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22 results

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  • 5 Associations Between Regional Perfusion and Locus Coeruleus MRI Contrast are Moderated by Plasma Alzheimer’s Disease Biomarkers in Older Adults

  • Shubir Dutt, Shelby L Bachman, Yanrong Li, Belinda Yew, Jung Y Jang, Jean K Ho, Kaoru Nashiro, Jungwon Min, Hyun Joo Yoo, Aimee Gaubert, Amy Nguyen, Isabel J Sible, Anna E Blanken, Anisa J Marshall, Arunima Kapoor, John P Alitin, Kim Hoang, Alessandra C Martini, Elizabeth Head, Xingfeng Shao, Danny J J Wang, Mara Mather, Daniel A Nation
  • Journal:
    Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
    Published online by Cambridge University Press:
    21 December 2023, pp. 610-611
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  • Objective:

    The locus coeruleus (LC) innervates the cerebrovasculature and plays a crucial role in optimal regulation of cerebral blood flow. However, no human studies to date have examined links between these systems with widely available neuroimaging methods. We quantified associations between LC structural integrity and regional cortical perfusion and probed whether varying levels of plasma Alzheimer’s disease (AD) biomarkers (Aß42/40 ratio and ptau181) moderated these relationships.

    Participants and Methods:

    64 dementia-free community-dwelling older adults (ages 55-87) recruited across two studies underwent structural and functional neuroimaging on the same MRI scanner. 3D-pCASL MRI measured regional cerebral blood flow in limbic and frontal cortical regions, while T1-FSE MRI quantified rostral LC-MRI contrast, a well-established proxy measure of LC structural integrity. A subset of participants underwent fasting blood draw to measure plasma AD biomarker concentrations (Aß42/40 ratio and ptau181). Multiple linear regression models examined associations between perfusion and LC integrity, with rostral LC-MRI contrast as predictor, regional CBF as outcome, and age and study as covariates. Moderation analyses included additional terms for plasma AD biomarker concentration and plasma x LC interaction.

    Results:

    Greater rostral LC-MRI contrast was linked to lower regional perfusion in limbic regions, such as the amygdala (ß = -0.25, p = 0.049) and entorhinal cortex (ß = -0.20, p = 0.042), but was linked to higher regional perfusion in frontal cortical regions, such as the lateral (ß = 0.28, p = 0.003) and medial (ß = 0.24, p = 0.05) orbitofrontal (OFC) cortices. Plasma amyloid levels moderated the relationship between rostral LC and amygdala CBF (Aß42/40 ratio x rostral LC interaction term ß = -0.31, p = 0.021), such that as plasma Aß42/40 ratio decreased (i.e., greater pathology), the strength of the negative relationship between rostral LC integrity and amygdala perfusion decreased. Plasma ptau181levels moderated the relationship between rostral LC and entorhinal CBF (ptau181 x rostral LC interaction term ß = 0.64, p = 0.001), such that as ptau181 increased (i.e., greater pathology), the strength of the negative relationship between rostral LC integrity and entorhinal perfusion decreased. For frontal cortical regions, ptau181 levels moderated the relationship between rostral LC and lateral OFC perfusion (ptau181 x rostral LC interaction term ß = -0.54, p = .004), as well as between rostral LC and medial OFC perfusion (ptau181 x rostral LC interaction term ß = -0.53, p = .005), such that as ptau181 increased (i.e., greater pathology), the strength of the positive relationship between rostral LC integrity and frontal perfusion decreased.

    Conclusions:

    LC integrity is linked to regional cortical perfusion in non-demented older adults, and these relationships are moderated by plasma AD biomarker concentrations. Variable directionality of the associations between the LC and frontal versus limbic perfusion, as well as the differential moderating effects of plasma AD biomarkers, may signify a compensatory mechanism and a shifting pattern of hyperemia in the presence of aggregating AD pathology. Linking LC integrity and cerebrovascular regulation may represent an important understudied pathway of dementia risk and may help to bridge competing theories of dementia progression in preclinical AD studies.

  • 19 - Korean Worlds and Echoes from the Cold War

  • from Part III - Transregional Worlding
  • Edited by Debjani Ganguly, University of Virginia
  • Book:
    The Cambridge History of World Literature
    Published online:
    17 August 2021
    Print publication:
    09 September 2021, pp 360-378

  • Summary

    Since the turn of the millennium a number of novels that look back to the Korean War have appeared in English including Ha Jin’s War Trash, Hwang Sok-yong’s The Guest, Chang-rae Lee’s The Surrendered and Jayne Anne Phillips’s Lark and Termite. These works issue address a location, the Korean peninsula, that interrupts putatively global frameworks for understanding the contemporary. Korea’s postcoloniality remains suspended as it has manifested in two still divided nation-state and its ongoing civil war testifies to the fact that the Cold War’s putative end is not an entirely global phenomenon. Moreover, these works illuminate how the “contact nebulae” (to use Karen Thornber’s phrase) that define East Asia—the formations of transculturation indigenous to that region—are not only shot through by complex asymmetries of power but also intertwined with more global histories of war and empire. As such, the network of literary examined in this essay contribute to a theorizing of the contemporary and of world literature that is attuned tracking the dynamic interaction of the multiple temporal and spatial registers—global, regional and national—in which various modalities of worlding take place.

  • Adolescents and adults with Fontan circulation: insights from the PREpArE-Fontan registry

  • Part of
  • Lars Søndergaard, Jamil Aboulhosn, Yves d’Udekem, Céline Faure, Wayne J Franklin, Alfred Hager, Yuli Y Kim, Erwan Muros-Le Rouzic, Daniel Rosenberg, Markus Schwerzmann, Paul Clift
  • Journal:
    Cardiology in the Young / Volume 32 / Issue 4 / April 2022
    Published online by Cambridge University Press:
    23 July 2021, pp. 597-605
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  • The Patient Registry for Adolescents and Adults with Stable Fontan Circulation aims to describe a contemporary cohort of Fontan patients who could be eligible for a clinical trial investigating macitentan, an endothelin receptor antagonist. This international, non-interventional, multicentre, cross-sectional, observational registry enrolled patients with “stable” Fontan circulation ≥10 years following extra-cardiac conduit or lateral tunnel procedure. Main exclusion criteria were NYHA functional class IV, reoperation of Fontan circulation, or signs of disease worsening. Patient characteristics at enrolment are described; available data were collected during a single registration visit. Of the 266 screened patients, 254 were included in this analysis. At enrolment, median (interquartile range) age was 24 (20;30) years, 37%/63% of patients were from the USA/Europe, 54% were male, 54%/47% had undergone extra-cardiac conduit/lateral tunnel procedures, and 95% were in NYHA functional class I or II. History of arrhythmia was more common in older patients and patients with lateral tunnel; overall prevalence was 19%. Most laboratory values were within the normal range but mean creatinine clearance was abnormally low (87.7 ml/min). Angiotensin-converting enzyme inhibitors were used by 48% of patients and their use was associated with creatinine clearance <90 ml/min (p = 0.007), as was Fontan completion at an older age (p = 0.007). 53.4% of patients had clinical characteristics that could potentially meet an endothelin receptor antagonist trial’s eligibility criteria. The PREpArE-Fontan registry describes a cohort of patients who could potentially participate in an endothelin receptor antagonist trial and identified early subtle signs of Fontan failure, even in “stable” patients.

  • Family Support and Readiness to Consider Smoking Cessation among Chinese and Vietnamese American Male Smokers

  • Joan A. Daniel, Jin E. Kim-Mozeleski, Krishna C. Poudel, Angela Sun, Nancy J. Burke, Janice Y. Tsoh, Kenneth Ward
  • Journal:
    Journal of Smoking Cessation / Volume 2021 / 2021
    Published online by Cambridge University Press:
    01 January 2024, e10
    Print publication:
    2021
    • Article
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  • Introduction. Smoking prevalence is disproportionately high among Asian American immigrant men with limited English proficiency. Understanding the role of family support may provide insights into culturally acceptable strategies to promote smoking cessation. Aims. This study examined how family support was associated with readiness to consider smoking cessation among Chinese and Vietnamese American male daily smokers. Methods. We analyzed baseline data (N = 340) from a cluster randomized trial of a family-based healthy lifestyle intervention. We assessed the frequency of receiving family support in various forms (encouraging use of cessation resources, praising efforts, checking in, and reminding of familial role). Multiple regression analysis was used to determine associations between family support areas and readiness to consider smoking cessation, controlling for covariates. Results/Findings. Reporting a higher frequency of receiving praise and encouragement for one’s efforts to quit was positively associated with readiness to consider cessation. Other areas of family support were not significant. Conclusions. These findings provide evidence to explore specific areas of family support in enhancing Asian American smokers’ readiness to consider cessation. As there is high interest from Asian American family members to support their smokers for quitting, culturally specific and acceptable strategies are needed to promote smoking cessation among Asian Americans.

  • Just the Facts: Recommendations on point-of-care ultrasound use and machine infection control during the coronavirus disease 2019 pandemic

  • Daniel J. Kim, Tomislav Jelic, Michael Y. Woo, Claire Heslop, Paul Olszynski
  • Journal:
    Canadian Journal of Emergency Medicine / Volume 22 / Issue 4 / July 2020
    Published online by Cambridge University Press:
    09 April 2020, pp. 445-449
    Print publication:
    July 2020
    • Article
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  • The World Health Organization declared the novel coronavirus disease 2019 (COVID-19) to be a pandemic on March 11, 2020, and, currently, there are over 10,000 confirmed cases in Canada, with this number expected to grow exponentially. There has been widespread interest in the use of point-of-care ultrasound (POCUS) in the management of patients with suspected COVID-19. The CAEP Emergency Ultrasound Committee has developed recommendations on the use of POCUS in these patients, with an emphasis on machine infection control measures.

  • Practical methods for effective vancomycin-resistant enterococci (VRE) surveillance: experience in a liver transplant surgical intensive care unit

  • Rebecca Y. Linfield, Shelley Campeau, Patil Injean, Aric Gregson, Fady Kaldas, Zachary Rubin, Tae Kim, Danielle Kunz, Alfred Chan, Delphine J. Lee, Romney M. Humphries, James A. McKinnell
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 39 / Issue 10 / October 2018
    Published online by Cambridge University Press:
    05 September 2018, pp. 1178-1182
    Print publication:
    October 2018
  • Objective

    We evaluated the utility of vancomycin-resistant Enterococcus (VRE) surveillance by varying 2 parameters: admission versus weekly surveillance and perirectal swabbing versus stool sampling.

    Design

    Prospective, patient-level surveillance program of incident VRE colonization.

    Setting

    Liver transplant surgical intensive care unit (SICU) of a tertiary-care referral medical center with a high prevalence of VRE.

    Patients

    All patients admitted to the SICU from June to August 2015.

    Methods

    We conducted a point-prevalence estimate followed by admission and weekly surveillance by perirectal swabbing and/or stool sampling. Incident colonization was defined as a negative screen followed by positive surveillance. VRE was detected by culture on Remel Spectra VRE chromogenic agar. Microbiologically-confirmed VRE bloodstream infections (BSIs) were tracked for 2 months. Statistical analyses were calculated using the McNemar test, the Fisher exact test, the t test, and the χ2 test.

    Results

    In total, 91 patients underwent VRE surveillance testing. The point prevalence of VRE colonization was 60.9%; VRE prevalence on admission was 30.1%. Weekly surveillance identified an additional 7 of 28 patients (25.0%) with incident colonization. VRE BSIs were more common in VRE-colonized patients than in noncolonized patients (8 of 43 vs 2 of 48; P=.028). In a direct comparison, perirectal swabs were more sensitive than stool samples in detecting VRE (64 of 67 vs 56 of 67; P=.023). Compliance with perirectal swabbing was 89% (201 of 226) compared to 56% (127 of 226) for stool collection (P≤0.001).

    Conclusions

    We recommend weekly VRE surveillance over admission-only screening in high-burden units such as liver transplant SICUs. Perirectal swabs had greater collection compliance and sensitivity than stool samples, making them the preferred methodology. Further work may have implications for antimicrobial stewardship and infection control.

The Cambridge Companion to Asian American Literature
  • Edited by Crystal Parikh, Daniel Y. Kim
  • Published online:
    05 September 2015
    Print publication:
    20 August 2015
  • The Cambridge Companion to Asian American Literature offers an engaging survey of Asian American literature from the nineteenth century to the present day. Since the 1980s, Asian American literary studies has developed into a substantial and vibrant field within English and American Studies. This Companion explores the variety of historical periods, literary genres and cultural movements affecting the development of Asian American literature. Written by a host of leading scholars in the field, this book provides insight into the representative movements, regional settings, archival resources and critical reception that define Asian American literature. Covering subjects from immigrant narratives and internment literature to contemporary race studies and the problem of translation, this Companion provides insight into the myriad traditions that have shaped the Asian American literary landscape.

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