151 results match your criteria: "Geriatric Research Education and Clinical Centers[Affiliation]"

Background: Cardiovascular disease (CVD) remains a leading cause of death for women in the United States, with veterans being at potentially higher risk than their nonveteran counterparts due to accelerated aging and distinct biopsychosocial mechanisms. We examined pathways between selected indicators of socioeconomic status (SES) such as education, occupation, household income, and neighborhood SES and major CVD events through lifestyle and health characteristics among veteran and nonveteran postmenopausal women.

Methods And Results: A total of 121 286 study-eligible WHI (Women's Health Initiative) participants (3091 veterans and 118 195 nonveterans) were prospectively followed for an average of 17 years, during which 16 108 major CVD events were documented.

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Smoking Assessment by Visit Modality Among Community-based Primary Care Clinics.

Am J Prev Med

December 2024

Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Geriatric Research Education and Clinical Centers, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee.

Introduction: Primary care delivery in the United States, including tobacco treatment, was negatively impacted by the COVID-19 public health emergency, leading to pandemic-related cessation disparities. Early in the public health emergency, rates of tobacco assessment during telehealth visits were substantially lower than during in-person visits. It is unknown if these changes persisted.

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Article Synopsis
  • The study examined how physical activity measurement methods (self-reported vs. accelerometer) impact the association between the American Heart Association's Life's Essential 8 (LE8) scores and cardiovascular disease (CVD) risk in older women.
  • A total of 4,243 participants with no prior CVD were analyzed over an average of 7.5 years, revealing 707 new CVD events during the study period, which demonstrated a lower risk of CVD with higher LE8 scores regardless of measurement method.
  • Results suggested that while accelerometer data may provide a more accurate assessment of physical activity for LE8 evaluation, self-reported measures can still be useful when accelerometers are not feasible.
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Targeting vascular senescence in cardiovascular disease with aging.

J Cardiovasc Aging

April 2024

Department of Nutrition and Integrated Physiology, University of Utah, Salt Lake City, UT 84112, USA.

Aging is a major risk factor for atherosclerosis and cardiovascular disease (CVD). Two major age-associated arterial phenotypes, endothelial dysfunction and large elastic arterial stiffness, are autonomous predictors of future CVD diagnosis and contribute to the progression of CVD in older adults. Senescent cells lose the capacity to proliferate but remain metabolically active and secrete inflammatory factors termed senescence-associated secretory phenotype (SASP), leading to an increase in inflammation and oxidative stress.

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Association between Smoking Abstinence and Depression and Anxiety Symptoms After Hospital Discharge: The Helping HAND 4 Trial.

J Addict Med

August 2024

From the Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston, MA (CSN, NAR, YC, DEL, JMS); Harvard Medical School, Boston, MA (NAR, YC, DEL, JMS); Harvard T.H. Chan School of Public Health, Boston, MA (CSN); National Jewish Health, Denver, CO (TY); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (SL, HAT); and Geriatric Research Education and Clinical Centers, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN (HAT).

Objectives: Some people who stop smoking experience improved mood, but few studies have examined this relationship after hospitalization or accounted for concomitant substance use and psychological factors. We examined associations between smoking abstinence after a hospital discharge and change in depression and anxiety symptoms.

Methods: We conducted a secondary analysis of data from the Helping HAND 4 smoking cessation trial, which enrolled people who used tobacco when admitted to three academic medical center general hospitals.

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Article Synopsis
  • The study investigates the potential of e-cigarettes (ECs) to aid pregnant smokers in quitting combustible cigarettes (CCs) and evaluates the characteristics of users who switch to ECs.
  • Approximately 1.5% of pregnant smokers reported using ECs, with around 29.7% of them becoming exclusive EC users; EC initiators tended to have lower socioeconomic status and less access to prenatal care.
  • Findings suggest that while some pregnant smokers who switch to ECs may reduce their CC usage, there is no evidence that this leads to significant health benefits for neonates, indicating that ECs may not be an effective strategy for smoking cessation during pregnancy.
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Importance: Identifying factors contributing to sustained physical functioning is critical for the health and well-being of the aging population, especially as physical functioning may precede and predict subsequent health outcomes. Prior work suggests optimism may protect health, but less is known about the association between optimism and objective physical functioning measures as individuals age.

Objective: To evaluate the longitudinal association between optimism and 3 physical functioning measures.

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Background: The feasibility of precision smoking treatment in socioeconomically disadvantaged communities has not been studied.

Methods: Participants in the Southern Community Cohort Study who smoked daily were invited to join a pilot randomized controlled trial of three smoking cessation interventions: guideline-based care (GBC), GBC plus nicotine metabolism-informed care (MIC), and GBC plus counseling guided by a polygenic risk score (PRS) for lung cancer. Feasibility was assessed by rates of study enrollment, engagement, and retention, targeting > 70% for each.

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Background: Lung cancer risk attributable to smoking is dose dependent, yet few studies examining a polygenic risk score (PRS) by smoking interaction have included comprehensive lifetime pack-years smoked.

Methods: We analyzed data from participants of European ancestry in the Framingham Heart Study Original (n = 454) and Offspring (n = 2,470) cohorts enrolled in 1954 and 1971, respectively, and followed through 2018. We built a PRS for lung cancer using participant genotyping data and genome-wide association study summary statistics from a recent study in the OncoArray Consortium.

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Newborn metabolite perturbations may identify potential biomarkers or mechanisms underlying adverse, smoking-related childhood health outcomes. We assessed associations between third-trimester smoking and newborn metabolite concentrations using the Tennessee Pregnancy Risk Assessment Monitoring System (PRAMS, 2009-2019) as the discovery cohort and INSPIRE (2012-2014) as the replication cohort. Children were linked to newborn screening metabolic data (33 metabolites).

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Anatomical segmentations generated using artificial intelligence (AI) have the potential to significantly improve video fluoroscopic swallow study (VFS) analysis. AI segments allow for various metrics to be determined without additional time constraints streamlining and creating new opportunities for analysis. While the opportunity is vast, it is important to understand the challenges and limitations of the underlying AI task.

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Background: Research on health effects and potential harms of electronic cigarette (EC) use during pregnancy is limited. We sought to determine the risks of pregnancy EC use on pregnancy-related adverse birth outcomes and assess whether quitting ECs reduces the risks.

Methods: Women with singleton live births who participated in the US Pregnancy Risk Assessment Monitoring System (PRAMS) survey study 2016-2020 were classified into four mutually exclusive groups, by their use of ECs and combustible cigarettes (CCs) during pregnancy: non-use, EC only use, CC only use, and dual use.

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Positive affect and emotional resources, such as optimism, may play a major role in women's health and promote healthy well-being later in life. However, positive affect and optimism measures have not been psychometrically assessed in older women, despite relations to health. Therefore, the objective of this study was to psychometrically assess measures of positive affect and optimism and test their association with other measures of well-being.

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Article Synopsis
  • Heavy drinking, smoking, and depression are common among women with HIV, but the long-term effects of having multiple conditions at once on mortality are not well understood.
  • This study analyzed data from over 3,000 women with HIV to investigate the relationship between these conditions and mortality risks, finding that nearly 17% had two or more conditions.
  • Women with multiple risk factors had a significantly higher all-cause mortality risk (almost 4 times greater compared to those with none), highlighting the necessity for coordinated treatment and screening for these interconnected health issues.*
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Article Synopsis
  • The study aims to identify clinical markers and therapeutic targets that can predict survival in patients with pulmonary hypertension (PH) using data from U.S. Veterans Affairs and Vanderbilt University, focusing on those with elevated mean pulmonary artery pressure (mPAP).
  • Analysis of 4,737 patients revealed 21 distinct subgroups based on pulmonary arterial compliance (PAC), with higher PAC levels correlating with better survival rates, especially in patients with precapillary PH.
  • The findings suggest that maintaining PAC levels at or above 3.0 ml/mm Hg is associated with significantly improved survival rates in both discovery and validation cohorts, indicating its potential as a critical biomarker in managing PH.
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Tobacco-Related Disease, Health Beliefs, and Post-hospital Tobacco Abstinence.

Am J Prev Med

November 2023

Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Tobacco Research & Treatment Center, Massachusetts General Hospital, Boston, Massachusetts; Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts.

Introduction: Most hospitalized patients who smoke resume after discharge. Associations of tobacco-related disease and health beliefs with post-hospitalization abstinence were examined.

Methods: This was a cohort study using data from a 2018-2020 multicenter trial of hospitalized adults who smoked and wanted to quit.

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This review summarizes the evidence to date on the development of biomarkers for personalizing the pharmacological treatment of combustible tobacco use. First, the latest evidence on FDA-approved medications is considered, demonstrating that, while these medications offer real benefits, they do not contribute to smoking cessation in approximately two-thirds of cases. Second, the case for using biomarkers to guide tobacco treatment is made based on the potential to increase medication effectiveness and uptake and reduce side effects.

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Ethylnitrosourea-induced gliomas: a song in the attic?

Aging Pathobiol Ther

June 2023

Barshop Institute for Longevity and Aging Studies and Department of Pathology, The University of Texas Health Science Center at San Antonio; Geriatric Research Education and Clinical Centers (GRECC), Audie L. Murphy VA Hospital (STVHCS), San Antonio, TX 78229, USA.

It is essential to seek the underlying molecular mechanisms of glioma development, and critical to discover interventions that reduce the incidence and attenuate the growth of gliomas using a well-established experimental model because glioma is clinically one of the most difficult malignant tumors to treat. Ethylnitrosourea (ENU)-induced glioma in the rat has been extensively utilized as an experimental brain tumor model since the mid-1960s, however, the scientific value of ENU-induced glioma has been underappreciated mainly due to the recent development of transgenic mouse glioma models. Because of the pathophysiological characteristics, which are similar to the high grade human malignant gliomas, ENU-induced glioma is an excellent model to: a) examine the cell origin, development, and pathophysiology of gliomas; b) investigate anti-tumor effects of calorie restriction (CR) and its underlying mechanisms; and c) discover new preventive and/or therapeutic interventions of glioma.

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Purpose: Quitting smoking improves patients' clinical outcomes, yet smoking is not commonly addressed as part of cancer care. The Cancer Center Cessation Initiative (C3I) supports National Cancer Institute-designated cancer centers to integrate tobacco treatment programs (TTPs) into routine cancer care. C3I centers vary in size, implementation strategies used, and treatment approaches.

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A CHCHD6-APP axis connects amyloid and mitochondrial pathology in Alzheimer's disease.

Acta Neuropathol

November 2022

Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, 10900 Euclid Ave, E516, Cleveland, OH, 44106-4970, USA.

The mechanistic relationship between amyloid-beta precursor protein (APP) processing and mitochondrial dysfunction in Alzheimer's disease (AD) has long eluded the field. Here, we report that coiled-coil-helix-coiled-coil-helix domain containing 6 (CHCHD6), a core protein of the mammalian mitochondrial contact site and cristae organizing system, mechanistically connects these AD features through a circular feedback loop that lowers CHCHD6 and raises APP processing. In cellular and animal AD models and human AD brains, the APP intracellular domain fragment inhibits CHCHD6 transcription by binding its promoter.

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Assessment of safety and effectiveness of non-neurosurgical management for minimal traumatic brain injury (TBI).

Injury

January 2023

Vanderbilt University School of Medicine, Nashville, TN, United States; Department of Neurological Surgery, Vanderbilt University Medical Center, Section of Surgical Sciences, Nashville, TN United States; Division of Acute Care Surgery, Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN United States; Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, United States. Electronic address:

Background: Patients with mild traumatic brain injury (TBI) and intracranial hemorrhage often receive neurosurgical consultation. However, only a small proportion of patients require intervention. Our hypothesis is that low-risk minimal TBI patients managed without immediate neurosurgical consultation will have a reasonable safety and effectiveness outcome profile.

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Importance: Smoking cessation interventions for hospitalized patients must continue after discharge to improve long-term tobacco abstinence. How health systems can best deliver postdischarge tobacco treatment is uncertain.

Objective: To determine if health system-based tobacco cessation treatment after hospital discharge produces more long-term tobacco abstinence than referral to a community-based quitline.

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We developed an endophenotype disease module-based methodology for Alzheimer's disease (AD) drug repurposing and identified sildenafil as a potential disease risk modifier. Based on retrospective case-control pharmacoepidemiologic analyses of insurance claims data for 7.23 million individuals, we found that sildenafil usage was significantly associated with a 69% reduced risk of AD (hazard ratio = 0.

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