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  • 1
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    A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk
    American Diabetes Association ; 2018
    In:  Diabetes Care Vol. 41, No. 9 ( 2018-09-01), p. 1887-1894
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 41, No. 9 ( 2018-09-01), p. 1887-1894
    Abstract: We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals. RESEARCH DESIGN AND METHODS We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients’ relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2–51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial–Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables. RESULTS Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06–1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS & gt;0.295, 95% CI 1.47–3.51; P = 0.0002). CONCLUSIONS The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc18-0087
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2018
    detail.hit.zdb_id: 1490520-6
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  • 2
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    Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes
    American Diabetes Association ; 2019
    In:  Diabetes Care Vol. 42, No. 2 ( 2019-02-01), p. 192-199
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 42, No. 2 ( 2019-02-01), p. 192-199
    Abstract: There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A] , and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P & lt; 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody–positive, 13% for single autoantibody–positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody–positive, 12% for single autoantibody–positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody–positive identical twins and multiple autoantibody–positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc18-0288
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2019
    detail.hit.zdb_id: 1490520-6
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  • 3
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    Estimating the effects of race and social vulnerability on hospital admission and mortality from COVID-19
    Oxford University Press (OUP) ; 2021
    In:  JAMIA Open Vol. 4, No. 4 ( 2021-10-08)
    Details
    In: JAMIA Open, Oxford University Press (OUP), Vol. 4, No. 4 ( 2021-10-08)
    Abstract: To estimate the risk of hospital admission and mortality from COVID-19 to patients and measure the association of race and area-level social vulnerability with those outcomes. Materials and Methods Using patient records collected at a multisite hospital system from April 2020 to October 2020, the risk of hospital admission and the risk of mortality were estimated for patients who tested positive for COVID-19 and were admitted to the hospital for COVID-19, respectively, using generalized estimating equations while controlling for patient race, patient area-level social vulnerability, and time course of the pandemic. Results Black individuals were 3.57 as likely (95% CI, 3.18–4.00) to be hospitalized than White people, and patients living in the most disadvantaged areas were 2.61 times as likely (95% CI, 2.26–3.02) to be hospitalized than those living in the least disadvantaged areas. While Black patients had lower raw mortality than White patients, mortality was similar after controlling for comorbidities and social vulnerability. Discussion Our findings point to potent correlates of race and socioeconomic status, including resource distribution, employment, and shared living spaces, that may be associated with inequitable burden of disease across patients of different races. Conclusions Public health and policy interventions should address these social factors when responding to the next pandemic.
    Type of Medium: Online Resource
    ISSN: 2574-2531
    URL: Article
    DOI: 10.1093/jamiaopen/ooab111
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2940623-7
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  • 4
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    Estimates of Fruit and Vegetable Intake in Childhood and Adult Dietary Behaviors of African American Women
    Elsevier BV ; 2004
    In:  Journal of Nutrition Education and Behavior Vol. 36, No. 6 ( 2004-11), p. 309-314
    Details
    In: Journal of Nutrition Education and Behavior, Elsevier BV, Vol. 36, No. 6 ( 2004-11), p. 309-314
    Type of Medium: Online Resource
    ISSN: 1499-4046
    URL: Article
    DOI: 10.1016/S1499-4046(06)60400-4
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2004
    detail.hit.zdb_id: 2095185-1
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  • 5
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    Reduced Hip Adduction Is Associated With Improved Function After Movement-Pattern Training in Young People With Chronic Hip Joint Pain
    Journal of Orthopaedic & Sports Physical Therapy (JOSPT) ; 2018
    In:  Journal of Orthopaedic & Sports Physical Therapy Vol. 48, No. 4 ( 2018-04), p. 316-324
    Details
    In: Journal of Orthopaedic & Sports Physical Therapy, Journal of Orthopaedic & Sports Physical Therapy (JOSPT), Vol. 48, No. 4 ( 2018-04), p. 316-324
    Type of Medium: Online Resource
    ISSN: 0190-6011 , 1938-1344
    URL: Article
    DOI: 10.2519/jospt.2018.7810
    Language: English
    Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
    Publication Date: 2018
    detail.hit.zdb_id: 2113650-6
    SSG: 31
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  • 6
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    Association of magnetic resonance imaging identification of mesial temporal sclerosis with pathological diagnosis and surgical outcomes in children following epilepsy surgery : Clinical article
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2012
    In:  Journal of Neurosurgery: Pediatrics Vol. 9, No. 5 ( 2012-05), p. 552-561
    Details
    In: Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 9, No. 5 ( 2012-05), p. 552-561
    Abstract: Mesial temporal sclerosis (MTS) is widely recognized as a significant underlying cause of temporal lobe epilepsy. Magnetic resonance imaging is routinely used in the preoperative evaluation of children with epilepsy. The purpose of this study was to evaluate the prevalence, reliability, and prognostic value of MRI identification of MTS and MRI findings indicative of MTS in a series of patients who underwent resection of the medial temporal lobe for medically refractory epilepsy. Methods The authors reviewed the medical records and preoperative MRI reports of 25 patients who had undergone medial temporal resections (anterior temporal lobectomy or functional hemispherotomy) for medically intractable epilepsy. The preoperative MRI studies were presented for blinded review by 2 neuroradiologists who independently evaluated the radiographs for selected MTS features and provided a final interpretation. To quantify interrater agreement and accuracy, the findings of the 2 blinded neuroradiologists, the nonblinded clinical preoperative radiology report, and the final pathology interpretation were compared. Results The preoperative MRI studies revealed MTS in 6 patients (24%), and histopathological analysis verified MTS in 8 (32%) of 25 specimens. Six MRI features of MTS were specifically evaluated: 1) increased hippocampal signal intensity, 2) reduced hippocampal size, 3) atrophy of the ipsilateral hippocampal collateral white matter, 4) enlarged ipsilateral temporal horn, 5) reduced gray-white matter demarcation in the temporal lobe, and 6) decreased temporal lobe size. The most prevalent feature of MTS identified on MRI was a reduced hippocampal size, found in 11 of the MRI studies (44%). Analysis revealed moderate interrater agreement for MRI identification of MTS between the 2 blinded neuroradiologists and the nonblinded preoperative report (Cohen κ 0.40–0.59). Interrater agreement was highly variable for different MTS features indicative of MTS, ranging from poor to near perfect. Agreement was highest for increased hippocampal signal and decreased temporal lobe size and was consistently poor for reduced gray-white matter demarcation. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and proportion perfect agreement were highest for increased hippocampal signal and reduced hippocampal size. An MRI finding of MTS was not predictive of seizure outcome in this small series. Conclusions Mesial temporal sclerosis identification on brain MRI in children evaluated for medial temporal resections has a PPV of 55%–67% and an NPV of 79%–87%. Increased hippocampal signal and reduced hippocampal size were associated with high predictive values, while gray-white differentiation and an enlarged temporal horn were not predictive of MTS. Seizure outcome following medial temporal resections was not associated with MRI findings of MTS or MRI abnormalities indicative of MTS in this small sample size.
    Type of Medium: Online Resource
    ISSN: 1933-0707 , 1933-0715
    URL: Article
    DOI: 10.3171/2012.1.PEDS11447
    RVK:
    XA 55270.2
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2012
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  • 7
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    Online Resource
    Inter‐rater Reliability of Three Musculoskeletal Physical Examination Techniques Used to Assess Motion in Three Planes While Standing
    Wiley ; 2009
    In:  PM&R Vol. 1, No. 7 ( 2009-07), p. 629-635
    Details
    In: PM&R, Wiley, Vol. 1, No. 7 ( 2009-07), p. 629-635
    Abstract: The objective of the study was to measure the reliability between examiners of 3 basic maneuvers of the Total Body Functional Profile physical examination test. The hypothesis was musculoskeletal health care providers of different disciplines could reliably use the 3 basic maneuvers as part of the musculoskeletal physical examination. Design A prospective observational study was conducted. Twenty‐eight adult volunteers were measured on both the left and right side by 2 independent raters on a single occasion. Setting The subjects were recruited through advertisements placed by the orthopedic department at a tertiary university. Participants Twenty‐eight volunteers were recruited and completed the study. The volunteers were between the ages of 18 and 51 years of age, had no symptoms in the lower extremity or spine, had no previous history of surgery or tumor involving the lower extremity, and no medical conditions that would preclude participation. Methods On a single occasion, 2 examiners per 1 volunteer were blinded to their own and each others' measurements. Each examiner assessed the distance of frontal and sagittal plane lunge and angle of motion for transverse plane testing. Main Outcome Measurements Inter‐rater agreement is expressed with intraclass correlation coefficients (ICCs) and corresponding 95% confidence intervals (CIs). The difference between raters is reported with 95% CIs. Baseline demographics, University of California Los Angeles (UCLA), and Harris hip questionnaires were completed by all participants. Results The UCLA and Harris hip scores showed no significant activity restrictions or pain limitations in all participants. The inter‐rater reliability for sagittal, frontal, and transverse plane matrix testing was good with ICCs of 0.86 (95% CI 0.77‐0.91), 0.90 (95% CI 0.84‐0.94), and 0.85 (95% CI 0.75‐0.91), respectively. The rater reliability between disciplines for transverse, sagittal, and frontal plane matrix testing was good with ICCs of 0.89 (95% CI 0.80‐0.94), 0.88 (95% CI 0.79‐0.94), and 0.90 (95% CI 0.81‐0.95), respectively. Conclusions The inter‐rater reliability for 3 basic maneuvers of the Total Body Functional Profile is good among musculoskeletal health care providers of different disciplines. These 3 maneuvers may be used consistently as part of the musculoskeletal physical examination.
    Type of Medium: Online Resource
    ISSN: 1934-1482 , 1934-1563
    URL: Article
    DOI: 10.1016/j.pmrj.2009.05.003
    Language: English
    Publisher: Wiley
    Publication Date: 2009
    detail.hit.zdb_id: 2480906-8
    SSG: 31
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  • 8
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    Online Resource
    Calorie restriction or exercise: effects on coronary heart disease risk factors. A randomized, controlled trial
    American Physiological Society ; 2007
    In:  American Journal of Physiology-Endocrinology and Metabolism Vol. 293, No. 1 ( 2007-07), p. E197-E202
    Details
    In: American Journal of Physiology-Endocrinology and Metabolism, American Physiological Society, Vol. 293, No. 1 ( 2007-07), p. E197-E202
    Abstract: Coronary heart disease (CHD) risk factors and the risk of CHD increase with increased adiposity. Fat loss induced by negative energy balance improves all metabolic CHD risk factors. To determine whether fat loss induced by long-term calorie restriction (CR) or increased energy expenditure induced by exercise (EX) has different effects on CHD risk factors in nonobese subjects, we conducted a 1-yr controlled trial involving 48 nonobese subjects who were randomly assigned to one of three groups: CR, 20% CR diet ( n = 18); EX, 20% increase in energy expenditure through daily exercise with no increase in energy intake ( n = 18); or HL, healthy lifestyle guidelines ( n = 10). Subjects were 29 women and 17 men aged 57 ± 3 yr, with BMI 27.3 ± 2.0 kg/m 2 . Assessments included total body fat by DEXA, lipoproteins, blood pressure, HOMA-IR, C-reactive protein (CRP), and estimated 10-yr CHD risk score. Body fat decreased by 6.3 ± 3.8 kg in CR, 5.6 ± 4.4 kg in EX, and 0.4 ± 1.7 kg in HL, which corresponded to reductions of 24.9, 22.3, and 1.2% of baseline body fat mass, respectively. These CR- and EX-induced energy deficits were accompanied by reductions in most of the major CHD risk factors, including plasma LDL-cholesterol, total cholesterol/HDL ratio, HOMA-IR index, and CRP concentrations that were similar in the two intervention groups. Data from the present study provide evidence that CR- and EX-induced negative energy balance result in substantial and similar improvements in the major risk factors for CHD in normal-weight and overweight middle-aged adults.
    Type of Medium: Online Resource
    ISSN: 0193-1849 , 1522-1555
    URL: Article
    DOI: 10.1152/ajpendo.00102.2007
    Language: English
    Publisher: American Physiological Society
    Publication Date: 2007
    detail.hit.zdb_id: 1477331-4
    SSG: 12
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  • 9
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    Online Resource
    Elbow Range of Motion in Professional Baseball Pitchers
    SAGE Publications ; 2006
    In:  The American Journal of Sports Medicine Vol. 34, No. 2 ( 2006-02), p. 190-193
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 34, No. 2 ( 2006-02), p. 190-193
    Abstract: Physicians involved with the care of baseball players have noted elbow range of motion changes in pitchers. Objective data regarding the extent of these changes have rarely been documented. Hypothesis Dominant and nondominant elbow range of motion differences are common in baseball pitchers, and these differences are related to player age, amount and length of time professionally pitched, and history of surgical procedures on the dominant extremity. Study Design Cross-sectional study; Level of evidence, 4. Methods Thirty-three professional pitchers were evaluated for elbow range of motion during spring training preseason physical examination. Dominant and nondominant elbow range of motion including flexion, extension, supination, and pronation were measured with a goniometer. Range of motion measures from the dominant and nondominant sides were compared. Baseball records were reviewed for arm dominance, age, years of professional pitching, professional innings pitched, and history of elbow surgery. These factors were evaluated for their possible association with range of motion for each side and the difference between sides. Results Statistically significant differences between dominant and nondominant sides were noted for elbow extension (dominant decreased 7.9° ± 7.4°, P 〈 . 0001), flexion (dominant decreased 5.5° ± 7.8°, P =. 0003), and total flexion-extension arc (dominant decreased 13.3° ± 13.7°, P 〈 . 0001). No significant difference between sides was found for the supination or pronation measures. No correlation was noted for age, pitching history, surgery, or arm dominance and the motion differences. Conclusion Professional pitchers demonstrate elbow flexion and extension differences between dominant and nondominant elbows. No correlation was found between motion differences and age, pitching history, surgery, or arm dominance.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546505279921
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2006
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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  • 10
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    Online Resource
    Factors Affecting Healing Rates after Arthroscopic Double-Row Rotator Cuff Repair
    SAGE Publications ; 2010
    In:  The American Journal of Sports Medicine Vol. 38, No. 12 ( 2010-12), p. 2435-2442
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 38, No. 12 ( 2010-12), p. 2435-2442
    Abstract: Double-row arthroscopic rotator cuff repairs were developed to improve initial biomechanical strength of repairs to improve healing rates. Despite biomechanical improvements, failure of healing remains a clinical problem. Purpose To evaluate the anatomical results after double-row arthroscopic rotator cuff repair with ultrasound to determine postoperative repair integrity and the effect of various factors on tendon healing. Study Design Case series; Level of evidence, 4. Methods Forty-eight patients (49 shoulders) who had a complete arthroscopic rotator cuff repair (double-row technique) were evaluated with ultrasound at a minimum of 6 months after surgery. Outcome was evaluated at a minimum of 1-year follow-up with standardized history and physical examination, visual analog scale for pain, active forward elevation, and preoperative and postoperative shoulder scores according to the system of the American Shoulder and Elbow Surgeons and the Simple Shoulder Test. Quantitative strength was measured postoperatively. Results Ultrasound and physical examinations were performed at a minimum of 6 months after surgery (mean, 16 months; range, 6 to 36 months) and outcome questionnaire evaluations at a minimum of 12 months after surgery (mean, 29 months; range, 12 to 55 months). Of 49 repairs, 25 (51%) were healed. Healing rates were 67% in single-tendon tears (16 of 24 shoulders) and 36% in multitendon tears (9 of 25 shoulders). Older age and longer duration of follow-up were correlated with poorer tendon healing (P 〈 .03). Visual analog scale for pain, active forward elevation, American Shoulder and Elbow Surgeons scores, and Simple Shoulder Test scores all had significant improvement from baseline after repair (P 〈 .0001). Conclusion Increased age and longer duration of follow-up were associated with lower healing rates after double-row rotator cuff repair. The biological limitation at the repair site, as reflected by the effects of age on healing, appears to be the most important factor influencing tendon healing, even after maximizing repair biomechanical strength with a double-row construct.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546510382835
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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