane, Australia. 14Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK Wansbeck General Hospital, Northumbria Healthcare NHS Foundation Trust, Ashington, UK. 15Rheumatology Division, Instituto de Investigación Biomédica-Hospital Universitario A Coruña, A Corunna, Spain. 16NIHR Biomedical Research Unit and ARUK Centre of excellence for Sport, Exercise and Osteoarthritis, University of Oxford, Oxford, UK. 17Department of Academic Rheumatology, University of Nottingham, Nottingham, UK. 18Department of Clinical Sciences Malmo, Lund University, Malmo, Sweden. 19Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands. 20Department of Orthopedic Surgery, Akureyri Hospital, Akureyri, Iceland School of Health Sciences, University of Akureyri, Akureyri, Iceland. 21Department of Medicine, The National University Hospital of Iceland, Reykjavik, Iceland Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 22Department of Public Health, University of Tartu, Tartu, Estonia Orthopedic Surgeons, Elva Hospital, Elva, Estonia. 23Department of Orthopedics, Leiden University Medical Center, Leiden, The Netherlands. 24Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. 25Department of Quantitative Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia. 26Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK. 27Department of Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, Australia. 28Estonian Genome Center, University of Tartu, Tartu, Estonia. 29Department of Molecular Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, Australia. 30Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA. 31Centre for Integrated Genomic Medical Research, University of Manchester, Manchester, UK. 32Worcestershire Acute Hospitals NHS Trust, Worcester, UK. 33Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK. 34Wansbeck General Hospital, Northumbria Healthcare NHS Foundation Trust, Ashington, UK. 35Department of Internal Medicine, Hospital U.M. Valdecilla-IFIMAV, University of Cantabria, Santander, Spain. 36Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands. 37Laboratorio Investigacion 10 and Rheumatology Unit, Instituto de Investigacion Sanitaria-Hospital Clinico Universitario de Santiago, Santiago de Compostela, Spain. 38Department of Population Genetics, deCODE Genetics, Reykjavik, Iceland Department of Medicine, The National University Hospital of Iceland, Reykjavik, Iceland. 39Department of Biology, University of Thessaly, Medical School, Larissa, Greece. 40Wellcome Trust Centre for Cell-Matrix Research, University of Manchester, Manchester, UK. 41Department of Human Metabolism, University of Sheffield, Sheffield, UK. 42Department of Medicine, University of California at Davis, Sacramento, USA. 43Research Unit for Musculoskeletal Function and Physiotherapy, and Department of Orthopedics and Traumatology, University of Southern Denmark, Odense, Denmark Department of Clinical Sciences Lund, Lund University, Lund, Sweden. 44Department of Population Genetics, deCODE Genetics, Reykjavik, Iceland Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 45Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, USA. 46Department of Twin Research & Genetic Epidemiology, King's College London, London, UK Department of Academic Rheumatology, University of Nottingham, Nottingham, UK., arcOGEN Consortium, Universidad de Cantabria, Medical Oncology, Epidemiology, and Internal Medicine
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Male ,Aging ,Epidemiology ,Genome-wide association study ,Calcium-Calmodulin-Dependent Protein Kinase Type 2/genetics ,Bioinformatics ,Osteoarthritis, Hip ,Nuclear Receptor Coactivator 3 ,Gene Frequency ,Grupo de Ascendencia Continental Europea ,Immunology and Allergy ,Medicine ,2.1 Biological and endogenous factors ,Osteoarthritis, Hip/genetics ,Aetiology ,European Continental Ancestry Group/genetics ,Gene polymorphism ,Single Nucleotide ,Protein-Tyrosine Kinases ,Protein-Serine-Threonine Kinases ,3. Good health ,Slitgigt ,1117 Public Health And Health Services ,1107 Immunology ,Nuclear Receptor Coactivator 3/genetics ,Female ,arcOGEN Consortium ,Frecuencia de los Genes ,Protein-Serine-Threonine Kinases/genetics ,Clinical Sciences ,Immunology ,European Continental Ancestry Group ,Predisposición Genética a la Enfermedad ,Single-nucleotide polymorphism ,Locus (genetics) ,Protein Serine-Threonine Kinases ,Public Health And Health Services ,Polymorphism, Single Nucleotide ,General Biochemistry, Genetics and Molecular Biology ,Immediate early protein ,White People ,Proteína Quinasa Tipo 2 Dependiente de Calcio Calmodulina ,Estudio de Asociación del Genoma Completo ,Immediate-Early Proteins ,Sex Factors ,Rheumatology ,Gene Polymorphism ,Osteoarthritis ,Genetics ,Humans ,Genetic Predisposition to Disease ,Polymorphism ,Allele frequency ,Genetic association ,Rheumatology and Autoimmunity ,Homeodomain Proteins ,Hip ,Protein-Tyrosine Kinases/genetics ,business.industry ,Whites ,Arthritis ,Prevention ,Human Genome ,1103 Clinical Sciences ,Clinical and Epidemiological Research ,Arfgengi ,Immediate-Early Proteins/genetics ,Arthritis & Rheumatology ,Minor allele frequency ,Musculoskeletal ,Mjaðmir ,HMGN Proteins ,Osteoartritis de la Cadera ,Homeodomain Proteins/genetics ,business ,Calcium-Calmodulin-Dependent Protein Kinase Type 2 ,HMGN Proteins/genetics ,Genome-Wide Association Study - Abstract
To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access. Osteoarthritis (OA) is the most common form of arthritis with a clear genetic component. To identify novel loci associated with hip OA we performed a meta-analysis of genome-wide association studies (GWAS) on European subjects. We performed a two-stage meta-analysis on more than 78,000 participants. In stage 1, we synthesised data from eight GWAS whereas data from 10 centres were used for 'in silico' or 'de novo' replication. Besides the main analysis, a stratified by sex analysis was performed to detect possible sex-specific signals. Meta-analysis was performed using inverse-variance fixed effects models. A random effects approach was also used. We accumulated 11,277 cases of radiographic and symptomatic hip OA. We prioritised eight single nucleotide polymorphism (SNPs) for follow-up in the discovery stage (4349 OA cases); five from the combined analysis, two male specific and one female specific. One locus, at 20q13, represented by rs6094710 (minor allele frequency (MAF) 4%) near the NCOA3 (nuclear receptor coactivator 3) gene, reached genome-wide significance level with p=7.9×10(-9) and OR=1.28 (95% CI 1.18 to 1.39) in the combined analysis of discovery (p=5.6×10(-8)) and follow-up studies (p=7.3×10(-4)). We showed that this gene is expressed in articular cartilage and its expression was significantly reduced in OA-affected cartilage. Moreover, two loci remained suggestive associated; rs5009270 at 7q31 (MAF 30%, p=9.9×10(-7), OR=1.10) and rs3757837 at 7p13 (MAF 6%, p=2.2×10(-6), OR=1.27 in male specific analysis). Novel genetic loci for hip OA were found in this meta-analysis of GWAS. info:eu-repo/grantAgreement/EC/FP7/200800 info:eu-repo/grantAgreement/EC/FP7/286213
- Published
- 2014
8. Non-randomised Ebola trials-lessons for optimal outbreak research
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Bates, Matthew, Zumla, Alimuddin, Ippolito, Giuseppe, Lanini, Simone, Brouqui, Philippe, Di Caro, Antonino, Vairo, Francesco, Fusco, Francesco Maria, Krishna, Sanjeev, Capobianchi, Maria Rosaria, Kyobe-Bosa, Henry, Puro, Vincenzo, Woelfel, Roman, Avsic-Zupanc, Tatjana, Ioannidis, John P. A., Portella, Gina, Kremsner, Peter, Dar, Osman, University College of London [London] (UCL), Department for Infectious Diseases, National Institute for Infectious Diseases ‘‘Lazarro Spallanzani’’, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord [CHU - APHM], Laboratory of microbiology and biorepository, INMI L. Spallanzani, Clinical Department, Institute for Infection and Immunity [Londres, UK], St George's, University of London, Laboratory of virology, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Biomedical Research Institute, Foundation for Research and Technology, Department of Medicine, Tufts University School of Medicine, Center for Genetic Epidemiology and Modeling and Tufts CTSI, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Stanford Prevention Research Center, Stanford Medicine, Stanford University-Stanford University, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), and University of Ioannina
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[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,ComputingMilieux_MISCELLANEOUS - Abstract
International audience; no abstract
- Published
- 2016
9. Age at menopause, reproductive history, and venous thromboembolism risk among postmenopausal women: the Women's Health Initiative Hormone Therapy clinical trials
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Geneviève Plu-Bureau, Barbara B. Cochrane, Marianne Canonico, Marcia L. Stefanick, JoAnn E. Manson, Pierre-Yves Scarabin, Mary Jo O'Sullivan, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université Paris Descartes - Paris 5 (UPD5), Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Maison du patrimoine Oral de Bourgogne (Anost) (MPOB), Stanford Prevention Research Center, Stanford Medicine, Stanford University-Stanford University, University of Washington [Seattle], Departments of Ophthalmology and Microbiology and Molecular Genetics, Harvard Medical School [Boston] (HMS), National Heart, Lung, and Blood Institute, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), SZTAJNBOK, Pascale, Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Descartes - Paris 5 ( UPD5 ), Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Maison du patrimoine Oral de Bourgogne ( MPO ), Maison du patrimoine Oral de Bourgogne, Stanford University School of Medicine, and Harvard Medical School [Boston] ( HMS )
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MESH : Venous Thromboembolism ,MESH: Reproductive History ,MESH: Menopause ,medicine.medical_treatment ,MESH : Aged ,030204 cardiovascular system & hematology ,MESH: Venous Thromboembolism ,MESH: Pregnancy ,0302 clinical medicine ,MESH : Child ,MESH: Risk Factors ,Pregnancy ,Risk Factors ,MESH: Child ,MESH : Female ,030212 general & internal medicine ,Child ,Reproductive History ,MESH: Aged ,Clinical Trials as Topic ,MESH : Estrogen Replacement Therapy ,MESH: Middle Aged ,Obstetrics ,Women's Health Initiative ,Hazard ratio ,Estrogen Replacement Therapy ,MESH : Menopause ,Age Factors ,MESH : Menarche ,Obstetrics and Gynecology ,[ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie ,Venous Thromboembolism ,MESH : Adult ,Middle Aged ,MESH : Risk Factors ,3. Good health ,MESH : Women's Health ,Menopause ,Postmenopause ,Parity ,MESH : Ovariectomy ,MESH: Menarche ,MESH : Postmenopause ,Menarche ,Female ,MESH: Postmenopause ,Adult ,medicine.medical_specialty ,MESH: Clinical Trials as Topic ,Adolescent ,Ovariectomy ,MESH: Ovariectomy ,Article ,03 medical and health sciences ,MESH : Adolescent ,MESH : Reproductive History ,medicine ,Humans ,MESH : Middle Aged ,cardiovascular diseases ,MESH : Parity ,Aged ,MESH: Adolescent ,MESH: Age Factors ,Gynecology ,MESH: Humans ,Proportional hazards model ,business.industry ,MESH : Humans ,MESH: Parity ,Oophorectomy ,MESH: Adult ,equipment and supplies ,medicine.disease ,MESH: Estrogen Replacement Therapy ,MESH : Clinical Trials as Topic ,MESH : Pregnancy ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Women's Health ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,MESH : Age Factors ,Hormone therapy ,business ,MESH: Women's Health ,MESH: Female - Abstract
International audience; This study aims to investigate venous thromboembolism (VTE) risk in relation to age at menopause, age at menarche, parity, bilateral oophorectomy, and time since menopause, as well as any interaction with randomized hormone therapy (HT) assignment, among postmenopausal women. Using pooled data from the Women's Health Initiative HT clinical trials including 27,035 postmenopausal women aged 50 to 79 years who had no history of VTE, we assessed the risk of VTE in relation to age at menopause, age at menarche, parity, bilateral oophorectomy, and time since menopause by Cox proportional hazards models. Linear trends, quadratic relationships, and interactions of reproductive life characteristics with HT on VTE risk were systematically tested. During follow-up, 426 women reported a first VTE, including 294 non-procedure-related events. No apparent interaction of reproductive life characteristics with HT assignment on VTE risk was detected, and there was not a significant association between VTE and age at menarche, age at menopause, parity, oophorectomy, or time since menopause. However, analyses restricted to non-procedure-related VTE showed a U-shaped relationship between age at menopause and thrombotic risk that persisted after multivariable analysis (P < 0.01). Compared with women aged 40 to 49 years at menopause, those who had early menopause (age 55 y) had a significantly increased VTE risk (hazard ratio [95% CI]: 1.8 [1.2-2.7] and 1.5 [1.0-2.4], respectively). Reproductive life characteristics have little association with VTE and do not seem to influence the effect of HT on thrombotic risk among postmenopausal women. Nevertheless, early and late onset of menopause might be newly identified risk factors for non-procedure-related VTE.
- Published
- 2013
10. Strengthening the reporting of genetic risk prediction studies (GRIPS): Explanation and elaboration
- Author
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Christopher J. O'Donnell, David F. Ransohoff, Muin J. Khoury, Jeremy M. Grimshaw, Stephanie Melillo, Caroline F. Wright, Deborah M. Winn, Sara Bedrosian, Daniela Seminara, John P. A. Ioannidis, Holly Janes, Michael J. Pencina, Siobhan M. Dolan, Mark A. Hlatky, Paolo Boffetta, Jeffrey R. Gulcher, Andrew N. Freedman, Isabel Fortier, Nicole F. Dowling, Julian Little, Peter Kraft, A. Cecile J.W. Janssens, Marta Gwinn, Sheri D. Schully, Cornelia M. van Duijn, Janssens, A.C.J.W., Ioannidis, J.P.A., Bedrosian, S., Boffetta, P., Dolan, S.M., Dowling, N., Fortier, I., Freedman, A.N., Grimshaw, J.M., Gulcher, J., Gwinn, M., Hlatky, M.A., Janes, H., Kraft, P., Melillo, S., O'Donnell, C.J., Pencina, M.J., Ransohoff, D., Schully, S.D., Seminara, D., Winn, D.M., Wright, C.F., Van Duijn, C.M., Little, J., Khoury, M.J., Department of Epidemiology [Rotterdam], Erasmus University Medical Center [Rotterdam] (Erasmus MC), Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Biomedical Research Institute, Foundation for Research and Technology, Department of Medicine, Tufts University School of Medicine, Center for Genetic Epidemiology and Modeling and Tufts CTSI, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Stanford Prevention Research Center, Stanford Medicine, Stanford University-Stanford University, Office of Public Health Genomics, Centers for Disease Control and Prevention, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai [New York] (MSSM), International Prevention Research Institute (IPRI), Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, Public Population Project in Genomics (P3G), National Cancer Institute [Bethesda] (NCI-NIH), National Institutes of Health [Bethesda] (NIH), Clinical Epidemiology Program, Ottawa Hospital Research Institute [Ottawa] (OHRI), University of Ottawa [Ottawa], deCODE Genetics, deCODE genetics [Reykjavik], Department of Health Research and Policy, Stanford University, Fred Hutchinson Cancer Research Center [Seattle] (FHCRC), Department of Epidemiology, Harvard School of Public Health, Framingham Heart Study, Boston University [Boston] (BU)-National Heart, Lung, and Blood Institute [Bethesda] (NHLBI), Cardiology Division, Massachusetts General Hospital, Harvard Medical School [Boston] (HMS), Department of Biostatistics, Boston University [Boston] (BU), Harvard Clinical Research Institute, University of North Carolina at Chapel Hill School of Medicine, University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC)-University of North Carolina System (UNC), PHG Foundation, Epidemiology and Community Medicine, O'donnell, C.J., and Epidemiology
- Subjects
Gerontology ,Male ,Epidemiology ,Genome-wide association study ,Strengthening the reporting of observational studies in epidemiology ,Bioinformatics ,computer.software_genre ,genetic risk ,0302 clinical medicine ,Multidisciplinary approach ,STROBE ,Disease ,030212 general & internal medicine ,Genetic risk ,Genetics (clinical) ,Randomized Controlled Trials as Topic ,CURVE ,0303 health sciences ,medicine.diagnostic_test ,GRIPS ,ASSOCIATION ,Genomics ,Middle Aged ,Checklist ,Risk prediction ,3. Good health ,Policy ,Risk analysis (engineering) ,Strengthening reporting genetic risk prediction studies GRIPS ,Strengthening ,Female ,Data mining ,Risk assessment ,Psychology ,Adult ,Genetic Research ,medicine.medical_specialty ,MODELS ,Guidelines as Topic ,Disclosure ,Guidelines ,Risk Assessment ,Article ,EXPLANATION ,Education ,03 medical and health sciences ,Genetic ,SDG 3 - Good Health and Well-being ,Genetics ,medicine ,Humans ,Genetic Predisposition to Disease ,Genetic Testing ,Elaboration ,Genetic testing ,Aged ,030304 developmental biology ,Publishing ,Models, Genetic ,Genome, Human ,business.industry ,Public health ,Methodology ,Epidemiologic Studies ,Reporting ,MARKER ,Genomics/*methods ,Interdisciplinary Communication ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,computer ,Strengths and weaknesses ,Genome-Wide Association Study - Abstract
The rapid and continuing progress in gene discovery for complex diseases is fuelling interest in the potential application of genetic risk models for clinical and public health practice. The number of studies assessing the predictive ability is steadily increasing, but they vary widely in completeness of reporting and apparent quality. Transparent reporting of the strengths and weaknesses of these studies is important to facilitate the accumulation of evidence on genetic risk prediction. A multidisciplinary workshop sponsored by the Human Genome Epidemiology Network developed a checklist of 25 items recommended for strengthening the reporting of Genetic RIsk Prediction Studies (GRIPS), building on the principles established by prior reporting guidelines. These recommendations aim to enhance the transparency, quality and completeness of study reporting and thereby to improve the synthesis and application of information from multiple studies that might differ in design, conduct or analysis. © 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation.
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- 2011
11. Strengthening the reporting of genetic risk prediction studies: the GRIPS statement
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A Cecile J W, Janssens, John P A, Ioannidis, Cornelia M, van Duijn, Julian, Little, Muin J, Khoury, Epidemiology, Department of Epidemiology, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Biomedical Research Institute, Foundation for Research and Technology, Department of Medicine, Tufts University School of Medicine, Center for Genetic Epidemiology and Modeling and Tufts CTSI, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Stanford Prevention Research Center, Stanford Medicine, Stanford University-Stanford University, Epidemiology and Community Medicine, University of Ottawa [Ottawa], Office of Public Health Genomics, and Centers for Disease Control and Prevention
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Epidemiology ,Statement (logic) ,Applied psychology ,Psychological intervention ,Genome-wide association study ,Disease ,Strengthening the reporting of observational studies in epidemiology ,0302 clinical medicine ,Multidisciplinary approach ,Health care ,Medicine ,Genetics(clinical) ,Genetic risk ,General Environmental Science ,0303 health sciences ,GRIPS ,Genomics ,General Medicine ,Reporting guideline ,3. Good health ,Systematic review ,Risk analysis (engineering) ,030220 oncology & carcinogenesis ,DOAJ:Health Sciences ,Cardiology and Cardiovascular Medicine ,Genetic Markers ,medicine.medical_specialty ,Guidelines as Topic ,Human genomics ,Disclosure ,Genetics and Genomics/Complex Traits ,Guidelines ,Risk Assessment ,Education ,Molecular Genetics ,03 medical and health sciences ,Genetic ,SDG 3 - Good Health and Well-being ,Drugs: Cardiovascular System ,Correspondence ,Genetics ,Humans ,Genetic Testing ,Molecular Biology ,Developing Countries ,Genetic testing ,Genetic association ,Models, Statistical ,Public health ,lcsh:R ,Methodology ,Genetic risk models ,lcsh:RA1-1270 ,Guideline ,body regions ,Epidemiologic Studies ,Genetic epidemiology ,Reporting ,Public Health and Epidemiology/Preventive Medicine ,Observational study ,Gene Discovery ,Research design ,Public Health and Epidemiology/Screening ,Operations research ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Bioinformatics ,Guidelines and Guidance ,Risk model ,Risk Factors ,030212 general & internal medicine ,Genetics (clinical) ,Framingham Risk Score ,medicine.diagnostic_test ,lcsh:Public aspects of medicine ,General Engineering ,Risk factor (computing) ,Risk prediction ,Checklist ,Predictive factor ,Policy ,Research Design ,Practice Guidelines as Topic ,Molecular Medicine ,Psychology ,Risk assessment ,Genetic Research ,Digital content ,Genetic counseling ,MEDLINE ,Internal Medicine ,Research Methods & Reporting ,Genetic Predisposition to Disease ,030304 developmental biology ,Publishing ,Actuarial science ,Models, Genetic ,Extramural ,Genome, Human ,business.industry ,Research ,Genetics and Genomics ,DOAJ:Public Health ,General Earth and Planetary Sciences ,Interdisciplinary Communication ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Artificial intelligence ,Public Health and Epidemiology/Epidemiology ,business ,Forecasting ,Genome-Wide Association Study - Abstract
The recent successes of genome-wide association studies and the promises of whole genome sequencing fuel interest in the translation of this new wave of basic genetic knowledge to health care practice. Knowledge about genetic risk factors may be used to target diagnostic, preventive, and therapeutic interventions for complex disorders based on a person's genetic risk, or to complement existing risk models based on classical nongenetic factors, such as the Framingham risk score for cardiovascular disease. Implementation of genetic risk prediction in health care requires a series of studies that encompass all phases of translational research,1,2 starting with a comprehensive evaluation of genetic risk prediction. With increasing numbers of discovered genetic markers that can be used in future genetic risk prediction studies, it is crucial to enhance the quality of the reporting of these studies, since valid interpretation could be compromised by the lack of reporting of key information. Information that is often missing includes details in the description of how the study was designed and conducted (eg, how genetic variants were selected and coded, how risk models or genetic risk scores were constructed, and how risk categories were chosen), or how the results should be interpreted. An appropriate assessment of the study's strengths and weaknesses is not possible without this information. There is ample evidence that prediction research often suffers from poor design and bias, and these may also have an impact on the results of the studies and on models of disease outcomes based on these studies.3–5 Although most prognostic studies published to date claim significant results,6,7 very few translate to clinically useful applications. Just as for observational epidemiological studies,8 poor reporting complicates the use of the specific study for research, clinical, or public health purposes and hampers the …
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- 2011
12. Preventable breast cancer is postmenopausal
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Seyed Mohsen Mousavi, Asta Försti, Kari Hemminki, Jan Sundquist, Division of Molecular Genetic Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Center for Primary Care Research, Lund University [Lund], Center for Family and Community Medicine, karolinska institute, Stanford Prevention Research Center, Stanford Medicine, Stanford University-Stanford University, Cancer Research Center of Cancer Institute, and Tehran University of Medical Sciences
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Adult ,Cancer Research ,medicine.medical_specialty ,Time Factors ,Emigrants and Immigrants ,Breast Neoplasms ,Ethnic origin ,Risk Assessment ,White People ,Danish ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Breast cancer ,Age Distribution ,Asian People ,Risk Factors ,Epidemiology ,Ethnic differences ,medicine ,Humans ,030212 general & internal medicine ,Environmental effect ,Risk factor ,Aged ,Sweden ,business.industry ,Incidence (epidemiology) ,Incidence ,Incidence change ,Age Factors ,Cancer ,Middle Aged ,medicine.disease ,language.human_language ,3. Good health ,Surgery ,Postmenopause ,Oncology ,Databases as Topic ,Age-incidence ,030220 oncology & carcinogenesis ,language ,Female ,Breast disease ,business ,Demography - Abstract
International audience; Breast cancer incidence has markedly increased in Western countries for reasons that are not entirely understood. We characterized periodic and age-specific incidence trends of breast cancer in immigrants who migrated from low incidence areas to Sweden. The incidence in immigrants was compared to that in native Swedes and standardized incidence ratios (SIRs) were calculated, based on the Swedish Family-Cancer Database. Age-specific incidence data for low and high incidence populations were obtained from Cancer Incidence in Five Continents IX and NORDCAN. For immigrants from the seven lowest countries/regions 535 breast cancers were identified; the SIRs ranging from 0.45 for Turkish to 0.70 for Greek women. The SIR increased somewhat with the length of stay in Sweden, from 0.55 for stay between 0 and 10 years to 0.59 for a stay of 20+ years. The age-specific incidence curves for these immigrants were superimposable upon the earliest Swedish (year 1960) or Danish (1943) rates. These rates differed from the current Swedish rates by a much lower postmenopausal component. Large incidence differences were also observed between white Californians and immigrants from China and Korea. Our results show that the main difference between high and low incidence areas is in postmenopausal cancer which has increased preferentially during the past century. Immigrants from low risk areas to Sweden show age-specific incidence patterns of Swedes half a century ago. These differences offer opportunities for the identification of factors underlying breast cancer etiology and tools for prevention.
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- 2010
13. Breast cancer risk in women who fulfill high-risk criteria: at what age should surveillance start?
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Justo Lorenzo Bermejo, Jan Sundquist, Andreas Brandt, Kari Hemminki, Division of Molecular Genetic Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Center for Primary Care Research, Lund University [Lund], Stanford Prevention Research Center, Stanford Medicine, and Stanford University-Stanford University
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Oncology ,Cancer Research ,medicine.medical_specialty ,Age of onset ,Psychological intervention ,Breast Neoplasms ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Risk Factors ,Internal medicine ,medicine ,Humans ,Mass Screening ,Genetic Predisposition to Disease ,Registries ,Family history ,030304 developmental biology ,Proportional Hazards Models ,Hereditary breast cancer ,0303 health sciences ,Hereditary breast–ovarian cancer syndrome ,Proportional hazards model ,business.industry ,Hazard ratio ,Age Factors ,Middle Aged ,medicine.disease ,3. Good health ,Pedigree ,030220 oncology & carcinogenesis ,Relative risk ,Female ,Clinical risk criteria ,business ,Familial breast cancer ,Demography - Abstract
International audience; Family history is a strong predictor of hereditary breast cancer, particularly when it includes cases of early onset or bilateral breast cancers and multiple cases of breast or ovarian cancers. This article provides relative risks and cumulative risks of breast cancer in women whose family history indicates high risk. Specifically, the aim was to determine how many years earlier the high-risk women reach the cumulative risk of women without family history at the age at which screening in average-risk women is initiated. The women of the nation-wide Swedish Family-Cancer Database were classified according to clinical criteria based on family history suggesting high risk for hereditary breast ovarian cancer syndrome. The relative risks of breast cancer were calculated as hazard ratio using Cox regression. Cumulative risks of breast cancer were estimated with a stratified Cox model based on Tsiatis' method. The hazard ratios of breast cancer for the considered criteria ranged from 1.50 to 5.99. The cumulative risks ranged from 1 to 10% by age 50 years. The age to reach the same cumulative risk as women lacking a family history at the age of 50 years ranged between 32.0 and 40.8 years. Relative and cumulative risks of women at high risk of breast cancer associated with different clinical criteria were diverse, which may be helpful in considering when current clinical criteria are revised. According to the present results, current recommendations of starting clinical interventions 10 years earlier in high-risk women, based on expert opinions, appear justified at least for the largest high-risk groups.
- Published
- 2009
14. Intensive, Real-Time Data Collection of Psychological and Physiological Stress During a 96-Hour Field Training Exercise at a Senior Military College: Feasibility and Acceptability Cohort Study.
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Pojednic R, Welch A, Thornton M, Garvey M, Grogan T, Roberts W, and Ash G
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- Humans, Male, Prospective Studies, Pilot Projects, Stress, Physiological physiology, Young Adult, Adult, Female, Cohort Studies, Data Collection, Universities, Wearable Electronic Devices, Actigraphy instrumentation, Biomarkers analysis, Exercise psychology, Exercise physiology, Accelerometry instrumentation, Saliva chemistry, Saliva metabolism, Military Personnel psychology, Feasibility Studies, Stress, Psychological diagnosis
- Abstract
Background: Poor physical fitness, stress, and fatigue are factors impacting military readiness, national security, and economic burden for the United States Department of Defense. Improved accuracy of wearable biosensors and remote field biologic sample collection strategies could make critical contributions to understanding how physical readiness and occupational stressors result in on-the-job and environment-related injury, sleep impairments, diagnosis of mental health disorders, and reductions in performance in war-fighters., Objective: This study aimed to evaluate the feasibility and acceptability of intensive biomarker and biometric data collection to understand physiological and psychological stress in Army Reserved Officer Training Corps cadets before, during, and after a 96-hour field training exercise (FTX)., Methods: A prospective pilot study evaluated the feasibility and acceptability of multimodal field data collection using passive drool saliva sampling, sweat sensors, accelerometry, actigraphy, and photoplethysmography. In addition, physical fitness (Army Combat Fitness Test), self-reported injury, and psychological resilience (Brief Resilience Scale) were measured., Results: A total of 22 cadets were included. Two were lost to follow-up due to injury during FTX, for a retention rate of 91%. Assessments of performance and psychological resilience were completed for all remaining participants, resulting in 100% testing adherence. All participants provided saliva samples before the FTX, with 98% adherence at the second time point and 91% at the third. For sweat, data collection was not possible. Average daily wear time for photoplethysmography devices was good to excellent, meeting a 70% threshold with data collected for ≥80% of person-days at all time points. Of the participants who completed the FTX and 12 completed a post-FTX acceptability survey for a response rate of 60%. Overall, participant acceptance was high (≥80%) for all metrics and devices., Conclusions: This study demonstrates that wearable biosensors and remote field biologic sample collection strategies during a military FTX have the potential to be used in higher stakes tactical environments in the future for some, but not all, of the strategies. Overall, real-time biometric and biomarker sampling is feasible and acceptable during field-based training and provides insights and strategies for future interventions on military cadet and active-duty readiness, environmental stress, and recovery., (©Rachele Pojednic, Amy Welch, Margaret Thornton, Meghan Garvey, Tara Grogan, Walter Roberts, Garrett Ash. Originally published in JMIR Formative Research (https://formative.jmir.org), 18.10.2024.)
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- 2024
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15. Rare variant contribution to the heritability of coronary artery disease.
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Rocheleau G, Clarke SL, Auguste G, Hasbani NR, Morrison AC, Heath AS, Bielak LF, Iyer KR, Young EP, Stitziel NO, Jun G, Laurie C, Broome JG, Khan AT, Arnett DK, Becker LC, Bis JC, Boerwinkle E, Bowden DW, Carson AP, Ellinor PT, Fornage M, Franceschini N, Freedman BI, Heard-Costa NL, Hou L, Chen YI, Kenny EE, Kooperberg C, Kral BG, Loos RJF, Lutz SM, Manson JE, Martin LW, Mitchell BD, Nassir R, Palmer ND, Post WS, Preuss MH, Psaty BM, Raffield LM, Regan EA, Rich SS, Smith JA, Taylor KD, Yanek LR, Young KA, Hilliard AT, Tcheandjieu C, Peyser PA, Vasan RS, Rotter JI, Miller CL, Assimes TL, de Vries PS, and Do R
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- Humans, Male, Female, Gene Frequency, Genome-Wide Association Study, White People genetics, Case-Control Studies, Whole Genome Sequencing, Genetic Variation, Middle Aged, Coronary Artery Disease genetics, Genetic Predisposition to Disease, Linkage Disequilibrium, Polymorphism, Single Nucleotide
- Abstract
Whole genome sequences (WGS) enable discovery of rare variants which may contribute to missing heritability of coronary artery disease (CAD). To measure their contribution, we apply the GREML-LDMS-I approach to WGS of 4949 cases and 17,494 controls of European ancestry from the NHLBI TOPMed program. We estimate CAD heritability at 34.3% assuming a prevalence of 8.2%. Ultra-rare (minor allele frequency ≤ 0.1%) variants with low linkage disequilibrium (LD) score contribute ~50% of the heritability. We also investigate CAD heritability enrichment using a diverse set of functional annotations: i) constraint; ii) predicted protein-altering impact; iii) cis-regulatory elements from a cell-specific chromatin atlas of the human coronary; and iv) annotation principal components representing a wide range of functional processes. We observe marked enrichment of CAD heritability for most functional annotations. These results reveal the predominant role of ultra-rare variants in low LD on the heritability of CAD. Moreover, they highlight several functional processes including cell type-specific regulatory mechanisms as key drivers of CAD genetic risk., (© 2024. The Author(s).)
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- 2024
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16. Seeing Is Knowing: Noninvasive Imaging Outperforms Traditional Risk Assessment.
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Maron DJ and Rodriguez F
- Abstract
Competing Interests: Funding Support and Author Disclosures Dr Maron has received research support from Cleerly, Inc. Dr Rodriguez has received consulting fees from HealthPals, Novartis, Novo Nordisk, Esperion Therapeutics, Movano Health, Kento Health, Inclusive Health, Edwards, Arrowhead Pharmaceuticals, iRhythm, and HeartFlow outside of the submitted work.
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- 2024
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17. Gastrointestinal Surgical Patient and Multidisciplinary Healthcare Provider Beliefs and Practices Around Perioperative Nutrition: A Mixed-Methods Study.
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Arbaugh C, Kimura C, and Kin C
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- Humans, Male, Female, Middle Aged, Adult, Digestive System Surgical Procedures, Health Knowledge, Attitudes, Practice, Attitude of Health Personnel, Aged, Surveys and Questionnaires statistics & numerical data, Nutritionists psychology, Nutritionists statistics & numerical data, Health Personnel psychology, Health Personnel statistics & numerical data, Perioperative Care methods, Perioperative Care standards, Perioperative Care statistics & numerical data
- Abstract
Introduction: Nutrition is critical to gastrointestinal (GI) disease prevention and treatment, including operations, yet perioperative nutrition practices vary widely. We aimed to understand GI surgical patient and health care provider's perioperative nutrition beliefs and practices., Materials and Methods: We used a mixed-methods approach, including a patient survey (n = 19), provider survey (n = 26), and semistructured interviews with a subset of providers (n = 15). Providers included surgeons, gastroenterologists, medical oncologists, advanced practice providers, and dietitians. Provider interviews were transcribed, iteratively coded, and thematically analyzed. Quantitative and qualitative data were integrated., Results: 94.7% of patients and 100% of providers surveyed believe that nutrition affects outcomes. Patients seek nutrition information from diverse resources (73.7% from websites or blogs, 42.1% from documentaries, and 36.8% from books or /magazines) and people (52.6% from family members, 42.1% from a significant other, partner, or spouse, and 36.8% from a dietitian or nutritionist). Providers cited a lack of quality information, misinformation, and inconsistency among health care providers as barriers to high-quality nutrition care. Both patients and providers noted that nutritional supplements have drawbacks, with 100% of patients and 96.2% of providers expressing interest in house- made plant-based protein smoothie or soup alternatives., Conclusions: This study led to the development of a multidisciplinary task force, which has collaborated on multiple interventions to improve inpatient perioperative surgical nutrition (e.g., smoothie pilot and postoperative menu revisions)., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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18. Risk factors for long COVID syndrome in postmenopausal women with previously reported diagnosis of COVID-19.
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Neuhouser ML, Butt HI, Hu C, Shadyab AH, Garcia L, Follis S, Mouton C, Harris HR, Wactawski-Wende J, Gower EW, Vitolins M, Von Ah D, Nassir R, Karanth S, Ng T, Paskett E, Manson JE, and Chen Z
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- Humans, Female, Risk Factors, Aged, Aged, 80 and over, Middle Aged, United States epidemiology, COVID-19 epidemiology, COVID-19 diagnosis, Postmenopause, Post-Acute COVID-19 Syndrome, SARS-CoV-2
- Abstract
Purpose: Long COVID-19 syndrome occurs in 10-20 % of people after a confirmed/probable SARS-COV-2 infection; new symptoms begin within three months of COVID-19 diagnosis and last > 8 weeks. Little is known about risk factors for long COVID, particularly in older people who are at greater risk of COVID complications., Methods: Data are from Women's Health Initiative (WHI) postmenopausal women who completed COVID surveys that included questions on whether they had ever been diagnosed with COVID and length and nature of symptoms. Long COVID was classified using standard consensus criteria. Using WHI demographic and health data collected at study enrollment (1993-98) through the present day, machine learning identified the top 20 risk factors for long COVID. These variables were tested in logistic regression models., Results: Of n = 37,280 survey respondents, 1237 (mean age = 83 years) reported a positive COVID-19 test and 425 (30 %) reported long COVID. Symptoms included an array of neurological, cardio-pulmonary, musculoskeletal, and general fatigue, and malaise symptoms. Long COVID risk factors included weight loss, physical and mobility limitations, and specific heath conditions (e.g., history of heart valve procedure, rheumatoid arthritis)., Conclusions: Knowledge of risk factors for long COVID may be the first step in understanding the etiology of this complex disease., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Marian L Neuhouser reports financial support was provided by National Institutes of Health. Mara Vitolins reports financial support was provided by National Center for Advancing Translational Sciences. No other COI declared by any authors If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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19. A randomized controlled trial evaluation of a smoking cessation and physical activity intervention delivered via telemedicine in the Norton Sound region of Alaska.
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Prochaska JJ, Vogel EA, Oppezzo M, Skan J, Knox M, Chieng A, Crouch MC, Aikens RC, Schnellbaecher M, and Benowitz NL
- Abstract
Objectives: Tobacco use disproportionately affects Alaska Native people. Physical activity may aid quitting smoking and provides health benefits. We tested telemedicine-delivered heart health interventions in Alaska's Norton Sound region., Methods: Alaska Native adults (N = 299, 51.5 % male, 60.5 % Inupiaq) with hypertension and/or hypercholesterolemia who smoked daily were randomized to intervention on smoking and physical activity (group 1) or traditional diet and medication adherence (group 2). Intention to change was not required for participation. Stage-tailored mailed workbooks and personalized reports were supported by telehealth counseling at baseline, 3, 6, and 12 months. Study outcomes were assessed at baseline, 3-, 6-, 12-, and 18-months (i.e., 6-months after the final counseling session). Smoking outcomes were self-reported 7-day point prevalence abstinence (7d-PPA),
1 bioconfirmed with urine anabasine; 24-hour quit attempts; and 50 % reduction in smoking. Self-reported physical activity outcomes were metabolic equivalent of task (MET) minutes and meeting moderate-to-vigorous physical activity (MVPA) guidelines., Results: At baseline, participants averaged 12.4 (SD = 10.0) cigarettes/day, with 19.4 % prepared to quit smoking, and 81.6 % meeting MVPA guidelines. During the study, most (70.2 % group 1; 63.5 % group 2) reported a 24-hr quit attempt (p = 0.219), and Group 1 (53.6 %) was more likely than Group 2 (28.4 %) to use nicotine replacement therapy (NRT), OR = 2.92, p < 0.001. At 18-months, 40.5 % (group 1) and 32.5 % (group 2) had reduced their smoking by half or more (p = 0.343), and 10.8 % vs. 7.9 % (group 1 vs. 2) reported 7d-PPA with 4 % vs. 6 % (group 1 vs. 2) bioconfirmed. Time and baseline stage of change predicted 7d-PPA (p's≤.015), with no group effect (p = 0.325). Activity levels did not significantly differ by group or time., Conclusions: Telemedicine counseling supported NRT use but did not significantly affect behavioral outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)- Published
- 2024
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20. Longitudinal Changes in Lifestyle Behaviors and Cardiovascular Health During the Transition to Fatherhood: The Dad Bod Study Rationale and Design.
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Landry MJ, Pineda JP, Lee JM, Hoyt MA, Edwards KL, Lindsay KL, Gardner CD, and Wong ND
- Abstract
Background: Despite the importance of the transition to fatherhood as a critical life stage among young adult men, much remains unknown about the factors predictive of ideal cardiovascular health (CVH) and how CVH is impacted as young men face new roles and responsibilities associated with fatherhood., Methods: To address this gap, the Dad Bod Study is a prospective, longitudinal and observational study designed to examine how fatherhood affects young men's CVH. A total of 125, first-time prospective fathers (men, 19-39 years) will be enrolled and followed over 1.5 years. Metrics of the American Heart Association's "Life's Essential 8" as well as demographic, social, and psychosocial factors will be collected at four time points ((baseline (during the pregnant partner's 2nd trimester) 1-month postpartum, 6-months postpartum, and 1-year postpartum). The primary aims are to measure predictors of CVH among first-time fathers and describe longitudinal changes in CVH. A secondary aim is to identify best practices for recruitment, retention, and remote data collection in this population., Summary: The Dad Bod Study offers a novel examination of CVH among first-time fathers, exploring how new paternal roles and responsibilities impact cardiovascular health. Findings may provide key insights into critical CVH behaviors and risk factors to monitor, preserve, and improve as young men transition to fatherhood., Competing Interests: Competing Interests Disclosure The authors declare that they have no competing interests.
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- 2024
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21. Coronary Artery Calcium Staging to Guide Preventive Interventions: A Proposal and Call to Action.
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Maron DJ, Budoff MJ, Sky JC, Bommer WJ, Epstein SD, Fisher DA, Stock EO, Taylor AJ, Wong ND, and DeMaria AN
- Abstract
Competing Interests: The views expressed in this paper are the authors and do not reflect an endorsement or the official policy of the U.S. Government, the Defense Health Agency, the Department of Defense, or the U.S. Air Force. Dr Maron has received research support from Cleerly, Inc; and consultant income from Regeneron. Dr Budoff has received grant support from General Electric. Dr Taylor has received speaking honorarium from Amgen. Dr Wong has received research support through UC Irvine from Novartis, Regeneron, and Novo Nordisk; and consultant/advisory board for Amgen, Novartis, Ionis, and Heart-Lung. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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- 2024
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22. Food Insecurity Knowledge and Training Among College Students in Health Majors.
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Gray VB, Cuite C, Patton-López M, Richards R, Savoie-Roskos M, Machado S, Heying E, Landry M, Chen S, Hagedorn-Hatfield RL, Mann G, Qamar Z, OoNorasak K, and Zigmont VA
- Abstract
Objective: To describe current food insecurity (FI)-related training among nutrition/dietetics, public health, and social work students., Methods: A cross-sectional online survey was used among students (n = 306) enrolled in health-related programs at 12 US universities. Participants reported FI-related course-based and extracurricular experiences and rated confidence to address FI on a scale of 1-3. Open-ended questions investigated perceived definitions of FI and impactful course activities. Descriptive statistics and thematic analysis were used for data analysis., Results: Participants' FI definitions were multifaceted. Most (80.6%) reported FI being covered in at least 1 course. The overall mean confidence to address FI was 2.2 ± 0.48. Participants suggested increasing application-based opportunities and skills training., Conclusions and Implications: Most students have a basic understanding of FI and report high confidence to address it in the future. Impactful FI-related experiences and participants' suggestions guide developing an FI training resource to enhance student FI competency and sensitivity., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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23. Urban Care for Unpaid Caregivers: Community Voices in the Care Block Program, in Bogotá, Colombia.
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Guevara-Aladino P, Sarmiento OL, Rubio MA, Gómez-García LM, Doueiri ZN, Martínez D, King AC, Hurtado-Tarazona A, Banchoff A, Guzman LA, Álvarez-Rivadulla MJ, and Palencia L
- Abstract
The Care Block of Bogotá, Colombia, is an urban program that offers services for low-income unpaid caregivers. This study aimed to (i) characterize unpaid caregivers' subjective well-being, mental health symptoms, physical activity levels, and use of public spaces linked to the Care Block; (ii) identify caregivers' perceived built and social environment facilitators and barriers to accessing the Care Block facility; and (iii) document the community-led advocacy process to improve the Care Block program. The quantitative component included a subjective well-being and mental health symptoms survey, and the System for Observing Play and Recreation in Communities (SOPARC) instrument. The qualitative component included the Our Voice citizen science method augmented with portable virtual reality equipment to engage participants in advocacy for changes. Participants (median age of 53 years) dedicated a median of 13.8 h a day to unpaid caregiving, had an average subjective well-being score of 7.0, and 19.1% and 23.8% reported having depression and generalized anxiety symptoms respectively. Caregivers reported that the program fosters their perception of purpose, enjoyment, resilience, and cognitive and emotional awareness. SOPARC evaluation showed that most women engaged in moderate to vigorous physical activity. The caregivers highlighted education, physical activity services, and integration of facilities as facilitators to accessing the Care Block program. Poor quality and lack of sidewalks and roads, limited personal safety, and the risk of pedestrian-vehicle collisions were identified as barriers. Virtual Reality sparked compelling dialogue between participants and stakeholders, allowing stakeholders to reflect on an urban program facilitating unpaid care work., (© 2024. The Author(s).)
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- 2024
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24. Low-Density Lipoprotein Cholesterol Control as a Performance Measure: A National Analysis of the VHA.
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Jain SS, Skye M, Din N, Furst A, Maron DJ, Heidenreich P, Kalwani N, Bhatt AS, Sandhu AT, and Rodriguez F
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- Humans, United States epidemiology, United States Department of Veterans Affairs, Male, Female, Middle Aged, Cholesterol, LDL blood
- Abstract
Competing Interests: Funding Support and Author Disclosures Dr Sandhu is supported by National Heart, Lung, and Blood Institute grant 1K23HL151672. Dr Rodriguez was funded by NIH National Heart, Lung, and Blood Institute grants 1K01HL144607, R01HL168188, and R01HL167974, the American Heart Association/Harold Amos Medical Faculty Development program, and Doris Duke Foundation Grant #2022051. Dr Jain has received consulting fees from Bristol Myers Squibb, ARTIS Ventures, and Broadview Ventures outside of the submitted work. Dr Bhatt has received research grant support to his institution from National Institutes of Health/National Heart, Lung, and Blood Institute, National Institutes of Health/National Institute on Aging, American College of Cardiology Foundation, and the Centers for Disease Control and Prevention; and has received consulting fees from Sanofi Pasteur, Merck, and Novo Nordisk. Dr Sandhu has received consulting fees from Lexicon Pharmaceuticals; and has received research funding from the American Heart Association, Novartis Pharmaceuticals, and Reprieve Cardiovascular outside of the submitted work. Dr Rodriguez has received equity from Carta Healthcare and HealthPals; and has received consulting fees from HealthPals, Novartis, NovoNordisk, Esperion Therapeutics, Movano Health, Kento Health, Inclusive Health, Edwards, Arrowhead Pharmaceuticals, HeartFlow, and iRhythm outside the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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- 2024
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25. Temporal trends in lipoprotein(a) testing among United States veterans from 2014 to 2023.
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Gomez SE, Furst A, Chen T, Din N, Maron DJ, Heidenreich P, Kalwani N, Nallamshetty S, Ward JH, Lozama A, Sandhu A, and Rodriguez F
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Objective: Lipoprotein (a) [Lp(a)] is a causal, genetically-inherited risk amplifier for atherosclerotic cardiovascular disease (ASCVD). Practice guidelines increasingly recommend broad Lp(a) screening among various populations to optimize preventive care. Corresponding changes in testing rates and population-level detection of elevated Lp(a) in recent years has not been well described., Methods: Using Veterans Affairs electronic health record data, we performed a retrospective cohort study evaluating temporal trends in Lp(a) testing and detection of elevated Lp(a) levels (defined as greater than 50 mg/dL) from January 1, 2014 to December 31, 2023 among United States Veterans without prior Lp(a) testing. Testing rates were stratified based on demographic and clinical factors to investigate possible drivers for and disparities in testing: age, sex, race and ethnicity, history of ASCVD, and neighborhood social vulnerability., Results: Lp(a) testing increased nationally from 1 test per 10,000 eligible Veterans (558 tests) in 2014 to 9 tests per 10,000 (4,440 tests) in 2023, while the proportion of elevated Lp(a) levels remained stable. Factors associated with higher likelihood of Lp(a) testing over time were a history of ASCVD, Asian race, and residing in neighborhoods with less social vulnerability., Conclusion: Despite a 9-fold increase in Lp(a) testing among US Veterans over the last decade, the overall testing rate remains extremely low. The steady proportion of Veterans with elevated Lp(a) over time supports the clinical utility of testing expansion. Efforts to increase testing, especially among Veterans living in neighborhoods with high social vulnerability, will be important to reduce emerging disparities as novel therapeutics to target Lp(a) become available., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Alexander Sandhu, Fatima Rodriguez, Novartis employees Anthony Lozama and Jonathan Ward reports financial support was provided by Novartis Pharmaceuticals Corporation. This work was supported by 10.13039/100004336Novartis Pharmaceutical Corporation. Mr. Ward and Doctor Lozama are employees of Novartis Pharmaceutical Corporation. Dr. Sandhu is supported by 10.13039/100000050NHLBI and AHA. He also receives research funding from Reprieve Cardiovascular and has done consulting for Lexicon Pharmaceuticals. Dr. Rodriguez reports equity from Carta Healthcare and HealthPals, and consulting fees from HealthPals, Novartis, NovoNordisk, Esperion Therapeutics, Movano Health, Kento Health, Inclusive Health, Edwards, Arrowhead Pharmaceuticals, and HeartFlow outside the submitted work. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier B.V.)
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- 2024
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26. Adapting a Financial Incentives Intervention for Smoking Cessation With Alaska Native Families: Phase 1 Qualitative Research to Inform the Aniqsaaq (To Breathe) Study.
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Sinicrope PS, Tranby BN, Young AM, Koller KR, King DK, Lee FR, Sabaque CV, Prochaska JJ, Borah BJ, Decker PA, McDonell MG, Stillwater B, Thomas TK, and Patten CA
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- Humans, Adult, Female, Male, Alaska, Middle Aged, Community-Based Participatory Research, Smoking Cessation methods, Smoking Cessation psychology, Smoking Cessation ethnology, Alaska Natives psychology, Qualitative Research, Motivation, Family psychology
- Abstract
Introduction: Alaska Native and American Indian (ANAI) peoples in Alaska currently experience a disproportionate burden of morbidity and mortality from tobacco cigarette use. Financial incentives for smoking cessation are evidence-based, but a family-level incentive structure has not been evaluated. We used a community-based participatory research and qualitative approach to culturally adapt a smoking cessation intervention with ANAI families., Aims and Methods: We conducted individual, semistructured telephone interviews with 12 ANAI adults who smoke, 12 adult family members, and 13 Alaska Tribal Health System stakeholders statewide between November 2022 and March 2023. Through content analysis, we explored intervention receptivity, incentive preferences, culturally aligned recruitment and intervention messaging, and future implementation needs., Results: Participants were receptive to the intervention. Involving a family member was viewed as novel and aligned with ANAI cultural values of commitment to community and familial interdependence. Major themes included choosing a family member who is supportive and understanding, keeping materials positive and encouraging, and offering cash and noncash incentives for family members to choose (eg, fuel, groceries, activities). Participants indicated that messaging should emphasize family collaboration and that cessation resources and support tips should be provided. Stakeholders also reinforced that program materials should encourage the use of other existing evidence-based cessation therapies (eg, nicotine replacement, counseling)., Conclusions: Adaptations, grounded in ANAI cultural strengths, were made to the intervention and recruitment materials based on participant feedback. Next steps include a beta-test for feasibility and a randomized controlled trial for efficacy., Implications: This is the first study to design and adapt a financial incentives intervention promoting smoking cessation among ANAI peoples and the first to involve the family system. Feedback from this formative work was used to develop a meaningful family-level incentive structure with ANAI people who smoke and family members and ensure intervention messaging is supportive and culturally aligned. The results provide qualitative knowledge that can inform future family-based interventions with ANAI communities, including our planned randomized controlled trial of the intervention., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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27. Advising patients on the use of non-alcoholic beverages that mirror alcohol.
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Bowdring MA, Rutledge GW, and Prochaska JJ
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•Non-alcoholic beverages that mirror alcohol have potential benefits and risks.•Providers are currently offering varied health guidance on use of these beverages.•Research is needed to yield consensus on non-alcoholic beverage use health effects., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Molly A. Bowdring reports financial support was provided by National Heart Lung and Blood Institute. Geoffrey W. Rutledge reports financial support was provided by HealthTap. Molly A. Bowdring reports a relationship with Pivot that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)
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- 2024
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28. A secondary β-hydroxybutyrate metabolic pathway linked to energy balance.
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Moya-Garzon MD, Wang M, Li VL, Lyu X, Wei W, Tung AS, Raun SH, Zhao M, Coassolo L, Islam H, Oliveira B, Dai Y, Spaas J, Delgado-Gonzalez A, Donoso K, Alvarez-Buylla A, Franco-Montalban F, Letian A, Ward C, Liu L, Svensson KJ, Goldberg EL, Gardner CD, Little JP, Banik SM, Xu Y, and Long JZ
- Abstract
β-hydroxybutyrate (BHB) is an abundant ketone body. To date, all known pathways of BHB metabolism involve interconversion of BHB and primary energy intermediates. Here we show that CNDP2 controls a previously undescribed secondary BHB metabolic pathway via enzymatic conjugation of BHB and free amino acids. This BHB-ylation reaction produces a family of endogenous ketone metabolites, the BHB-amino acids. Genetic ablation of CNDP2 in mice eliminates tissue amino acid BHB-ylation activity and reduces BHB-amino acid levels. Administration of BHB-Phe, the most abundant BHB-amino acid, to obese mice activates neural populations in the hypothalamus and brainstem and suppresses feeding and body weight. Conversely, CNDP2-KO mice exhibit increased food intake and body weight upon ketosis stimuli. CNDP2-dependent amino acid BHB-ylation and BHB-amino acid metabolites are also conserved in humans. Therefore, the metabolic pathways of BHB extend beyond primary metabolism and include secondary ketone metabolites linked to energy balance., Competing Interests: Declaration of interests A provisional patent application has been filed by Stanford University on BHB-amino acids for the treatment of cardiometabolic disease.
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- 2024
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29. Associations between accurate measures of adiposity and fitness, blood proteins, and insulin sensitivity among South Asians and Europeans.
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Kho PF, Stell L, Jimenez S, Zanetti D, Panyard DJ, Watson KL, Sarraju A, Chen ML, Lind L, Petrie JR, Chan KN, Fonda H, Kent K, Myers JN, Palaniappan L, Abbasi F, and Assimes TL
- Abstract
Objective: South Asians (SAs) may possess a unique predisposition to insulin resistance (IR). We explored this possibility by investigating the relationship between 'gold standard' measures of adiposity, fitness, selected proteomic biomarkers, and insulin sensitivity among a cohort of SAs and Europeans (EURs)., Methods: A total of 46 SAs and 41 EURs completed 'conventional' (lifestyle questionnaires, standard physical exam) as well as 'gold standard' (dual energy X-ray absorptiometry scan, cardiopulmonary exercise test, and insulin suppression test) assessments of adiposity, fitness, and insulin sensitivity. In a subset of 28 SAs and 36 EURs, we also measured the blood-levels of eleven IR-related proteins. We conducted Spearman correlation to identify correlates of steady-state plasma glucose (SSPG) derived from the insulin suppression test, followed by multivariable linear regression analyses of SSPG, adjusting for age, sex and ancestral group., Results: Sixteen of 30 measures significantly associated with SSPG, including one conventional and eight gold standard measures of adiposity, one conventional and one gold standard measure of fitness, and five proteins. Multivariable regressions revealed that gold standard measures and plasma proteins attenuated ancestral group differences in IR, suggesting their potential utility in assessing IR, especially among SAs., Conclusion: Ancestral group differences in IR may be explained by accurate measures of adiposity and fitness, with specific proteins possibly serving as useful surrogates for these measures, particularly for SAs., Competing Interests: Conflict of Interest: Authors have no conflicts of interest.
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- 2024
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30. Agreement Between Mega-Trials and Smaller Trials: A Systematic Review and Meta-Research Analysis.
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Kastrati L, Raeisi-Dehkordi H, Llanaj E, Quezada-Pinedo HG, Khatami F, Ahanchi NS, Llane A, Meçani R, Muka T, and Ioannidis JPA
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- Humans, Clinical Trials as Topic, Sample Size, Randomized Controlled Trials as Topic statistics & numerical data
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Importance: Mega-trials can provide large-scale evidence on important questions., Objective: To explore how the results of mega-trials compare with the meta-analysis results of trials with smaller sample sizes., Data Sources: ClinicalTrials.gov was searched for mega-trials until January 2023. PubMed was searched until June 2023 for meta-analyses incorporating the results of the eligible mega-trials., Study Selection: Mega-trials were eligible if they were noncluster nonvaccine randomized clinical trials, had a sample size over 10 000, and had a peer-reviewed meta-analysis publication presenting results for the primary outcome of the mega-trials and/or all-cause mortality., Data Extraction and Synthesis: For each selected meta-analysis, we extracted results of smaller trials and mega-trials included in the summary effect estimate and combined them separately using random effects. These estimates were used to calculate the ratio of odds ratios (ROR) between mega-trials and smaller trials in each meta-analysis. Next, the RORs were combined using random effects. Risk of bias was extracted for each trial included in our analyses (or when not available, assessed only for mega-trials). Data analysis was conducted from January to June 2024., Main Outcomes and Measures: The main outcomes were the summary ROR for the primary outcome and all-cause mortality between mega-trials and smaller trials. Sensitivity analyses were performed with respect to the year of publication, masking, weight, type of intervention, and specialty., Results: Of 120 mega-trials identified, 41 showed a significant result for the primary outcome and 22 showed a significant result for all-cause mortality. In 35 comparisons of primary outcomes (including 85 point estimates from 69 unique mega-trials and 272 point estimates from smaller trials) and 26 comparisons of all-cause mortality (including 70 point estimates from 65 unique mega-trials and 267 point estimates from smaller trials), no difference existed between the outcomes of the mega-trials and smaller trials for primary outcome (ROR, 1.00; 95% CI, 0.97-1.04) nor for all-cause mortality (ROR, 1.00; 95% CI, 0.97-1.04). For the primary outcomes, smaller trials published before the mega-trials had more favorable results than the mega-trials (ROR, 1.05; 95% CI, 1.01-1.10) and subsequent smaller trials published after the mega-trials (ROR, 1.10; 95% CI, 1.04-1.18)., Conclusions and Relevance: In this meta-research analysis, meta-analyses of smaller studies showed overall comparable results with mega-trials, but smaller trials published before the mega-trials gave more favorable results than mega-trials. These findings suggest that mega-trials need to be performed more often given the relative low number of mega-trials found, their low significant rates, and the fact that smaller trials published prior to mega-trial report more beneficial results than mega-trials and subsequent smaller trials.
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- 2024
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31. Fractures by race and ethnicity in a diverse sample of postmenopausal women: a current evaluation among Hispanic and Asian origin groups.
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Wright NC, Follis S, Larson JC, Crandall CJ, Stefanick ML, Ing SW, and Cauley JA
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- Aged, Female, Humans, Middle Aged, Incidence, White, Asian, Fractures, Bone ethnology, Fractures, Bone epidemiology, Hispanic or Latino, Postmenopause ethnology
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Using 1998-2022 Women's Health Initiative (WHI) data, our study provides contemporary fracture data by race and ethnicity, specifically focusing on Hispanic and Asian women. Fractures of interest included any clinical, hip, and major osteoporotic fractures (MOFs). We utilized the updated race and ethnicity information collected in 2003, which included seven Asian and five Hispanic origin groups. We computed crude and age-standardized fracture incidence rates per 10 000 woman-years across race and ethnic categories and by Asian and Hispanic origin. We used Cox proportional hazards model, adjusting for age and WHI clinical trial arm, to evaluate the risk of fracture (1) by race compared to White women, (2) Asian origin compared to White women, (3) Hispanic compared to non-Hispanic women, and (4) Asian and Hispanic origins compared the most prevalent origin group. Over a median (interquartile range) follow-up of 19.4 (9.2-24.2) years, 44.2% of the 160 824 women experienced any clinical fracture, including 36 278 MOFs and 8962 hip fractures. Compared to White women, Black, Pacific Islander, Asian, and multiracial women had significantly lower risk of any clinical and MOFs, while only Black and Asian women had significantly lower hip fracture risk. Within Asian women, Filipina women had 24% lower risk of any clinical fracture compared to Japanese women. Hispanic women had significantly lower risk of any clinical, hip, and MOF fractures compared to non-Hispanic women, with no differences in fracture risk observed within Hispanic origin groups. In this diverse sample of postmenopausal women, we confirmed racial and ethnic differences in fracture rates and risk, with novel findings among within Asian and Hispanic subgroups. These data can aid in future longitudinal studies evaluate contributors to racial and ethnic differences in fractures., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Society for Bone and Mineral Research.)
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- 2024
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32. Sodium-Glucose Cotransporter Inhibitors in Heart Failure: Access, Economics, and Clinical Promise.
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Sandhu AT and Zheng J
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- Humans, Health Services Accessibility economics, Heart Failure drug therapy, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Sodium-Glucose Transporter 2 Inhibitors economics
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Competing Interests: Funding Support and Author Disclousres Dr Sandhu has received prior consulting fees from Lexicon Pharmaceuticals; and has received research funding from the American Heart Association, National Institute of Health, Novartis Pharmaceuticals, and Reprieve Cardiovascular outside of the submitted work. Dr Zheng has reported that he has no relationships relevant to the contents of this paper to disclose.
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- 2024
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33. Physical performance changes as clues to late-life blood pressure changes with advanced age: the osteoporotic fractures in men study.
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Laddu DR, Kim H, Cawthon PM, LaMonte MJ, Phillips SA, Ma J, and Stefanick ML
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- Humans, Male, Aged, Prospective Studies, Aged, 80 and over, Aging physiology, Osteoporotic Fractures, Walking Speed physiology, Antihypertensive Agents therapeutic use, Cardiovascular Diseases, Longitudinal Studies, Hypertension drug therapy, Hypertension physiopathology, Blood Pressure physiology, Hand Strength, Physical Functional Performance
- Abstract
Objectives: This study examined whether changes in late-life physical performance are associated with contemporaneous changes in blood pressure (BP) in older men., Design: prospective cohort study over 7 years., Setting and Participants: Physical performance (gait speed, grip strength, chair stand performance) and clinic-measured BP at baseline and at least one follow-up (year 7 or 9) were assessed in 3,135 men aged ≥65 y enrolled in the Osteoporotic Fractures in Men Study (MrOS)., Methods: Generalized estimating equation analysis of multivariable models with standardized point estimates (β [95% CI]) described longitudinal associations between physical performance and BP changes in participants overall, and stratified by baseline cardiovascular disease (CVD), antihypertensive medication use (none, ≥1), and enrollment age (<75 years; ≥75 years)., Results: Overall, positive associations (z-score units) were found between each increment increase in gait speed and systolic (SBP) (0.74 [0.22, 1.26]) and grip strength (0.35 [0.04, 0.65]) or gait speed (0.55 [0.24, 0.85]) with diastolic (DBP). Better grip strength and chair stand performance over time were associated with 1.83 [0.74, 2.91] and 3.47 [0.20, 6.74] mmHg higher SBP, respectively in men with CVD at baseline (both interaction P < .05). Gait speed increases were associated with higher SBP in men without CVD (0.76 [0.21, 1.32]), antihypertensive medication non-users (0.96 [0.30, 1.62]), aged <75 years (0.73 [0.05, 1.41]) and ≥75 years (0.76 [0.06, 1.47]). Similar positive, but modest associations for DBP were observed with grip strength in men with CVD, antihypertensive medication non-users, and aged <75 years, and with gait speed in men without CVD, aged <75 years, and irrespective of antihypertensive medication use., Conclusion: In older men, better physical performance is longitudinally associated with higher BP. Mechanisms and implications of these seemingly paradoxical findings, which appears to be modified by CVD status, antihypertensive medication use, and age, requires further investigation., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)
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- 2024
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34. The Need for Age Restrictions on Sales of Nonalcoholic Beverages.
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Bowdring MA and Prochaska JJ
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- Humans, Age Factors, United States, Child, Adolescent, Beverages economics, Commerce legislation & jurisprudence
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- 2024
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35. Crime-related perceptions and walking for recreation inside and outside one's home neighborhood.
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Roman CG, Chen R, Natarajan L, Conway TL, Patch C, Taylor RB, Cain KL, Roesch S, Adams MA, Saelens BE, King AC, Frank LD, Glanz K, and Sallis JF
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- Humans, Male, Female, Adult, Adolescent, Cross-Sectional Studies, Middle Aged, Aged, Perception, Surveys and Questionnaires, Young Adult, United States, Environment Design, Walking psychology, Crime, Residence Characteristics, Recreation
- Abstract
It is widely assumed crime and related concerns, including neighborhood incivilities and fear of crime, are barriers to physical activity (PA). Past studies reveal mixed evidence. Studies of impacts for crime-protective factors are less common but have similarly mixed results. This paper evaluates a comprehensive transdisciplinary conceptual framework of cross-sectional associations between crime-related perceptions and reported minutes/week of recreational walking inside and outside one's home neighborhood. Safe and Fit Environments Study (SAFE) recruited and surveyed 2302 participants from adolescents to older adults from four U.S. metropolitan areas. A zero-inflated model estimated two components of each outcome: whether the respondent walked, and minutes/week walked. Correlates of recreational walking were location-specific, differing based on walking location. Fear of crime, risk evaluation, victimization, and incivilities were not consistently associated with walking for recreation inside one's neighborhood. People with crime concerns about their own neighborhoods, however, more commonly walked for recreation outside their neighborhoods. Protective crime-related perceptions that seldom have been studied in relation to PA, such as street efficacy (i.e., the perceived ability to avoid and manage danger), were strongly associated with recreational walking in both locations, indicating the additional heuristic value of the SAFE conceptual framework. Crime-related perceptions and walking for recreation: Evaluating a conceptual model., (Copyright © 2024 Elsevier Ltd. All rights reserved.)
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- 2024
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36. Characterization of peripheral artery disease and associations with traditional risk factors, mobility, and biomarkers in the project baseline health study.
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Kercheval JB, Narcisse DI, Nguyen M, Rao SV, Gutierrez JA, Leeper NJ, Maron DJ, Rodriguez F, Hernandez AF, Mahaffey KW, Shah SH, and Swaminathan RV
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- Humans, Female, Male, Risk Factors, Aged, Prospective Studies, Middle Aged, Quality of Life, Longitudinal Studies, Hypertension epidemiology, Smoking epidemiology, Diabetes Mellitus epidemiology, Diabetes Mellitus blood, Immunophenotyping, United States epidemiology, Flow Cytometry, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease epidemiology, Biomarkers blood, Ankle Brachial Index
- Abstract
Background: There is a dearth of research on immunophenotyping in peripheral artery disease (PAD). This study aimed to describe the baseline characteristics, immunophenotypic profile, and quality of life (QoL) of participants with PAD in the Project Baseline Health Study (PBHS)., Methods: The PBHS study is a prospective, multicenter, longitudinal cohort study that collected clinical, molecular, and biometric data from participants recruited between 2017 and 2018. In this analysis, baseline demographic, clinical, mobility, QoL, and flow cytometry data were stratified by the presence of PAD (ankle brachial index [ABI] ≤0.90)., Results: Of 2,209 participants, 58 (2.6%) had lower-extremity PAD, and only 2 (3.4%) had pre-existing PAD diagnosed prior to enrollment. Comorbid smoking (29.3% vs 14%, P < .001), hypertension (54% vs 30%, P < .001), diabetes (25% vs 14%, P = .031), and at least moderate coronary calcifications (Agatston score >100: 32% vs 17%, P = .01) were significantly higher in participants with PAD than in those with normal ABIs, as were high-sensitivity C-reactive protein levels (5.86 vs 2.83, P < .001). After adjusting for demographic and risk factors, participants with PAD had significantly fewer circulating CD56-high natural killer cells, IgM+ memory B cells, and CD10/CD27 double-positive B cells (P < .05 for all)., Conclusions: This study reinforces existing evidence that a large proportion of PAD without claudication may be underdiagnosed, particularly in female and Black or African American participants. We describe a novel immunophenotypic profile of participants with PAD that could represent a potential future screening or diagnostic tool to facilitate earlier diagnosis of PAD., Gov Identifier: NCT03154346, https://clinicaltrials.gov/ct2/show/NCT03154346., Competing Interests: Conflict of interest JAG reports research funding from the Department of Veterans Affairs. NL reports grants from the NIH and AHA. He is a director of Bitterroot Bio and receives consulting fees unrelated to this study. FR reports consulting relationships with Healthpals, Amgen, NovoNordisk (CEC), and Novartis outside the submitted work. AH reports grants from Verily; grants and personal fees from AstraZeneca, Amgen, Bayer, Merck, and Novartis; and personal fees from Boston Scientific outside the submitted work. KM reports grants from Verily, Afferent, the American Heart Association (AHA), Cardiva Medical Inc, Gilead, Luitpold, Medtronic, Merck, Eidos, Ferring, Apple Inc, Sanifit, and St. Jude; grants and personal fees from Amgen, AstraZeneca, Bayer, CSL Behring, Johnson & Johnson, Novartis, and Sanofi; and personal fees from Anthos, Applied Therapeutics, Elsevier, Inova, Intermountain Health, Medscape, Mount Sinai, Mundi Pharma, Myokardia, Novo Nordisk, Otsuka, Portola, SmartMedics, and Theravance outside the submitted work. RVS reports advisory board fees from Philips; research support from ACIST Medical. The other authors have no conflicts of interest to disclose., (Published by Elsevier Inc.)
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- 2024
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37. A functional genomic framework to elucidate novel causal metabolic dysfunction-associated fatty liver disease genes.
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Saliba-Gustafsson P, Justesen JM, Ranta A, Sharma D, Bielczyk-Maczynska E, Li J, Najmi LA, Apodaka M, Aspichueta P, Björck HM, Eriksson P, Schurr TM, Franco-Cereceda A, Gloudemans M, Mujica E, den Hoed M, Assimes TL, Quertermous T, Carcamo-Orive I, Park CY, and Knowles JW
- Abstract
Background and Aims: Metabolic dysfunction-associated fatty liver disease (MASLD) is the most prevalent chronic liver pathology in western countries, with serious public health consequences. Efforts to identify causal genes for MASLD have been hampered by the relative paucity of human data from gold standard magnetic resonance quantification of hepatic fat. To overcome insufficient sample size, genome-wide association studies using MASLD surrogate phenotypes have been used, but only a small number of loci have been identified to date. In this study, we combined genome-wide association studies of MASLD composite surrogate phenotypes with genetic colocalization studies followed by functional in vitro screens to identify bona fide causal genes for MASLD., Approach and Results: We used the UK Biobank to explore the associations of our novel MASLD score, and genetic colocalization to prioritize putative causal genes for in vitro validation. We created a functional genomic framework to study MASLD genes in vitro using CRISPRi. Our data identify VKORC1 , TNKS , LYPLAL1 , and GPAM as regulators of lipid accumulation in hepatocytes and suggest the involvement of VKORC1 in the lipid storage related to the development of MASLD., Conclusions: Complementary genetic and genomic approaches are useful for the identification of MASLD genes. Our data supports VKORC1 as a bona fide MASLD gene. We have established a functional genomic framework to study at scale putative novel MASLD genes from human genetic association studies., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2024
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38. Urinary Response to Consuming Plant-Based Meat Alternatives in Persons with Normal Kidney Function: The SWAP-MEAT Pilot Trial.
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Ward CP, Landry MJ, Cunanan KM, Raphael KL, Dant CC, Gardner CD, and Pao AC
- Abstract
Background: Consuming excess animal meat may exacerbate kidney disorders such as urinary stone disease and chronic kidney disease. Plant-based meat alternatives imitate animal meat, and replace animal with vegetable protein, but it is unclear whether eating plant-meat confers similar health benefits as eating whole vegetables. We hypothesized that eating plant-meat when compared with animal meat decreases dietary acid load but increases dietary phosphorus and nitrogen., Methods: SWAP-MEAT was a randomized eight-week, crossover trial (NCT03718988) of participants consuming >2 servings/day of either plant-meat or animal meat for each eight-week phase. We measured urine sulfate, ammonium, pH, phosphorus, urea nitrogen, citrate, and creatinine concentrations, and serum creatinine and bicarbonate concentrations from stored participant samples from each phase., Results: At a single site, we enrolled 36 generally healthy participants (mean±SD age 50.2 ± 13.8 years, 67% women, and 69% White). Eating the plant-meat diet vs. eating the animal meat diet was associated with lower mean concentration of urine sulfate (-6.7 mEq/L; 95% CI -11.0, -2.4), urine ammonium (-4.2 mmol/L; 95% CI -8.2, -0.1), urine phosphorus (-9.0 mg/dL; 95% CI -17.5, -0.5), and urine urea nitrogen (-124.8 mg/dL; 95% CI -226.9, -22.6). Eating plant-meat compared with eating animal meat was associated with higher mean urine pH (+0.3 units; 95% CI 0.2, 0.5) and mean urine citrate/creatinine ratio (+111.65; 95% CI 52.69-170.60). After participants consumed a plant-meat diet compared with when they consumed an animal meat diet, mean serum creatinine concentration was lower (-0.07 mg/dL, 95% CI -0.10, -0.04), whereas mean serum bicarbonate concentration was not different., Conclusions: Eating plant-based meat products, compared with eating animal meat, was associated with lower urinary excretion of sulfate, ammonium, phosphorus, and urea nitrogen and higher urinary excretion of citrate. Our findings provide rationale for examining whether plant-based meat will benefit patients with kidney disease., (Copyright © 2024 by the American Society of Nephrology.)
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- 2024
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39. Evaluations of Compliance With California's First Tobacco Sales Bans and Tobacco Marketing in Restricted and Cross-Border Stores.
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Henriksen L, Andersen-Rodgers E, Voelker DH, Johnson TO, and Schleicher NC
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- California, Humans, Electronic Nicotine Delivery Systems economics, Electronic Nicotine Delivery Systems statistics & numerical data, Advertising legislation & jurisprudence, Commerce legislation & jurisprudence, Tobacco Products economics, Tobacco Products legislation & jurisprudence, Marketing legislation & jurisprudence
- Abstract
Introduction: Beverly Hills and Manhattan Beach were the first California cities to end tobacco sales. Previous research assessed retailers' perceptions of the laws. This study is the first to evaluate compliance (Study 1), assess whether branded or unbranded tobacco cues remain, and examine cigarette prices/discounts in cross-border stores (Study 2)., Aims and Methods: Each of the four data collectors requested Marlboro or e-cigarettes (randomly assigned) in all restricted stores (n = 33) until four attempts were exhausted or a violation occurred. Follow-up visits recorded whether former tobacco retailers advertised tobacco or contained unbranded cues. In a random sample of 126 cross-border stores (half within 1 mile of no-sales cities and half 2-4 miles away), data collectors recorded price of Marlboro and presence of cigarette discounts. Mixed models (stores within tracts), tested for differences between near and far stores, adjusting for store type and median household income., Results: Compliance was 87.5%: three stores sold Marlboro (US $8, $10, and $10) and one sold Puff Bar (US $16). Tobacco-branded items and unbranded tobacco cues remained in one store each. Mean Marlboro price was US $10.61 (SD = 1.92) at stores within 1 mile of no-sales cities, averaging US $0.73 more than at stores farther away (p < .05). However, odds of advertising cigarette discounts did not differ between stores nearby and farther from no-sales cities., Conclusions: Nearly all retailers complied with tobacco sales bans within 6-12 months of implementation. In addition, retail tobacco marketing was nearly eliminated in the two cities. There was no evidence of price gouging for Marlboro cigarettes in cross-border stores., Implications: Evidence from two early adopters of tobacco sales bans suggests that such local laws can be implemented effectively in California, although results from these high-income cities in a state with a strong tobacco control record limits generalizability. Enforcement involving routine purchase attempts rather than visual inspection of tobacco products is recommended. Although Beverly Hills and Manhattan Beach are each surrounded by communities where tobacco sales persist, there was no evidence of price gouging for cigarettes or greater presence of discounts in cross-border stores. Evaluations of the economic impacts and public health benefits of tobacco sales bans are much needed., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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40. Genetically predicted lipoprotein(a) associates with coronary artery plaque severity independent of low-density lipoprotein cholesterol.
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Clarke SL, Huang RDL, Hilliard AT, Levin MG, Sharma D, Thomson B, Lynch J, Tsao PS, Gaziano JM, and Assimes TL
- Abstract
Aims: Elevated Lipoprotein(a) [Lp(a)] is a causal risk factor for atherosclerotic cardiovascular disease, but the mechanisms of risk are debated. Studies have found inconsistent associations between Lp(a) and measurements of atherosclerosis. We aimed to assess the relationship between Lp(a), low-density lipoprotein cholesterol (LDL-C) and coronary artery plaque severity., Methods: The study population consisted of participants of the Million Veteran Program who have undergone an invasive angiogram. The primary exposure was genetically predicted Lp(a), estimated by a polygenic score. Genetically predicted LDL-C was also assessed for comparison. The primary outcome was coronary artery plaque severity, categorized as normal, non-obstructive disease, 1-vessel disease, 2-vessel disease, and 3-vessel or left main disease., Results: Among 18,927 adults of genetically inferred European ancestry and 4,039 adults of genetically inferred African ancestry, we observed consistent associations between genetically predicted Lp(a) and obstructive coronary plaque, with effect sizes trending upward for increasingly severe categories of disease. Associations were independent of risk factors, clinically measured LDL-C and genetically predicted LDL-C. However, we did not find strong or consistent evidence for an association between genetically predicted Lp(a) and risk for non-obstructive plaque., Conclusions: Genetically predicted Lp(a) is positively associated with coronary plaque severity independent of LDL-C, consistent with Lp(a) promoting atherogenesis. However, the effects of Lp(a) may be greater for progression of plaque to obstructive disease than for the initial development of non-obstructive plaque. A limitation of this study is that Lp(a) was estimated using genetic markers and could not be directly assayed, nor could apo(a) isoform size., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2024
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41. Dietary Supplementation on Physical Performance and Recovery in Active-Duty Military Personnel: A Systematic Review of Randomized and Quasi-Experimental Controlled Trials.
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Harlow J, Blodgett K, Stedman J, and Pojednic R
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- Humans, beta-Alanine administration & dosage, Creatine administration & dosage, Dietary Carbohydrates administration & dosage, Dietary Proteins administration & dosage, Probiotics administration & dosage, Quercetin administration & dosage, Randomized Controlled Trials as Topic, Resveratrol administration & dosage, Valerates administration & dosage, Dietary Supplements, Military Personnel, Physical Functional Performance
- Abstract
Background: Warfighters, often called tactical athletes, seek dietary supplementation to enhance training and recovery. Roughly 69% of active-duty US military personnel have reported consuming dietary supplements. The objective of this systematic review was to examine the impact of dietary supplements on muscle-related physical performance and recovery in active-duty military personnel., Methods: Randomized controlled trials and quasi-experimental controlled trials of oral dietary supplementation in active-duty military members were examined. A protocol was registered (PROSPERO CRD42023401472), and a systematic search of MEDLINE and CINAHL was undertaken. Inclusion criteria consisted of studies published between 1990-2023 with outcomes of muscle performance and recovery among active-duty military populations. The risk of bias was assessed with the McMaster University Guidelines and Critical Review Form for Quantitative Studies., Results: Sixteen studies were included. Four were conducted on protein or carbohydrate; four on beta-alanine alone, creatine alone, or in combination; two on mixed nutritional supplements; two on probiotics alone or in combination with beta hydroxy-beta methylbutyrate calcium; and four on phytonutrient extracts including oregano, beetroot juice, quercetin, and resveratrol. Ten examined outcomes related to physical performance, and six on outcomes of injury or recovery. Overall, protein, carbohydrate, beta-alanine, creatine, and beetroot juice modestly improved performance, while quercetin did not. Protein, carbohydrates, beta-alanine, probiotics, and oregano reduced markers of inflammation, while resveratrol did not., Conclusions: Nutrition supplementation may have small benefits on muscle performance and recovery in warfighters. However, there are significant limitations in interpretation due to the largely inconsistent evidence of ingredients and comparable outcomes. Thus, there is inadequate practical evidence to suggest how dietary supplementation may affect field performance.
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- 2024
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42. The association between reproductive history and abdominal adipose tissue among postmenopausal women: results from the Women's Health Initiative.
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Banack HR, Cook CE, Grandi SM, Scime NV, Andary R, Follis S, Allison M, Manson JE, Jung SY, Wild RA, Farland LV, Shadyab AH, Bea JW, and Odegaard AO
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- Humans, Female, Middle Aged, Aged, Prospective Studies, Women's Health, Abdominal Fat, Pregnancy, Body Mass Index, Parity physiology, Menopause physiology, Intra-Abdominal Fat, Adiposity physiology, Postmenopause physiology, Reproductive History, Menarche physiology
- Abstract
Study Question: What is the association between reproductive health history (e.g. age at menarche, menopause, reproductive lifespan) with abdominal adiposity in postmenopausal women?, Summary Answer: Higher visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) tissue levels were observed among women with earlier menarche, earlier menopause, and greater parity., What Is Known Already: Postmenopausal women are predisposed to accumulation of VAT and SAT. Reproductive health variables are known predictors of overall obesity status in women, defined by BMI., Study Design, Size, Duration: This study is a secondary analysis of data collected from the baseline visit of the Women's Health Initiative (WHI). The WHI is a large prospective study of postmenopausal women, including both a randomized trial and observational study. There were 10 184 women included in this analysis., Participants/materials, Setting, Methods: Data were collected from a reproductive health history questionnaire, dual-energy x-ray absorptiometry scans, and anthropometric measures at WHI baseline. Reproductive history was measured via self-report, and included age at menarche, variables related to pregnancy, and age at menopause. Reproductive lifespan was calculated as age at menopause minus age at menarche. Statistical analyses included descriptive analyses and multivariable linear regression models to examine the association between reproductive history with VAT, SAT, total body fat, and BMI., Main Results and the Role of Chance: Women who reported early menarche (<10 years) or early menopause (<40 years) had the highest levels of VAT. Adjusted multivariable linear regression results demonstrate women who experienced menarche >15 years had 23 cm2 less VAT (95% CI: -31.4, -14.4) and 47 cm2 less SAT (95% CI: -61.8, -33.4) than women who experienced menarche at age 10 years or earlier. A similar pattern was observed for age at menopause: compared to women who experienced menopause <40 years, menopause at 50-55 years was associated with 19.3 cm2 (95% CI: -25.4, -13.3) less VAT and 27.4 cm2 (-29.6, 10.3) less SAT. High parity (>3 pregnancies) was also associated with VAT and SAT. For example, adjusted beta coefficients for VAT were 8.36 (4.33, 12.4) and 17.9 (12.6, 23.2) comparing three to four pregnancies with the referent, one to two pregnancies., Limitations, Reasons for Caution: The WHI reproductive health history questionnaire may be subject to poor recall owing to a long look-back window. Residual confounding may be present given lack of data on early life characteristics, such as maternal and pre-menarche characteristics., Wider Implications of the Findings: This study contributes to our understanding of reproductive lifespan, including menarche and menopause, as an important predictor of late-life adiposity in women. Reproductive health has also been recognized as a sentinel marker for chronic disease in late life. Given established links between adiposity and cardiometabolic outcomes, this research has implications for future research, clinical practice, and public health policy that makes use of reproductive health history as an opportunity for chronic disease prevention., Study Funding/competing Interest(s): HRB and AOO are supported by the National Institute of Health National Institute of Aging (R01AG055018-04). JWB reports royalties from 'ACSM'S Body Composition Assessment Book' and consulting fees from the WHI. The remaining authors have no competing interests to declare., Trial Registration Number: N/A., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)
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- 2024
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43. TPPP-BRD9 fusion-related gallbladder carcinomas are frequently associated with intracholecystic neoplasia, neuroendocrine carcinoma, and a distinctive small tubular-type adenocarcinoma commonly accompanied with a syringomatous pattern.
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Pehlivanoglu B, Araya JC, Lawrence S, Roa JC, Balci S, Andersen JB, Rashid A, Hsing AW, Zhu B, Gao YT, Koshiol J, and Adsay V
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- Adult, Aged, Female, Humans, Male, Middle Aged, Biomarkers, Tumor analysis, Biomarkers, Tumor genetics, Gene Fusion, Nerve Tissue Proteins genetics, Oncogene Proteins, Fusion genetics, Transcription Factors genetics, Adenocarcinoma pathology, Adenocarcinoma genetics, Carcinoma, Neuroendocrine pathology, Carcinoma, Neuroendocrine genetics, Gallbladder Neoplasms pathology, Gallbladder Neoplasms genetics
- Abstract
A fusion between tubulin polymerization-promoting protein (TPPP), a regulatory cytoskeletal gene, and the chromatin remodeling factor, bromodomain-containing protein 9 (BRD9), TPPP-BRD9 fusion has been found in rare cancer cases, including lung and gallbladder cancers (GBC). In this study, we investigated the histopathological features of 16 GBCs previously shown by RNA sequencing to harbor the TPPP-BRD9 fusion. Findings in the fusion-positive GBCs were compared with 645 GBC cases from the authors' database. Among the 16 TPPP-BRD9 fusion-positive GBC cases, most were females (F:M = 7:1) of Chinese ethnicity (12/16), whereas the remaining cases were from Chile. The histopathological examination showed the following findings: 1) Intracholecystic neoplasm (ICN) in 7/15 (47% vs. 7% 645 reference GBCs, p < 0.001), all with gastro-pancreatobiliary phenotype, often with clear cell change, and in the background of pyloric gland metaplasia and extensive high-grade dysplasia. 2) Neuroendocrine carcinoma (NEC) morphology: 3 cases (27% vs. 4.6% in the reference database, p = 0.001) showed a sheet-like and nested/trabecular growth pattern of monotonous cells with salt-and-pepper chromatin characteristic of NECs. Two were large cell type, one had prominent clear cell features, a rare finding in GBNECs; the other one had relatively bland, well-differentiated morphology, and the remaining case was small cell type. 3) Adenocarcinoma identified in 8 cases had a distinctive pattern characterized by widely separated small, round tubular units with relatively uniform nuclei in a fashion seen in mesonephric adenocarcinomas, including hobnail-like arrangement and apical snouts, reminiscent of tubular carcinomas of the breast in many areas. In some foci, the epithelium was attenuated, and glands were elongated, some with comma shapes, which along with the mucinous/necrotic intraluminal debris created a "syringoid" appearance. 4) Other occasional patterns included the cribriform, glomeruloid patterns, and metaplastic tubular-spindle cell pattern accompanied by hemorrhage. In conclusion, TPPP-BRD9 fusion-positive GBCs often develop through intracholecystic neoplasms (adenoma-carcinoma sequence) of gastro-pancreatobiliary lineage, appear more prone to form NEC morphology and have a propensity to display clear cell change. Invasive adenocarcinomas arising in this setting often seem to display a distinctive appearance that we tentatively propose as the TPPP-BRD9 fusion-positive pattern of GBC., Competing Interests: Declaration of competing interest The authors have no conflict of interest to declare., (Copyright © 2024. Published by Elsevier Inc.)
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- 2024
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44. How adoption of new pharmaceuticals can impact US health system reimbursement under alternative payment models: An economic model measuring the impact of sotagliflozin among patients with heart failure and diabetes.
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Shafrin J, Wang S, Kim J, Sikirica S, and Sandhu AT
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- Humans, United States, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Sodium-Glucose Transporter 2 Inhibitors economics, Hospitalization economics, Diabetes Mellitus drug therapy, Diabetes Mellitus economics, Reimbursement Mechanisms, Patient Readmission statistics & numerical data, Patient Readmission economics, Heart Failure drug therapy, Heart Failure economics, Glycosides therapeutic use, Glycosides economics, Models, Economic
- Abstract
Background: Heart failure (HF) is among the leading causes of death in the United States. Further, patients hospitalized because of HF with comorbid diabetes mellitus (DM) are at a significantly increased risk of death and rehospitalization. Results from the SOLOIST-WHF trial show that sotagliflozin lowered rates of readmission among hospitalized patients with HF and comorbid DM. However, it is unclear what the economic impact of the use of sotagliflozin would be on hospitals and health systems, particularly in an age where provider reimbursement is increasingly tied to value., Objective: To quantify the 1-year financial impact on US provider health systems of adopting sotagliflozin relative to standard of care (SoC) across different alternative payment models., Methods: This study created a 3-part decision tree model to quantify the financial impact of using sotagliflozin to treat patients hospitalized with HF in a US hospital setting. The model first estimated the clinical and economic outcomes of health systems with current SoC (no sotagliflozin) to treat US patients hospitalized for HF with comorbid DM. Then, using the results from the SOLOIST trial, the changes in clinical and economic outcomes with sotagliflozin adoption were modeled. Finally, the differences in health care utilization between sotagliflozin and SoC arms were translated to differences in health system reimbursement in the context of 3 common alternative payment models (APMs) in addition to the baseline fee-for-service (FFS) model: FFS with the Hospital Readmissions Reduction Program, the Bundled Payments for Care Improvement-Advanced program, and Accountable Care Organizations., Results: A typical community hospital would have 83.4 patients per year on average with an index HF hospitalization with comorbid DM. The model predicted that sotagliflozin would reduce the probability of hospitalization, emergency department visits, and deaths by 29.3%, 38.5%, and 17.8%, respectively, compared with SoC. For hospitals not participating in APM programs, sotagliflozin resulted in a net loss of $92.94 per person ($7,754 per health system). Conversely, when accounting for provider health system participation in APMs, sotagliflozin adoption increased financial returns by $4,720 per person ($305,604 per health system) under the Hospital Readmissions Reduction Program, $1,200 per person ($100,106 per health system) for the Bundled Payments for Care Improvement-Advanced program, and $1,078 per person ($31,029 per health system) for Accountable Care Organizations. Based on the national average composition of APM reimbursement, sotagliflozin adoption resulted in a $1,576 increase in margin per patient with HF ($105,454 per health system)., Conclusions: Although sotagliflozin adoption reduced health system revenue in an FFS payment model, it led to a net positive financial impact after accounting for APM bonus payments.
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- 2024
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45. Diagnosing glaucoma in primary eye care and the role of Artificial Intelligence applications for reducing the prevalence of undetected glaucoma in Australia.
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Jan C, He M, Vingrys A, Zhu Z, and Stafford RS
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- Humans, Australia epidemiology, Prevalence, Artificial Intelligence, Glaucoma diagnosis, Glaucoma epidemiology, Primary Health Care
- Abstract
Glaucoma is the commonest cause of irreversible blindness worldwide, with over 70% of people affected remaining undiagnosed. Early detection is crucial for halting progressive visual impairment in glaucoma patients, as there is no cure available. This narrative review aims to: identify reasons for the significant under-diagnosis of glaucoma globally, particularly in Australia, elucidate the role of primary healthcare in glaucoma diagnosis using Australian healthcare as an example, and discuss how recent advances in artificial intelligence (AI) can be implemented to improve diagnostic outcomes. Glaucoma is a prevalent disease in ageing populations and can have improved visual outcomes through appropriate treatment, making it essential for general medical practice. In countries such as Australia, New Zealand, Canada, USA, and the UK, optometrists serve as the gatekeepers for primary eye care, and glaucoma detection often falls on their shoulders. However, there is significant variation in the capacity for glaucoma diagnosis among eye professionals. Automation with Artificial Intelligence (AI) analysis of optic nerve photos can help optometrists identify high-risk changes and mitigate the challenges of image interpretation rapidly and consistently. Despite its potential, there are significant barriers and challenges to address before AI can be deployed in primary healthcare settings, including external validation, high quality real-world implementation, protection of privacy and cybersecurity, and medico-legal implications. Overall, the incorporation of AI technology in primary healthcare has the potential to reduce the global prevalence of undiagnosed glaucoma cases by improving diagnostic accuracy and efficiency., (© 2024. The Author(s).)
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- 2024
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46. Who Benefits? A Mixed Methods Study Assessing Community Use of a Major Metropolitan Park During the COVID-19 Pandemic.
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O'Connor Á, Resendiz E, Nason L, Eyler AA, Brownson RC, Reis RS, Banchoff A, King AC, and Salvo D
- Subjects
- Humans, Male, Female, Adult, Middle Aged, Missouri epidemiology, Young Adult, Pandemics, Focus Groups, Aged, Adolescent, Community-Based Participatory Research, Urban Population, Recreation, COVID-19 epidemiology, Parks, Recreational, SARS-CoV-2
- Abstract
By providing spaces for recreation, physical activity, social gatherings, and time in nature, urban parks offer physical, mental, and social benefits to users. However, many urban residents face barriers to park use. The COVID-19 pandemic introduced new potential barriers to urban park access and use, including changes to daily life and employment, closure of park amenities and restrictions to public movement, and risk from the coronavirus itself. The mixed-methods PARCS study measured use and perceptions of a large urban park in St. Louis, Missouri before, during, and after local COVID-19 contingency measures and restrictions. We examine data from 1,157 direct observation assessments of park usership, an online survey of park users (n=561), interviews with key stakeholders (n=27), four focus groups (n=30), and a community-based participatory research sub-study (n=66) to comprehensively characterize the effects of the COVID-19 pandemic on park use. Park users who felt unsafe from the coronavirus experienced 2.65 higher odds of reducing park use. However, estimated park visits during COVID-19 contingency measures (n=5,023,759) were twice as high as post-contingency (n=2,277,496). Participants reported using the park for physical activity, recreation, time in nature, and socializing during the contingency period. Black, Hispanic/Latino, and young people were less likely to visit the park than others, suggesting an additional, disproportionate impact of the pandemic on minoritized and socioeconomically disadvantaged communities. This study highlights the role of public spaces like parks as resources for health and sites where urban health inequities can be alleviated in times of public crisis., (© 2024. The New York Academy of Medicine.)
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- 2024
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47. Regarding: the impacts of partial replacement of red and processed meat with legumes or cereals on protein and amino acid intakes: a modelling study in the Finnish adult population.
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Mariotti F, Gardner C, Fouillet H, and Huneau JF
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- Humans, Finland epidemiology, Adult, Meat Products, Meat, Edible Grain, Dietary Proteins administration & dosage, Amino Acids administration & dosage, Fabaceae
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- 2024
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48. Conversion practice recall and mental health symptoms in sexual and gender minority adults in the USA: a cross-sectional study.
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Tran NK, Lett E, Cassese B, Streed CG Jr, Kinitz DJ, Ingram S, Sprague K, Dastur Z, Lubensky ME, Flentje A, Obedin-Maliver J, and Lunn MR
- Subjects
- Humans, Male, Cross-Sectional Studies, Female, Adult, United States, Prospective Studies, Middle Aged, Mental Recall, Gender Identity, Surveys and Questionnaires, Mental Health, Young Adult, Stress Disorders, Post-Traumatic psychology, Sexual Behavior psychology, Sexual and Gender Minorities psychology
- Abstract
Background: Conversion practices are associated with psychological morbidity, yet few studies have evaluated differences between efforts to change gender identity, sexual orientation, or both. We aimed to examine the individual and joint association of conversion practice recall targeted at gender identity or sexual orientation, or both, with current mental health symptoms among sexual and gender minority people., Methods: This cross-sectional study used data from The PRIDE Study, a US-based, online, prospective cohort study of sexual and gender minority adults who were recruited through social media, digital advertisements, and sexual and gender minority community-based events and organisations. For this analysis, we included participants who completed a lifetime questionnaire in 2019-20 and a subsequent annual questionnaire in 2020-21 without missing outcome data. All questionnaires were in English. The exposure was lifetime recall of conversion practice targeting gender identity alone, sexual orientation alone, or both (versus no conversion practice). Mental health outcomes were continuous measures: Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire 9-item (depression) scale, Post-Traumatic Stress Disorder Checklist 6-item scale, and Suicide Behaviors Questionnaire-Revised scale. We used linear regression to analyse the associations of conversion practice recall and mental health symptoms, controlling for demographic and childhood factors and stratified between cisgender and transgender and gender diverse groups. Sensitivity analyses evaluated the potential impact of unmeasured confounding. Analyses were conducted in R. We included people with related lived experience in the design and implementation of this study., Findings: Of 6601 participants who completed the lifetime questionnaire in 2019-20, 4440 completed the subsequent annual questionnaire in 2020 or 2021, and 4426 did not have missing outcome data. Of the 4426 included participants, 4073 (92·0%) identified as White (either alone or in combination with other ethnoracial options), 460 (10·4%) identified with multiple ethnoracial identities, and 1923 (43·4%) were transgender and gender diverse. Participants' age ranged from 18 years to 84 years (median 31·7 years, IQR 25·5-44·1). 149 (3·4%) participants reported sexual orientation-related conversion practice alone, 43 (1·0%) reported gender identity-related conversion practice alone, and 42 (1·0%) reported both. Recalling both forms of conversion practice was most strongly associated with greater post-traumatic stress disorder (PTSD; β 2·84, 95% CI 0·94-4·74) and suicidality (2·14, 0·95-3·32) symptoms. Recall of only sexual orientation-related conversion practice was associated with greater symptoms of PTSD (1·10, 0·22-1·98). Recall of gender identity-related conversion practice alone was most strongly associated with greater depressive symptoms (3·24, 1·03-5·46). Only associations for suicidality differed between cisgender and transgender and gender diverse participants, although the latter showed higher mental health symptoms overall. Findings were moderately robust to potential sources of unmeasured confounding in sensitivity analysis., Interpretation: Recall of conversion practice exposure was associated with a range of mental health symptoms among sexual and gender minority people. These findings support calls to ban conversion practices because of their effects as a structural determinant of mental health., Funding: Gill Foundation, Dona Rockstad, and Patient-Centered Outcomes Research Institute., Competing Interests: Declaration of interests CGS received consultation fees from EverlyWell, The Texas Health Institute, and L'Oreal, and is the current President of the United States Professional Association for Transgender Health. JO-M has received consultation fees from Ibis Reproductive Health, Hims, Folx Health, Sage Therapeutics, and Upstream on topics unrelated to this work; and participates in the Quality Family Planning 2.0 Advisory Board in the Office of Populations Affairs and Contraception: Medical Advisory Board in the Center for Disease Control and Prevention. MRL received consultation fees from Otsuka Pharmaceutical Development and Commercialization, and the American Dental Association on topics unrelated to this work; and is a Scientific Advisory Board member for SPARK and Simons Foundation. NKT is a Resource Access Board member for the All of Us Research Program. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)
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- 2024
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49. Digital health as a tool for patient activation and improving quality of care for heart failure.
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Verma A, Azizi Z, and Sandhu AT
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- Humans, Telemedicine, Self Care methods, Quality of Life, Quality of Health Care, Digital Health, Heart Failure therapy, Patient Participation methods, Quality Improvement
- Abstract
The clinical and economic impact of heart failure (HF) is immense and will continue to rise due to the increasing prevalence of the disease. Despite the availability of guideline-recommended medications that improve mortality, reduce hospitalizations, and enhance quality of life, there are major gaps in the implementation of such care. Quality improvement interventions have generally focused on clinicians. While certain interventions have had modest success in improving the use of heart failure medications, they remain insufficient in optimizing HF care. Here, we discuss how patient-facing interventions can add value and supplement clinician-centered interventions. We discuss how digital health can be leveraged to create patient activation tools that create a larger, sustainable impact. Small studies have suggested the promise of digital tools for patient engagement and self-care, but there are also important barriers to the adoption of such interventions that we describe. We share key principles and strategies around the design and implementation of digital health innovations to maximize patient participation and engagement. By uniquely activating patients in their own care, digital health can unlock the full potential of both existing and new quality improvement initiatives to drive forward high-quality and equitable heart failure care., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
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- 2024
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50. Examining Relationships between Perceptions of Air Quality-Objectively Assessed Particulate Matter-And Health-Related Attributions among Midlife and Older Adults from the San Francisco Bay Area, California, USA.
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Zamora AN, Campero MI, Garcia DM, and King AC
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- Humans, Female, San Francisco, Aged, Male, Middle Aged, Perception, Air Pollutants analysis, Aged, 80 and over, Particulate Matter analysis, Air Pollution analysis
- Abstract
This investigation explored (1) correlations between midlife and older adults' air quality perceptions with objective particulate matter 2.5 (PM
2.5 ) and diesel PM, and (2) correlations between air quality perceptions with health-related attributions among a sample of midlife and older adults ( n = 66) living in or around senior affordable public housing sites in California's San Francisco Bay Area. The adapted air quality perception scale was used to measure perceptions of air quality, while health-related attributions were obtained from the vitality plus scale (VPS), with higher values indicating worse perceptions of air quality and poorer responses to health-related attributions, respectively. Self-reported data were linked to zip code level PM2.5 and diesel PM obtained from the CalEnviroScreen 4.0. All correlations were evaluated using Spearman's rank correlations. The mean (SD) age was 70.6 (9.1) years, and 75.7% were female. We observed moderate, positive correlations between both PM2.5 and diesel PM with three domains: perceptions related to protection measures against air quality, emotional/mental perceptions, and sensorial perceptions. We also found evidence of moderate, positive correlations between the domains of physical symptoms, perceptions related to protection measures against air quality, and emotional/mental perceptions with health-related attributions, such as sleep-related items and feelings of restlessness or agitation. Results from this exploratory study suggest that midlife and older adults' perceptions of air quality may be moderately related to both objective air quality data and certain health behaviors and symptoms. Findings underscore the importance of considering individual perceptions as an additional area in public health strategies aimed at protecting midlife and older adults from the impacts of air pollution.- Published
- 2024
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