36 results on '"Sonia Davis"'
Search Results
2. Rationale, design, and methods for the Medical Optimization and Management of Pregnancies with Overt Type 2 Diabetes (MOMPOD) study
- Author
-
Diane C. Berry, Sonia Davis Thomas, Karen F. Dorman, Amber Rose Ivins, Maria de los Angeles Abreu, Laura Young, and Kim Boggess
- Subjects
Type 2 diabetes ,Pregnancy ,Maternal outcomes ,Fetal outcomes ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Background Annually in the US, over 100,000 pregnant women with overt type 2 diabetes give birth. Strict maternal glycemic control is the key to optimizing infant outcomes. Medical treatment of type 2 diabetes in pregnancy is generally restricted to insulin, as data on the safety and efficacy of oral hypoglycemic agents in pregnancy are limited. However, over one-third of infants born to women with type 2 diabetes experience an adverse outcome, such as premature delivery, large-for-gestational age, hypoglycemia, hyperbilirubinemia, or birth trauma, suggesting that current treatment regimens fall short of optimizing outcomes. Metformin is the pharmacologic treatment of choice for type 2 diabetes outside of pregnancy. Metformin is favored over insulin because it results in less weight gain, fewer hypoglycemic episodes, and is administered orally rather than injected. However, metformin is not typically used for treatment of type 2 diabetes complicating pregnancy, mainly because no large clinical studies have been conducted to examine its use in this context. Methods/design This is a randomized double-blind multi-center clinical trial of insulin plus metformin versus insulin plus placebo for the treatment of type 2 diabetes complicating pregnancy. A total of 1200 women with type 2 diabetes will be randomized between 10 weeks 0 days’ and 20 weeks 6 days’ gestation and followed until 30 days after delivery. Neonate outcomes will be followed until 30 days of age. The primary aim is to compare the effect of insulin and metformin versus insulin and placebo on composite adverse neonatal outcomes, comprising perinatal mortality, preterm delivery, neonatal hypoglycemia, hyperbilirubinemia, large-for-gestational age small for gestational age, low birth weight, and/or birth trauma. Key secondary aims are to compare treatment groups for neonatal fat mass and rate of maternal hypoglycemia. Additional aims are to assess the side effects and safety of insulin and metformin among pregnant women with overt type 2 diabetes and to compare gestational weight gain among women treated with metformin plus insulin versus insulin alone. Discussion Successful completion of this study will result in high-quality, contemporary evidence for management of overt type 2 diabetes complicating pregnancy to improve neonatal outcomes. Trial registration NCT02932475 (05/17/2016).
- Published
- 2018
- Full Text
- View/download PDF
3. Stress and sleep: Results from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study
- Author
-
Carmela Alcántara, Sanjay R. Patel, Mercedes Carnethon, Sheila F. Castañeda, Carmen R. Isasi, Sonia Davis, Alberto R. Ramos, Elva Arredondo, Susan Redline, Phyllis C. Zee, and Linda C. Gallo
- Subjects
United States of America ,Discrimination ,Acculturation ,Stress ,Sleep ,Insomnia ,Hispanics ,Public aspects of medicine ,RA1-1270 ,Social sciences (General) ,H1-99 - Abstract
Hispanics/Latinos face specific sociocultural stressors associated with their marginalized status in the United States. While stress is known to cause poor sleep, the differential effects of the specific stressors faced by Hispanics/Latinos have not been evaluated. Using cross-sectional data from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study, we conducted weighted generalized linear models to evaluate the associations of acculturation stress, ethnic discrimination, and chronic moderate/severe stress with self-reported sleep outcomes (insomnia symptoms, daytime sleepiness, sleep duration) in individual and aggregate models adjusted for site, socio-demographics, behavioral, and medical conditions. Participants included 5313 Hispanic/Latino adults; 43.5% ≥ age 45, 54.8% female, and 22.0% US-born. Chronic moderate/severe stress, ethnic discrimination, and acculturation stress were each positively associated with sleep. In the adjusted aggregate model, only chronic moderate/severe stress was associated with insomnia symptoms (exp(b) = 1.07 for each additional stressor, 95% CI = 1.05, 1.09). Both acculturation stress (exp(b) = 1.05 for each additional SD, 95% CI = 1.02, 1.10) and ethnic discrimination (exp(b) = 1.05 for each additional SD, 95% CI = 1.01, 1.08) were associated with daytime sleepiness. Each SD increase in ethnic discrimination related to a 16% and 13% increased prevalence of short (< 7 h) (RRR = 1.16, 95% CI = 1.02, 1.31) and long sleep duration (> 9 h) (RRR = 1.13, 95% CI = 1.00, 1.27), respectively. These associations were consistent across sex. Acculturation stress and ethnic discrimination are associated with poor sleep in Hispanics/Latinos. Future research should explore whether behavioral sleep interventions minimize the impact of sociocultural stressors on sleep.
- Published
- 2017
- Full Text
- View/download PDF
4. Negative-pressure wound therapy versus standard dressings for adults with an open lower limb fracture: the WOLLF RCT
- Author
-
Matthew L Costa, Juul Achten, Julie Bruce, Sonia Davis, Susie Hennings, Keith Willett, Stavros Petrou, Steven Jeffery, Damian Griffin, Ben Parker, James Masters, Sarah E Lamb, Elizabeth Tutton, and Nick Parsons
- Subjects
open fracture ,wound management ,clinical effectiveness ,cost-effectiveness ,orthopaedic trauma ,randomised controlled trial ,Medical technology ,R855-855.5 - Abstract
Background: Open fractures of the lower limb occur when a broken bone penetrates the skin and is exposed to the outside environment. These are life-changing injuries. The risk of deep infection may be as high as 27%. The type of dressing applied after surgical debridement could potentially reduce the risk of infection in the open-fracture wound. Objectives: To assess the disability, rate of deep infection, quality of life and resource use in patients with severe open fracture of the lower limb treated with negative-pressure wound therapy (NPWT) versus standard wound management after the first surgical debridement of the wound. Design: A pragmatic, multicentre randomised controlled trial. Setting: Twenty-four specialist trauma hospitals in the UK Major Trauma Network. Participants: A total of 460 patients aged ≥ 16 years with a severe open fracture of the lower limb were recruited from July 2012 through to December 2015. Patients were excluded if they presented more than 72 hours after their injury or were unable to complete questionnaires. Interventions: Negative-pressure wound therapy (n = 226) where an ‘open-cell’ solid foam or gauze was placed over the surface of the wound and connected to a suction pump which created a partial vacuum over the dressing versus standard dressings not involving negative pressure (n = 234). Main outcome measures: Disability Rating Index (DRI) – a score of 0 (no disability) to 100 (completely disabled) at 12 months was the primary outcome measure, with a minimal clinically important difference of 8 points. The secondary outcomes were deep infection, quality of life and resource use collected at 3, 6, 9 and 12 months post randomisaton. Results: There was no evidence of a difference in the patients’ DRI at 12 months. The mean DRI in the NPWT group was 45.5 points [standard deviation (SD) 28.0 points] versus 42.4 points (SD 24.2 points) in the standard dressing group, giving a difference of –3.9 points (95% confidence interval –8.9 to 1.2 points) in favour of standard dressings (p = 0.132). There was no difference in HRQoL and no difference in the number of surgical site infections or other complications at any point in the 12 months after surgery. NPWT did not reduce the cost of treatment and it was associated with a low probability of cost-effectiveness. Limitations: Owing to the emergency nature of the interventions, we anticipated that some patients who were randomised into the trial would subsequently be unable or unwilling to take part. Such post-randomisation withdrawal of patients could have posed a risk to the external validity of the trial. However, the great majority of these patients (85%) were found to be ineligible after randomisation. Therefore, we can be confident that the patients who took part were representative of the population with severe open fractures of the lower limb. Conclusions: Contrary to the existing literature and current clinical guidelines, NPWT dressings do not provide a clinical or an economic benefit for patients with an open fracture of the lower limb. Future work: Future work should investigate alternative strategies to reduce the incidence of infection and improve outcomes for patients with an open fracture of the lower limb. Two specific areas of potentially great benefit are (1) the use of topical antibiotic preparations in the open-fracture wound and (2) the role of orthopaedic implants with antimicrobial coatings when fixing the associated fracture. Trial registration: Current Controlled Trials ISRCTN33756652 and UKCRN Portfolio ID 11783. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 73. See the NIHR Journals Library website for further project information.
- Published
- 2018
- Full Text
- View/download PDF
5. American College of Cardiology/American Heart Association (ACC/AHA) Class I Guidelines for the Treatment of Cholesterol to Reduce Atherosclerotic Cardiovascular Risk: Implications for US Hispanics/Latinos Based on Findings From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
- Author
-
Waqas T. Qureshi, Robert C. Kaplan, Katrina Swett, Gregory Burke, Martha Daviglus, Molly Jung, Gregory A. Talavera, Diana A. Chirinos, Samantha A. Reina, Sonia Davis, and Carlos J. Rodriguez
- Subjects
ACC/AHA cholesterol treatment ,disparities ,epidemiology ,guideline ,Hispanics/Latinos ,statin therapy ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundThe prevalence estimates of statin eligibility among Hispanic/Latinos living in the United States under the new 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol treatment guidelines are not known. Methods and ResultsWe estimated prevalence of statin eligibility under 2013 ACC/AHA and 3rd National Cholesterol Education Program Adult Treatment Panel (NCEP/ATP III) guidelines among Hispanic Community Health Study/Study of Latinos (n=16 415; mean age 41 years, 40% males) by using sampling weights calibrated to the 2010 US census. We examined the characteristics of Hispanic/Latinos treated and not treated with statins under both guidelines. We also redetermined the statin‐therapy eligibility by using black risk estimates for Dominicans, Cubans, Puerto Ricans, and Central Americans. Compared with NCEP/ATP III guidelines, statin eligibility increased from 15.9% (95% CI 15.0–16.7%) to 26.9% (95% CI 25.7–28.0%) under the 2013 ACC/AHA guidelines. This was mainly driven by the ≥7.5% atherosclerotic cardiovascular disease risk criteria (prevalence 13.9% [95% CI 13.0–14.7%]). Of the participants eligible for statin eligibility under NCEP/ATP III and ACC/AHA guidelines, only 28.2% (95% CI 26.3–30.0%) and 20.6% (95% CI 19.4–21.9%) were taking statins, respectively. Statin‐eligible participants who were not taking statins had a higher prevalence of cardiovascular risk factors compared with statin‐eligible participants who were taking statins. There was no significant increase in statin eligibility when atherosclerotic cardiovascular disease risk was calculated by using black estimates instead of recommended white estimates (increase by 1.4%, P=0.12) for Hispanic/Latinos. ConclusionsThe eligibility of statin therapy increased consistently across all Hispanic/Latinos subgroups under the 2013 ACC/AHA guidelines and therefore will potentially increase the number of undertreated Hispanic/Latinos in the United States.
- Published
- 2017
- Full Text
- View/download PDF
6. Ulcerative colitis mucosal transcriptomes reveal mitochondriopathy and personalized mechanisms underlying disease severity and treatment response
- Author
-
Haberman, Yael, Karns, Rebekah, Dexheimer, Phillip J, Schirmer, Melanie, Somekh, Judith, Jurickova, Ingrid, Braun, Tzipi, Novak, Elizabeth, Bauman, Laura, Collins, Margaret H, Mo, Angela, Rosen, Michael J, Bonkowski, Erin, Gotman, Nathan, Marquis, Alison, Nistel, Mason, Rufo, Paul A, Baker, Susan S, Sauer, Cary G, Markowitz, James, Pfefferkorn, Marian D, Rosh, Joel R, Boyle, Brendan M, Mack, David R, Baldassano, Robert N, Shah, Sapana, Leleiko, Neal S, Heyman, Melvin B, Grifiths, Anne M, Patel, Ashish S, Noe, Joshua D, Aronow, Bruce J, Kugathasan, Subra, Walters, Thomas D, Gibson, Greg, Thomas, Sonia Davis, Mollen, Kevin, Shen-Orr, Shai, Huttenhower, Curtis, Xavier, Ramnik J, Hyams, Jeffrey S, and Denson, Lee A
- Subjects
Biological Sciences ,Biomedical and Clinical Sciences ,Immunology ,Nutrition ,Inflammatory Bowel Disease ,Clinical Research ,Autoimmune Disease ,Digestive Diseases ,Genetics ,Biotechnology ,4.1 Discovery and preclinical testing of markers and technologies ,Aetiology ,2.1 Biological and endogenous factors ,Detection ,screening and diagnosis ,Oral and gastrointestinal ,Good Health and Well Being ,Adolescent ,Adult ,Anti-Inflammatory Agents ,Non-Steroidal ,Child ,Colitis ,Ulcerative ,Feces ,Female ,Gene Expression Profiling ,Genes ,Mitochondrial ,Glucocorticoids ,Humans ,Integrins ,Intestinal Mucosa ,Male ,Mesalamine ,Microbiota ,Mitochondria ,Mitochondrial Diseases ,Precision Medicine ,Prospective Studies ,Rectum ,Remission Induction ,Sequence Analysis ,RNA ,Severity of Illness Index ,Transcriptome ,Treatment Outcome ,Tumor Necrosis Factor-alpha - Abstract
Molecular mechanisms driving disease course and response to therapy in ulcerative colitis (UC) are not well understood. Here, we use RNAseq to define pre-treatment rectal gene expression, and fecal microbiota profiles, in 206 pediatric UC patients receiving standardised therapy. We validate our key findings in adult and paediatric UC cohorts of 408 participants. We observe a marked suppression of mitochondrial genes and function across cohorts in active UC, and that increasing disease severity is notable for enrichment of adenoma/adenocarcinoma and innate immune genes. A subset of severity genes improves prediction of corticosteroid-induced remission in the discovery cohort; this gene signature is also associated with response to anti-TNFα and anti-α4β7 integrin in adults. The severity and therapeutic response gene signatures were in turn associated with shifts in microbes previously implicated in mucosal homeostasis. Our data provide insights into UC pathogenesis, and may prioritise future therapies for nonresponders to current approaches.
- Published
- 2019
7. Retinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study
- Author
-
Deal, Jennifer A., Sharrett, A. Richey, Albert, Marilyn, Bandeen-Roche, Karen, Burgard, Sheila, Thomas, Sonia Davis, Gottesman, Rebecca F., Knopman, David, Mosley, Thomas, Klein, Barbara, and Klein, Ronald
- Published
- 2019
- Full Text
- View/download PDF
8. Rationale, design, and methods for the Medical Optimization and Management of Pregnancies with Overt Type 2 Diabetes (MOMPOD) study
- Author
-
Berry, Diane C., Thomas, Sonia Davis, Dorman, Karen F., Ivins, Amber Rose, de los Angeles Abreu, Maria, Young, Laura, and Boggess, Kim
- Published
- 2018
- Full Text
- View/download PDF
9. Stratification of risk of progression to colectomy in ulcerative colitis via measured and predicted gene expression
- Author
-
David R. Mack, Jarod Prince, Susan S. Baker, Brendan M. Boyle, Rebekah Karns, Suresh Venkateswaran, Subra Kugathasan, Talin Haritunians, Dermot P.B. McGovern, Mamta Giri, James Markowitz, Nai Yun Hsu, Melvin B. Heyman, Lee A. Denson, Ling-Shiang Chuang, Mayte Suárez-Fariñas, Greg Gibson, Jeffrey S. Hyams, Neal S. LeLeiko, Andrew Kasarskis, Kyle Gettler, Bruce J. Aronow, Cary G. Sauer, Yael Haberman, Carmen Argmann, Anne M. Griffiths, Joel R. Rosh, Nathan Gotman, Angela Mo, Dalia Arafat, Sapana Shah, Paul A. Rufo, Thomas D. Walters, Marian Pfefferkorn, Ashish S. Patel, Sonia Davis Thomas, Judy H. Cho, Robert N. Baldassano, Emebet Mengesha, Joshua D. Noe, and Sini Nagpal
- Subjects
Oncology ,Multifactorial Inheritance ,medicine.medical_treatment ,Datasets as Topic ,Ulcerative ,Disease ,Medical and Health Sciences ,cell-type-specific gene expression ,Cohort Studies ,Crohn Disease ,Colectomy ,Genetics (clinical) ,Biological Specimen Banks ,Genetics & Heredity ,Framingham Risk Score ,eQTLs ,Biological Sciences ,Colitis ,Prognosis ,Ulcerative colitis ,transcriptome-wide association studies ,Disease Progression ,Patient Safety ,predicted polygenic transcriptional risk scores ,Biotechnology ,medicine.medical_specialty ,Colon ,Quantitative Trait Loci ,Quantitative trait locus ,Autoimmune Disease ,Risk Assessment ,Article ,Clinical Research ,Internal medicine ,Genetics ,medicine ,Humans ,Genetic association ,business.industry ,Prevention ,Gene Expression Profiling ,Human Genome ,Inflammatory Bowel Disease ,medicine.disease ,United Kingdom ,Gene expression profiling ,transcriptional risk scores ,prediction of disease progression ,Expression quantitative trait loci ,Colitis, Ulcerative ,Generic health relevance ,Digestive Diseases ,Transcriptome ,business ,Genome-Wide Association Study - Abstract
Summary An important goal of clinical genomics is to be able to estimate the risk of adverse disease outcomes. Between 5% and 10% of individuals with ulcerative colitis (UC) require colectomy within 5 years of diagnosis, but polygenic risk scores (PRSs) utilizing findings from genome-wide association studies (GWASs) are unable to provide meaningful prediction of this adverse status. By contrast, in Crohn disease, gene expression profiling of GWAS-significant genes does provide some stratification of risk of progression to complicated disease in the form of a transcriptional risk score (TRS). Here, we demonstrate that a measured TRS based on bulk rectal gene expression in the PROTECT inception cohort study has a positive predictive value approaching 50% for colectomy. Single-cell profiling demonstrates that the genes are active in multiple diverse cell types from both the epithelial and immune compartments. Expression quantitative trait locus (QTL) analysis identifies genes with differential effects at baseline and week 52 follow-up, but for the most part, differential expression associated with colectomy risk is independent of local genetic regulation. Nevertheless, a predicted polygenic transcriptional risk score (PPTRS) derived by summation of transcriptome-wide association study (TWAS) effects identifies UC-affected individuals at 5-fold elevated risk of colectomy with data from the UK Biobank population cohort studies, independently replicated in an NIDDK-IBDGC dataset. Prediction of gene expression from relatively small transcriptome datasets can thus be used in conjunction with TWASs for stratification of risk of disease complications.
- Published
- 2021
10. Stratification of Risk of Progression to Colectomy in Ulcerative Colitis using Measured and Predicted Gene Expression
- Author
-
Suresh Venkateswaran, Melvin B. Heyman, Neal S. LeLeiko, Judy H. Cho, Robert N. Baldassano, T Walters, Ashish S. Patel, Brendan M. Boyle, Andrew Kasarskis, Ling-Shiang Chuang, Emebet Mengesha, Greg Gibson, Talin Haritunians, Nai Yun Hsu, Joshua D. Noe, Cary G. Sauer, David R. Mack, Yael Haberman, Jarod Prince, Susan S. Baker, Marian Pfefferkorn, Sini Nagpal, Mayte Suárez-Fariñas, Subra Kugathasan, Lee A. Denson, Anne M. Griffiths, James Markowitz, Bruce J. Aronow, Dalia Arafat, Sonia Davis Thomas, Rebekah Karns, Joel R. Rosh, Nathan Gotman, Angela Mo, Sapana Shah, Paul A. Rufo, Mamta Giri, Kyle Gettler, Dermot P.B. McGovern, Jeffrey S. Hyams, and Carmen Argmann
- Subjects
Oncology ,medicine.medical_specialty ,Framingham Risk Score ,business.industry ,medicine.medical_treatment ,Genome-wide association study ,Disease ,medicine.disease ,Ulcerative colitis ,Clinical trial ,Gene expression profiling ,Internal medicine ,medicine ,business ,Colectomy ,Genetic association - Abstract
SUMMARYAn important goal of clinical genomics is to be able to estimate the risk of adverse disease outcomes. Between 5% and 10% of ulcerative colitis (UC) patients require colectomy within five years of diagnosis, but polygenic risk scores (PRS) utilizing findings from GWAS are unable to provide meaningful prediction of this adverse status. By contrast, in Crohn’s disease, gene expression profiling of GWAS-significant genes does provide some stratification of risk of progression to complicated disease in the form of a Transcriptional Risk Score (TRS). Here we demonstrate that both measured (TRS) and polygenic predicted gene expression (PPTRS) identify UC patients at 5-fold elevated risk of colectomy with data from the PROTECT clinical trial and UK Biobank population cohort studies, independently replicated in an NIDDK-IBDGC dataset. Prediction of gene expression from relatively small transcriptome datasets can thus be used in conjunction with transcriptome-wide association studies to stratify risk of disease complications.
- Published
- 2021
11. Stratification of Risk of Progression to Colectomy in Ulcerative Colitis using Measured and Predicted Gene Expression
- Author
-
Mo, Angela, primary, Nagpal, Sini, additional, Gettler, Kyle, additional, Haritunians, Talin, additional, Giri, Mamta, additional, Haberman, Yael, additional, Karns, Rebekah, additional, Prince, Jarod, additional, Arafat, Dalia, additional, Hsu, Nai-Yun, additional, Chuang, Ling-Shiang, additional, Argmann, Carmen, additional, Kasarskis, Andrew, additional, Suarez-Farinas, Mayte, additional, Gotman, Nathan, additional, Mengesha, Emebet, additional, Venkateswaran, Suresh, additional, Rufo, Paul A., additional, Baker, Susan S., additional, Sauer, Cary G., additional, Markowitz, James, additional, Pfefferkorn, Marian D., additional, Rosh, Joel R., additional, Boyle, Brendan M., additional, Mack, David R., additional, Baldassano, Robert N., additional, Shah, Sapana, additional, LeLeiko, Neal S., additional, Heyman, Melvin B., additional, Griffiths, Anne M., additional, Patel, Ashish S., additional, Noe, Joshua D., additional, Thomas, Sonia Davis, additional, Aronow, Bruce J., additional, Walters, Thomas D., additional, McGovern, Dermot P. B., additional, Hyams, Jeffrey S., additional, Kugathasan, Subra, additional, Cho, Judy H., additional, Denson, Lee A., additional, and Gibson, Greg, additional
- Published
- 2021
- Full Text
- View/download PDF
12. Hearing treatment for reducing cognitive decline: Design and methods of the Aging and Cognitive Health Evaluation in Elders randomized controlled trial
- Author
-
Frank R. Lin, Theresa H. Chisolm, Thomas H. Mosley, Josef Coresh, Theresa Gmelin, A. Richey Sharrett, Kathleen M. Hayden, Marilyn S. Albert, Michelle L. Arnold, Sonia Davis Thomas, Jennifer A. Deal, James S. Pankow, Sheila Burgard, Nicholas S. Reed, David Couper, Adele M. Goman, Nancy W. Glynn, and Victoria A. Sanchez
- Subjects
Gerontology ,Longitudinal study ,Epidemiology ,Presbycusis ,law.invention ,03 medical and health sciences ,Clinical trials ,Cognition ,0302 clinical medicine ,Quality of life (healthcare) ,Hearing ,Randomized controlled trial ,Memory ,law ,medicine ,Dementia ,030212 general & internal medicine ,Cognitive decline ,business.industry ,Featured Article ,medicine.disease ,3. Good health ,Psychiatry and Mental health ,Health education ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Introduction Hearing impairment is highly prevalent and independently associated with cognitive decline. The Aging and Cognitive Health Evaluation in Elders study is a multicenter randomized controlled trial to determine efficacy of hearing treatment in reducing cognitive decline in older adults. Clinicaltrials.gov Identifier: NCT03243422 . Methods Eight hundred fifty participants without dementia aged 70 to 84 years with mild-to-moderate hearing impairment recruited from four United States field sites and randomized 1:1 to a best-practices hearing intervention or health education control. Primary study outcome is 3-year change in global cognitive function. Secondary outcomes include domain-specific cognitive decline, incident dementia, brain structural changes on magnetic resonance imaging, health-related quality of life, physical and social function, and physical activity. Results Trial enrollment began January 4, 2018 and is ongoing. Discussion When completed in 2022, Aging and Cognitive Health Evaluation in Elders study should provide definitive evidence of the effect of hearing treatment versus education control on cognitive decline in community-dwelling older adults with mild-to-moderate hearing impairment.
- Published
- 2018
13. Stress and sleep: Results from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study
- Author
-
Carmen R. Isasi, Sanjay R. Patel, Mercedes R. Carnethon, Sonia Davis, Phyllis C. Zee, Elva M. Arredondo, Susan Redline, Carmela Alcántara, Alberto R. Ramos, Sheila F. Castañeda, and Linda C. Gallo
- Subjects
Gerontology ,OR, Odds Ratio ,Health (social science) ,AHI, apnea-hypopnea index ,Insomnia ,Hispanics ,Psychological intervention ,United States of America ,Stress ,Non-rapid eye movement sleep ,NREM, Non-rapid eye movement ,PEDQ-CV, Perceived Ethnic Discrimination Questionnaire – Community Version ,Article ,US, United States ,ESS, Epworth Sleepiness Scale ,03 medical and health sciences ,0302 clinical medicine ,Stress (linguistics) ,Discrimination ,medicine ,SCAS, Sociocultural Ancillary Study ,SD, Standard deviation ,030212 general & internal medicine ,lcsh:Social sciences (General) ,10. No inequality ,HSI, Hispanic Stress Inventory ,WHIIRS, Women’s Health Initiative Insomnia Rating Scale ,lcsh:Public aspects of medicine ,Health Policy ,Stressor ,Public Health, Environmental and Occupational Health ,VIF, variance inflation factor ,lcsh:RA1-1270 ,Sleep in non-human animals ,CES-D, Center for Epidemiological Studies Depression Scale ,Acculturation ,CI, Confidence Interval ,HCHS/SOL, Hispanic Community Health Study/Study of Latinos ,Community health ,lcsh:H1-99 ,medicine.symptom ,Psychology ,RRR, Relative Risk Ratio ,Sleep ,030217 neurology & neurosurgery ,Demography - Abstract
Hispanics/Latinos face specific sociocultural stressors associated with their marginalized status in the United States. While stress is known to cause poor sleep, the differential effects of the specific stressors faced by Hispanics/Latinos have not been evaluated. Using cross-sectional data from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study, we conducted weighted generalized linear models to evaluate the associations of acculturation stress, ethnic discrimination, and chronic moderate/severe stress with self-reported sleep outcomes (insomnia symptoms, daytime sleepiness, sleep duration) in individual and aggregate models adjusted for site, socio-demographics, behavioral, and medical conditions. Participants included 5313 Hispanic/Latino adults; 43.5% ≥ age 45, 54.8% female, and 22.0% US-born. Chronic moderate/severe stress, ethnic discrimination, and acculturation stress were each positively associated with sleep. In the adjusted aggregate model, only chronic moderate/severe stress was associated with insomnia symptoms (exp(b) = 1.07 for each additional stressor, 95% CI = 1.05, 1.09). Both acculturation stress (exp(b) = 1.05 for each additional SD, 95% CI = 1.02, 1.10) and ethnic discrimination (exp(b) = 1.05 for each additional SD, 95% CI = 1.01, 1.08) were associated with daytime sleepiness. Each SD increase in ethnic discrimination related to a 16% and 13% increased prevalence of short (< 7 h) (RRR = 1.16, 95% CI = 1.02, 1.31) and long sleep duration (> 9 h) (RRR = 1.13, 95% CI = 1.00, 1.27), respectively. These associations were consistent across sex. Acculturation stress and ethnic discrimination are associated with poor sleep in Hispanics/Latinos. Future research should explore whether behavioral sleep interventions minimize the impact of sociocultural stressors on sleep., Highlights • Latina/os face unique stressors associated with their marginalized status in the USA. • We explored the association of sociocultural stressors with Latina/o sleep. • Acculturation stress and ethnic discrimination were associated with daytime sleepiness. • Only chronic psychosocial stress was associated with insomnia symptoms. • Ethnic discrimination was associated with both short and long sleep duration.
- Published
- 2017
14. Ulcerative colitis mucosal transcriptomes reveal mitochondriopathy and personalized mechanisms underlying disease severity and treatment response
- Author
-
Susan S. Baker, Melanie Schirmer, Alison Marquis, Joel R. Rosh, Cary G. Sauer, Laura Bauman, Mason Nistel, Phillip J. Dexheimer, James Markowitz, Kevin P. Mollen, Sapana Shah, Neal S. Leleiko, Anne M. Grifiths, Paul A. Rufo, Robert N. Baldassano, Rebekah Karns, Elizabeth Novak, Ashish S. Patel, Melvin B. Heyman, Judith Somekh, Yael Haberman, Erin Bonkowski, Ingrid Jurickova, Thomas D. Walters, Brendan M. Boyle, Tzipi Braun, Nathan Gotman, Angela Mo, Jeffrey S. Hyams, Curtis Huttenhower, Sonia Davis Thomas, Subra Kugathasan, Ramnik J. Xavier, Lee A. Denson, Marian D. Pfefferkorn, Greg Gibson, Joshua D. Noe, Bruce J. Aronow, Michael J. Rosen, Shai S. Shen-Orr, Margaret H. Collins, and David R. Mack
- Subjects
Male ,0301 basic medicine ,Integrins ,Mitochondrial Diseases ,Anti-Inflammatory Agents ,General Physics and Astronomy ,Ulcerative ,02 engineering and technology ,Severity of Illness Index ,Oral and gastrointestinal ,Pathogenesis ,Feces ,2.1 Biological and endogenous factors ,Medicine ,Prospective Studies ,Intestinal Mucosa ,Precision Medicine ,Aetiology ,lcsh:Science ,Mesalamine ,Child ,Prospective cohort study ,screening and diagnosis ,Multidisciplinary ,Microbiota ,Anti-Inflammatory Agents, Non-Steroidal ,Remission Induction ,Colitis ,021001 nanoscience & nanotechnology ,Ulcerative colitis ,Mitochondria ,Mitochondrial ,3. Good health ,Detection ,Genes, Mitochondrial ,Treatment Outcome ,Adenocarcinoma ,Female ,Non-Steroidal ,0210 nano-technology ,Sequence Analysis ,Biotechnology ,Adult ,Adolescent ,Science ,Autoimmune Disease ,Article ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Clinical Research ,Severity of illness ,Genetics ,Humans ,Glucocorticoids ,Nutrition ,Sequence Analysis, RNA ,Tumor Necrosis Factor-alpha ,business.industry ,Gene Expression Profiling ,Inflammatory Bowel Disease ,Rectum ,General Chemistry ,Gene signature ,medicine.disease ,4.1 Discovery and preclinical testing of markers and technologies ,Gene expression profiling ,Good Health and Well Being ,030104 developmental biology ,Genes ,Immunology ,RNA ,Colitis, Ulcerative ,lcsh:Q ,Transcriptome ,Digestive Diseases ,business - Abstract
Molecular mechanisms driving disease course and response to therapy in ulcerative colitis (UC) are not well understood. Here, we use RNAseq to define pre-treatment rectal gene expression, and fecal microbiota profiles, in 206 pediatric UC patients receiving standardised therapy. We validate our key findings in adult and paediatric UC cohorts of 408 participants. We observe a marked suppression of mitochondrial genes and function across cohorts in active UC, and that increasing disease severity is notable for enrichment of adenoma/adenocarcinoma and innate immune genes. A subset of severity genes improves prediction of corticosteroid-induced remission in the discovery cohort; this gene signature is also associated with response to anti-TNFα and anti-α4β7 integrin in adults. The severity and therapeutic response gene signatures were in turn associated with shifts in microbes previously implicated in mucosal homeostasis. Our data provide insights into UC pathogenesis, and may prioritise future therapies for nonresponders to current approaches., The severity of ulcerative colitis, and response to treatment, is highly variable. Here, the authors examine rectal gene expression signatures and faecal microbiomes of children and adults with the disease and provide new insights in to pathogenesis.
- Published
- 2019
15. Negative-pressure wound therapy versus standard dressings for adults with an open lower limb fracture: the WOLLF RCT
- Author
-
Benjamin A. Parker, Stavros Petrou, Sonia Davis, Susie Hennings, Nicholas R. Parsons, Julie Bruce, Keith Willett, Juul Achten, Steven Jeffery, James P. M. Masters, Elizabeth Tutton, Sarah E Lamb, Matthew L. Costa, and Damian R. Griffin
- Subjects
Adult ,Male ,medicine.medical_specialty ,lcsh:Medical technology ,Technology Assessment, Biomedical ,Cost effectiveness ,medicine.medical_treatment ,Cost-Benefit Analysis ,Population ,law.invention ,03 medical and health sciences ,Fractures, Open ,0302 clinical medicine ,Quality of life ,Randomized controlled trial ,law ,Negative-pressure wound therapy ,Medicine ,Humans ,Surgical Wound Infection ,030212 general & internal medicine ,education ,education.field_of_study ,business.industry ,030503 health policy & services ,Health Policy ,Minimal clinically important difference ,Major trauma ,Middle Aged ,medicine.disease ,Bandages ,Confidence interval ,United Kingdom ,lcsh:R855-855.5 ,Lower Extremity ,Physical therapy ,Quality of Life ,Female ,0305 other medical science ,business ,RD ,Negative-Pressure Wound Therapy ,Research Article - Abstract
Background Open fractures of the lower limb occur when a broken bone penetrates the skin and is exposed to the outside environment. These are life-changing injuries. The risk of deep infection may be as high as 27%. The type of dressing applied after surgical debridement could potentially reduce the risk of infection in the open-fracture wound. Objectives To assess the disability, rate of deep infection, quality of life and resource use in patients with severe open fracture of the lower limb treated with negative-pressure wound therapy (NPWT) versus standard wound management after the first surgical debridement of the wound. Design A pragmatic, multicentre randomised controlled trial. Setting Twenty-four specialist trauma hospitals in the UK Major Trauma Network. Participants A total of 460 patients aged ≥ 16 years with a severe open fracture of the lower limb were recruited from July 2012 through to December 2015. Patients were excluded if they presented more than 72 hours after their injury or were unable to complete questionnaires. Interventions Negative-pressure wound therapy (n = 226) where an ‘open-cell’ solid foam or gauze was placed over the surface of the wound and connected to a suction pump which created a partial vacuum over the dressing versus standard dressings not involving negative pressure (n = 234). Main outcome measures Disability Rating Index (DRI) – a score of 0 (no disability) to 100 (completely disabled) at 12 months was the primary outcome measure, with a minimal clinically important difference of 8 points. The secondary outcomes were deep infection, quality of life and resource use collected at 3, 6, 9 and 12 months post randomisaton. Results There was no evidence of a difference in the patients’ DRI at 12 months. The mean DRI in the NPWT group was 45.5 points [standard deviation (SD) 28.0 points] versus 42.4 points (SD 24.2 points) in the standard dressing group, giving a difference of –3.9 points (95% confidence interval –8.9 to 1.2 points) in favour of standard dressings (p = 0.132). There was no difference in HRQoL and no difference in the number of surgical site infections or other complications at any point in the 12 months after surgery. NPWT did not reduce the cost of treatment and it was associated with a low probability of cost-effectiveness. Limitations Owing to the emergency nature of the interventions, we anticipated that some patients who were randomised into the trial would subsequently be unable or unwilling to take part. Such post-randomisation withdrawal of patients could have posed a risk to the external validity of the trial. However, the great majority of these patients (85%) were found to be ineligible after randomisation. Therefore, we can be confident that the patients who took part were representative of the population with severe open fractures of the lower limb. Conclusions Contrary to the existing literature and current clinical guidelines, NPWT dressings do not provide a clinical or an economic benefit for patients with an open fracture of the lower limb. Future work Future work should investigate alternative strategies to reduce the incidence of infection and improve outcomes for patients with an open fracture of the lower limb. Two specific areas of potentially great benefit are (1) the use of topical antibiotic preparations in the open-fracture wound and (2) the role of orthopaedic implants with antimicrobial coatings when fixing the associated fracture. Trial registration Current Controlled Trials ISRCTN33756652 and UKCRN Portfolio ID 11783. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 73. See the NIHR Journals Library website for further project information.
- Published
- 2018
16. Rationale, design, and methods for the Medical Optimization and Management of Pregnancies with Overt Type 2 Diabetes (MOMPOD) study
- Author
-
Laura A. Young, Kim A. Boggess, Amber Rose Ivins, Sonia Davis Thomas, Maria de los Angeles Abreu, Diane C. Berry, and Karen F. Dorman
- Subjects
Maternal outcomes ,Pediatrics ,medicine.medical_treatment ,Pregnancy in Diabetics ,Type 2 diabetes ,Infant, Newborn, Diseases ,Fetal Macrosomia ,Study Protocol ,0302 clinical medicine ,Pregnancy ,Insulin ,030212 general & internal medicine ,Fetal outcomes ,Disease Management ,Obstetrics and Gynecology ,Middle Aged ,Metformin ,3. Good health ,Infant, Small for Gestational Age ,Premature Birth ,Drug Therapy, Combination ,Female ,Hyperbilirubinemia, Neonatal ,medicine.symptom ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,030209 endocrinology & metabolism ,Hypoglycemia ,lcsh:Gynecology and obstetrics ,Young Adult ,03 medical and health sciences ,Double-Blind Method ,Birth Injuries ,medicine ,Humans ,Hypoglycemic Agents ,Perinatal Mortality ,lcsh:RG1-991 ,business.industry ,Neonatal hypoglycemia ,Infant, Newborn ,Infant, Low Birth Weight ,medicine.disease ,Low birth weight ,Diabetes Mellitus, Type 2 ,Small for gestational age ,business - Abstract
Background Annually in the US, over 100,000 pregnant women with overt type 2 diabetes give birth. Strict maternal glycemic control is the key to optimizing infant outcomes. Medical treatment of type 2 diabetes in pregnancy is generally restricted to insulin, as data on the safety and efficacy of oral hypoglycemic agents in pregnancy are limited. However, over one-third of infants born to women with type 2 diabetes experience an adverse outcome, such as premature delivery, large-for-gestational age, hypoglycemia, hyperbilirubinemia, or birth trauma, suggesting that current treatment regimens fall short of optimizing outcomes. Metformin is the pharmacologic treatment of choice for type 2 diabetes outside of pregnancy. Metformin is favored over insulin because it results in less weight gain, fewer hypoglycemic episodes, and is administered orally rather than injected. However, metformin is not typically used for treatment of type 2 diabetes complicating pregnancy, mainly because no large clinical studies have been conducted to examine its use in this context. Methods/design This is a randomized double-blind multi-center clinical trial of insulin plus metformin versus insulin plus placebo for the treatment of type 2 diabetes complicating pregnancy. A total of 1200 women with type 2 diabetes will be randomized between 10 weeks 0 days’ and 20 weeks 6 days’ gestation and followed until 30 days after delivery. Neonate outcomes will be followed until 30 days of age. The primary aim is to compare the effect of insulin and metformin versus insulin and placebo on composite adverse neonatal outcomes, comprising perinatal mortality, preterm delivery, neonatal hypoglycemia, hyperbilirubinemia, large-for-gestational age small for gestational age, low birth weight, and/or birth trauma. Key secondary aims are to compare treatment groups for neonatal fat mass and rate of maternal hypoglycemia. Additional aims are to assess the side effects and safety of insulin and metformin among pregnant women with overt type 2 diabetes and to compare gestational weight gain among women treated with metformin plus insulin versus insulin alone. Discussion Successful completion of this study will result in high-quality, contemporary evidence for management of overt type 2 diabetes complicating pregnancy to improve neonatal outcomes. Trial registration NCT02932475 (05/17/2016).
- Published
- 2018
17. A Genome-Wide Association Study in Hispanics/Latinos Identifies Novel Signals for Lung Function. The Hispanic Community Health Study/Study of Latinos
- Author
-
Burkart, Kristin M., Sofer, Tamar, London, Stephanie J., Manichaikul, Ani, Hartwig, Fernando P., Yan, Qi, Avila, Lydiana, Chen, Wei, Thomas, Sonia Davis, Diaz, Alejandro A., Hall, Ian P., Horta, Bernardo L., Kaplan, Robert C., Laurie, Cathy C., Menezes, Ana M., Morrison, Jean V., Oelsner, Elizabeth C., Rastogi, Deepa, Rich, Stephen S., Soto-Quiros, Manuel, Stilp, Adrienne M., Tobin, Martin D., Wain, Louise V., Celedon, Juan C., and Barr, R. Graham
- Subjects
Hispanic/Latino, genome-wide association, single nucleotide polymorphisms, lung function, chronic obstructive pulmonary disease ,respiratory tract diseases - Abstract
Rationale: Lung function and chronic obstructive pulmonary disease (COPD) are heritable traits. Genome-wide association studies (GWAS) have identified numerous pulmonary function and COPD loci, primarily in cohorts of European ancestry.Objectives: Perform a GWAS of COPD-phenotypes in Hispanic/Latino populations to identify loci not previously detected in European populations. Methods: GWAS of lung function and COPD in Hispanic/Latino participants from a population-based cohort. We performed replication studies of novel loci in independent studies.Measurements and Main Results: Among 11,822 Hispanic/Latino participants, we identified eight novel signals; three replicated in independent populations of European Ancestry. A novel locus for forced expiratory volume in one second (FEV1) in ZSWIM7 (rs4791658; p=4.99×10-9) replicated. A rare variant (MAF=0.002) in HAL (rs145174011) was associated with FEV1 to forced vital capacity (FEV1/FVC) (p=9.59×10-9) in a region previously identified for COPD-related phenotypes; it remained significant in conditional analyses but did not replicate. Admixture mapping identified a novel region, with a variant in AGMO (rs41331850), associated with Amerindian ancestry and FEV1, which replicated. A novel locus for FEV1 identified among ever smokers (rs291231; p=1.92×10-8) approached statistical significance for replication in admixed populations of African ancestry and a novel SNP for COPD in PDZD2 (rs7709630; p=1.56×10-8) regionally replicated. Additionally, loci previously identified for lung function in European samples were associated in Hispanic/Latino participants in HCHS/SOL at the genome-wide significance level.Conclusions: We identified novel signals for lung function and COPD in a Hispanic/Latino cohort. Including admixed populations when performing genetic studies may identify variants contributing togenetic etiologies of COPD.
- Published
- 2018
18. A Genome-Wide Association Study in Hispanics/Latinos Identifies Novel Signals for Lung Function. The Hispanic Community Health Study/Study of Latinos
- Author
-
Jean Morrison, Qi Yan, Deepa Rastogi, Stephanie J. London, Ana Maria Menezes, Lydiana Avila, Wei Chen, Robert C. Kaplan, María Soler Artigas, Tamar Sofer, Cathy C. Laurie, Kristin M. Burkart, Fernando Pires Hartwig, Ani Manichaikul, Adrienne M. Stilp, Alejandro A. Diaz, Elizabeth C. Oelsner, Martin D. Tobin, Ian P. Hall, Manuel Soto-Quiros, Louise V. Wain, Bernardo L. Horta, Sonia Davis Thomas, Stephen S. Rich, R. Graham Barr, and Juan C. Celedón
- Subjects
Adult ,Male ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,Adolescent ,Genome-wide association study ,Single-nucleotide polymorphism ,Critical Care and Intensive Care Medicine ,Bioinformatics ,White People ,Pulmonary function testing ,Cohort Studies ,Pulmonary Disease, Chronic Obstructive ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Gene Frequency ,Medicine ,Humans ,Genetic Predisposition to Disease ,Lung function ,Aged ,Genetic association ,COPD ,business.industry ,Hispanic latino ,Original Articles ,Hispanic or Latino ,Middle Aged ,medicine.disease ,United States ,Respiratory Function Tests ,respiratory tract diseases ,Europe ,030104 developmental biology ,030228 respiratory system ,Genetic Loci ,Community health ,Respiratory Physiological Phenomena ,Female ,Public Health ,business ,Genome-Wide Association Study ,Program Evaluation - Abstract
Lung function and chronic obstructive pulmonary disease (COPD) are heritable traits. Genome-wide association studies (GWAS) have identified numerous pulmonary function and COPD loci, primarily in cohorts of European ancestry.Perform a GWAS of COPD phenotypes in Hispanic/Latino populations to identify loci not previously detected in European populations.GWAS of lung function and COPD in Hispanic/Latino participants from a population-based cohort. We performed replication studies of novel loci in independent studies.Among 11,822 Hispanic/Latino participants, we identified eight novel signals; three replicated in independent populations of European Ancestry. A novel locus for FEVWe identified novel signals for lung function and COPD in a Hispanic/Latino cohort. Including admixed populations when performing genetic studies may identify variants contributing to genetic etiologies of COPD.
- Published
- 2018
19. Retinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study
- Author
-
Jennifer A. Deal, David S. Knopman, Marilyn S. Albert, A. Richey Sharrett, Sonia Davis Thomas, Thomas H. Mosley, Rebecca F. Gottesman, Karen Bandeen-Roche, Barbara E.K. Klein, Sheila Burgard, and Ronald Klein
- Subjects
Male ,medicine.medical_specialty ,Epidemiology ,Population ,030204 cardiovascular system & hematology ,White People ,Article ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Developmental Neuroscience ,Retinal Diseases ,Risk Factors ,Internal medicine ,mental disorders ,Medicine ,Dementia ,Humans ,Cognitive Dysfunction ,Prospective Studies ,education ,Aged ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Health Policy ,Hazard ratio ,Fundus photography ,Retinal Vessels ,Middle Aged ,medicine.disease ,Atherosclerosis ,Confidence interval ,Black or African American ,Psychiatry and Mental health ,Quartile ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery ,Cohort study ,Retinopathy ,Follow-Up Studies - Abstract
Introduction The easily-imaged retinal microvasculature may reflect the brain microvasculature and therefore be related to dementia. Methods In a population-based study of 12,482 adults aged 50-73 years (22% African American), we estimated the relationship of retinal characteristics from fundus photography (1993-1995) with incident all-cause dementia (1993-1995 to 2011-2013) and with etiologic subtype of dementia/mild cognitive impairment (2011-13). Results A total of 1259 (10%) participants developed dementia over a mean 15.6 years. Moderate/severe (vs. no) retinopathy (hazard ratio [HR], 1.86; 95% confidence interval [CI]: 1.36–2.55) and central retinal arteriolar equivalent (narrowest quartile vs. widest three quartiles; HR, 1.26; 95% CI: 1.09–1.45) were associated with all-cause dementia. Results were qualitatively stronger (but not statistically significantly different) in participants with diabetes. Retinopathy was associated with a joint outcome of cerebrovascular-related, but not Alzheimer's disease–related, dementia/mild cognitive impairment (HR, 2.29; 95% CI: 1.24–4.23). Discussion Exploration of measures in the eye may provide surrogate indices of microvascular lesions relevant to dementia.
- Published
- 2018
20. Ankle brachial index and cognitive function among Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos
- Author
-
Hector M. González, Robert C. Kaplan, Myriam Fornage, Martha L. Daviglus, Michael H. Criqui, Matthew A. Allison, Sonia Davis, Clinton B. Wright, Alan S. Conceicao, and Wassim Tarraf
- Subjects
Male ,Aging ,Epidemiology ,Hispanics ,Disease ,030204 cardiovascular system & hematology ,Cardiorespiratory Medicine and Haematology ,Neuropsychological Tests ,Cardiovascular ,Executive Function ,0302 clinical medicine ,Cognition ,Risk Factors ,Verbal fluency test ,Medicine ,Prospective Studies ,Stroke ,Confounding ,Hispanic or Latino ,Middle Aged ,Prognosis ,Mental Health ,Ankle-brachial index ,Female ,Hispanic Americans ,ABI ,Cardiology and Cardiovascular Medicine ,Clinical psychology ,Adult ,medicine.medical_specialty ,Adolescent ,Clinical Sciences ,Verbal learning ,Risk Assessment ,Article ,03 medical and health sciences ,Peripheral Arterial Disease ,Young Adult ,Vascular Stiffness ,Clinical Research ,Memory ,Predictive Value of Tests ,Behavioral and Social Science ,Humans ,Ankle Brachial Index ,Latinos ,Aged ,business.industry ,Verbal Behavior ,Prevention ,medicine.disease ,Atherosclerosis ,Cardiovascular health ,United States ,Brain Disorders ,Good Health and Well Being ,Cross-Sectional Studies ,Cardiovascular System & Hematology ,business ,Cognition Disorders ,030217 neurology & neurosurgery ,Dyslipidemia - Abstract
© 2018 Elsevier B.V. Background and aims: The Ankle-Brachial index (ABI) is a well-accepted measure of peripheral artery disease (arterial stenosis and stiffness) and has been shown to be associated with cognitive function and disorders; however, these associations have not been examined in Hispanics/Latinos. Therefore, we sought to examine relationships between ABI and cognitive function among diverse middle-age and older Hispanics/Latinos. Methods: We used cross-sectional data on n = 7991 participants aged 45–74 years, without stroke or coronary heart disease, from the Hispanic Community Health Study/Study of Latinos. Our primary outcome, global cognition (GC), was a continuous composite score of four cognitive domains (verbal learning and memory, verbal fluency, executive function, and mental status). Secondary outcomes were the individual tests representing these domains. The ABI was analyzed continuously and categorically with standard clinical cut-points. We tested associations using generalized survey regression models incrementally adjusting for confounding factors. Age, sex, hypertension, diabetes, and dyslipidemia moderations were examined through interactions with the primary exposure. Results: In age, sex, and education adjusted models, continuous ABI had an inverse u-shape association with worse GC. We found similar associations with measures of verbal learning and memory, verbal fluency, executive function, but not with low mental status. The associations were attenuated, but not completely explained, by accounting for the confounders and not modified by age, sex, education, and vascular disease risks. Conclusions: In addition to being a robust indicator of arterial compromise, our study suggests that abnormal ABI readings may also be useful for early signaling of subtle cognitive deficits.
- Published
- 2018
21. Tu1756 – The Treatment Naive Rectal Transcriptome Identifies Pathways Underlying Response to Induction Corticosteroid Therapy in Ulcerative Colitis
- Author
-
Haberman, Yael, primary, Karns, Rebekah, additional, Dexheimer, Phillip J., additional, Schirmer, Melanie, additional, Jurickova, Ingrid, additional, Collins, Margaret H., additional, Mo, Angela, additional, Rosen, Michael J., additional, Bonkowski, Erin, additional, Gotman, Nathan, additional, Marquis, Alison, additional, Rufo, Paul A., additional, Baker, Susan S., additional, Sauer, Cary G., additional, Markowitz, James, additional, Pfefferkorn, Marian D., additional, Rosh, Joel R., additional, Boyle, Brendan M., additional, Mack, David R., additional, Baldassano, Robert N., additional, Shah, Sapana.shah, additional, Leleiko, Neal S., additional, Heyman, Melvin B., additional, Griffiths, Anne M., additional, Patel, Ashish S., additional, Noe, Joshua D., additional, Aronow, Bruce J., additional, Kugathasan, Subra, additional, Walters, Thomas D., additional, Gibson, Greg, additional, Thomas, Sonia Davis Thomas Davis, additional, Mollen, Kevin, additional, Huttenhower, Curtis, additional, Xavier, Ramnik, additional, Hyams, Jeffrey S., additional, and Denson, Lee A., additional
- Published
- 2019
- Full Text
- View/download PDF
22. Retinal signs and risk of incident dementia in the Atherosclerosis Risk in Communities study
- Author
-
Deal, Jennifer A., primary, Sharrett, A. Richey, additional, Albert, Marilyn, additional, Bandeen‐Roche, Karen, additional, Burgard, Sheila, additional, Thomas, Sonia Davis, additional, Gottesman, Rebecca F., additional, Knopman, David, additional, Mosley, Thomas, additional, Klein, Barbara, additional, and Klein, Ronald, additional
- Published
- 2018
- Full Text
- View/download PDF
23. Accelerometer Adherence and Performance in a Cohort Study of US Hispanic Adults
- Author
-
Dale W. Esliger, Kelly R. Evenson, Sonia Davis, Carmen R. Isasi, Yu Deng, Simon J. Marshall, and Daniela Sotres-Alvarez
- Subjects
Adult ,Male ,medicine.medical_specialty ,Future studies ,Adolescent ,Physical activity ,Physical Therapy, Sports Therapy and Rehabilitation ,Motor Activity ,Accelerometer ,Article ,Young Adult ,Interquartile range ,Accelerometry ,ComputingMilieux_COMPUTERSANDEDUCATION ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Mass index ,Young adult ,Aged ,business.industry ,Hispanic or Latino ,Middle Aged ,United States ,ComputerSystemsOrganization_MISCELLANEOUS ,Community health ,Physical therapy ,Patient Compliance ,ComputingMilieux_COMPUTERSANDSOCIETY ,Female ,business ,human activities ,Cohort study - Abstract
AB Purpose: This study described participant adherence to wearing the accelerometer and accelerometer performance in a cohort study of adults. Methods: From 2008 to 2011, 16,415 US Hispanic/Latino adults age 18-74 yr enrolled in the Hispanic Community Health Study/Study of Latinos. Immediately after the baseline visit, participants wore an Actical accelerometer for 1 wk. This study explored correlates of accelerometer participation and adherence, defined as wearing it for at least three of a possible six days for >=10 h[middle dot]d-1. Accelerometer performance was assessed by exploring the number of different values of accelerometer counts per minute for each participant. Results: Overall, 92.3% (n = 15,153) had at least 1 d with accelerometer data and 77.7% (n = 12,750) were adherent. Both accelerometer participation and adherence were higher among participants who were married or partnered, reported a higher household income, were first-generation immigrants, or reported lower sitting time. Participation was also higher among those with no stair limitations. Adherence was higher among participants who were male, older, employed or retired, not US born, preferred Spanish over English, reported higher work activity or lower recreational activity, and with a lower body mass index. Among the sample that met the adherence definition, the maximum recorded count per minute was 12,000, and there were a total of 5846 different counts per minute. On average, participants had 112.5 different counts per minute over 6 d (median, 106; interquartile range, 91-122). The number of different counts per minute was higher among men, younger ages, normal weight, and those with higher accelerometer-assessed physical activity. Conclusion: Several correlates differed between accelerometer participation and adherence. These characteristics could be targeted in future studies to improve accelerometer wear. The performance of the accelerometer provided insight into creating a more accurate nonwear algorithm.
- Published
- 2015
24. Metabolic Syndrome and Neurocognition Among Diverse Middle-Aged and Older Hispanics/Latinos: HCHS/SOL Results
- Author
-
Natalya Rosenberg, Sonia Davis, Wassim Tarraf, Martha L. Daviglus, Bharat Thyagarajan, Hector M. González, Ashley H. Sanderlin, Jianwen Cai, Tasneem Khambaty, Priscilla M. Vásquez, Carlos J. Rodriguez, Neil Schneiderman, and Linda C. Gallo
- Subjects
Gerontology ,Research design ,Adult ,Male ,Aging ,Cardiovascular and Metabolic Risk ,Adolescent ,Cross-sectional study ,Endocrinology, Diabetes and Metabolism ,Ethnic Groups ,Verbal learning ,Medical and Health Sciences ,Endocrinology & Metabolism ,03 medical and health sciences ,Executive Function ,Young Adult ,0302 clinical medicine ,Cognition ,Internal Medicine ,Ethnicity ,Medicine ,Verbal fluency test ,Humans ,030212 general & internal medicine ,Young adult ,Aged ,Advanced and Specialized Nursing ,Metabolic Syndrome ,business.industry ,Hispanic or Latino ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Community health ,Female ,Hispanic Americans ,Metabolic syndrome ,business ,Cognition Disorders ,Neurocognitive ,030217 neurology & neurosurgery - Abstract
OBJECTIVE Hispanics/Latinos have the highest risks for metabolic syndrome (MetS) in the U.S. and are also at increased risk for Alzheimer disease. In this study, we examined associations among neurocognitive function, MetS, and inflammation among diverse middle-aged and older Hispanics/Latinos. RESEARCH DESIGN AND METHODS Cross-sectional data (2008–2011) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were analyzed to examine associations between neurocognition and MetS among diverse Hispanics/Latinos (N = 9,136; aged 45–74 years). RESULTS MetS status was associated with lower global neurocognition, mental status, verbal learning and memory, verbal fluency, and executive function. Age significantly modified the associations between MetS and learning and memory measures. Significant associations between MetS and neurocognition were observed among middle-aged Hispanics/Latinos, and all associations remained robust to additional covariates adjustment. CONCLUSIONS We found that MetS was associated with lower neurocognitive function, particularly in midlife. Our findings support and extend current hypotheses that midlife may be a particularly vulnerable developmental period for unhealthy neurocognitive aging.
- Published
- 2017
25. Abstract P337: Social Network Size is Associated With Healthy Lifestyle Factors: Results From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
- Author
-
Rosenda Murillo, Amber Pirzada, Sonia Davis, Linda C Gallo, Natania W Ostrovsky, Frank J Penedo, Krista Perreira, Samantha A Reina, Jeremiah Stamler, Linda Van Horn, and Martha L Daviglus
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Background: Social ties within social networks have been shown to influence healthy lifestyles. However, little is known about the association among size of familial social networks, social network dynamics (such as frequency of contact and perceived connectedness), and healthy lifestyle factors in Hispanic/Latino adults. We examined cross-sectional associations of central family social network size, as well as frequency of contact with central family members (children, parents, in-laws) and perceived connectedness to extended family members (uncles, aunts, and other relatives), with individual healthy lifestyle factors. Methods: Data were analyzed from 15,511 self-identified Hispanic/Latino adults ages 18-74 years from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Size of central family, frequency of contact with central family members in past 2 weeks, and perceived connectedness to extended family, were categorized into approximate tertiles based on the distribution of the data. Healthy lifestyle factors included alcohol use (men 2 , physical activity in the highest sex-specific 40%, and healthy diet in the highest sex-specific 40%. Survey logistic regression was used to compute odds ratios [OR] and 95% confidence intervals [CI], with models adjusted for age, sex, education, income, Hispanic/Latino background, employment status, religion, church attendance, marital status, acculturation, and language preference. Results: Compared to participants with a central family social network of 0-3 individuals, those with a family social network of 4-5 members were significantly less likely to have a healthy diet (OR: 0.86; 95% CI: 0.74, 0.99) or a healthy BMI (OR: 0.74; 95% CI: 0.65, 0.85). Also, those with 6-11 members were also significantly less likely to have a healthy BMI (OR: 0.58; 95% CI: 0.49, 0.69). Individuals reporting frequent contact with 3-4 and 5-11 family members were less likely to have a healthy BMI (OR: 0.76; 95% CI: 0.66, 0.87; OR: 0.60; 95% CI: 0.51, 0.72; respectively) versus those reporting frequent contact with only 0-2 family members. However, individuals who reported feeling connected to 3-5 extended family members were more likely to have a healthy diet (OR: 1.16; 95% CI: 1.00, 1.36) and healthy BMI (OR: 1.15; 95% CI: 1.00, 1.33), and those who felt connected to 6-7 extended family members were more likely to be non-smokers and to have a healthy BMI (OR: 1.16; 95% CI: 1.00, 1.34; OR: 1.20, 95% CI: 1.20; 95% CI: 1.04, 1.38; respectively) versus those who reported feeling connected to 0-2 extended family members. Conclusions: These findings suggest that social network size and dynamics may play an important role in influencing healthy lifestyle factors among Hispanic/Latino adults. Further, specific influences may differ based on the type of relationship.
- Published
- 2017
26. Tu1756 – The Treatment Naive Rectal Transcriptome Identifies Pathways Underlying Response to Induction Corticosteroid Therapy in Ulcerative Colitis
- Author
-
Greg Gibson, Anne M. Griffiths, Melanie Schirmer, Alison Marquis, Thomas D. Walters, Curtis Huttenhower, Kevin P. Mollen, Joshua D. Noe, Sonia Davis Thomas, Margaret H. Collins, Paul A. Rufo, Brendan M. Boyle, Phillip J. Dexheimer, Cary G. Sauer, James Markowitz, Ashish S. Patel, Sapana Shah, Bruce J. Aronow, Melvin B. Heyman, Michael J. Rosen, Nathan Gotman, Angela Mo, Yael Haberman, Rebekah Karns, Lee A. Denson, Susan S. Baker, David R. Mack, Ingrid Jurickova, Subra Kugathasan, Ramnik J. Xavier, Marian D. Pfefferkorn, Joel R. Rosh, Neal S. Leleiko, Erin Bonkowski, Robert N. Baldassano, and Jeffrey S. Hyams
- Subjects
Therapy naive ,Transcriptome ,Hepatology ,Corticosteroid therapy ,business.industry ,Immunology ,Gastroenterology ,medicine ,medicine.disease ,business ,Ulcerative colitis - Published
- 2019
27. Compositional and Temporal Changes in the Gut Microbiome of Pediatric Ulcerative Colitis Patients Are Linked to Disease Course
- Author
-
Cary G. Sauer, David R. Mack, Susan S. Baker, Ashish S. Patel, Nathan Gotman, Robert N. Baldassano, Jeffrey S. Hyams, Ramnik J. Xavier, Sonia Davis Thomas, Subra Kugathasan, Thomas D. Walters, Curtis Huttenhower, Melanie Schirmer, Paul A. Rufo, Neal Leleiko, David J. Keljo, Lee A. Denson, James Markowitz, Anne M. Griffiths, Marian D. Pfefferkorn, Joel R. Rosh, Joshua D. Noe, Maria Oliva-Hemker, Melvin B. Heyman, Hera Vlamakis, Brendan M. Boyle, Anthony R. Otley, and Eric A. Franzosa
- Subjects
Male ,0301 basic medicine ,Time Factors ,medicine.medical_treatment ,Anti-Inflammatory Agents ,gut microbiome ,Ulcerative ,Gastroenterology ,Oral and gastrointestinal ,corticosteroids ,Cohort Studies ,Feces ,0302 clinical medicine ,Adrenal Cortex Hormones ,Longitudinal Studies ,Mesalamine ,Child ,Colectomy ,Pediatric ,Clostridiales ,pediatric ulcerative colitis ,disease course ,Anti-Inflammatory Agents, Non-Steroidal ,treatment-naive ,Colitis ,Ulcerative colitis ,5.1 Pharmaceuticals ,Medical Microbiology ,Child, Preschool ,Disease Progression ,Female ,030211 gastroenterology & hepatology ,Development of treatments and therapeutic interventions ,Non-Steroidal ,medicine.medical_specialty ,Adolescent ,Immunology ,Pediatric ulcerative colitis ,host-microbial interactions ,Biology ,Autoimmune Disease ,Microbiology ,Article ,Disease course ,03 medical and health sciences ,response to therapy ,Clinical Research ,Virology ,Internal medicine ,medicine ,Humans ,Microbiome ,Preschool ,Nutrition ,Inflammatory Bowel Disease ,5ASA ,medicine.disease ,Gut microbiome ,Gastrointestinal Microbiome ,serological markers ,030104 developmental biology ,Colitis, Ulcerative ,Parasitology ,Digestive Diseases ,Leukocyte L1 Antigen Complex - Abstract
Evaluating progression risk and determining optimal therapy for ulcerative colitis (UC) is challenging as many patients exhibit incomplete responses to treatment. As part of the PROTECT (Predicting Response to Standardized Colitis Therapy) Study, we evaluated the role of the gut microbiome in disease course for 405 pediatric, new-onset, treatment-naive UC patients. Patients were monitored for one year upon treatment initiation, and microbial taxonomic composition was analyzed from fecal samples and rectal biopsies. Depletion of core gut microbes and expansion of bacteria typical of the oral cavity were associated with baseline disease severity. Remission and refractory disease were linked to species-specific temporal changes that may be implicative of therapy efficacy, and a pronounced increase in microbiome variability was observed prior to colectomy. Finally, microbial associations with disease-associated serological markers suggest host-microbial interactions in UC. These insights will help improve existing treatments and develop therapeutic approaches guiding optimal medical care.
- Published
- 2018
28. Cardiovascular health among diverse Hispanics/Latinos: Hispanic Community Health Study/Study of Latinos (HCHS/SOL) results
- Author
-
Robert C. Kaplan, Ralph L. Sacco, Gerardo Heiss, Wassim Tarraf, Gregory A. Talavera, Hector M. González, Rosalba Hernandez, Linda C. Gallo, Sonia Davis, Martha L. Daviglus, Jorge R. Kizer, Neil Schneiderman, and Carlos J. Rodriguez
- Subjects
Adult ,Male ,Gerontology ,MEDLINE ,Ethnic group ,030204 cardiovascular system & hematology ,Article ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Prevalence ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Aged ,Cultural Characteristics ,Operationalization ,business.industry ,Regression analysis ,Health Status Disparities ,Hispanic or Latino ,Middle Aged ,respiratory system ,United States ,Health promotion ,Socioeconomic Factors ,Cardiovascular Diseases ,Community health ,Female ,Cardiology and Cardiovascular Medicine ,business ,Goals ,human activities ,Strengths and weaknesses ,Cohort study - Abstract
Seven national 2020 Strategic Impact Goals for cardiovascular health (Life's Simple 7 [LS7]) estimates for major ethnic/racial groups are available, but not for diverse Hispanics/Latinos. Herein, we describe and examine LS7 profiles of diverse Hispanic/Latino groups.HCHS/SOL (analytic n = 15,825; ages 18-74 years) data were used to estimate LS7 metrics. LS7 metrics were operationalized as Ideal, Intermediate, or Poor and indexed as an additive score. We calculated Hispanic/Latino group and sex-specific prevalence estimates for LS7 metrics and used survey-based regression models to examine (1) associations between LS7 scores and pertinent sociocultural characteristics and (2) relationships between LS7 scores and coronary heart disease, and stroke and transient ischemic attacks prevalence.Few HCHS/SOL participants met all 7 Ideal LS7 criteria (1%), and a similarly small proportion did not meet any Ideal LS7 criteria (1.1%). We found significant variability in LS7 distributions between men and women and across HCHS/SOL Hispanic/Latino heritages. We also found a substantial sex-adjusted age gradient in LS7 cardiovascular health (ie, ≥4 Ideal LS7s). Finally, higher Ideal LS7 scores were associated with decreased odds of both coronary heart disease and self-reported stroke/transient ischemic attack; these associations persisted after model covariate adjustments.Hispanic/Latino LS7s compared favorably with existing national estimates; however, we found areas for improvement. Several Hispanic/Latino LS7 strengths and weaknesses varied by sex and heritage, providing important information to guide targeted health promotion efforts toward achieving 2020 goals.
- Published
- 2016
- Full Text
- View/download PDF
29. Sleep Duration and Neurocognitive Function in the Hispanic Community Health Study/Study of Latinos
- Author
-
Alberto R. Ramos, Clinton B. Wright, Sonia Davis, Linda C. Gallo, Daniela Sotres-Alvarez, Ralph L. Sacco, Tatjana Rundek, Martha L. Daviglus, Hector M. González, Susan Redline, Yasmin Mossavar-Rahmani, Frank J. Penedo, Wassim Tarraf, and Phyllis C. Zee
- Subjects
Male ,Time Factors ,Cross-sectional study ,Standard score ,Sleep Cognition and Behavior ,Neuropsychological Tests ,Verbal learning ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Cognition ,Residence Characteristics ,Physiology (medical) ,Humans ,030212 general & internal medicine ,Community Health Services ,Prospective Studies ,Prospective cohort study ,Aged ,Hispanic or Latino ,Middle Aged ,United States ,Cross-Sectional Studies ,Cohort ,Community health ,Female ,Neurology (clinical) ,Self Report ,Psychology ,Sleep ,Neurocognitive ,030217 neurology & neurosurgery ,Clinical psychology ,Cohort study - Abstract
Study objectives To evaluate the association between sleep duration and neurocognitive function in a representative sample of middle-aged to older Hispanic/Latino adults in the US. We tested the hypothesis that sleep duration has a nonlinear, inverted U-shaped association with neurocognitive function. Methods We performed a cross-sectional analysis from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants ages 45-74 years (n = 8,676). HCHS/SOL is a community-based cohort from four US urban areas sampled using a probability design from 2008-2011. Self-reported sleep duration was calculated as a weighted average of the difference between habitual wake and bedtimes assessed by separate questions for weekdays and weekends. Neurocognitive function was measured with standardized scores for Word (Phonemic) Fluency (WF), Brief-Spanish English Verbal learning test (B-SEVLT), and Digit Symbol Substitution (DSS) tests. Results The mean age was 56.5 years; 55% were women; and 40.4% had less than high school education. Average sleep duration was 7.8 ± 1.7 hours. There was an inverted U-shaped association with sleep duration and WF, B-SEVLT sum, and the DSS, with no association with B-SEVLT delayed-recall. Participants with intermediate sleep duration had the best neurocognitive function, while long sleepers had worse neurocognitive function adjusting for demographic, behavioral, and medical factors, daytime sleepiness, and use of sleep medications. Conclusions Sleep duration had curvilinear inverted U-shaped associations with neurocognitive function, with worse scores among participants with longer sleep duration. These findings may provide a framework to further examine sleep duration in the prevention and treatment of neurocognitive disorders.
- Published
- 2016
- Full Text
- View/download PDF
30. Binge drinking and perceived ethnic discrimination among Hispanics/Latinos: Results from the Hispanic community health study/study of Latinos sociocultural ancillary study
- Author
-
Gwen T. Lapham, Linda C. Gallo, Veronica Y. Womack, India J. Ornelas, Sonia Davis, Frank J. Penedo, Nathan Gotman, Sylvia Smoller, Hugo Salgado, and Emily C. Williams
- Subjects
Gerontology ,Adult ,Male ,Health (social science) ,Medicine (miscellaneous) ,Binge drinking ,Article ,Odds ,Binge Drinking ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,030212 general & internal medicine ,Sociocultural evolution ,Aged ,030505 public health ,business.industry ,Hispanic latino ,Ancillary Study ,Hispanic or Latino ,Middle Aged ,Community health ,Residence ,Ethnic discrimination ,Female ,0305 other medical science ,business ,Prejudice ,Demography - Abstract
The study assessed whether overall perceived ethnic discrimination and four unique discrimination types were associated with binge drinking in participants from the Hispanic Community Health Study/Study of Latinos who also completed the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (n = 5,313). In unadjusted analyses that were weighted for sampling strategy and design, each unit increase in discrimination type was associated with a 12-63% increase in odds of binge drinking; however, after adjusting for important demographic variables including age, sex, heritage group, language, and duration of U.S. residence, there was no longer an association between discrimination and binge drinking. Further research still needs to identify the salient factors that contribute to increased risk for binge drinking among Hispanics/Latinos.
- Published
- 2016
- Full Text
- View/download PDF
31. Abstract 13457: ACC/AHA Guidelines on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk: Implications for US Hispanics/Latino Based on fFndings From the HCHS-SOL
- Author
-
Waqas Qureshi, Robert C Kaplan, Katrina Swett, Gregory Burke, Martha Davilgus, Molly Jung, Gregory A Talavera, Diana A Chirinos, Samantha A Reina, Sonia Davis, and Carlos Rodriguez
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: Hispanic/Latinos are the largest ethnic minority in United States with significant cultural and racial heterogeneity. The recent cholesterol treatment guidelines are mainly based on estimates from non-Hispanic white and black cohorts. Aim: To estimate the proportion of US Hispanic adults potentially affected by recent changes in recommendations for statin therapy eligibility under the 3rd National Cholesterol Education Program Adult Treatment Panel (NCEP/ATP III) and the new 2013 ACC/AHA cholesterol treatment guidelines. Methods: HCHS/SOL is a large multi-center study of Hispanics/Latinos in US communities (Bronx, NY; Chicago, IL; Miami, FL; and San Diego, CA) (n=16,415; mean age 41 years, 40% males) . We evaluated weighted prevalence of statin-treated individuals and the proportion of target population that met the eligibility criteria for statin therapy under NCEP/ATP III versus 2013 ACC/AHA cholesterol treatment guidelines. Results: A total of 1,716 (10.4%) were treated with statins in HCHS/SOL cohort. However, 3,366 (20.5%) and 5,268 (32.1%) were eligible for statin therapy under NCEP/ATP III and 2013 ACC/AHA guidelines respectively. The proportion of statin-eligible adults increased primarily among older adults from 44% to 87% and males from 19% to 39% under NCEP/ATP III guidelines and 2013 ACC/AHA guidelines respectively (Figure 1). There was also an increase in eligibility for statin therapy in middle aged adults (44% to 65%). Conclusions: Regardless of the definition for statin eligibility, Hispanics are grossly undertreated (only half and only a third of those statin-eligible under the ATP III or the new ACC/AHA guidelines respectively are receiving treatment). The eligibility of statin therapy almost doubles consistently across all Hispanic/Latinos subgroups of under the new 2013 ACC/AHA guidelines.
- Published
- 2015
32. Anaerobic bacteria cultured from cystic fibrosis airways correlate to milder disease: a multisite study
- Author
-
Stef J. McGrath, J. Stuart Elborn, Michelle A. Murray, Richard C. Boucher, Bojana Mirković, Sonia Davis Thomas, Matthew C. Wolfgang, Gillian M. Lavelle, Paul McNally, Joseph Hatch, Nathan Gotman, Peter H. Gilligan, Michael M. Tunney, Noel G. McElvaney, Deirdre F Gilipin, Gisli G. Einarsson, and Marianne S. Muhlebach
- Subjects
Adult ,Male ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,Internationality ,Adolescent ,Cystic Fibrosis ,Aerobic bacteria ,Respiratory System ,Cystic fibrosis ,Microbiology ,Bacteria, Anaerobic ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Child ,Aged ,Colony-forming unit ,medicine.diagnostic_test ,biology ,business.industry ,Microbiota ,Sputum ,Infant ,Bacterial Infections ,Middle Aged ,biology.organism_classification ,medicine.disease ,Anti-Bacterial Agents ,Logistic Models ,030104 developmental biology ,Bronchoalveolar lavage ,030228 respiratory system ,Child, Preschool ,Multivariate Analysis ,Female ,Anaerobic bacteria ,medicine.symptom ,business ,Anaerobic exercise ,Bacteria - Abstract
Anaerobic and aerobic bacteria were quantitated in respiratory samples across three cystic fibrosis (CF) centres using extended culture methods. Subjects aged 1–69 years who were clinically stable provided sputum (n=200) or bronchoalveolar lavage (n=55). 18 anaerobic and 39 aerobic genera were cultured from 59% and 95% of samples, respectively; 16 out of 57 genera had a ≥5% prevalence across centres.Analyses of microbial communities using co-occurrence networks in sputum samples showed groupings of oral, including anaerobic, bacteria, whereas typical CF pathogens formed distinct entities. Pseudomonas was associated with worse nutrition and F508del genotype, whereas anaerobe prevalence was positively associated with pancreatic sufficiency, better nutrition and better lung function. A higher total anaerobe/total aerobe CFU ratio was associated with pancreatic sufficiency and better nutrition. Subjects grouped by factor analysis who had relative dominance of anaerobes over aerobes had milder disease compared with a Pseudomonas-dominated group with similar proportions of subjects that were homozygous for F508del.In summary, anaerobic bacteria occurred at an early age. In sputum-producing subjects anaerobic bacteria were associated with milder disease, suggesting that targeted eradication of anaerobes may not be warranted in sputum-producing CF subjects.
- Published
- 2018
33. Social and physical predictors of mental health impact in adult women who have an FMR1 premutation
- Author
-
Claudine M. Kraan, Minh Bui, Alison Archibald, Sonia Davison, Rachel C. Cvejic, Sylvia Metcalfe, David J. Amor, Julian N. Trollor, Jonathan Cohen, and Kim Cornish
- Subjects
Fragile X-associated primary ovarian insufficiency (FXPOI) ,Fragile X-associated tremor/ataxia syndrome (FXTAS) ,social anxiety ,depression ,premutation ,Genetics ,QH426-470 ,Medicine - Abstract
Purpose: Clear understanding of mental health phenotypes and associated socioeconomic, physical health and well-being impacts in adult women with an FMR1 premutation (PM) is needed for counseling and primary healthcare. Methods: A questionnaire captured mental health conditions in women with a PM, using lifetime diagnosis and nested psychometric scales (Liebowitz Social Anxiety Scale; Depression and Anxiety Stress Scale). Socioeconomic, physical health and well-being data were entered into 2 multivariable logistic regression models (1 with depression status as the outcome variable and 1 with social anxiety as the outcome). Results: 137 participants were included. Depression was found in ∼30% and social anxiety in ∼38%. With depression status the outcome variable, strongest associations were for low education, diagnosis of migraine, diagnosis of irritable bowel syndrome, and self-reported hearing loss symptoms. With social anxiety status as the outcome, strongest associations were with education, migraine, irritable bowel syndrome, relationship status, and subjective memory complaints. Conclusion: Mental health impacts were found in more than 1 in 3 women. Poor mental health was significantly associated with socioeconomic and physical health factors. Findings may inform health care professionals about personalized treatment options for women with a PM.
- Published
- 2023
- Full Text
- View/download PDF
34. Mixed Models for Repeated Measures using Categorical time Effects (MMRM)
- Author
-
Sonia Davis
- Subjects
Mixed model ,Statistics ,Econometrics ,Repeated measures design ,Missing data ,Categorical variable ,Mathematics - Published
- 2014
35. Factors Associated With Ocular Health Care Utilization Among Hispanics/Latinos
- Author
-
Byron L. Lam, Sonia Davis, Daniel F. López-Cevallos, Laura A. McClure, Claudia Pulido Chambers, Zhu Ming Zhang, Marston E. Youngblood, Stacey L. Tannenbaum, D. Diane Zheng, Charlotte E. Joslin, and David J. Lee
- Subjects
Adult ,Male ,Gerontology ,Eye Diseases ,Eye disease ,Health Services Accessibility ,Article ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Health care ,Odds Ratio ,Humans ,Medicine ,030212 general & internal medicine ,Vision test ,medicine.diagnostic_test ,business.industry ,Vision Tests ,Health services research ,Cuba ,Central America ,Hispanic or Latino ,Odds ratio ,Middle Aged ,Patient Acceptance of Health Care ,South America ,medicine.disease ,Health Surveys ,Ophthalmology ,Eye examination ,Community health ,030221 ophthalmology & optometry ,Female ,Health Services Research ,business ,Cohort study - Abstract
Importance Regular ocular care is critical to early detection and prevention of eye disease and associated morbidity and mortality; however, there have been relatively few studies of ocular health care utilization among Hispanics/Latinos of diverse backgrounds. Objective To examine factors associated with ocular health care utilization among Cuban, Central American, and South American Hispanics/Latinos in a cohort study. Design, Setting, and Participants An ancillary study to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) evaluating ocular health, knowledge, risk factors, and health care use was conducted with 1235 HCHS/SOL participants (aged ≥40 years) at the Miami, Florida, study site. Data were collected from October 17, 2011, to September 30, 2013, and analyses were conducted from May 28, 2014, to March 18, 2015. Descriptive and multivariable logistic regression analyses were performed for 3 ocular health care outcomes. Regression models were built sequentially with variables conceptually grouped according to Andersen’s Behavioral Model of Health Services Use. Main Outcomes and Measures Ever having an eye examination, having an eye examination performed within the past 2 years, and difficulty obtaining needed eye care in the past year. Results Of the 1235 participants, 478 were men and 757 were women, and they had a mean (SD) age of 53.6 (8.1) years. Those who never had insurance were less likely to have had an eye examination (with data reported as odds ratios [95% CIs]) ever, 0.19 (0.07-0.53) and in the past 2 years, 0.22 (0.15-0.33) and were more likely to have had difficulty obtaining needed eye care in the past year (3.72 [1.75-7.93]). Those with less than excellent or good self-rated eyesight were less likely to ever have had an eye examination (0.26 [0.12-0.56]) and more likely to have had difficulty obtaining care (3.00 [1.48-6.11]). Men were less likely to ever have had an eye examination (0.31 [0.18-0.53]). Older (55-64 years) Hispanics/Latinos (3.04 [1.47-6.31]) and those with a high school degree or general educational development certification (2.06 [1.02-4.13]) or higher levels of education (4.20 [2.12-8.30]) were more likely to ever have had an eye examination. Finally, those living in the United States for more than 15 years (0.42 [0.21-0.82]) were less likely to have had difficulty obtaining care. Conclusions and Relevance Our findings suggest that increasing insurance coverage, decreasing the costs of care, and increasing the availability of care for Hispanics/Latinos with poor self-rated eyesight are relevant issues to address to improve ocular health care use among Hispanics/Latinos of diverse backgrounds.
- Published
- 2016
36. Gunshot wounds
- Author
-
Sonia Davis
- Subjects
Engineering ,business.industry ,General Medicine ,Computer security ,computer.software_genre ,business ,Security token ,computer ,Test (assessment) - Published
- 2009
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.