scholarly journals The Chile Biliary Longitudinal Study: A Gallstone Cohort

Author(s):  
Jill Koshiol ◽  
Vanessa Van De Wyngard ◽  
Emma E McGee ◽  
Paz Cook ◽  
Ruth M Pfeiffer ◽  
...  

Abstract Gallbladder cancer (GBC) is a highly fatal cancer that can be cured through cholecystectomy if identified early. The presence of gallstones is the primary risk factor for GBC, but few people with gallstones develop GBC. A key question is what drives the development of GBC among persons with gallstones. We initiated the Chile Biliary Longitudinal Study (Chile BiLS) to address this question. From 2016 to 2019, Chile BiLS enrolled 4,726 women aged 50–74 years with ultrasound-detected gallstones from southern-central Chile, accounting for an estimated 36% of eligible women with gallstones in the study area. The median age was 59 years; 25% of the women were Amerindian (Mapuche), 60% were obese, 25% had diabetes, and 6% had cardiovascular disease. Participants will be followed for gallbladder dysplasia or cancer for 6 years. As of April 30, 2020, over 91% of those eligible completed the year 2 follow-up visit. Data being collected include epidemiologic and sociodemographic information, anthropometric measurements, blood pressure, and tooth counts. Biosamples being taken include baseline plasma, buffy coat, red blood cells, serum, blood clot from serum, and PAXgene whole blood (PreAnalytiX GmbH, Hombrechtikon, Switzerland). Complete gallbladder sampling is conducted for most participants undergoing cholecystectomy. The Chile BiLS cohort study will increase our understanding of GBC etiology and could identify potential risk stratification and early detection strategies in high-risk areas.

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Seán Fitzgerald ◽  
Daying Dai ◽  
Andrew S Douglas ◽  
Oana M Mereuta ◽  
Thomas Caracena ◽  
...  

Introduction: Previous studies have successfully created blood clot analogues for In-vitro testing using animal blood. Blood components vary greatly among species and thus, creating clot analogues with human blood is likely a more accurate representation of thrombi formed in the human vasculature. We present a novel method of creating clot analogues from human blood and platelets that mimic the process by which clots form In-vivo . Methods: Following IRB approval from Mayo Clinic, human whole blood and platelets donations were obtained from the Blood Transfusion service. The whole blood was centrifuged at 1,200RPM for 20 minutes to separate it into its constituents. Plasma was removed and the remaining Red Blood Cells and Buffy Coat were mixed together by inverting. A total of 12 clot analogues were created with varying concentrations of components; Red Blood cells/Buffy Coat, Plasma and Platelets. Thrombin was added first to stimulate platelets activation for a total of 5 mins whilst continuously mixing by inversion. The RBC/WBC mixture was added next followed by CaCl2. The mixture was then quickly drawn into a 3cc syringe and spun overnight at 20RPM at room temperature to mimic dynamic flow conditions. Macro-photographs were taken to display the variation in texture and color between different clot analogue types. The clots were then fixed in 10% neutral buffered formalin for 24 hours prior to being processed. Histopathological analysis was performed using Hematoxylin and Eosin (H&E) and Martius Scarlet Blue (MSB) staining to confirm clot composition. Results: Red Blood cell-rich, Fibrin-rich, Platelet-rich and mixed clot analogues that accurately mimic clots retrieved from Acute Ischemic Stroke Patients were created. The range of histopathological compositions of the clot analogues is similar to that of the clinical samples. Conclusions: The addition and activation of platelets is key to creating accurate clot analogues for In-vitro testing. Spinning the clots is important to prevent natural sedimentation and mimic the In-vivo situation.


2020 ◽  
Author(s):  
Wan-Jun Guo ◽  
Xia Yang ◽  
Yu-Jie Tao ◽  
Ya-Jing Meng ◽  
Hui-Yao Wang ◽  
...  

BACKGROUND Evidence indicates that Internet addiction (IA) is associated with depression, but longitudinal studies have rarely been reported, and no studies have yet investigated potential common vulnerability or a possible specific causal relationship between these disorders. OBJECTIVE To overcome these gaps, the present 12-month longitudinal study based on a large-sample employed a cross-lagged panel model (CLPM) approach to investigate the potential common vulnerability and specific cross-causal relationships between IA and CSD (or depression). METHODS IA and clinically-significant depression (CSD) among 12 043 undergraduates were surveyed at baseline (as freshmen) and in follow-up after 12 months (as sophomores). Application of CLPM revealed two well-fitted design between IA and CSD, and between severities of IA and depression, adjusting for demographics. RESULTS Rates of baseline IA and CSD were 5.47% and 3.85%, respectively; increasing to 9.47% and 5.58%, respectively at follow-up. Among those with baseline IA and CSD, 44.61% and 34.48% remained stable at the time of the follow-up survey, respectively. Rates of new-incidences of IA and CSD over 12 months were 7.43% and 4.47%, respectively. Application of a cross-lagged panel model approach (CLPM, a discrete time structural equation model used primarily to assess causal relationships in real-world settings) revealed two well-fitted design between IA and CSD, and between severities of IA and depression, adjusting for demographics. Models revealed that baseline CSD (or depression severity) had a significant net-predictive effect on follow-up IA (or IA severity), and baseline IA (or IA severity) had a significant net-predictive effect on follow-up CSD (or depression severity). CONCLUSIONS These correlational patterns using a CLPM indicate that both common vulnerability and bidirectional specific cross-causal effects between them may contribute to the association between IA and depression. As the path coefficients of the net-cross-predictive effects were significantly smaller than those of baseline to follow-up cross-section associations, vulnerability may play a more significant role than bidirectional-causal effects. CLINICALTRIAL Ethics Committee of West China Hospital, Sichuan University (NO. 2016-171)


2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lars Lind ◽  
Johan Sundström ◽  
Johan Ärnlöv ◽  
Ulf Risérus ◽  
Erik Lampa

AbstractThe impact of most, but not all, cardiovascular risk factors decline by age. We investigated how the metabolic syndrome (MetS) was related to cardiovascular disease (CVD) during 40 years follow-up in the Uppsala Longitudinal Study of Adult Men (ULSAM, 2,123 men all aged 50 at baseline with reinvestigations at age 60, 70, 77 and 82). The strength of MetS as a risk factor of incident combined end-point of three outcomes (CVD) declined with ageing, as well as for myocardial infarction, ischemic stroke and heart failure when analysed separately. For CVD, the risk ratio declined from 2.77 (95% CI 1.90–4.05) at age 50 to 1.30 (95% CI 1.05–1.60) at age 82. In conclusion, the strength of MetS as a risk factor of incident CVD declined with age. Since MetS was significantly related to incident CVD also at old age, our findings suggest that the occurrence of MetS in the elderly should not be regarded as innocent. However, since our data were derived in an observational study, any impact of MetS in the elderly needs to be verified in a randomized clinical intervention trial.


Author(s):  
Rebecca Bendayan ◽  
Yajing Zhu ◽  
A D Federman ◽  
R J B Dobson

Abstract Background We aimed to examine the multimorbidity patterns within a representative sample of UK older adults and their association with concurrent and subsequent memory. Methods Our sample consisted of 11,449 respondents (mean age at baseline was 65.02) from the English Longitudinal Study of Ageing (ELSA). We used fourteen health conditions and immediate and delayed recall scores (IMRC and DLRC) over 7 waves (14 years of follow up). Latent class analyses were performed to identify the multimorbidity patterns and linear mixed models were estimated to explore their association with their memory trajectories. Models were adjusted by socio-demographics, BMI and health behaviors. Results Results showed 8 classes: Class 1:Heart Disease/Stroke (26%), Class 2:Asthma/Lung Disease (16%), Class 3:Arthritis/Hypertension (13%), Class 4:Depression/Arthritis (12%), Class 5:Hypertension/Cataracts/Diabetes (10%), Class 6:Psychiatric Problems/Depression (10%), Class 7:Cancer (7%) and Class 8:Arthritis/Cataracts (6%). At baseline, Class 4 was found to have lower IMRC and DLRC scores and Class 5 in DLRC, compared to the no multimorbidity group (n=6380, 55.72% of total cohort). For both tasks, in unadjusted models, we found an accelerated decline in Classes 1, 3 and 8; and, for DLRC, also in Classes 2 and 5. However, it was fully attenuated after adjustments. Conclusions These findings suggest that individuals with certain combinations of health conditions are more likely to have lower levels of memory compared those with no multimorbidity and their memory scores tend to differ between combinations. Socio-demographics and health behaviours have a key role to understand who is more likely to be at risk of an accelerated decline.


2021 ◽  
pp. 1-10
Author(s):  
Che-Chia Chang ◽  
Chi-Shin Wu ◽  
Han-Yun Tseng ◽  
Chun-Yi Lee ◽  
I-Chien Wu ◽  
...  

ABSTRACT Objectives: To estimate the risks of depressive symptoms for developing frailty, accounting for baseline robust or pre-frailty status. Design: An incident cohort study design. Setting: Community dwellers aged 55 years and above from urban and rural areas in seven regions in Taiwan. Participants: A total of 2,717 participants from the Healthy Aging Longitudinal Study in Taiwan (HALST) were included. Subjects with frailty at baseline were excluded. The average follow-up period was 5.9 years. Measurements: Depressive symptoms were measured by the 20-item Center for Epidemiological Studies Depression (CES-D) Scale. Frailty was assessed using the Fried frailty measurement. Participants were stratified by baseline robust or pre-frailty status to reduce the confounding effects of the shared criteria between depressive symptoms and frailty. Overall and stratified survival analyses were conducted to assess risks of developing frailty as a result of baseline depressive symptoms. Results: One hundred individuals (3.7%) had depressive symptoms at baseline. Twenty-seven individuals (27.0%) with depressive symptoms developed frailty, whereas only 305 out of the 2,617 participants (11.7%) without depressive symptoms developed frailty during the follow-up period. After adjusting for covariates, depressive symptoms were associated with a 2.6-fold (95% CI 1.6, 4.2) increased hazard of incident frailty. The patterns of increased hazard were also observed when further stratified by baseline robust or pre-frailty status. Conclusions: Depressive symptoms increased the risk of developing frailty among the older Asian population. The impact of late-life depressive symptoms on physical health was notable. These findings also replicated results from Western populations. Future policies on geriatric public health need to focus more on treatment and intervention against geriatric depressive symptoms to prevent incident frailty among older population.


2015 ◽  
Vol 12 (7) ◽  
pp. 909-914 ◽  
Author(s):  
Jasper Schipperijn ◽  
Mathias Ried-Larsen ◽  
Merete S. Nielsen ◽  
Anneli F. Holdt ◽  
Anders Grøntved ◽  
...  

Background:This longitudinal study aimed to examine if a Movability Index (MI), based on objectively measured built environment characteristics, was a determinant for objectively measured physical activity (PA) among young adults.Methods:Data collected from 177 persons participating in the Danish part of the European Youth Hearth Study (EYHS) was used to examine the effect of the built environment on PA. A MI was developed using objectively measured built environment characteristics, and included residential density, recreational facilities, daily destinations and street connectivity.Results:Results showed a positive cross-sectional association between MI and PA. PA decreased from baseline to follow-up. MI increased, primarily due to participants relocating to larger cities. An increase in MI from baseline to follow-up was associated with a reduced decrease in PA for females.Conclusions:Our findings suggest that the built environment is a determinant for PA, especially for females. The found gender differences might suggest the need to develop gender specific environmental indices in future studies. The validity of the measures can be further improved by creating domain specific PA measures as well as domain specific environmental indices and this can potentially reveal more specific built environment determinants for PA.


BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016358 ◽  
Author(s):  
Nafeesa N Dhalwani ◽  
Radia Fahami ◽  
Harini Sathanapally ◽  
Sam Seidu ◽  
Melanie J Davies ◽  
...  

ObjectivesAssess the longitudinal association between polypharmacy and falls and examine the differences in this association by different thresholds for polypharmacy definitions in a nationally representative sample of adults aged over 60 years from England.DesignLongitudinal cohort study.SettingThe English Longitudinal Study of Ageing waves 6 and 7.Participants5213 adults aged 60 or older.Main outcome measuresRates, incidence rate ratio (IRR) and 95% CI for falls in people with and without polypharmacy.ResultsA total of 5213 participants contributed 10 502 person-years of follow-up, with a median follow-up of 2.02 years (IQR 1.9–2.1 years). Of the 1611 participants with polypharmacy, 569 reported at least one fall within the past 2 years (rate: 175 per 1000 person-years, 95% CI 161 to 190), and of the 3602 participants without polypharmacy 875 reported at least one fall (rate: 121 per 1000 person-years, 95% CI 113 to 129). The rate of falls was 21% higher in people with polypharmacy compared with people without polypharmacy (adjusted IRR 1.21, 95% CI 1.11 to 1.31). Using ≥4 drugs threshold the rate of falls was 18% higher in people with polypharmacy compared with people without (adjusted IRR 1.18, 95% CI 1.08 to 1.28), whereas using ≥10 drugs threshold polypharmacy was associated with a 50% higher rate of falls (adjusted IRR 1.50, 95% CI 1.34 to 1.67).ConclusionsWe found almost one-third of the total population using five or more drugs, which was significantly associated with 21% increased rate of falls over a 2-year period. Further exploration of the effects of these complex drug combinations in the real world with a detailed standardised assessment of polypharmacy is greatly required along with pragmatic studies in primary care, which will help inform whether the threshold for a detailed medication review should be lowered.


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