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Erratum : Publisher Correction: Stroke genetics informs drug discovery and risk prediction across ancestries (Nature (2022) 611 7934 (115-123))
(2022-11-14) PRECISE4Q Consortium; FinnGen Consortium; NINDS Stroke Genetics Network (SiGN); MEGASTROKE Consortium; SIREN Consortium; China Kadoorie Biobank Collaborative Group; VA Million Veteran Program; International Stroke Genetics Consortium (ISGC); Biobank Japan; CHARGE consortium.; GIGASTROKE Consortium; COMPASS Consortium; INVENT Consortium; Dutch Parelsnoer Initiative (PSI) Cerebrovascular Disease Study Group; Estonian Biobank; Faculty of Medicine
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Aging and Driving : A Comparison of Driving Performance Between Older and Younger Drivers in an On-Road Driving Test
(2022-04-01) Robertsen, Rolf; Lorås, Håvard W.; Polman, Remco; Simsekoglu, Ozlem; Sigmundsson, Hermundur; Education
It is important to examine changes in driving performance and driver behavior with increasing age to improve road safety. The main purpose of this study was to explore if there were any differences in a group of young drivers (n = 36, Mage = 32) and a group of elderly drivers (n = 40, Mage = 72) on driving performance and driving skills on a number of driving tasks. An on-road driving test was conducted using a fixed 25-km route lasting approximately 30 minutes. Expert examiners assessed the participants’ driving skills and performance using assessment form measuring seven categories: car handling, observation/overview, signaling, positioning, speed adaption/risk, traffic flow/assessing gaps, and give way/traffic flow. Younger drivers reported significantly longer annual mileage (mean = 24,719 km) than older drivers (mean = 12,750 km). There were no significant group differences on self-reported number of accidents the last 3 years, driving frequency, or self-assessment scores. Independent sample t-test results show that compared to older drivers, the younger drivers scored significantly higher on 4 out of totally 32 category items in the assessment form. Two of them were in category total scores; car handling total score and speed adaption/risk total score, the other two were subcategory scores; use of controls and following traffic flow. The results indicate that aging itself and/or potential negative age-related decline in certain functions important for safe driving do effect driving performance, but less than expected and commonly assumed. One plausible explanation is that older drivers use compensatory actions related to factors like maturity and a behavioral adaptation to overcome difficulties in driving.
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Associations of Pulmonary Function with MRI Brain Volumes : A Coordinated Multi-Study Analysis
(2022-11-22) Frenzel, Stefan; Bis, Joshua C.; Gudmundsson, Elias F.; O'Donnell, Adrienne; Simino, Jeannette; Yaqub, Amber; Bartz, Traci M.; Brusselle, Guy G.O.; Bülow, Robin; DeCarli, Charles S.; Ewert, Ralf; Gharib, Sina A.; Ghosh, Saptaparni; Gireud-Goss, Monica; Gottesman, Rebecca F.; Ikram, M. Arfan; Knopman, David S.; Launer, Lenore J.; London, Stephanie J.; Longstreth, W. T.; Lopez, Oscar L.; Melo van Lent, Debora; O'Connor, George; Satizabal, Claudia L.; Shrestha, Srishti; Sigurdsson, Sigurdur; Stubbe, Beate; Talluri, Rajesh; Vasan, Ramachandran S.; Vernooij, Meike W.; Völzke, Henry; Wiggins, Kerri L.; Yu, Bing; Beiser, Alexa S.; Gudnason, Vilmundur; Mosley, Thomas; Psaty, Bruce M.; Wolters, Frank J.; Grabe, Hans J.; Seshadri, Sudha; Faculty of Medicine
BACKGROUND: Previous studies suggest poor pulmonary function is associated with increased burden of cerebral white matter hyperintensities and brain atrophy among elderly individuals, but the results are inconsistent. OBJECTIVE: To study the cross-sectional associations of pulmonary function with structural brain variables. METHODS: Data from six large community-based samples (N = 11,091) were analyzed. Spirometric measurements were standardized with respect to age, sex, height, and ethnicity using reference equations of the Global Lung Function Initiative. Associations of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and their ratio FEV1/FVC with brain volume, gray matter volume, hippocampal volume, and volume of white matter hyperintensities were investigated using multivariable linear regressions for each study separately and then combined using random-effect meta-analyses. RESULTS: FEV1 and FVC were positively associated with brain volume, gray matter volume, and hippocampal volume, and negatively associated with white matter hyperintensities volume after multiple testing correction, with little heterogeneity present between the studies. For instance, an increase of FVC by one unit was associated with 3.5 ml higher brain volume (95% CI: [2.2, 4.9]). In contrast, results for FEV1/FVC were more heterogeneous across studies, with significant positive associations with brain volume, gray matter volume, and hippocampal volume, but not white matter hyperintensities volume. Associations of brain variables with both FEV1 and FVC were consistently stronger than with FEV1/FVC, specifically with brain volume and white matter hyperintensities volume. CONCLUSION: In cross-sectional analyses, worse pulmonary function is associated with smaller brain volumes and higher white matter hyperintensities burden.
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Engaging with EPIO, a digital pain self-management program : a qualitative study
(2022-04-29) Bostrøm, Katrine; Varsi, Cecilie; Eide, Hilde; Børøsund, Elin; Kristjansdottir, Ólöf B.; Schreurs, Karlein M.G.; Waxenberg, Lori B.; Weiss, Karen E.; Morrison, Eleshia J.; Nordang, Elise Flakk; Stubhaug, Audun; Nes, Lise Solberg; Faculty of Nursing and Midwifery
Background: Chronic pain conditions entail significant personal and societal burdens and improved outreach of evidence-based pain self-management programs are needed. Digital cognitive-behavioral self-management interventions have shown promise. However, evidence is still scarce and several challenges with such interventions for chronic pain exist. Exploring patients' experiences and engagement with digital interventions may be an essential step towards developing meaningful digital self-management interventions for those living with chronic pain. Objectives: This study aimed to gain insight into the experiences of people with chronic pain when engaging with EPIO, an application (app)-based cognitive-behavioral pain self-management intervention program. Methods: Participants (N = 50) living with chronic pain received access to the EPIO intervention in a feasibility pilot-study for 3 months. During this time, all participants received a follow-up phone call at 2–3 weeks, and a subsample (n = 15) also participated in individual semi-structured interviews after 3 months. A qualitative design was used and thematic analysis was employed aiming to capture participants’ experiences when engaging with the EPIO intervention program. Results: Findings identifying program-related experiences and engagement were organized into three main topics, each with three sub-themes: (1) Engaging with EPIO; motivation to learn, fostering joy and enthusiasm, and helpful reminders and personalization, (2) Coping with pain in everyday life; awareness, practice and using EPIO in everyday life, and (3) The value of engaging with the EPIO program; EPIO – a friend, making peace with the presence of pain, and fostering communication and social support. Conclusions: This qualitative study explored participants’ experiences and engagement with EPIO, a digital self-management intervention program for people living with chronic pain. Findings identified valued aspects related to motivation for engagement, and showed how such a program may be incorporated into daily life, and encourage a sense of acceptance, social support and relatedness. The findings highlight vital components for facilitating digital program engagement and use in support of self-management for people living with chronic pain. Trial registration: ClinicalTrials.gov NCT03705104.
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Use of hormonal contraceptives and antidepressants and risks of suicidal behavior and accidents among women with premenstrual disorders : a nationwide cohort study
(2022-12-15) Yang, Qian; Lagerberg, Tyra; Sjölander, Arvid; Bertone-Johnson, Elizabeth R.; Fang, Fang; Ye, Weimin; Chang, Zheng; Valdimarsdóttir, Unnur A.; Lu, Donghao; Faculty of Medicine
Background: Women with premenstrual disorders (PMDs) are at increased risks of suicidal behavior and accidents. However, the effect of PMD first-line treatment on such risks have not been assessed. Methods: To study the association between use of hormonal contraceptives or antidepressants and subsequent risks of suicidal behavior and accidents among women with PMDs. We conducted a nationwide register-based cohort study with between- and within-individual analyses in Sweden. All women with a clinical diagnosis/indication of PMDs recorded in the Patient Register and the Prescribed Drug Register during 1987–2011 were included (n = 23 029, age 15–52 years). Information on hormonal contraceptives and antidepressants prescribed for these women was obtained from the Prescribed Drug Register. Events of suicidal behavior (complete suicide and suicide attempt) and accidents were separately identified through the Patient and the Causes of Death Registers. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of suicidal behavior and accidents after use of hormonal contraceptives or antidepressants were estimated in between-individual and within-individual analyses (i.e., comparing the risk between use and no use in the same individual) using Poisson regression. Results: Women with PMDs were followed for a median of 6.2 years. Compared to no use of hormonal contraceptives, use of hormonal contraceptives was associated with a lower risk of suicidal behavior in both between-individual (IRR 0.76, 0.43–1.34) and within-individual analyses (IRR 0.65, 0.51–0.83). These risk reductions were primarily restricted to combined products (IRR 0.18, 0.07–0.47 and 0.19, 0.08–0.42 in between- and within-individual analyses) and observed among women with/without psychiatric comorbidities (p for interaction 0.830 and 0.043 in between- and within-individual analyses). Yet, the use of hormonal contraceptives was not consistently associated with risk of accidents between between-individual (IRR 1.13, 1.01–1.27) and within-individual analyses (IRR 1.01, 0.92–1.11). Use of antidepressants was associated with a higher risk of suicidal behavior and accidents in both between- and within-individual analyses. Conclusions: Our findings suggest that use of hormonal contraceptives, particularly combined products, is associated with reduced rates of suicidal behaviors, but not accidents, among women with PMDs. The estimates for antidepressants may be biased by indication.