1,641 results match your criteria: "West Roxbury; and Harvard Medical School[Affiliation]"

Background: Preventing worsening osteoarthritis (OA) in persons with early OA is a major treatment goal. We evaluated if different early OA definitions yielded enough cases of worsening OA within 2-5 years to make trial testing treatments feasible.

Methods: We assessed different definitions of early OA using data from Multicenter Osteoarthritis (MOST) Study participants who were followed up longitudinally.

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Objective: Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) includes multiple subtypes with varying histopathology, prognosis, and potential treatments. Limited research has investigated risk factors for different RA-ILD subtypes. Therefore, we examined demographic, serologic, and lifestyle associations with RA-ILD subtypes.

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While respiratory diseases such as COPD and asthma share many risk factors, most studies investigate them in insolation and in predominantly European ancestry populations. Here, we conducted the most powerful multi-trait and -ancestry genetic analysis of respiratory diseases and auxiliary traits to date. Our approach improves the power of genetic discovery across traits and ancestries, identifying 44 novel loci associated with lung function in individuals of East Asian ancestry.

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Smoking and 10-year risk of cardiovascular and non-cardiovascular events after contemporary coronary stenting.

Am J Prev Cardiol

September 2024

Veterans Affairs Boston Healthcare System, West Roxbury, MA, USA.

The impact of smoking cessation on long-term clinical outcomes after contemporary percutaneous coronary intervention (PCI) is not well known. We estimated the association of smoking and smoking cessation on the 10-year risk of cardiovascular and non-cardiovascular events in patients after contemporary PCI in a multicenter retrospective cohort of all patients having PCI with second generation drug-eluting stents in the VA Healthcare System between 2008 and 2016. Smoking status, comorbidities and clinical outcomes were extracted from the medical record and the National Death Index.

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SGLT2 Inhibitor and Urinary Tract Infection in Men at Risk for Voiding Dysfunction: A VigiBase Analysis.

Urol Pract

January 2025

Department of Surgery, VA Boston Healthcare System, West Roxbury, Massachusetts.

Article Synopsis
  • The study examined the association between SGLT2 inhibitors and the risk of urinary tract infections (UTIs) in men, focusing on older men at higher risk for voiding issues.
  • Using a global drug safety database (VigiBase), researchers analyzed data from 1967 to 2022, finding significantly elevated risks for both UTIs and complex UTIs among men, especially those aged 65 and older.
  • The findings indicate that while SGLT2 inhibitors are beneficial for diabetes, healthcare providers need to be cautious due to the increased risk of UTIs, particularly in older men who may have existing urinary health issues.
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Protein biomarkers are associated with mortality in cardiovascular disease, but their effect on predicting respiratory and all-cause mortality is not clear. We tested whether a protein risk score (protRS) can improve prediction of all-cause mortality over clinical risk factors in smokers. We utilized smoking-enriched (COPDGene, LSC, SPIROMICS) and general population-based (MESA) cohorts with SomaScan proteomic and mortality data.

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Background: Patients with post-traumatic stress disorder (PTSD) experience higher risk of adverse cardiovascular (CV) outcomes. This study explores shared loci, and genes between PTSD and CV conditions from three major domains: CV diagnoses from electronic health records (CV-EHR), cardiac and aortic imaging, and CV health behaviors defined in Life's Essential 8 (LE8).

Methods: We used genome-wide association study (GWAS) of PTSD (N=1,222,882), 246 CV diagnoses based on EHR data from Million Veteran Program (MVP; N=458,061), UK Biobank (UKBB; N=420,531), 82 cardiac and aortic imaging traits (N=26,893), and GWAS of traits defined in the LE8 (N = 282,271 ~ 1,320,016).

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Article Synopsis
  • Individuals with interstitial lung abnormalities (ILA) may have suspected interstitial lung disease (ILD), which can lead to worse health outcomes and higher mortality rates.
  • A study of 9,588 participants found that 2.8% had prevalent ILD, with a 52% mortality rate after about 10.6 years, significantly higher than those with ILA only (33%).
  • Progression of ILD, particularly the presence of fibrosis and CT changes, was linked to increased mortality, emphasizing the need for careful monitoring of those with suspected ILD.
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Assessment of Chronic Hypercapnic Respiratory Failure.

Sleep Med Clin

September 2024

Division of Pulmonary and Critical Care Medicine, Mayo Clinic Alix School of Medicine, Mayo Clinic Center for Sleep Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905, USA. Electronic address:

Undiagnosed chronic hypercapnic respiratory failure may be encountered during the evaluation of sleep-related breathing disorders at the sleep clinic. This article reviews the mechanism of chronic hypercapnic respiratory failure and the systematic approach to the assessment of specific sleep disorders associated with nocturnal hypoventilation encountered in clinical practice.

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A novel multimodal, intraoperative cognitive workload assessment of cardiac surgery team members.

J Thorac Cardiovasc Surg

July 2024

Medical Robotics & Computer-Assisted Surgery Laboratory, Harvard Medical School, Boston, Mass; Division of Cardiac Surgery, Veterans Affairs Boston Healthcare System, West Roxbury, Mass; Division of Cardiac Surgery, Mass General Brigham, Boston, Mass.

Objective: To characterize cognitive workload (CWL) of cardiac surgery team members in a real-world setting during coronary artery bypass grafting (CABG) surgery using providers' heart rate variability (HRV) data as a surrogate measure of CWL.

Methods: HRV was collected from the surgeon, anesthesiologist, perfusionist, and scrub nurse, and audio/video recordings were made during isolated, nonemergency CABG surgeries (n = 27). Eight surgical phases were annotated by trained researchers, and HRV was calculated for each phase.

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Importance: Assessing nontechnical skills in operating rooms (ORs) is crucial for enhancing surgical performance and patient safety. However, automated and real-time evaluation of these skills remains challenging.

Objective: To explore the feasibility of using motion features extracted from surgical video recordings to automatically assess nontechnical skills during cardiac surgical procedures.

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Background: Alcohol withdrawal is a common reason for admission to acute care hospitals. Prescription of medications for alcohol-use disorder (AUD) and close outpatient follow-up are commonly recommended, but few studies report their effects on postdischarge outcomes.

Objectives: The objective of this study is to evaluate the effects of medications for AUD and follow-up appointments on readmission and abstinence.

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Sleep occurs in all animals but its amount, form, and timing vary considerably between species and between individuals. Currently, little is known about the basis for these differences, in part, because we lack a complete understanding of the brain circuitry controlling sleep-wake states and markers for the cell types which can identify similar circuits across phylogeny. Here, I explain the utility of an "Evo-devo" approach for comparative studies of sleep regulation and function as well as for sleep medicine.

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Objective: To compare longitudinal changes in spirometric measures between patients with rheumatoid arthritis (RA) and non-RA comparators.

Methods: We analysed longitudinal data from two prospective cohorts: the UK Biobank and COPDGene. Spirometry was conducted at baseline and a second visit after 5-7 years.

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We construct non-linear machine learning (ML) prediction models for systolic and diastolic blood pressure (SBP, DBP) using demographic and clinical variables and polygenic risk scores (PRSs). We developed a two-model ensemble, consisting of a baseline model, where prediction is based on demographic and clinical variables only, and a genetic model, where we also include PRSs. We evaluate the use of a linear versus a non-linear model at both the baseline and the genetic model levels and assess the improvement in performance when incorporating multiple PRSs.

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Aims: Significant changes in tricuspid regurgitation (TR) and mitral regurgitation (MR) post-cardiac implantable electronic devices (CIEDs) are increasingly recognized. However, uncertainty remains as to whether the risk of CIED-associated TR and MR differs with right ventricular pacing (RVP) via CIED with trans-tricuspid RV leads, compared with cardiac resynchronization therapy (CRT), conduction system pacing (CSP), and leadless pacing (LP). The study aims to synthesize extant data on risk and prognosis of significant post-CIED TR and MR across pacing strategies.

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Extreme Temperatures and Stroke Mortality: Evidence From a Multi-Country Analysis.

Stroke

July 2024

Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society (A.G.), London School of Hygiene & Tropical Medicine, United Kingdom.

Background: Extreme temperatures contribute significantly to global mortality. While previous studies on temperature and stroke-specific outcomes presented conflicting results, these studies were predominantly limited to single-city or single-country analyses. Their findings are difficult to synthesize due to variations in methodologies and exposure definitions.

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Article Synopsis
  • New York and Massachusetts have implemented 1115 Medicaid demonstration waivers to focus on social determinants of health and better engage community organizations in health outcomes.
  • An evaluation of 359 public comments from direct service providers within these states, narrowed to 58 focusing on social service delivery, revealed concerns about funding and improving healthcare-community organization relationships.
  • Community organizations expressed feelings of underfunding and disenfranchisement while suggesting that the states should enhance support to foster better partnerships and improve integration of social services into healthcare delivery.
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The concept of acupoints is a key defining feature of acupuncture, yet the scientific basis of acupoints remains unclear. In recent years, there has been an emerging body of animal studies demonstrating an association between cutaneous sensitivity and visceral pathophysiology, through which acupoints over the skin are sensitized in pathologic conditions. Several studies with humans have also been conducted to assess whether the sensitivity of acupoints is distinct in healthy versus clinical populations.

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Optochemistry, an emerging pharmacologic approach in which light is used to selectively activate or deactivate molecules, has the potential to alleviate symptoms, cure diseases, and improve quality of life while preventing uncontrolled drug effects. The development of in-vivo applications for optochemistry to render brain cells photoresponsive without relying on genetic engineering has been progressing slowly. The nucleus accumbens (NAc) is a region for the regulation of slow-wave sleep (SWS) through the integration of motivational stimuli.

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Objective: To investigate the relationship between physician-hospital integration within accountable care organizations (ACOs) and inpatient care utilization and expenditure.

Data Sources: The primary data were Massachusetts All-Payer Claims Database (2009-2013).

Study Setting: Fifteen provider organizations that entered a commercial ACO contract with a major private payer in Massachusetts between 2009 and 2013.

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Sleep-wake scoring is a time-consuming, tedious but essential component of clinical and preclinical sleep research. Sleep scoring is even more laborious and challenging in rodents due to the smaller EEG amplitude differences between states and the rapid state transitions which necessitate scoring in shorter epochs. Although many automated rodent sleep scoring methods exist, they do not perform as well when scoring new datasets, especially those which involve changes in the EEG/EMG profile.

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