Institution
Australian Catholic University
Education•Brisbane, Queensland, Australia•
About: Australian Catholic University is a education organization based out in Brisbane, Queensland, Australia. It is known for research contribution in the topics: Population & Poison control. The organization has 2721 authors who have published 10013 publications receiving 215248 citations. The organization is also known as: ACU & ACU National.
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TL;DR: This meta-analysis has adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was written according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) proposal.
Abstract: IMPORTANCE
Cerebral microbleeds (CMBs) have been established as an independent predictor of cerebral bleeding. There are contradictory data regarding the potential association of CMB burden with the risk of symptomatic intracerebral hemorrhage (sICH) in patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT).
OBJECTIVE
To investigate the association of high CMB burden (>10 CMBs on a pre-IVT magnetic image resonance [MRI] scan) with the risk of sICH following IVT for AIS.
DATA SOURCES
Eligible studies were identified by searching Medline and Scopus databases. No language or other restrictions were imposed. The literature search was conducted on October 7, 2015. This meta-analysis has adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was written according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) proposal.
STUDY SELECTION
Eligible prospective study protocols that reported sICH rates in patients with AIS who underwent MRI for CMB screening prior to IVT.
DATA EXTRACTION AND SYNTHESIS
The reported rates of sICH complicating IVT in patients with AIS with pretreatment MRI were extracted independently for groups of patients with 0 CMBs (CMB absence), 1 or more CMBs (CMB presence), 1 to 10 CMBs (low to moderate CMB burden), and more than 10 CMBs (high CMB burden). An individual-patient data meta-analysis was also performed in the included studies that provided complete patient data sets.
MAIN OUTCOMES AND MEASURES
Symptomatic intracerebral hemorrhage based on the European Cooperative Acute Stroke Study-II definition (any intracranial bleed with ≥4 points worsening on the National Institutes of Health Stroke Scale score).
RESULTS
We included 9 studies comprising 2479 patients with AIS. The risk of sICH after IVT was found to be higher in patients with evidence of CMB presence, compared with patients without CMBs (risk ratio [RR], 2.36; 95% CI, 1.21-4.61; P = .01). A higher risk for sICH after IVT was detected in patients with high CMB burden (>10 CMBs) when compared with patients with 0 to 10 CMBs (RR, 12.10; 95% CI, 4.36-33.57; P < .001) or 1 to 10 CMBs (RR, 7.01; 95% CI, 3.20-15.38; P < .001) on pretreatment MRI. In the individual-patient data meta-analysis, high CMB burden was associated with increased likelihood of sICH before (unadjusted odds ratio, 31.06; 95% CI, 7.12-135.44; P < .001) and after (adjusted odds ratio, 18.17; 95% CI, 2.39-138.22; P = .005) adjusting for potential confounders.
CONCLUSIONS AND RELEVANCE
Presence of CMB and high CMB burdens on pretreatment MRI were independently associated with sICH in patients with AIS treated with IVT. High CMB burden may be included in individual risk stratification scores predicting sICH risk following IVT for AIS.
153 citations
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TL;DR: The findings indicate that physical and cognitive training depend on discrete neuronal mechanisms for their therapeutic efficacy, information that may help develop targeted lifestyle-based preventative strategies.
Abstract: Physical and cognitive exercise may prevent or delay dementia in later life but the neural mechanisms underlying these therapeutic benefits are largely unknown. We examined structural and functional magnetic resonance imaging (MRI) brain changes after 6 months of progressive resistance training (PRT), computerized cognitive training (CCT) or combined intervention. A total of 100 older individuals (68 females, average age=70.1, s.d.±6.7, 55-87 years) with dementia prodrome mild cognitive impairment were recruited in the SMART (Study of Mental Activity and Resistance Training) Trial. Participants were randomly assigned into four intervention groups: PRT+CCT, PRT+SHAM CCT, CCT+SHAM PRT and double SHAM. Multimodal MRI was conducted at baseline and at 6 months of follow-up (immediately after training) to measure structural and spontaneous functional changes in the brain, with a focus on the hippocampus and posterior cingulate regions. Participants' cognitive changes were also assessed before and after training. We found that PRT but not CCT significantly improved global cognition (F(90)=4.1, P<0.05) as well as expanded gray matter in the posterior cingulate (Pcorrected <0.05), and these changes were related to each other (r=0.25, P=0.03). PRT also reversed progression of white matter hyperintensities, a biomarker of cerebrovascular disease, in several brain areas. In contrast, CCT but not PRT attenuated decline in overall memory performance (F(90)=5.7, P<0.02), mediated by enhanced functional connectivity between the hippocampus and superior frontal cortex. Our findings indicate that physical and cognitive training depend on discrete neuronal mechanisms for their therapeutic efficacy, information that may help develop targeted lifestyle-based preventative strategies.
153 citations
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TL;DR: While the Kinect V2 body tracking may not accurately obtain lower body kinematic data, it shows great potential as a tool for measuring spatiotemporal aspects of gait.
153 citations
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TL;DR: The shift to a more sustainable materialism is examined using three frameworks: a move beyond an individualist and value-focused notion of post-materialism, into a focus on collective practices and institutions for the provision of the basic needs of everyday life; Foucault's conceptions of governmentality and biopolitics, which articulate modes of power around the circulation of things, information, and individuals as mentioned in this paper.
Abstract: This article analyzes recent developments in environmental activism, in particular movements focused on reconfiguring material flows. The desire for sustainability has spawned an interest in changing the material relationship between humans, other beings, and the non-human realm. No longer willing to take part in unsustainable practices and institutions, and not satisfied with purely individualistic and consumer responses, a growing focus of environmental movement groups is on restructuring everyday practices of circulation, for example, on sustainable food, renewable energy, and making. The shift to a more sustainable materialism is examined using three frameworks: a move beyond an individualist and value-focused notion of post-materialism, into a focus on collective practices and institutions for the provision of the basic needs of everyday life; Foucault’s conceptions of governmentality and biopolitics, which articulate modes of power around the circulation of things, information, and individuals; and a new ethos around vibrant and sustainable materialism with an explicit recognition of human immersion in non-human natural systems. These frames allow us to see and interpret common themes across numerous, seemingly disparate initiatives focused on replacing unsustainable practices and forging alternative flows.
151 citations
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University of Zurich1, University of Toulouse2, Geneva College3, University of Basel4, University of Coimbra5, Innsbruck Medical University6, University of Manchester7, Boston University8, University of Sheffield9, Dresden University of Technology10, Charité11, Harvard University12, Tufts University13, Brigham and Women's Hospital14, University of Health Sciences Antigua15, Australian Catholic University16
TL;DR: Treating adults without major comorbidities aged 70 years or older with vitamin D, omega-3s, or a strength-training exercise program did not result in statistically significant differences in improvement in systolic or diastolic blood pressure, nonvertebral fractures, physical performance, infection rates, or cognitive function.
Abstract: Importance The benefits of vitamin D, omega-3 fatty acids, and exercise in disease prevention remain unclear. Objective To test whether vitamin D, omega-3s, and a strength-training exercise program, alone or in combination, improved 6 health outcomes among older adults. Design, Setting, and Participants Double-blind, placebo-controlled, 2 × 2 × 2 factorial randomized clinical trial among 2157 adults aged 70 years or older who had no major health events in the 5 years prior to enrollment and had sufficient mobility and good cognitive status. Patients were recruited between December 2012 and November 2014, and final follow-up was in November 2017. Interventions Participants were randomized to 3 years of intervention in 1 of the following 8 groups: 2000 IU/d of vitamin D3, 1 g/d of omega-3s, and a strength-training exercise program (n = 264); vitamin D3and omega-3s (n = 265); vitamin D3and exercise (n = 275); vitamin D3alone (n = 272); omega-3s and exercise (n = 275); omega-3s alone (n = 269); exercise alone (n = 267); or placebo (n = 270). Main Outcomes and Measures The 6 primary outcomes were change in systolic and diastolic blood pressure (BP), Short Physical Performance Battery (SPPB), Montreal Cognitive Assessment (MoCA), and incidence rates (IRs) of nonvertebral fractures and infections over 3 years. Based on multiple comparisons of 6 primary end points, 99% confidence intervals are presented andP Results Among 2157 randomized participants (mean age, 74.9 years; 61.7% women), 1900 (88%) completed the study. Median follow-up was 2.99 years. Overall, there were no statistically significant benefits of any intervention individually or in combination for the 6 end points at 3 years. For instance, the differences in mean change in systolic BP with vitamin D vs no vitamin D and with omega-3s vs no omega-3s were both −0.8 (99% CI, –2.1 to 0.5) mm Hg, withP Conclusions and Relevance Among adults without major comorbidities aged 70 years or older, treatment with vitamin D3, omega-3s, or a strength-training exercise program did not result in statistically significant differences in improvement in systolic or diastolic blood pressure, nonvertebral fractures, physical performance, infection rates, or cognitive function. These findings do not support the effectiveness of these 3 interventions for these clinical outcomes. Trial Registration ClinicalTrials.gov Identifier:NCT01745263
151 citations
Authors
Showing all 2824 results
Name | H-index | Papers | Citations |
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John J.V. McMurray | 178 | 1389 | 184502 |
James F. Sallis | 169 | 825 | 144836 |
Richard M. Ryan | 164 | 405 | 244550 |
Herbert W. Marsh | 152 | 646 | 89512 |
Jacquelynne S. Eccles | 136 | 378 | 84036 |
John A. Kanis | 133 | 625 | 96992 |
Edward L. Deci | 130 | 284 | 206930 |
Thomas J. Ryan | 116 | 675 | 67462 |
Bruce E. Kemp | 110 | 423 | 45441 |
Mark J. Nieuwenhuijsen | 107 | 647 | 49080 |
Peter Rosenbaum | 103 | 446 | 45732 |
Barbara Riegel | 101 | 507 | 77674 |
Ego Seeman | 101 | 529 | 46392 |
Paul J. Frick | 100 | 306 | 33579 |
Robert J. Vallerand | 98 | 301 | 41840 |