National Neuroinformatics Framework for Canadian Consortium on Neurodegeneration in Aging (CCNA)

The Canadian Institutes for Health Research (CIHR) launched the “International Collaborative Research Strategy for Alzheimer's Disease” as a signature initiative, focusing on Alzheimer's Disease (AD) and related neurodegenerative disorders (NDDs). The Canadian Consortium for Neurodegeneration and Aging (CCNA) was subsequently established to coordinate and strengthen Canadian research on AD and NDDs. To facilitate this research, CCNA uses LORIS, a modular data management system that integrates acquisition, storage, curation, and dissemination across multiple modalities. Through an unprecedented national collaboration studying various groups of dementia-related diagnoses, CCNA aims to investigate and develop proactive treatment strategies to improve disease prognosis and quality of life of those affected. However, this constitutes a unique technical undertaking, as heterogeneous data collected from sites across Canada must be uniformly organized, stored, and processed in a consistent manner. Currently clinical, neuropsychological, imaging, genomic, and biospecimen data for 509 CCNA subjects have been uploaded to LORIS. In addition, data validation is handled through a number of quality control (QC) measures such as double data entry (DDE), conflict flagging and resolution, imaging protocol checks1, and visual imaging quality validation. Site coordinators are also notified of incidental findings found in MRI reads or biosample analyses. Data is then disseminated to CCNA researchers via a web-based Data-Querying Tool (DQT). This paper will detail the wide array of capabilities handled by LORIS for CCNA, aiming to provide the necessary neuroinformatic infrastructure for this nation-wide investigation of healthy and diseased aging

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) Study neuropsychology battery of the Canadian Consortium on Neurodegeneration in Aging (CCNA): Design overview and initial validation

The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) is an observational study of 1100+ participants from across the dementia spectrum. We describe the development and features of the Neuropsychological Research Battery, which assesses learning and memory, processing speed, attention, executive function, visuoperceptual processing, and language. We report preliminary results (Fourth Data Release) from 60 cognitively unimpaired (CU) older adults, 56 participants with normal cognition but subjective cognitive decline (SCD), 104 with mild cognitive impairment (MCI), and 48 with Alzheimer’s dementia (AD). The tests were sensitive to performance differences between the diagnostic groups. Regression models indicated associations with age, education, and sex on multiple test scores. Future work will: (1) increase the educational diversity and sex balance of the participant cohorts, (2) determine the psychometric properties of the battery, (3) establish normative data from control participants, and (4) examine longitudinal data on individuals at risk for dementia and across the dementia spectrum. COMPASS-ND (Comprehensive Assessment of Neurodegeneration and Dementia) est une étude d'observation portant sur plus de 1,100 participants de l'ensemble du spectre des troubles neurocognitifs. Nous décrivons le développement et les caractéristiques de la batterie de recherche neuropsychologique, qui évalue l'apprentissage et la mémoire, la vitesse de traitement, l'attention, les fonctions exécutives, le traitement visuoperceptuel et le langage. Nous présentons les résultats préliminaires (quatrième publication des données) obtenus auprès de 60 personnes âgées sans trouble cognitif (CN), 56 participants ayant une cognition normale mais un déclin cognitif subjectif (SCD), 104 personnes atteintes d'un trouble cognitif léger (MCI) et 48 personnes atteintes de la maladie d'Alzheimer (AD). Les tests étaient sensibles aux différences de performance entre les groupes de diagnostic. Les modèles de régression ont indiqué des associations avec l'âge, l'éducation et le sexe sur les scores des tests multiples. Les travaux futurs viseront à (1) augmenter la diversité de l'éducation et l'équilibre entre les sexes dans les cohortes de participants, (2) déterminer les propriétés psychométriques de la batterie, (3) établir des données normatives à partir de contrôles, et (4) examiner les données longitudinales sur les individus à risque de troubles neurocognitifs et sur l'ensemble du spectre des troubles neurocognitifs

LORIS (Longitudinal Online Research and Imaging System)

<h2>What's Changed</h2> <ul> <li>[media] React Warning on Upload Tab by @skarya22 in https://github.com/aces/Loris/pull/8721</li> <li>[issue_tracker] Do not display inactive users in issue form by @charlottesce in https://github.com/aces/Loris/pull/8841</li> <li>[LINST] skip metadatafields for surveys by @zaliqarosli in https://github.com/aces/Loris/pull/8961</li> <li>[dictionary] Fixes for correct displaying "Data Type" column for the enumeration type in the "Data Dictionary (Beta)" table by @yagurdmitriy in https://github.com/aces/Loris/pull/8976</li> <li>[tools] Fix efficiency of fix_candidate_age script by @CamilleBeau in https://github.com/aces/Loris/pull/8992</li> <li>[media] fixes issue when media module try to instantiate a non existing instrument. by @racostas in https://github.com/aces/Loris/pull/8903</li> <li>[instrument_list] Fix deprecation warning by @driusan in https://github.com/aces/Loris/pull/8867</li> <li>[LINST] fix survey and date issues by @ridz1208 in https://github.com/aces/Loris/pull/8858</li> <li>[JSX] Modal Width Prop by @skarya22 in https://github.com/aces/Loris/pull/8893</li> <li>[libraries] Get examiner sites by UserID by @CamilleBeau in https://github.com/aces/Loris/pull/8994</li> <li>[genomic_browser] Download button not showing up in the Files tab by @ridz1208 in https://github.com/aces/Loris/pull/8480</li> <li>[issue_tracker - raisinbread/tools] Fix issue tracker history wrong module ID by @zaliqarosli in https://github.com/aces/Loris/pull/8677</li> <li>[Issue Tracker] Issue Change Notifications by @skarya22 in https://github.com/aces/Loris/pull/8885</li> <li>[behavioural_qc] fixes visitLevel feedback not showing up. by @racostas in https://github.com/aces/Loris/pull/8900</li> <li>[battery_manager] Update Test Plan by @skarya22 in https://github.com/aces/Loris/pull/8782</li> </ul> <h2>New Contributors</h2> <ul> <li>@yagurdmitriy made their first contribution in https://github.com/aces/Loris/pull/8976</li> </ul> <p><strong>Full Changelog</strong>: https://github.com/aces/Loris/compare/v25.0.1...v25.0.2</p>If you use this software, please cite it using these metadata

Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19

International audienc