scholarly journals B-26 Predictors of Cognitive Decline Over a 2-year Follow up: Olfaction and Scans Without Evidence of Dopaminergic Deficit Status (SWEDD)

2019 ◽  
Vol 34 (6) ◽  
pp. 972-972
Author(s):  
F Lopez ◽  
B Rohl ◽  
A Wagle Shukla ◽  
D Bowers
Keyword(s):  
Cognitive Decline ◽  
Total Sample ◽  
University Of Pennsylvania ◽  
Dopamine Depletion ◽  
High Discriminatory Power ◽  
Progression Markers ◽  
And Gender ◽  
The University ◽  
Study Participants

Abstract Objective Given the high discriminatory power of olfaction assessments in movement disorders, the current study sought to determine whether olfaction dysfunction differentially predicted cognitive decline in patients who have scans without evidence of dopaminergic deficit (SWEDD). Dopamine depletion is a major neuropathological feature of Parkinson’s disease (PD); however, 15% of patients with a clinical PD diagnosis have neuroimaging evidence of intact dopaminergic function. Recent work has suggested that patients with SWEDD are at a greater risk of cognitive impairment relative to those with PD. Methods Archival data were obtained from the Parkinson’s Progression Markers Initiative database. The total sample included three groups: PD (n = 401), SWEDD (n = 51), and HC (n = 175). Participants were categorized into non-impaired (-) or impaired (+) olfaction groups based on performance on the University of Pennsylvania Smell Identification Test, corrected for age and gender. Participants were administered the Montreal Cognitive Assessment twice and change scores were calculated to examine changes in cognition over time (baseline – two-year follow-up). Results A bootstrapped analysis of variance (ANOVA) revealed that the SWEDD+ group had lower MoCA scores than PD+ and HC+ groups at baseline (ps < .05). A bootstrapped ANOVA indicated that group differences were not significant at follow-up; rather, impaired baseline olfaction predicted cognitive decline across all study participants (p < .05), regardless of diagnosis. Conclusions Future studies are needed to assess whether the profile of motor and non-motor symptoms in SWEDD patients, including olfaction, is deserving of its own syndrome, or whether individual patients may fit better under alternative, existing diagnoses.

scholarly journals Self-Efficacy of the University Students’ Toefl Performance: Differences in the Test Skill and English Skills in Toefl

2020 ◽  
Vol 8 (3) ◽  
pp. 497
Author(s):  
Marisa Yoestara ◽  
Zaiyana Putri
Keyword(s):  
University Students ◽  
Self Efficacy ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Total Sample ◽  
P Value ◽  
Significant Difference ◽  
The University ◽  
One Way Anova

This study aimed at reporting differences in terms of the university students’ TOEFL self-efficacy in the test skill and the English skills tested in TOEFL namely listening, structure, and reading. In conducting the study, the explanatory sequential mixed method was used as the study design, where the quantitative data from the survey was conducted first followed by the follow-up interview as the qualitative data. To collect the data in this study, a specifically designed self-efficacy questionnaire of TOEFL was distributed to the total sample of 200 university students across different disciplines from Syiah Kuala University and the University of Serambi Mekkah. The interview was then conducted with 3 selected students to have a deeper understanding of the study result. In terms of the data analysis, one-way ANOVA and t-test were used to describe the quantitative data, while the qualitative data was described and elaborated in words with detailed explanations. The result showed that there was a significant difference among the test skill and the English skills in TOEFL, where F= 13.61 (3, 796), p<0.05. The result also revealed that within the gender, only reading skill had a significant difference, where t198= -2.003, p <. 005, and within the language course participation, all the test skills and TOEFL skills were significantly different as the p-value of each skill was smaller than .005 (p< .005).

scholarly journals SARS-CoV-2 seropositivity and seroconversion in patients undergoing active cancer-directed therapy

2021 ◽  
Author(s):  
Lova Sun ◽  
Sanjna Surya ◽  
Noah G. Goodman ◽  
Anh N. Le ◽  
Gregory Kelly ◽  
...  
Keyword(s):  
Cancer Care ◽  
Negative Impact ◽  
Care Delivery ◽  
Seroconversion Rate ◽  
University Of Pennsylvania ◽  
Blood Draw ◽  
The University ◽  
Initial Blood ◽  
Active Cancer

AbstractMultiple studies have demonstrated the negative impact of cancer care delays during the COVID-19 pandemic, and transmission mitigation techniques are imperative for continued cancer care delivery. To gauge the effectiveness of these measures at the University of Pennsylvania, we conducted a longitudinal study of SARS-CoV-2 antibody seropositivity and seroconversion in patients presenting to infusion centers for cancer-directed therapy between 5/21/2020 and 10/8/2020. Participants completed questionnaires and had up to five serial blood collections. Of 124 enrolled patients, only two (1.6%) had detectable SARS-CoV-2 antibodies on initial blood draw, and no initially seronegative patients developed newly detectable antibodies on subsequent blood draw(s), corresponding to a seroconversion rate of 0% (95%CI 0.0-4.1%) over 14.8 person-years of follow up, with a median of 13 healthcare visits per patient. These results suggest that cancer patients receiving in-person care at a facility with aggressive mitigation efforts have an extremely low likelihood of COVID-19 infection.

scholarly journals Inclusion of sex and gender in biomedical research: survey of clinical research proposed at the University of Pennsylvania

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Anne Freeman ◽  
Patrick Stanko ◽  
Lily N. Berkowitz ◽  
Neanta Parnell ◽  
Anastasia Zuppe ◽  
...  
Keyword(s):  
Clinical Research ◽  
Biomedical Research ◽  
University Of Pennsylvania ◽  
Sex And Gender ◽  
Research Survey ◽  
And Gender ◽  
The University

Head-to-head comparison between decipher and prolaris tests: Two commercially available post-prostatectomy genomic tests.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 348-348
Author(s):  
Mohammed Shahait ◽  
Mohammed Alshalalfa ◽  
Edward M. Schaeffer ◽  
Huei-Chung Huang ◽  
Andrea Cronican ◽  
...  
Keyword(s):  
High Risk ◽  
Pearson Correlation ◽  
Additional Treatment ◽  
University Of Pennsylvania ◽  
Johns Hopkins University ◽  
Risk Of Progression ◽  
Small Cohort ◽  
Highly Correlated ◽  
The University

348 Background: Several post-prostatectomy genomic tests are available; which are used to improve prognostication and to guide additional treatment after radical prostatectomy (RP). There has been no head to head comparison between these tests. The objective of this study is to compare the performance of two genomic tests in predicting oncological outcomes. Methods: 16 patients who underwent RP at the University of Pennsylvania (UPenn) (2013-2018), had adverse pathology (margin, and/or pT3a/b) and had each been tested with both Decipher (D) and Prolaris (P). Pearson correlation was used to compare scores from D and P as well as CCP scores and microarray derived CCP (mCCP). The associations of D and P with biochemical recurrence (BCR) and metastasis (M) was evaluated in survival analysis in a large cohort of RP patients treated at Johns Hopkins University (1992-2010) (JHU). Results: The median follow-up of the UPenn cohort was 24 months. 6 patients developed BCR and two distant M. There was a significant correlation between the D and P score (r=0.67,p=0.004), and between the 10-year BCR risk reported by P and the 5-year M risk reported by D (r=0.69, p=0.003). Each test called 7 patients to be high risk; 5 were in common. Both tests correctly called the 2 M cases as high risk and 4/6 BCR patients to be high risk. A microarray-derived CCP (mCCP) was highly correlated to the CCP scores reported from P (r=0.88, p=6.7e-6) in the UPenn cohort. To compare the prognostic performance of mCCP to D for predicting BCR and M, we used Post-RP cohort from JHU (N=355). Both scores were correlated (r=0.36, p2e-12). D and mCCP were stratified into 5 groups of incremental 20%. When including mCCP groups, D groups, Gleason score, SVI, EPE, LNI, and PSA; D remained independent prognostic variable of BCR (HR 1.16, 95%CI [1.05-1.3], p=0.005) and M (HR 1.3, 95%CI [1.12-1.52], p=0.0005). However, mCCP was not prognostic of BCR (p=0.59) nor M (p=0.62). Conclusions: The findings from this study show that P and D scores post-RP were highly correlated and help in identifying patients who at high risk of progression in this small cohort with short follow up. However, D outperformed mCCP for predicting BCR and M in larger cohorts with longer follow up.

Electronic Consults in Otolaryngology: A Pilot Study to Evaluate the Use, Content, and Outcomes in an Academic Health System

2019 ◽  
Vol 129 (2) ◽  
pp. 170-174 ◽  
Author(s):  
Sapideh Gilani ◽  
Krishna Bommakanti ◽  
Lawrence Friedman
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Primary Care Physicians ◽  
Multinomial Logistic Regression ◽  
Medical Center ◽  
Office Visits ◽  
Use Of Resources ◽  
And Gender ◽  
The University

Objectives: To categorize the primary reasons for electronic consults (eConsults) to otolaryngology from primary care physicians (PCPs). To determine how many patients avoided subsequent in-person otolaryngology office visits. Methods: This is a retrospective analysis of a pilot study that took place between 2016 and 2017 regarding eConsults to adult otolaryngology placed by primary care physicians at the University of California, San Diego (UCSD) Medical Center. The complaints were categorized as related to the following: ear, nose, throat or neck. Initial recommendations were classified as (1) providing education only (no intervention), (2) suggesting medical therapy provided by the PCP, or (3) suggesting surgical intervention. Univariate statistics and multinomial logistic regression were used to analyze the association of problem type with the need for follow-up in the otolaryngology offices. The data was analyzed for differences in patient age and gender. Results: The study population included 64 patients (average age 54.6 years, 60.9% male). Within this group, 41% of consults were for ear complaints, 15% for nose complaints, 28% had throat-related complaints, and 16% had neck-related complaints. In-person follow-up was not required for 82.8% of the consults. Overall, 76.9% of ear, 100% of nose, 88.9% of throat, and 70.0% of neck complaints did not require in-person visits. Conclusions: eConsults to otolaryngology were primarily for ear concerns. Of the eConsults, 82.4% did not require in-person follow-up. We therefore conclude that the use of eConsults prevented substantial office visits that would not otherwise be necessary. Efforts should be made to promote the widespread use of eConsults, which may to the more efficient use of resources.

scholarly journals COVID-19 Pandemic Impact on Sexually Transmitted Infection Testing in a College Setting

2021 ◽  
Author(s):  
Agustina M Marconi ◽  
Elizabeth C Falk-Hanson ◽  
Megan E Crass ◽  
Peter Campbell
Keyword(s):  
Total Sample ◽  
National Data ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Positive Rate ◽  
College Setting ◽  
The University ◽  
The Impact

Objective: Assess the impact of the pandemic on STI (sexually transmitted infections) testing in a college health setting. Design: Exploratory analysis of the number of STI tests done, positive rates for those tests and of percentage of compliance to follow-up from March to December 2020 and its comparison with historical data at the University Health Services, UW-Madison. Sample: students STI tests during the analyzed period. Measurement: Observed (2020) vs Expected (2015-2019, average) number of STI tests, positive rate, compliance to follow-up testing for STIs. Results: There was a significant decrease in the number of tests done and increase of positive rate when compared to historical for total sample and per sex. There was a decrease in the percentage of follow-up for the entire sample and females and an increase for males. Conclusions: Considering the three outcomes assessed, we observe an impact in STI testing during the pandemic. In concordance with national data, our analysis shows significant declines in STI testing and follow-up during 2020 compared to previous years and an increase in positivity rate. The finding of higher positivity with lower number of tests is likely due to triaging patients, facilitating testing for those at highest risk of infection.

scholarly journals Asymptomatic carriers of the p.A53T SNCA mutation: data from the PPMI study

2021 ◽  
Author(s):  
Athina Maria Simitsi ◽  
Christos Koros ◽  
Maria Stamelou ◽  
Ion Beratis ◽  
Efthymia Efthymiopoulou ◽  
...  
Keyword(s):  
University Of Pennsylvania ◽  
Strong Positive Correlation ◽  
Prodromal Phase ◽  
Asymptomatic Carriers ◽  
Positive Correlation ◽  
Progression Markers ◽  
Olfactory Impairment ◽  
The University ◽  
Non Motor Symptoms ◽  
Smell Identification

AbstractIntroductionThere has been great interest in the prodromal phase of Parkinson’s disease (PD), especially in subjects who are asymptomatic carriers of genetic mutations leading to PD because of the high risk to convert to PD. The objective of the present study was to assess non motor characteristics of asymptomatic p.A53T mutation carriers (A53T-AC) compared with healthy controls (HC).MethodsWe compared 12 A53T-AC with 36 matched HC enrolled into in the Parkinson’s Progression Markers Initiative (PPMI) study. Baseline data extracted from the PPMI database, contained demographics and non-motor symptoms (e.g. the Montreal Cognitive Assessment (MOCA) for cognition, the University of Pennsylvania Smell Identification Test (UPSIT) for olfaction, MDS-UPDRS I etc.)ResultsThe mean UPSIT score was lower in A53T-AC vs HC (p =0.000). MoCA test showed a trend towards lower scores in A53T AC. We found a significant positive correlation between UPSIT score and MOCA in A53T-AC (rs = 0,68, p=0,021) but not in HC. Total scores for MDS-UPDRS I did not differ between the groups but the subscore of anxiety was more prevalent in A53T-AC.ConclusionThe more affected olfaction in A53T-AC may indicate that olfactory function is affected quite early in A53T carriers. The strong positive correlation between UPSIT and MOCA in the A53T-AC group may indicate that cognitive dysfunction and olfactory impairment progress alongside, prior to nigrostriatal degeneration. Anxiety was also more prevalent in A53T-AC and may represent an additional prodromal feature in this group of subjects.

scholarly journals Immunogenicity of Oxford-AstraZeneca COVID-19 Vaccine in Vietnamese Health-Care Workers

2022 ◽  
Author(s):  
Nguyen Van Vinh Chau ◽  
Lam Anh Nguyet ◽  
Nguyen Thanh Truong ◽  
Le Mau Toan ◽  
Nguyen Thanh Dung ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Neutralizing Antibodies ◽  
Seroconversion Rate ◽  
Age And Gender ◽  
Care Workers ◽  
And Gender ◽  
Study Participants ◽  
Age Range

We studied the immunogenicity of the Oxford-AstraZeneca vaccine in health-care workers of a major infectious diseases hospital in Vietnam. We measured neutralizing antibodies before and 14 days after each dose, and at day 28 and month 3 after dose 1. A total of 554 workers (136 men and 418 women; age range, 22–71 years; median age, 36 years) participated with the study. Of the 144 participants selected for follow-up after dose 1, 104 and 94 gave blood for antibody measurement at weeks 6 and 8, and at month 3 after dose 1, respectively. The window time between the two doses was 6 weeks. At baseline, none had detectable neutralizing antibodies. After dose 1, the proportion of participants with detectable neutralizing antibodies increased from 27.3% (151 of 554) at day 14 to 78.0% (432 of 554) at day 28. Age correlated negatively with the development and the levels of neutralizing antibodies. However, at day 28, these differences were less profound, and women had a greater seroconversion rate and greater levels of neutralizing antibodies than men. After dose 2, these age and gender associations were not observable. In addition, the proportion of study participants with detectable neutralizing antibodies increased from 70.2% (73 of 104) before dose 2 (week 6, after dose 1) to 98.1% (102 of 104) 14 days later. At month 3, neutralizing antibodies decreased and 94.7% (89 of 94) of the study participants remained seropositive. The Oxford-AstraZeneca COVID-19 vaccine is immunogenic in Vietnamese health-care workers. These data are critical to informing the deployment of the COVID-19 vaccine in Vietnam and in Southeast Asia, where vaccination coverage remains inadequate.

scholarly journals Short daytime napping reduces the risk of cognitive decline in community-dwelling older adults: a 5-year longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kaori Kitamura ◽  
Yumi Watanabe ◽  
Kazutoshi Nakamura ◽  
Chikako Takano ◽  
Naomi Hayashi ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Multiple Logistic Regression Analysis ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Beneficial Effects ◽  
Daytime Nap ◽  
Study Participants

Abstract Background Beneficial effects of napping on cognition have been suggested in cross-sectional studies. This study aimed to clarify longitudinal associations between cognitive decline and sleep characteristics, particularly daytime napping, over a 5-year period in older adults. Methods Study participants were 389 community-dwelling individuals aged ≥65 years living in Ojiya City, Niigata, Japan. Baseline and follow-up examinations were conducted in 2011–2013 and 2016–2018, respectively. Trained nurses visited and interviewed participants to collect the following information at baseline and follow-up: demographic characteristics, disease history, lifestyle habits including bedtime, sleeping hours, and daytime nap duration, and cognitive function. The assessment of cognitive function was performed using the revised Hasegawa’s dementia scale (HDS-R), with cognitive decline defined as a change in the HDS-R of ≤ − 3 over 5 years. Odds ratios (ORs) for cognitive decline were calculated using multiple logistic regression analysis. Results Mean age of participants was 74.6 years (SD 6.4), and the cumulative incidence of cognitive decline was 106/389 (27.3%). The adjusted OR for 1–29 min daytime napping was significantly lower compared to that for no napping (OR = 0.47, 95%CI: 0.23–0.96). Earlier bedtime was associated with cognitive decline (adjusted P for trend = 0.0480). Conclusion Short daytime napping (< 30 min) reduces the risk of cognitive decline over 5 years for community-dwelling older people. A future study will be necessary to confirm the effect of short napping on the reduction of risk for clinically diagnosed dementia.

Outcomes of advanced HL with ABVD: The University of Pennsylvania experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e18529-e18529
Author(s):  
Meghna S. Trivedi ◽  
David Bajor ◽  
Tahamtan Ahmadi ◽  
Jakub Svoboda ◽  
Alison W. Loren ◽  
...  
Keyword(s):  
Salvage Therapy ◽  
Standard Therapy ◽  
Prognostic Score ◽  
Stage Iv ◽  
Retrospective Chart Review ◽  
Complete Response ◽  
Salvage Chemotherapy ◽  
University Of Pennsylvania ◽  
The University

e18529 Background: Hodgkin Lymphoma (HL) is considered a curable malignancy with standard therapy using the doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) regimen. Even with standard therapy, the relapse rate for patients with advanced HL (stage IIB and higher) remains significant. The International Prognostic Score (IPS) uses 7 adverse prognostic factors (serum albumin, hemoglobin, male sex, age, stage IV disease, leukocytosis, and lymphopenia) to predict outcomes in advanced HL. Methods: We performed a retrospective chart review of all patients evaluated at the University of Pennsylvania for primary HL from July 2006 to June 2011. Of 257 patients, 26 were identified as those with advanced HL who initiated ABVD treatment at the University of Pennsylvania. The study outcomes were defined by RECIST criteria. The 26 patients were stratified by IPS and outcomes were evaluated. Results: 22 of 26 patients (85%) achieved lasting complete response (CR) after receiving treatment with ABVD with a median length of follow-up of 2.93 years. Three patients had primary refractory disease. Of these patients, two (IPS 1-2) achieved CR with salvage therapy. The third patient (IPS 5) had initial partial response (PR) to ABVD then continued to have relapsed disease after 4.50 years of follow-up. One patient (IPS 5) relapsed 2.74 years after receiving ABVD and at best had PR with salvage chemotherapy. Conclusions: ABVD was effective in achieving CR; however, 4 patients were unable to achieve lasting CR from ABVD alone. Two patients with IPS of 1 and 2 eventually achieved CR from salvage therapy. Two patients with IPS of 5 were unable to achieve lasting CR. Based on this data, IPS of 5 was associated with worse outcome. Use of IPS may be helpful to identify patients needing more intensive initial therapies. [Table: see text]

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