Effects Of Antihypertensive And Cardiac Drugs And Level Of Depression In Community-Based Elders

The purpose of this ex post facto study was to determine the effects of antihypertensive and cardiac drugs on the level of depression in community-based elders. Roy\u27s Adaptation Model provided the theoretical framework for this study. Data were collected using the Brink Geriatric Depression Scale and the Drug Information Sheet. These questionnaires were administered to 40 subjects ages 55 and older who were taking antihypertensive and/or cardiac drugs or neither antihypertensive nor cardiac drugs. One null hypothesis and five directional hypotheses guided this study. The null hypothesis stated that there would be no difference in mean depression scores among the following groups: (a) elders taking neither antihypertensive nor cardiac drugs, (b) elders taking antihypertensive drugs alone, (c) elders taking cardiac drugs alone, and (d) elders taking a combination of antihypertensive and cardiac drugs. Utilizing the ANOVA, the result was significant at the .05 level. Thus, the researcher rejected the null hypothesis. Directional hypotheses made the following comparisons of community-based elders : Elders who took antihypertensive drugs only and elders who took no drugs, elders who took cardiac drugs only and elders who took no drugs, elders who took antihypertensive and cardiac drugs and elders who took antihypertensive drugs alone, elders who took antihypertensive and cardiac drugs and elders who took cardiac drugs alone, and elders who took antihypertensive and cardiac drugs and elders who took neither antihypertensive nor cardiac drugs. Utilizing the t test, the following comparisons were significant at the .05 level: Elders who took antihypertensive drugs only and elders who took no drugs, elders who took cardiac drugs only and elders who took no drugs, and elders who took antihypertensive and cardiac drugs and elders who took neither antihypertensive nor cardiac drugs. The findings of this study indicate that elders who take antihypertensive and/or cardiac drugs experience a significantly higher level of depression as compared to elders who do not take antihypertensive or cardiac drugs. Pharmacotherapeutic depression may or may not result when antihypertensive and/or cardiac drugs are ingested. Perhaps, as a function of the aging process, depression may be experienced by all elders. Recommendations for further study include conduction of a similar study including chronic illnesses and level of depression and conduction of a study to determine effects of multiple medication ingestion and level of depression

REACH MUSC: A Telemedicine Facilitated Network for Stroke: Initial Operational Experience

REACH Medical University of South Carolina (MUSC) provides stroke consults via the internet in South Carolina. From May 2008 to April 2011 231 patients were treated with intravenous (IV) thrombolysis and 369 were transferred to MUSC including 42 for intra-arterial revascularization [with or without IV tissue plasminogen activator (tPA)]. Medical outcomes and hemorrhage rates, reported elsewhere, were good (Lazaridis et al., 2011). Here we report operational features of REACH MUSC which covers 15 sites with 2,482 beds and 471,875 Emergency Department (ED) visits per year. Eight Academic Faculty from MUSC worked with 165 different physicians and 325 different nurses in the conduct of 1085 consults. For the 231 who received tPA, time milestones (in minutes) were: Onset to Door: 62 (mean), 50 (median); Door to REACH Consult: 43 and 33, Consult Request to Consult Start: was 9 and 7, Consult Start to tPA Decision: 31 and 25; Decision to Infusion: 20 and 14, and total Door to Needle: 98 and 87. The comparable times for the 854 not receiving tPA were: Onset to Door: 140 and 75; Door to REACH Consult: 61 and 41; Consult Request to Consult Start: 9 and 7, Consult Start to tPA Decision: 27 and 23. While the consultants respond to consult requests in <10, there is a long delay between arrival and Consult request. Tracking of operations indicates if we target shortening Door to Call time and time from tPA decision to start of drug infusion we may be able to improve Door to Needle times to target of <60. The large number of individuals involved in the care of these patients, most of whom had no training in REACH usage, will require novel approaches to staff education in ED based operations where turnover is high. Despite these challenges, this robust system delivered tPA safely and in a high fraction of patients evaluated using the REACH MUSC system

Automated, Efficient, and Accelerated Knowledge Modeling of the Cognitive Neuroimaging Literature Using the ATHENA Toolkit

Neuroimaging research is growing rapidly, providing expansive resources for synthesizing data. However, navigating these dense resources is complicated by the volume of research articles and variety of experimental designs implemented across studies. The advent of machine learning algorithms and text-mining techniques has advanced automated labeling of published articles in biomedical research to alleviate such obstacles. As of yet, a comprehensive examination of document features and classifier techniques for annotating neuroimaging articles has yet to be undertaken. Here, we evaluated which combination of corpus (abstract-only or full-article text), features (bag-of-words or Cognitive Atlas terms), and classifier (Bernoulli naïve Bayes, k-nearest neighbors, logistic regression, or support vector classifier) resulted in the highest predictive performance in annotating a selection of 2,633 manually annotated neuroimaging articles. We found that, when utilizing full article text, data-driven features derived from the text performed the best, whereas if article abstracts were used for annotation, features derived from the Cognitive Atlas performed better. Additionally, we observed that when features were derived from article text, anatomical terms appeared to be the most frequently utilized for classification purposes and that cognitive concepts can be identified based on similar representations of these anatomical terms. Optimizing parameters for the automated classification of neuroimaging articles may result in a larger proportion of the neuroimaging literature being annotated with labels supporting the meta-analysis of psychological constructs

Unravelling migratory connectivity in marine turtles using multiple methods

1. Comprehensive knowledge of the fundamental spatial ecology of marine species is critical to allow the identification of key habitats and the likely sources of anthropogenic threats, thus informing effective conservation strategies. 2. Research on migratory marine vertebrates has lagged behind many similar terrestrial animal groups, but studies using electronic tagging systems and molecular techniques offer great insights. 3. Marine turtles have complex life history patterns, spanning wide spatio-temporal scales. As a result of this multidimensional complexity, and despite extensive effort, there are no populations for which a truly holistic understanding of the spatial aspects of the life history has been attained. There is a particular lack of information regarding the distribution and habitats utilized during the first few years of life. 4. We used satellite tracking technology to track individual turtles following nesting at the green turtle Chelonia mydas nesting colony at Poila˜o Island, Guinea Bissau; the largest breeding aggregation in the eastern Atlantic. 5. Wefurther contextualize these data with pan-Atlantic molecular data and oceanographic current modelling to gain insights into likely dispersal patterns of hatchlings and small pelagic juveniles. 6. All adult turtles remained in the waters of West Africa, with strong connectivity demonstrated with Banc D’Arguin, Mauritania. 7. Despite shortcomings in current molecular markers, we demonstrate evidence for profound sub-structuring of marine turtle stocks across the Atlantic; with a high likelihood based on oceanographic modelling that most turtles from Guinea-Bissau are found in the eastern Atlantic. 8. Synthesis and applications. There is an increased need for a better understanding of spatial distribution of marine vertebrates demonstrating life histories with spatio-temporal complexity. We propose the synergistic use of the technologies and modelling used here as a working framework for the future rapid elucidation of the range and likely key habitats used by the different life stages from such species

Evaluation of polygenic risk scores for breast and ovarian cancer risk prediction in BRCA1 and BRCA2 mutation carriers

Background: Genome-wide association studies (GWAS) have identified 94 common single-nucleotide polymorphisms (SNPs) associated with breast cancer (BC) risk and 18 associated with ovarian cancer (OC) risk. Several of these are also associated with risk of BC or OC for women who carry a pathogenic mutation in the high-risk BC and OC genes BRCA1 or BRCA2. The combined effects of these variants on BC or OC risk for BRCA1 and BRCA2 mutation carriers have not yet been assessed while their clinical management could benefit from improved personalized risk estimates. Methods: We constructed polygenic risk scores (PRS) using BC and OC susceptibility SNPs identified through population-based GWAS: for BC (overall, estrogen receptor [ER]-positive, and ER-negative) and for OC. Using data from 15 252 female BRCA1 and 8211 BRCA2 carriers, the association of each PRS with BC or OC risk was evaluated using a weighted cohort approach, with time to diagnosis as the outcome and estimation of the hazard ratios (HRs) per standard deviation increase in the PRS. Results: The PRS for ER-negative BC displayed the strongest association with BC risk in BRCA1 carriers (HR = 1.27, 95% confidence interval [CI] = 1.23 to 1.31, P = 8.2 x 10(53)). In BRCA2 carriers, the strongest association with BC risk was seen for the overall BC PRS (HR = 1.22, 95% CI = 1.17 to 1.28, P = 7.2 x 10(-20)). The OC PRS was strongly associated with OC risk for both BRCA1 and BRCA2 carriers. These translate to differences in absolute risks (more than 10% in each case) between the top and bottom deciles of the PRS distribution; for example, the OC risk was 6% by age 80 years for BRCA2 carriers at the 10th percentile of the OC PRS compared with 19% risk for those at the 90th percentile of PRS. Conclusions: BC and OC PRS are predictive of cancer risk in BRCA1 and BRCA2 carriers. Incorporation of the PRS into risk prediction models has promise to better inform decisions on cancer risk management

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy