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1. Digital health interventions for osteoporosis and post-fragility fracture care

Author

Gupta, A., Maslen, C., Vindlacheruvu, M., Abel, R.L., Bhattacharya, P., Bromiley, P.A., Clark, E.M., Compston, J.E., Crabtree, N., Gregory, J.S., Kariki, E.P., Harvey, N.C., McCloskey, E., Ward, K.A., and Poole, K.E.S.

Abstract

The growing burden from osteoporosis and fragility fractures highlights a need to improve osteoporosis management across healthcare systems. Sub-optimal management of osteoporosis is an area suitable for digital health interventions. While fracture liaison services (FLSs) are proven to greatly improve care for people with osteoporosis, such services might benefit from technologies that enhance automation. The term ‘Digital Health’ covers a variety of different tools including clinical decision support systems, electronic medical record tools, patient decision aids, patient apps, education tools, and novel artificial intelligence (AI) algorithms. Within the scope of this review are AI solutions that use algorithms within health system registries to target interventions. Clinician-targeted, patient-targeted, or system-targeted digital health interventions could be used to improve management and prevent fragility fractures. This review was commissioned by The Royal Osteoporosis Society and Bone Research Academy during the production of the 2020 Research Roadmap (https://theros.org.uk), with the intention of identifying gaps where targeted research funding could lead to improved patient health. We explore potential uses of digital technology in the general management of osteoporosis. Evidence suggests that digital technologies can support multidisciplinary teams to provide the best possible patient care based on current evidence and to support patients in self-management. However, robust randomised controlled studies are still needed to assess the effectiveness and cost-effectiveness of these technologies.

Published
2022

4. ‘Sink or swim’: an evaluation of the clinical characteristics of individuals with high bone mass

Author

Gregson, C. L., Steel, S. A., O’Rourke, K. P., Allan, K., Ayuk, J., Bhalla, A., Clunie, G., Crabtree, N., Fogelman, I., Goodby, A., Langman, C. M., Linton, S., Marriott, E., McCloskey, E., Moss, K. E., Palferman, T., Panthakalam, S., Poole, K. E. S., Stone, M. D., Turton, J., Wallis, D., Warburton, S., Wass, J., Duncan, E. L., Brown, M. A., Davey-Smith, G., and Tobias, J. H.

Published
2012
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9. Long-term cost-effectiveness of screening for fracture risk in a UK primary care setting : The SCOOP Study

Author

Söreskog, E., Borgström, F., Shepstone, L., Clarke, S., Cooper, C., Harvey, I., Harvey, N. C., Howe, A., Johansson, H., Marshall, T., O’Neill, T. W., Peters, T. J., Redmond, N. M., Turner, D., Holland, R., McCloskey, E., Kanis, J. A., Heawood, A., Crabtree, N., Duffy, H., Gittoes, N., Parle, J., Rashid, F., Stant, K., Taylor, K., Thomas, C., Knox, E., Tenneson, C., Williams, H., Adams, D., Bion, V., Blacklock, J., Dyer, T., Fong-Soe-Khioe, R., Lenaghan, E., Bratherton, S., Fidler, M., Knight, K., McGurk, C., Smith, K., Young, S., Collins, K., Cushnaghan, J., Arundel, C., Bell, K., Clark, L., Collins, S., Gardner, S., Mitchell, N., Torgeson, D., and SCOOP Study Team

Subjects
0301 basic medicine, Fracture risk, medicine.medical_specialty, Cost effectiveness, Cost-Benefit Analysis, Endocrinology, Diabetes and Metabolism, SCOOP, 030209 endocrinology & metabolism, High fracture, Primary care, Article, law.invention, Screening programme, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Randomized controlled trial, law, medicine, fracture risk assessment, Humans, Mass Screening, UK, cost-effectiveness, Aged, computer.programming_language, Aged, 80 and over, Primary Health Care, business.industry, Fracture risk assessment, United Kingdom, randomized controlled trial, Quality of Life, Physical therapy, Female, Cost-effectiveness, Quality-Adjusted Life Years, 030101 anatomy & morphology, business, computer, Osteoporotic Fractures, FRAX
Abstract

Community-based screening and treatment of women age 70–85 years at high fracture risk reduced fractures; moreover, the screening programme of fracture risk in older women had an effect that was cost-saving. The results support a case for a screening programme of fracture risk in older women in the UK.Purpose The SCOOP (screening for prevention of fractures in older women) randomised controlled trial investigated whether community-based screening could reduce fractures in women age 70–85 years. The objective of this study was to estimate the long-term cost-effectiveness of screening for fracture risk in a UK primary care setting compared with usual management, based on the SCOOP study.Methods:A health economic Markov model was used to predict the life-time consequences in terms of costs and quality of life of the screening programme compared with the control arm. The model was populated with costs related to drugs, administration and screening intervention derived from the SCOOP study. Fracture risk reduction in the screening arm compared with the usual management arm was derived from SCOOP. Modelled fracture risk corresponded to the risk observed in SCOOP. Results: Screening saved 9 hip fractures and 20 non-hip fractures over the remaining lifetime (mean 14 years) of 1,000 patients compared with usual management. In total, the screening arm saved costs (£286) and gained 0.015 QALYs/patient in comparison with usual management arm. Conclusions:This analysis suggests that a screening programme of fracture risk in older women in the UK would gain quality of life and life years, and reduce fracture costs to more than offset the cost of running the programme.

Published
2020
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10. Osteosarcoma in the femur of a horse

Author

Pfeifle, R. L., primary, Beasley, E. M., additional, Crabtree, N. E., additional, Fraser, C., additional, Elbert, J. A., additional, Ducker, E., additional, Nagata, K., additional, Garner, B. C., additional, and Sakamoto, K., additional

Published
2021
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18. Systematic screening using FRAX leads to increased use of, and adherence to, anti-osteoporosis medications: An analysis of the UK SCOOP Trial

Author

Parsons, C. M., Harvey, N., Shepstone, L., Kanis, J. A., Lenaghan, E., Clarke, S., Fordham, R., Gittoes, N., Harvey, I., Holland, R., Redmond, N. M., Howe, A., Marshall, T., Peters, T. J., Torgerson, D., O’Neill, T. W., McCloskey, E., Cooper, C., Crabtree, N., Duffy, H., Parle, J., Rashid, F., Stant, K., Taylor, K., Thomas, C., Knox, E., Tenneson, C., Williams, H., Adams, D., Bion, V., Blacklock, J., Dyer, T., Bratherton, S., Fidler, M., Knight, K., McGurk, C., Smith, K., Young, S., Collins, K., Cushnaghan, J., Arundel, C., Bell, K., Clark, L., Collins, S., Gardner, S., Mitchell, N., and the Scoop Trial Group

Subjects
medicine.medical_specialty, Hip fracture, FRAX, business.industry, Cost effectiveness, screening, Endocrinology, Diabetes and Metabolism, Osteoporosis, FRAX®, medicine.disease, Logistic regression, osteoporosis, Rheumatology, Internal medicine, Epidemiology, Orthopedic surgery, medicine, epidemiology, medication, adherence, business
Abstract

Summary In the large community-based SCOOP trial, systematic fracture risk screening using FRAX® led to greater use of AOM and greater adherence, in women at high fracture risk, compared with usual care. Introduction In the SCreening of Older wOmen for Prevention of fracture (SCOOP) trial, we investigated the effect of the screening intervention on subsequent long-term self-reported adherence to anti-osteoporosis medications (AOM). Methods SCOOP was a primary care–based UK multicentre trial of screening for fracture risk. A total of 12,483 women (70–85 years) were randomised to either usual NHS care, or assessment using the FRAX® tool ± dual-energy X-ray absorptiometry (DXA), with medication recommended for those found to be at high risk of hip fracture. Self-reported AOM use was obtained by postal questionnaires at 6, 12, 24, 36, 48 and 60 months. Analysis was limited to those who initiated AOM during follow-up. Logistic regression was used to explore baseline determinants of adherence (good ≥ 80%; poor

Published
2019
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22. Carbon dioxide embolism associated with transanal total mesorectal excision surgery: A report from the international registries

Author

Dickson, E. A., Penna, M., Cunningham, C., Ratcliffe, F. M., Chantler, J., Crabtree, N. A., Tuynman, J. B., Albert, M. R., Monson, J. R. T., Hompes, R., Abdelmoaty, W., Adamina, M., Aigner, F., Alavi, K., Albers, B., Al Furajii, H., Allison, A., Eduardo, S., Araujo, A., Apostolides, G. Y., Arezzo, A., Arnold, S. J., Aryal, K., Ashamalla, S., Ashraf, Sana, Attaluri, V., Austin, R., Barugo-La, G., Beggs, A., Belgers, H. J., Bell, S., Bemelman, W., Berti, S., Biebl, M., Blondeel, J., Binky, B., Baloyiannis, I. -N., Bandyopadhyay, D., Boni, L., Bordeianou, L., Box, B., Boyce, S., Brokelman, W., Brown, C. J., Bruegger, L., Buchli, C., Christian Buchs, N., Bulut, O., Burt, C., Bursics, A., Cahill, R. A., Pablo Campana, J., Caricato, M., Caro-Tar-Rago, A., Casans, F., Cassinotti, E., Caycedo-Marulan-Da, A., Chadi, S. A., Chandrasinghe, P., Chaudhri, S., Chaumont, N., Chitsabesan, P., Coget, J., Collera, P., Coleman, M., Courtney, E. D., Dagbert, F., Dalton, S. J., Daniel, G., Clark, D. A., De-Drye, L., De La Torre, J., Dapri, G., Dayal, S. P., De Chaisemartin, C., Borja De Lacy, F., Blasco Delgado, O., Di Candido, F., Diaz Del Gobbo, G., De Graaf, E. J. R., Delrio, P., De Pooter, K., D'Hooge, P., Doornebosch, P., Duff, S., Du Jardin, P., Dzhumabaev, K. E., Tom Edwards, M., Egenvall, I., Espin, E., Eugenio, M., Egenvall, M. -I., Ravn Eriksen, J., Faerden, A. E., Faes, S., Simo Fernandez, V., Fichera, A., Fierens, J., Fierens, K., Forgan, T., Francis, N., Francombe, J., Francone, E., Francone, T., Gamage, B., Perez Garcia, J. A., Ethem Gecim, I., Van Geluwe, B., Gin-Gert, C., George, V., Gloeckler, M., Gogenur, I., Goulart, A., Grolich, T., Haas, E., Hameed, U., Hahnloser, D., Harikrishnan, A., Harris, G., Haunold, I., Hendrickse, C., Hendrickx, T., Heyns, M., Horwood, J., Huerga, D., Ito, M., Jarimba, A., Joeng, H. K. M., Jones, O., Jutten, G., Kala, Z., Kita, Y., Knol, J., Thengugal Kochupapy, R., Kneist, W., Kok, A. S. Y., Kusters, M., Lacy, A. M., Laka-Tos, M., Lal, R., Lakkis, Z., Leao, P., Lambrechts, A., Lee, L., Lelong, B., Leung, E., Lezoche, E., Sender Liberman, A., Lidder, P., An-Drade Lima, M., Loganathan, A., Lombana, L. J., Lorenzon, Laura, Loriz, H., Lukas, M., Lutrin, D., Mackey, P., Mamedli, Z. Z., Mansfield, S., Marcello, P., Marcoen, S., Romero Marcos, J. M., Marcy, T., Marecik, S., Marks, J., Marsanic, P., Mattacheo, A., Maun, D., May, D., Maykel, J. A., Mcarthur, D., Mccallum, I., Mccarthy, K., Mclemore, E. C., Ramon Sil-Viera Mendes, C., Messaris, E., Michalopoulos, A., Mikalauskas, S., Miles, A., Millan, M., Mills, S., Miskovic, D., Montroni, I., Moore, E., Moore, T., Mori, Simona, Morino, M., Muratore, A., Mutafchiyski, V., Myers, A., Van Nieuwenhove, Y., Nishizawa, Y., Ng, P., John Nolan, G., Obias, V., Ochsner, A., Hwan Oh, J., Onghena, T., Oommen, S., Orkin, B. A., Osman, K., Ouro, S., Panis, Y., Papavramidis, T., Von Papen, M., Papp, G., Paquette, I., Paraoan, M. T., Paredes, J. P., Pastor, C., Pattyn, P. R. L., Karim Perdawood, S., Wan Pei, C. F., Piehslinger, J., Penchev, D., Oliva Perez, R., Persiani, Roberto, Pfeffer, F., Terry Phang, P., Pokela, V., Picchetto, A., Poskus, E., Prieto, D., Que-Reshy, F. A., Ramcharan, S., Rauch, S., Rega, D., Reyes, J. C., Ris, F., Delgado Rivilla, S., Alexander Rockall, T., Roquete, P., Rossi, G., Ruffo, G., Sakai, Y. -S., Sands, D., Sao Juliao, G. P., Scala, Alessandro, Scala, D., Estevez Schwarz, L., Edmond Seid, V., Seitinger, G., Shaikh, I. A., Sharma, A., Siet-Ses, C., Singh, B., Helmer Sjo, O., Kyung Sohn, D., Sora-Via, C., Sosef, M. N., Spinelli, A., Speakman, C., Steele, S., Stephan, V., Stevenson, A. R. L., Stotland, P., Studer, P., Strypstein, S., Sylla, P., Szyszkowitz, A., Talwar, A., Tanis, P., Tejedor, P., Pastor Teso, E., Tognelli, J., Torkington, J., Tschann, P., Tuech, J. -J., Tuerler, A., Tzovaras, G., Ugolini, G., Vallribera, F., Vansteenkiste, F., Vangenechten, E., Verdaasdonk, E. G. G., Vilela, N., Walter, B., Warren, O. J., Visser, T., Warrier, S., Warner, M., Waru-Savitarne, J., Whiteford, M. H., Andreas Wik, T., Witzig, J. -A., Wolff, T., Wolthuis, A. M., Wynn, G., Ashraf S., Lorenzon L. (ORCID:0000-0001-6736-0383), Mori S., Persiani R. (ORCID:0000-0002-1537-5097), Scala A., Dickson, E. A., Penna, M., Cunningham, C., Ratcliffe, F. M., Chantler, J., Crabtree, N. A., Tuynman, J. B., Albert, M. R., Monson, J. R. T., Hompes, R., Abdelmoaty, W., Adamina, M., Aigner, F., Alavi, K., Albers, B., Al Furajii, H., Allison, A., Eduardo, S., Araujo, A., Apostolides, G. Y., Arezzo, A., Arnold, S. J., Aryal, K., Ashamalla, S., Ashraf, Sana, Attaluri, V., Austin, R., Barugo-La, G., Beggs, A., Belgers, H. J., Bell, S., Bemelman, W., Berti, S., Biebl, M., Blondeel, J., Binky, B., Baloyiannis, I. -N., Bandyopadhyay, D., Boni, L., Bordeianou, L., Box, B., Boyce, S., Brokelman, W., Brown, C. J., Bruegger, L., Buchli, C., Christian Buchs, N., Bulut, O., Burt, C., Bursics, A., Cahill, R. A., Pablo Campana, J., Caricato, M., Caro-Tar-Rago, A., Casans, F., Cassinotti, E., Caycedo-Marulan-Da, A., Chadi, S. A., Chandrasinghe, P., Chaudhri, S., Chaumont, N., Chitsabesan, P., Coget, J., Collera, P., Coleman, M., Courtney, E. D., Dagbert, F., Dalton, S. J., Daniel, G., Clark, D. A., De-Drye, L., De La Torre, J., Dapri, G., Dayal, S. P., De Chaisemartin, C., Borja De Lacy, F., Blasco Delgado, O., Di Candido, F., Diaz Del Gobbo, G., De Graaf, E. J. R., Delrio, P., De Pooter, K., D'Hooge, P., Doornebosch, P., Duff, S., Du Jardin, P., Dzhumabaev, K. E., Tom Edwards, M., Egenvall, I., Espin, E., Eugenio, M., Egenvall, M. -I., Ravn Eriksen, J., Faerden, A. E., Faes, S., Simo Fernandez, V., Fichera, A., Fierens, J., Fierens, K., Forgan, T., Francis, N., Francombe, J., Francone, E., Francone, T., Gamage, B., Perez Garcia, J. A., Ethem Gecim, I., Van Geluwe, B., Gin-Gert, C., George, V., Gloeckler, M., Gogenur, I., Goulart, A., Grolich, T., Haas, E., Hameed, U., Hahnloser, D., Harikrishnan, A., Harris, G., Haunold, I., Hendrickse, C., Hendrickx, T., Heyns, M., Horwood, J., Huerga, D., Ito, M., Jarimba, A., Joeng, H. K. M., Jones, O., Jutten, G., Kala, Z., Kita, Y., Knol, J., Thengugal Kochupapy, R., Kneist, W., Kok, A. S. Y., Kusters, M., Lacy, A. M., Laka-Tos, M., Lal, R., Lakkis, Z., Leao, P., Lambrechts, A., Lee, L., Lelong, B., Leung, E., Lezoche, E., Sender Liberman, A., Lidder, P., An-Drade Lima, M., Loganathan, A., Lombana, L. J., Lorenzon, Laura, Loriz, H., Lukas, M., Lutrin, D., Mackey, P., Mamedli, Z. Z., Mansfield, S., Marcello, P., Marcoen, S., Romero Marcos, J. M., Marcy, T., Marecik, S., Marks, J., Marsanic, P., Mattacheo, A., Maun, D., May, D., Maykel, J. A., Mcarthur, D., Mccallum, I., Mccarthy, K., Mclemore, E. C., Ramon Sil-Viera Mendes, C., Messaris, E., Michalopoulos, A., Mikalauskas, S., Miles, A., Millan, M., Mills, S., Miskovic, D., Montroni, I., Moore, E., Moore, T., Mori, Simona, Morino, M., Muratore, A., Mutafchiyski, V., Myers, A., Van Nieuwenhove, Y., Nishizawa, Y., Ng, P., John Nolan, G., Obias, V., Ochsner, A., Hwan Oh, J., Onghena, T., Oommen, S., Orkin, B. A., Osman, K., Ouro, S., Panis, Y., Papavramidis, T., Von Papen, M., Papp, G., Paquette, I., Paraoan, M. T., Paredes, J. P., Pastor, C., Pattyn, P. R. L., Karim Perdawood, S., Wan Pei, C. F., Piehslinger, J., Penchev, D., Oliva Perez, R., Persiani, Roberto, Pfeffer, F., Terry Phang, P., Pokela, V., Picchetto, A., Poskus, E., Prieto, D., Que-Reshy, F. A., Ramcharan, S., Rauch, S., Rega, D., Reyes, J. C., Ris, F., Delgado Rivilla, S., Alexander Rockall, T., Roquete, P., Rossi, G., Ruffo, G., Sakai, Y. -S., Sands, D., Sao Juliao, G. P., Scala, Alessandro, Scala, D., Estevez Schwarz, L., Edmond Seid, V., Seitinger, G., Shaikh, I. A., Sharma, A., Siet-Ses, C., Singh, B., Helmer Sjo, O., Kyung Sohn, D., Sora-Via, C., Sosef, M. N., Spinelli, A., Speakman, C., Steele, S., Stephan, V., Stevenson, A. R. L., Stotland, P., Studer, P., Strypstein, S., Sylla, P., Szyszkowitz, A., Talwar, A., Tanis, P., Tejedor, P., Pastor Teso, E., Tognelli, J., Torkington, J., Tschann, P., Tuech, J. -J., Tuerler, A., Tzovaras, G., Ugolini, G., Vallribera, F., Vansteenkiste, F., Vangenechten, E., Verdaasdonk, E. G. G., Vilela, N., Walter, B., Warren, O. J., Visser, T., Warrier, S., Warner, M., Waru-Savitarne, J., Whiteford, M. H., Andreas Wik, T., Witzig, J. -A., Wolff, T., Wolthuis, A. M., Wynn, G., Ashraf S., Lorenzon L. (ORCID:0000-0001-6736-0383), Mori S., Persiani R. (ORCID:0000-0002-1537-5097), and Scala A.

Abstract

BACKGROUND: Carbon dioxide embolus has been reported as a rare but clinically important risk associated with transanal total mesorectal excision surgery. To date, there exists limited data describing the incidence, risk factors, and management of carbon dioxide embolus in transanal total mesorectal excision. OBJECTIVE: This study aimed to obtain data from the transanal total mesorectal excision registries to identify trends and potential risk factors for carbon dioxide embolus specific to this surgical technique. DESIGN: Contributors to both the LOREC and OSTRiCh transanal total mesorectal excision registries were invited to report their incidence of carbon dioxide embolus. Case report forms were collected detailing the patient-specific and technical factors of each event. SETTINGS: The study was conducted at the collaborating centers from the international transanal total mesorectal excision registries. MAIN OUTCOME MEASURES: Characteristics and outcomes of patients with carbon dioxide embolus associated with transanal mesorectal excision were measured. RESULTS: Twenty-five cases were reported. The incidence of carbon dioxide embolus during transanal total mesorectal excision is estimated to be ≈0.4% (25/6375 cases). A fall in end tidal carbon dioxide was noted as the initial feature in 22 cases, with 13 (52%) developing signs of hemodynamic compromise. All of the events occurred in the transanal component of dissection, with mean (range) insufflation pressures of 15 mm Hg (12-20 mm Hg). Patients were predominantly (68%) in a Trendelenburg position, between 30° and 45°. Venous bleeding was reported in 20 cases at the time of carbon dioxide embolus, with periprostatic veins documented as the most common site (40%). After carbon dioxide embolus, 84% of cases were completed after hemodynamic stabilization. Two patients required cardiopulmonary resuscitation because of cardiovascular collapse. There were no deaths. LIMITATIONS: This is a retrospective study surveying r

Published
2019

27. Systematic screening using FRAX® leads to increased use of, and adherence to, anti-osteoporosis medications: an analysis of the UK SCOOP trial.

Author

Parsons, C.M., Harvey, N., Shepstone, L., Kanis, J.A., Lenaghan, E., Clarke, S., Fordham, R., Gittoes, N., Harvey, I., Holland, R., Redmond, N.M., Howe, A., Marshall, T., Peters, T.J., Torgerson, D., O'Neill, T.W., McCloskey, E., Cooper, C., the SCOOP Trial Group, and Crabtree, N.

Subjects
CONFIDENCE intervals, DRUGS, BONE fractures, HIP joint injuries, OSTEOPOROSIS, PATIENT compliance, QUESTIONNAIRES, RISK assessment, WOMEN'S health, LOGISTIC regression analysis, PHOTON absorptiometry, OLD age
Abstract

Summary: In the large community-based SCOOP trial, systematic fracture risk screening using FRAX® led to greater use of AOM and greater adherence, in women at high fracture risk, compared with usual care. Introduction: In the SCreening of Older wOmen for Prevention of fracture (SCOOP) trial, we investigated the effect of the screening intervention on subsequent long-term self-reported adherence to anti-osteoporosis medications (AOM). Methods: SCOOP was a primary care–based UK multicentre trial of screening for fracture risk. A total of 12,483 women (70–85 years) were randomised to either usual NHS care, or assessment using the FRAX® tool ± dual-energy X-ray absorptiometry (DXA), with medication recommended for those found to be at high risk of hip fracture. Self-reported AOM use was obtained by postal questionnaires at 6, 12, 24, 36, 48 and 60 months. Analysis was limited to those who initiated AOM during follow-up. Logistic regression was used to explore baseline determinants of adherence (good ≥ 80%; poor < 80%). Results: The mean (SD) age of participants was 75.6 (4.2) years, with 6233 randomised to screening and 6250 to the control group. Of those participants identified at high fracture risk in the screening group, 38.2% of those on treatment at 6 months were still treated at 60 months, whereas the corresponding figure for the control group was 21.6%. Older age was associated with poorer adherence (OR per year increase in age 0.96 [95% CI 0.93, 0.99], p = 0.01), whereas history of parental hip fracture was associated with greater rate adherence (OR 1.67 [95% CI 1.23, 2.26], p < 0.01). Conclusions: Systematic fracture risk screening using FRAX® leads to greater use of AOM and greater adherence, in women at high fracture risk, compared with usual care. [ABSTRACT FROM AUTHOR]

Published
2020
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29. No benefit of ultrasound-guided transversus abdominis plane blocks over wound infiltration with local anaesthetic in elective laparoscopic colonic surgery: results of a double-blind randomized controlled trial

Author

Rashid, A., primary, Gorissen, K. J., additional, Ris, F., additional, Gosselink, M. P., additional, Shorthouse, J. R., additional, Smith, A. D., additional, Pandit, J. J., additional, Lindsey, I., additional, and Crabtree, N. A., additional

Published
2017
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30. Physical activity, sedentary time and physical capability in early old age: British birth cohort study

Author

Cooper, AJM, Simmons, RK, Kuh, D, Brage, S, Cooper, R, Hardy, R, Pierce, M, Richards, M, Abington, J, Wong, A, Adams, JE, Machin, M, Stephens, AM, Bonar, K, Bryant, S, Cole, D, Nip, W, Ambrosini, G, Pellerin, D, Chaturvedi, N, Hughes, A, Ghosh, A, March, K, Macfarlane, P, Inglis, L, Friberg, P, Osika, W, Ekelund, U, Mayle, S, Westgate, K, Deanfield, J, Donald, A, Kok, S, Masi, S, Phalora, R, Woodside, J, Bruce, I, Harwood, N, Oughton, E, Chapman, A, Khattar, RS, Nair, SB, Franklyn, J, Palmer, S, Boardman, K, Crabtree, N, Clements, R, Suvari, M, Steeds, R, Craig, K, Howard, E, Morley, T, Scanlon, M, Petit, R, Evans, W, Fraser, A, Edwards, J, Reece, E, Newby, D, Marshall, F, Hannan, J, Miller, C, White, A, MacAllister, R, Harris, J, Singzon, R, Ell, P, Townsend, C, Demetrescu, C, Chowienczyk, P, Darroch, P, McNeill, K, Spector, T, Clements, G, Jiang, B, Lessof, C, Cheshire, H, Medical Research Council (MRC), Simmons, Rebecca [0000-0002-7726-8529], Brage, Soren [0000-0002-1265-7355], and Apollo - University of Cambridge Repository

Subjects
Gerontology, Genetics and Molecular Biology (all), Male, Cross-sectional study, General Science & Technology, Physical activity, lcsh:Medicine, Motor Activity, Biochemistry, Grip strength, Heart rate, MD Multidisciplinary, Medicine, Humans, lcsh:Science, Exercise, Sedentary lifestyle, Multidisciplinary, Wales, business.industry, Mortality rate, Medicine (all), Cross-Sectional Studies, Energy Metabolism, England, Female, Middle Aged, Scotland, Sedentary Lifestyle, Biochemistry, Genetics and Molecular Biology (all), Agricultural and Biological Sciences (all), lcsh:R, Confidence interval, lcsh:Q, Sedentary Behavior, business, human activities, Cohort study, Demography, Research Article
Abstract

PURPOSE: To investigate the associations of time spent sedentary, in moderate-to-vigorous-intensity physical activity (MVPA) and physical activity energy expenditure (PAEE) with physical capability measures at age 60-64 years. METHODS: Time spent sedentary and in MVPA and, PAEE were assessed using individually calibrated combined heart rate and movement sensing among 1727 participants from the MRC National Survey of Health and Development in England, Scotland and Wales as part of a detailed clinical assessment undertaken in 2006-2010. Multivariable linear regression models were used to examine the cross-sectional associations between standardised measures of each of these behavioural variables with grip strength, chair rise and timed up-&-go (TUG) speed and standing balance time. RESULTS: Greater time spent in MVPA was associated with higher levels of physical capability; adjusted mean differences in each capability measure per 1 standard deviation increase in MVPA time were: grip strength (0.477 kg, 95% confidence interval (CI): 0.015 to 0.939), chair rise speed (0.429 stands/min, 95% CI: 0.093 to 0.764), standing balance time (0.028 s, 95% CI: 0.003 to 0.053) and TUG speed (0.019 m/s, 95% CI: 0.011 to 0.026). In contrast, time spent sedentary was associated with lower grip strength (-0.540 kg, 95% CI: -1.013 to -0.066) and TUG speed (-0.011 m/s, 95% CI: -0.019 to -0.004). Associations for PAEE were similar to those for MVPA. CONCLUSION: Higher levels of MVPA and overall physical activity (PAEE) are associated with greater levels of physical capability whereas time spent sedentary is associated with lower levels of capability. Future intervention studies in older adults should focus on both the promotion of physical activity and reduction in time spent sedentary.

Published
2014

31. Habitual physical activity maintains neutrophil migratory dynamics in healthy older adults

Author

Barlett, B., Fox, O., McNulty, C., Greenwood, H., Murphy, L., Sapey, E., Goodman, M., Crabtree, N., Thogersen-Ntoumani, Cecilie, Fisher, J., Wagenmakers, A., Lord, J., Barlett, B., Fox, O., McNulty, C., Greenwood, H., Murphy, L., Sapey, E., Goodman, M., Crabtree, N., Thogersen-Ntoumani, Cecilie, Fisher, J., Wagenmakers, A., and Lord, J.

Abstract

Background: Dysfunctional neutrophils with advanced age are a hallmark of immunosenescence. Reduced migration and bactericidal activity increase the risk of infection. It remains unclear why neutrophil dysfunction occurs with age. Physical activity and structured exercise have been suggested to improve immune function in the elderly. The aim of this study was to assess a comprehensive range of neutrophil functions and determine their association with habitual physical activity. Method Physical activity levels were determined in 211 elderly (67 ± 5 years) individuals by 7-days of accelerometry wear. Twenty of the most physically active men and women were matched for age and gender to twenty of the least physically active individuals. Groups were compared for neutrophil migration, phagocytosis, oxidative burst, cell surface receptor expression, metabolic health parameters and systemic inflammation. Groups were also compared against ten young participants (23 ± 4 years). Results The most active group completed over twice as many steps/day as the least active group (p < 0.001), had lower BMI’s (p = 0.007) and body fat percentages (p = 0.029). Neutrophils migrated towards IL-8 better in the most active group compared to the least active (p < 0.05) and was comparable to that of the young (p > 0.05).These differences remained after adjusting for BMI, body fat and plasma metabolic markers which were different between groups. Correlations revealed that steps/day, higher adiponectin and lower insulin were positively associated with migratory ability (p < 0.05). There was no difference in expression of the chemokine receptors CXCR1 or CXCR2 (p > 0.05 for both). CD11b was higher in the most active group compared to the least active (p = 0.048). No differences between activity groups or young controls were observed for neutrophil phagocytosis or oxidative burst in response to Escherichia coli (p > 0.05). The young group had lower concentrations of IL-6, IL-8, MCP-1, CRP, IL-10 a

Published
2016

32. Guidelines for the use of a `standard' for measuring bone density with DEXA and optical densitometry

Author

BRICKLEY, M. and CRABTREE, N.

Subjects
Bone densitometry -- Measurement, Bones -- Density, Medical equipment and supplies industry -- Product introduction, Measuring instruments -- Product introduction, Anthropology/archeology/folklore
Abstract

Growing awareness of the morbidity and mortality caused by fractures associated with age-related bone loss and osteoporosis has led to an increasing number of studies of bone loss in archaeological material. There are a variety of ways through which age-related bone loss can be investigated; density, cortical thickness and micro-architectural structure of trabecular bone. One of the most widely applied approaches has been investigation of density. However, due to the lack of a `standard' it has not been possible to make direct comparisons between the results of different investigations. A `standard' (calibration device) has now been produced for use with DEXA and other density techniques allowing direct comparison of results of studies in which it is used. Investigations demonstrated that only high resolution DEXA scans using research tools such as `small animal software' (Lunar inc.) should be applied to archaeological bone. Same day scans with repositioning of samples produced precision of 1.68% C.V. (high resolution) compared to 7.8% (standard software). All samples should be scanned a minimum of 3 times, as poor condition or odd shape (e.g. osteophytes) can result in poor precision (4.7% C.V.) even with high resolution scanning. Type of analysis performed on data after scanning was also important. Only manual analysis produced reproducible results and a region of interest of 12mm X 12mm is recommended. Variation in results obtained on different days with repositioning (2.59% C.V.) demonstrated that scanning the `standard' each time equipment is turned on is vital for allow calibration of results. The study demonstrated that if basic guidelines are followed use of the `standard' will allow direct comparison of future studies, allowing spatial and temporal differences in age-related bone loss to be determined.

Published
2001

34. Physical activity, sedentary time and physical capability in early old age: British birth cohort study

Author

Cooper, AJM, Simmons, RK, Kuh, D, Brage, S, Cooper, R, Hardy, R, Pierce, M, Richards, M, Abington, J, Wong, A, Adams, JE, Machin, M, Stephens, AM, Bonar, K, Bryant, S, Cole, D, Nip, W, Ambrosini, G, Pellerin, D, Chaturvedi, N, Hughes, A, Ghosh, A, March, K, Macfarlane, P, Inglis, L, Friberg, P, Osika, W, Ekelund, U, Mayle, S, Westgate, K, Deanfield, J, Donald, A, Kok, S, Masi, S, Phalora, R, Woodside, J, Bruce, I, Harwood, N, Oughton, E, Chapman, A, Khattar, RS, Nair, SB, Franklyn, J, Palmer, S, Boardman, K, Crabtree, N, Clements, R, Suvari, M, Steeds, R, Craig, K, Howard, E, Morley, T, Scanlon, M, Petit, R, Evans, W, Fraser, A, Edwards, J, Reece, E, Newby, D, Marshall, F, Hannan, J, Miller, C, White, A, MacAllister, R, Harris, J, Singzon, R, Ell, P, Townsend, C, Demetrescu, C, Chowienczyk, P, Darroch, P, McNeill, K, Spector, T, Clements, G, Jiang, B, Lessof, C, Cheshire, H, Cooper, AJM, Simmons, RK, Kuh, D, Brage, S, Cooper, R, Hardy, R, Pierce, M, Richards, M, Abington, J, Wong, A, Adams, JE, Machin, M, Stephens, AM, Bonar, K, Bryant, S, Cole, D, Nip, W, Ambrosini, G, Pellerin, D, Chaturvedi, N, Hughes, A, Ghosh, A, March, K, Macfarlane, P, Inglis, L, Friberg, P, Osika, W, Ekelund, U, Mayle, S, Westgate, K, Deanfield, J, Donald, A, Kok, S, Masi, S, Phalora, R, Woodside, J, Bruce, I, Harwood, N, Oughton, E, Chapman, A, Khattar, RS, Nair, SB, Franklyn, J, Palmer, S, Boardman, K, Crabtree, N, Clements, R, Suvari, M, Steeds, R, Craig, K, Howard, E, Morley, T, Scanlon, M, Petit, R, Evans, W, Fraser, A, Edwards, J, Reece, E, Newby, D, Marshall, F, Hannan, J, Miller, C, White, A, MacAllister, R, Harris, J, Singzon, R, Ell, P, Townsend, C, Demetrescu, C, Chowienczyk, P, Darroch, P, McNeill, K, Spector, T, Clements, G, Jiang, B, Lessof, C, and Cheshire, H

Abstract

Purpose To investigate the associations of time spent sedentary, in moderate-to-vigorous-intensity physical activity (MVPA) and physical activity energy expenditure (PAEE) with physical capability measures at age 60-64 years. Methods Time spent sedentary and in MVPA and, PAEE were assessed using individually calibrated combined heart rate and movement sensing among 1727 participants from the MRC National Survey of Health and Development in England, Scotland and Wales as part of a detailed clinical assessment undertaken in 2006-2010. Multivariable linear regression models were used to examine the cross-sectional associations between standardised measures of each of these behavioural variables with grip strength, chair rise and timed up-&-go (TUG) speed and standing balance time. Results Greater time spent in MVPA was associated with higher levels of physical capability; adjusted mean differences in each capability measure per 1standard deviation increase in MVPA time were: grip strength (0.477 kg, 95% confidence interval (CI): 0.015 to 0.939), chair rise speed (0.429 stands/min, 95% CI: 0.093 to 0.764), standing balance time (0.028 s, 95% CI: 0.003 to 0.053) and TUG speed (0.019 m/s, 95% CI: 0.011 to 0.026). In contrast, time spent sedentary was associated with lower grip strength (-0.540 kg, 95% CI: -1.013 to -0.066) and TUG speed (-0.011 m/s, 95% CI: -0.019 to -0.004). Associations for PAEE were similar to those for MVPA. Conclusion Higher levels of MVPA and overall physical activity (PAEE) are associated with greater levels of physical capability whereas time spent sedentary is associated with lower levels of capability. Future intervention studies in older adults should focus on both the promotion of physical activity and reduction in time spent sedentary.

Published
2015

40. The relationship between bone density and incident vertebral fracture in men and women

Author

O'Neill T.W., Cooper C., Lunt, M., Silman, A.J., Felsenberg, D., Benevolenskaya, L.I., Bhalla, A.K., Cannata, J.B., Crabtree, N., Dequeker, J., Hoszowski, K., Jajic, Ivo, Kanis, J.A., Kragl, G., Lopes, Vaz A., Lorenc, R., Lyritis, G., Masaryk, P., Miazgowski, T., Parisi, G., Pols, H.A.P., Poor, G., Reid, D.M., Scheidt-Nave, C., Stepan, J., Todd, C., Weber, K., Woolf, A.D. and Reeve, and J. EPOS Study Group.

Subjects
The relationship between bone density and incident vertebral fracture in men and women
Abstract

The relationship between bone density and incident vertebral fracture in men and women

Published
2002

41. 'Sink or swim': An evaluation of the clinical characteristics of individuals with high bone mass

Author

Gregson, Celia, Steel, S., O'Rourke, K., Allan, K., Ayuk, J., Bhalla, Ashok, Clunie, Gavin, Crabtree, N., Fogelman, Ignac, Brown, Matthew, other, and, Gregson, Celia, Steel, S., O'Rourke, K., Allan, K., Ayuk, J., Bhalla, Ashok, Clunie, Gavin, Crabtree, N., Fogelman, Ignac, Brown, Matthew, and other, and

Abstract

Summary High bone mineral density on routine dual energy X-ray absorptiometry (DXA) may indicate an underlying skeletal dysplasia. Two hundred fifty-eight individuals with unexplained high bone mass (HBM), 236 relatives (41% with HBM) and 58 spouses were studied. Cases could not float, had mandible enlargement, extra bone, broad frames, larger shoe sizes and increased body mass index (BMI). HBM cases may harbour an underlying genetic disorder. Introduction High bone mineral density is a sporadic incidental finding on routine DXA scanning of apparently asymptomatic individuals. Such individuals may have an underlying skeletal dysplasia, as seen in LRP5 mutations. We aimed to characterize unexplained HBM and determine the potential for an underlying skeletal dysplasia. Methods Two hundred fifty-eight individuals with unexplained HBM (defined as L1 Z-score ≥ +3.2 plus total hip Z-score ≥ +1.2, or total hip Z-score ≥ +3.2) were recruited from 15 UK centres, by screening 335,115 DXA scans. Unexplained HBM affected 0.181% of DXA scans. Next 236 relatives were recruited of whom 94 (41%) had HBM (defined as L1 Z-score + total hip Z-score ≥ +3.2). Fifty-eight spouses were also recruited together with the unaffected relatives as controls. Phenotypes of cases and controls, obtained from clinical assessment, were compared using random-effects linear and logistic regression models, clustered by family, adjusted for confounders, including age and sex. Results Individuals with unexplained HBM had an excess of sinking when swimming (7.11 [3.65, 13.84], p < 0.001; adjusted odds ratio with 95% confidence interval shown), mandible enlargement (4.16 [2.34, 7.39], p < 0.001), extra bone at tendon/ligament insertions (2.07 [1.13, 3.78], p = 0.018) and broad frame (3.55 [2.12, 5.95], p < 0.001). HBM cases also had a larger shoe size (mean difference 0.4 [0.1, 0.7] UK sizes, p = 0.009) and increased BMI (mean difference 2.2 [1.3, 3.1] kg/m 2, p < 0.001). Conclusion Individuals with unexpla

Published
2012

43. Hip geometry, bone mineral distribution, and bone strength in European men and women: the EPOS Study

Author

Crabtree, N Lunt, M Holt, G Kroger, H Burger, H and Grazio, S Khaw, KT Lorenc, RS Nijs, J Stepan, J and Falch, JA Miazgowski, T Raptou, P Pols, HAP Dequeker, J and Havelka, S Hoszowski, K Jajic, I Czekalski, S and Lyritis, G Silman, AJ Reeve, J

Abstract

Hip geometry and bone mineral density (BMD) have been shown previously to relate, independently of each other, to risk of hip fracture. We used Lunar DPX “beta” versions of hip strength analysis (HSA) and hip axis length (HAL) software to analyze scans from ten representative age-stratified population samples in the European Prospective Osteoporosis Study (EPOS), All 1617 subjects were >50 years of age, and 1033 were women. The data were modeled with gender and center as categorical variables. The bone mineral density of the upper half of the femoral neck declined at a faster rate with age than that in the lower half, Femoral neck cross-sectional moment of inertia (CSMI), a measure of resistance to bending, showed no significant age reduction in either gender. However,height and weight effects on CSMI were significantly more beneficial in men than in women (0.002 < p < 0.012) and the weight effect appeared to be mediated by bone mineral content (BMC), Compressive stress (Cstress), defined as the stress in the femoral neck at its weakest cross section arising from a standardized fall, was higher in women. Although Cstress increased with body weight when BMC was held constant, in practice it fell through the association and statistical interaction of rising body weight with rising BMC, HAL, as expected, was strongly positively associated with male gender and also height (p < 0.0001). Hip strength-related indices were markedly center-dependent. Significant differences (p < 0.0001) were noted between the centers for all the variables investigated that related to hip geometry. Adjustment for femoral neck bone mineral content (totBMC) showed these center differences to account for >50% of center variation in hip strength, which remained highly significant (p < 0.0001). We conclude that there are substantial geographical differences in femoral neck geometry as well as in BMD, These geometric variations may contribute to the large variations in hip fracture risk across Europe. The effects of aging on hip strength need to be explored in longitudinal studies. (Bone 27:151-159; 2000) (C) 2000 by Elsevier Science Inc. All rights reserved.

Published
2000

47. ‘Sink or swim’: an evaluation of the clinical characteristics of individuals with high bone mass

Author

Gregson, C. L., primary, Steel, S. A., additional, O’Rourke, K. P., additional, Allan, K., additional, Ayuk, J., additional, Bhalla, A., additional, Clunie, G., additional, Crabtree, N., additional, Fogelman, I., additional, Goodby, A., additional, Langman, C. M., additional, Linton, S., additional, Marriott, E., additional, McCloskey, E., additional, Moss, K. E., additional, Palferman, T., additional, Panthakalam, S., additional, Poole, K. E. S., additional, Stone, M. D., additional, Turton, J., additional, Wallis, D., additional, Warburton, S., additional, Wass, J., additional, Duncan, E. L., additional, Brown, M. A., additional, Davey-Smith, G., additional, and Tobias, J. H., additional

Published
2011
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