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Article ; Online: The influence of primary language on postoperative stroke outcomes.

Bakillah, Emna / Moneme, Adora / Brown, Danielle / Sharpe, James / McGarvey, Michael L / Kelz, Rachel R

2024

Abstract: ... of feeding tube placement (OR 1.95, 95 % CI 1.10-3.47, p = 0.0227) in n-EPL.: Conclusions: Postoperative ...

Abstract	Background: Language barriers have the potential to influence acute stroke outcomes. Thus, we examined postoperative stroke outcomes among non-English primary language speakers. Methods: Utilizing the Healthcare Cost and Utilization Project State Inpatient Database (2016-2019), we conducted a retrospective cohort study of adults diagnosed with a postoperative stroke in Michigan, Maryland, and New Jersey. Patients were classified by primary language spoken: English (EPL) or non-English (n-EPL). The primary outcome was hospital length-of-stay. Secondary outcomes included stroke intervention, feeding tube, tracheostomy, mortality, cost, disposition, and readmission. Propensity-score matching and post-match regression were used to quantify outcomes. Results: Among 3078 postoperative stroke patients, 6.2 % were n-EPL. There were no differences in length-of-stay or secondary outcomes, except for higher odds of feeding tube placement (OR 1.95, 95 % CI 1.10-3.47, p = 0.0227) in n-EPL. Conclusions: Postoperative stroke outcomes were comparable by primary language spoken. However, higher odds of feeding tube placement in n-EPL may suggest differences in patient-provider communication.
Language	English
Publishing date	2024-04-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2024.04.023
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Article ; Online: Accelerometer-Based Estimates of Physical Activity and Sedentary Time Among Samoan Adults.

Hawley, Nicola L / Zarei, Parmida / Crouter, Scott E / Desai, Mayur M / Pomer, Alysa / Rivara, Anna C / Naseri, Take / Reupena, Muagututia Sefuiva / Viali, Satupaitea / Duckham, Rachel L / McGarvey, Stephen T

Journal of physical activity & health

2024 , Page(s) 1–9

Abstract: ... confidence interval [CI], 80-97) and women (78 [4] min; 95% CI, 70-86; P = .08). Women, however, spent more time ... 358; P < .001). While there were no differences in physical activity by census region, education, or ... physical activity than those in peri-urban and rural areas (P = .015). Women with class II/III obesity spent more ...

Abstract	Background: The prevalence of obesity-related cardiometabolic disease in Samoa is among the highest globally. While physical activity is a modifiable risk factor for obesity-related disease, little is known about physical activity levels among adult Samoans. Using wrist-worn accelerometer-based devices, this study aimed to characterize physical activity among Samoan adults. Methods: Samoan adults (n = 385; 55% female, mean [SD] age 52 [10] y) wore Actigraph GT3X+ devices for 7 to 10 days. General linear models were used to examine mean daily minutes of sedentary time, light physical activity, and moderate to vigorous physical activity by various participant characteristics. Results: Time spent in moderate to vigorous physical activity did not differ statistically between men (88 [5] min; 95% confidence interval [CI], 80-97) and women (78 [4] min; 95% CI, 70-86; P = .08). Women, however, spent more time than men in light physical activity: 380 (7) minutes (95% CI, 367-393) versus 344 (7) minutes (95% CI, 329-358; P < .001). While there were no differences in physical activity by census region, education, or occupation among women, men in urban areas spent significantly less time in moderate to vigorous physical activity than those in peri-urban and rural areas (P = .015). Women with class II/III obesity spent more time in sedentary activities than those with healthy weight or overweight/class I obesity (P = .048). Conclusions: This study characterizes physical activity among Samoan adults and highlights variation by sex, urbanicity, and weight status. In providing initial device-measured estimates of physical activity in Samoa, this analysis establishes a baseline from which the success of future attempts to intervene on physical activity may be assessed.
Language	English
Publishing date	2024-04-15
Publishing country	United States
Document type	Journal Article
ISSN	1543-5474
ISSN (online)	1543-5474
DOI	10.1123/jpah.2023-0590
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Article ; Online: Chronic cough: new insights and future prospects.

Morice, Alyn / Dicpinigaitis, Peter / McGarvey, Lorcan / Birring, Surinder S

European respiratory review : an official journal of the European Respiratory Society

2021 Volume 30, Issue 162

Abstract: Chronic cough is defined in adults as a cough that lasts for ≥8 weeks. When it proves intractable to standard-of-care treatment, it can be referred to as refractory chronic cough (RCC). Chronic cough is now understood to be a condition of neural ... ...

Abstract	Chronic cough is defined in adults as a cough that lasts for ≥8 weeks. When it proves intractable to standard-of-care treatment, it can be referred to as refractory chronic cough (RCC). Chronic cough is now understood to be a condition of neural dysregulation. Chronic cough and RCC result in a serious, often unrecognized, disease burden, which forms the focus of the current review.The estimated global prevalence of chronic cough is 2-18%. Patients with chronic cough and RCC report many physical and psychological effects, which impair their quality of life. Chronic cough also has a significant economic burden for the patient and healthcare systems. RCC diagnosis and treatment are often delayed for many years as potential treatable triggers must be excluded first and a stepwise empirical therapeutic regimen is recommended.Evidence supporting most currently recommended treatments is limited. Many treatments do not address the underlying pathology, are used off-label, have limited efficacy and produce significant side-effects. There is therefore a significant unmet need for alternative therapies for RCC that target the underlying disease mechanisms. Early clinical data suggest that antagonists of the purinergic P2X3 receptor, an important mediator of RCC, are promising, though more evidence is needed.
MeSH term(s)	Adult ; Chronic Disease ; Cough/diagnosis ; Cough/drug therapy ; Cough/epidemiology ; Humans ; Quality of Life
Language	English
Publishing date	2021-11-30
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1077620-5
ISSN	1600-0617 ; 0905-9180
ISSN (online)	1600-0617
ISSN	0905-9180
DOI	10.1183/16000617.0127-2021
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Article ; Online: Derivation and Validation of an Algorithm to Detect Stroke Using Arm Accelerometry Data.

Messé, Steven R / Kasner, Scott E / Cucchiara, Brett L / McGarvey, Michael L / Cummings, Stephanie / Acker, Michael A / Desai, Nimesh / Atluri, Pavan / Wang, Grace J / Jackson, Benjamin M / Weimer, James

Journal of the American Heart Association

2023 Volume 12, Issue 3, Page(s) e028819

Abstract: Background Early diagnosis is essential for effective stroke therapy. Strokes in hospitalized patients are associated with worse outcomes compared with strokes in the community. We derived and validated an algorithm to identify strokes by monitoring ... ...

Abstract	Background Early diagnosis is essential for effective stroke therapy. Strokes in hospitalized patients are associated with worse outcomes compared with strokes in the community. We derived and validated an algorithm to identify strokes by monitoring upper limb movements in hospitalized patients. Methods and Results A prospective case-control study in hospitalized patients evaluated bilateral arm accelerometry from patients with acute stroke with lateralized weakness and controls without stroke. We derived a stroke classifier algorithm from 123 controls and 77 acute stroke cases and then validated the performance in a separate cohort of 167 controls and 33 acute strokes, measuring false alarm rates in nonstroke controls and time to detection in stroke cases. Faster detection time was associated with more false alarms. With a median false alarm rate among nonstroke controls of 3.6 (interquartile range [IQR], 2.1-5.0) alarms per patient per day, the median time to detection was 15.0 (IQR, 8.0-73.5) minutes. A median false alarm rate of 1.1 (IQR. 0-2.2) per patient per day was associated with a median time to stroke detection of 29.0 (IQR, 11.0-58.0) minutes. There were no differences in algorithm performance for subgroups dichotomized by age, sex, race, handedness, nondominant hemisphere involvement, intensive care unit versus ward, or daytime versus nighttime. Conclusions Arm movement data can be used to detect asymmetry indicative of stroke in hospitalized patients with a low false alarm rate. Additional studies are needed to demonstrate clinical usefulness.
MeSH term(s)	Humans ; Arm ; Case-Control Studies ; Stroke/diagnosis ; Algorithms ; Accelerometry
Language	English
Publishing date	2023-01-31
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.122.028819
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Article ; Online: The P2X3 receptor antagonist filapixant in patients with refractory chronic cough: a randomized controlled trial.

Friedrich, Christian / Francke, Klaus / Birring, Surinder S / van den Berg, Jan Willem K / Marsden, Paul A / McGarvey, Lorcan / Turner, Alice M / Wielders, Pascal / Gashaw, Isabella / Klein, Stefan / Morice, Alyn H

Respiratory research

2023 Volume 24, Issue 1, Page(s) 109

Abstract: Background: P2X3 receptor antagonists seem to have a promising potential for treating patients with refractory chronic cough. In this double-blind, randomized, placebo-controlled study, we investigated the efficacy, safety, and tolerability of the novel ...

Abstract	Background: P2X3 receptor antagonists seem to have a promising potential for treating patients with refractory chronic cough. In this double-blind, randomized, placebo-controlled study, we investigated the efficacy, safety, and tolerability of the novel selective P2X3 receptor antagonist filapixant (BAY1902607) in patients with refractory chronic cough. Methods: Following a crossover design, 23 patients with refractory chronic cough (age: 60.4 ± 9.1 years) received ascending doses of filapixant in one period (20, 80, 150, and 250 mg, twice daily, 4-days-on/3-days-off) and placebo in the other. The primary efficacy endpoint was the 24-h cough frequency on Day 4 of each dosing step. Further, subjective cough severity and health-related quality of life were assessed. Results: Filapixant at doses ≥ 80 mg significantly reduced cough frequency and severity and improved cough health-related quality of life. Reductions in 24-h cough frequency over placebo ranged from 17% (80 mg dose) to 37% (250 mg dose), reductions over baseline from 23% (80 mg) to 41% (250 mg) (placebo: 6%). Reductions in cough severity ratings on a 100-mm visual analog scale ranged from 8 mm (80 mg) to 21 mm (250 mg). No serious or severe adverse events or adverse events leading to discontinuation of treatment were reported. Taste-related adverse events occurred in 4%, 13%, 43%, and 57% of patients treated with filapixant 20, 80, 150, and 250 mg, respectively, and in 12% treated with placebo. Conclusions: Filapixant proved to be efficacious, safe, and-apart from the occurrence of taste disturbances, especially at higher dosages-well tolerated during the short therapeutic intervention. Clinical trial registration EudraCT, eudract.ema.europa.eu, 2018-000129-29; ClinicalTrials.gov, NCT03535168.
MeSH term(s)	Humans ; Middle Aged ; Aged ; Cough/chemically induced ; Purinergic P2X Receptor Antagonists ; Quality of Life ; Chronic Disease ; Double-Blind Method
Chemical Substances	Purinergic P2X Receptor Antagonists
Language	English
Publishing date	2023-04-11
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2041675-1
ISSN	1465-993X ; 1465-993X
ISSN (online)	1465-993X
ISSN	1465-993X
DOI	10.1186/s12931-023-02384-8
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Article ; Online: When the cold gets under your skin: Evidence for brown adipose tissue activity in Samoan adults.

Niclou, Alexandra / Vesi, Lupesina / Arorae, Maria / Naseri, New Caledonia / Faasalele Savusa, Kima / Naseri, Take / DeLany, James P / McGarvey, Stephen T / Rivara, Anna C / Ocobock, Cara

American journal of biological anthropology

2023 Volume 183, Issue 2, Page(s) e24848

Abstract: Objectives: Brown adipose tissue (BAT) is a heat-producing organ aiding nonshivering thermogenesis (NST) during cold stress. Due to its potential cold-adaptive role BAT has been predominantly studied in cold and temperate climate populations, but not ... ...

Abstract	Objectives: Brown adipose tissue (BAT) is a heat-producing organ aiding nonshivering thermogenesis (NST) during cold stress. Due to its potential cold-adaptive role BAT has been predominantly studied in cold and temperate climate populations, but not among warm-climate adults. This work explores if BAT activity can be inferred in Samoans. Materials and methods: We inferred BAT activity by comparing metabolic rate and surface heat dissipation using indirect calorimetry and thermal imaging between room temperature and cold exposure among Samoans (N = 61, females: n = 38) from 'Upolu Island, Samoa. BAT activity was inferred using ANOVA linear regression models with the variables measured at cold exposure as outcomes. T-tests were used to compare changes in surface temperature between room temperature and cold exposure. Results: Metabolic rate significantly increased after cooling. In both the supraclavicular area, a known BAT location, and the sternum, a non-BAT location, temperatures decreased significantly upon cold exposure. Differences in supraclavicular temperatures between room temperature and cold were significantly smaller than differences in sternum temperatures between exposures. These results suggest that BAT thermogenesis occurred in known BAT-locations and thus contributed to NST during cooling. Conclusions: This study adds to our understanding of BAT activity across different populations and climates. Further study may illuminate whether the cold-adaptive properties of BAT may have played a role in the successful expansion of populations across the globe, including warm-climate groups.
MeSH term(s)	Adult ; Female ; Humans ; Adipose Tissue, Brown/metabolism ; Body Temperature Regulation ; Cold Temperature ; Pacific Island People ; Thermogenesis ; Male
Language	English
Publishing date	2023-09-23
Publishing country	United States
Document type	Journal Article
ISSN	2692-7691
ISSN (online)	2692-7691
DOI	10.1002/ajpa.24848
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Article ; Online: The Efficacy and Safety of Gefapixant in a Phase 3b Trial of Patients with Recent-Onset Chronic Cough.

McGarvey, Lorcan / Sher, Mandel / Shvarts, Yury Grigorievich / Lu, Susan / Wu, Wen-Chi / Xu, Ping / Schelfhout, Jonathan / La Rosa, Carmen / Nguyen, Allison Martin / Reyfman, Paul A / Afzal, Amna Sadaf

Lung

2023 Volume 201, Issue 2, Page(s) 111–118

Abstract: ... A statistically significant treatment difference of 0.75 (95% CI: 0.06, 1.44; p = 0.034) for gefapixant vs ...

Abstract	Purpose: We evaluated gefapixant, a P2X3 receptor antagonist, in participants with recent-onset (≤ 12 months) refractory chronic cough (RCC) or unexplained chronic cough (UCC). Methods: Participants (≥ 18 years of age; ≥ 40 mm on a 100-mm cough severity visual analog scale [VAS] at screening and randomization) with chronic cough for < 12 months were enrolled in this phase 3b, double-blind, placebo-controlled, parallel group, multicenter study (NCT04193202). Participants were randomized 1:1 to gefapixant 45 mg BID or placebo for 12 weeks with a 2-week follow-up. The primary efficacy endpoint was change from baseline at Week 12 in Leicester Cough Questionnaire (LCQ) total score. Adverse events were monitored and evaluated. Results: There were 415 participants randomized and treated (mean age 52.5 years; median [range] duration 7.5 [1-12] months): 209 received placebo and 206 received gefapixant 45 mg BID. A statistically significant treatment difference of 0.75 (95% CI: 0.06, 1.44; p = 0.034) for gefapixant vs. placebo was observed for change from baseline in LCQ total score at Week 12. The most common AE was dysgeusia (32% gefapixant vs. 3% placebo participants); serious AEs were rare (1.5% gefapixant vs. 1.9% placebo participants). Conclusion: Gefapixant 45 mg BID demonstrated significantly greater improvement in cough-specific health status from baseline compared to placebo, in participants with recent-onset chronic cough. The most common AEs were related to taste and serious AEs were rare.
MeSH term(s)	Humans ; Middle Aged ; Cough/drug therapy ; Chronic Disease ; Pyrimidines/therapeutic use ; Sulfonamides/therapeutic use ; Double-Blind Method ; Treatment Outcome
Chemical Substances	Gefapixant (6K6L7E3F1L) ; Pyrimidines ; Sulfonamides
Language	English
Publishing date	2023-03-06
Publishing country	United States
Document type	Randomized Controlled Trial ; Multicenter Study ; Clinical Trial, Phase III ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	6165-7
ISSN	1432-1750 ; 0341-2040
ISSN (online)	1432-1750
ISSN	0341-2040
DOI	10.1007/s00408-023-00606-w
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Article ; Online: Patterns of cough in the clinic.

McGarvey, L P A

Pulmonary pharmacology & therapeutics

2011 Volume 24, Issue 3, Page(s) 300–303

Abstract: Current guidelines for the management of cough highlight the value of a taking a careful history to establish specific features of the cough in particular its duration, typical triggers or aggravants and associated symptoms. Unfortunately the diagnostic ... ...

Abstract	Current guidelines for the management of cough highlight the value of a taking a careful history to establish specific features of the cough in particular its duration, typical triggers or aggravants and associated symptoms. Unfortunately the diagnostic yield from a history alone is poor and there is a need to understand the pattern of clinical cough in a more precise way. As the technology to record cough in ambulatory settings becomes more sophisticated so the possibility that precise measurement of the cough frequency, intensity and acoustic characteristics may offer diagnostically valuable information in individual patients becomes a reality. In this article the current knowledge of the clinical patterns of cough is discussed and the potential for new technology to record cough patterns in a meaningful way is considered.
MeSH term(s)	Ambulatory Care/methods ; Animals ; Biomedical Technology ; Cough/diagnosis ; Cough/etiology ; Cough/physiopathology ; Humans ; Practice Guidelines as Topic
Language	English
Publishing date	2011-06
Publishing country	England
Document type	Journal Article
ZDB-ID	1399707-5
ISSN	1522-9629 ; 1094-5539
ISSN (online)	1522-9629
ISSN	1094-5539
DOI	10.1016/j.pupt.2011.01.014
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Zs.A 2389: Show issues

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Article ; Online: Association between age at menarche and cardiometabolic risk among Samoan adults.

Oyama, Sakurako / Duckham, Rachel L / Pomer, Alysa / Rivara, Anna C / Kershaw, Erin E / Wood, Ashlee / Fidow, Ulai T / Naseri, Take / Reupena, Muagututia S / Viali, Satupaitea / McGarvey, Stephen T / Hawley, Nicola L

American journal of human biology : the official journal of the Human Biology Council

2023 Volume 36, Issue 1, Page(s) e23982

Abstract: ... at menarche was associated with a 15% decrease (OR = 0.85, 95% CI: 0.72-1.01, p = .067) in odds ... of hypertension, but a 21% increase (OR = 1.21, 95% CI: 1.01-1.45, p = .044) in odds of diabetes and 18% increase ... OR = 1.18, 95% CI: 0.98-1.42, p = .081) in odds of high total cholesterol. Each additional year ...

Abstract	Objectives: Recent studies suggest that early menarche may increase cardiometabolic morbidity and mortality. Yet few studies have examined this association in the Pacific Islands, where obesity prevalence is among the highest globally. We sought to examine associations between age at menarche and cardiometabolic risk in Samoa. Methods: Participants were from the Soifua Manuia study (n = 285, age 32-72 years) conducted in Samoa from 2017 to 2019. Logistic regressions were conducted to estimate odds of obesity, hypertension, diabetes, dyslipidemia, and metabolic syndrome per one-year increase in age at menarche. Linear regressions were conducted to examine associations between age at menarche and continuous measures of adiposity, blood pressure, insulin resistance, and serum lipids. Results: Median age at menarche was 14 years (IQR = 2). After controlling for relevant covariates, each one-year increase in age at menarche was associated with a 15% decrease (OR = 0.85, 95% CI: 0.72-1.01, p = .067) in odds of hypertension, but a 21% increase (OR = 1.21, 95% CI: 1.01-1.45, p = .044) in odds of diabetes and 18% increase (OR = 1.18, 95% CI: 0.98-1.42, p = .081) in odds of high total cholesterol. Each additional year in age at menarche was associated with a 1.60 ± 0.52 kg (p = .002) decrease in lean mass and 1.56 ± 0.51 kg (p = .003) decrease in fat-free mass. Conclusions: Associations between age at menarche and cardiometabolic risk may be population-specific and are likely influenced by both current and historical nutritional and epidemiological contexts. Prospective studies are needed to clarify the role of childhood adiposity and other early life exposures on age at menarche and subsequent cardiometabolic risk.
MeSH term(s)	Adult ; Female ; Humans ; Child, Preschool ; Middle Aged ; Aged ; Menarche/physiology ; Risk Factors ; Body Mass Index ; Age Factors ; Pediatric Obesity ; Hypertension/epidemiology ; Hypertension/etiology ; Diabetes Mellitus ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology
Language	English
Publishing date	2023-09-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1025339-7
ISSN	1520-6300 ; 1042-0533
ISSN (online)	1520-6300
ISSN	1042-0533
DOI	10.1002/ajhb.23982
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Article ; Online: Trypsin-Like Proteases and Their Role in Muco-Obstructive Lung Diseases.

Carroll, Emma L / Bailo, Mariarca / Reihill, James A / Crilly, Anne / Lockhart, John C / Litherland, Gary J / Lundy, Fionnuala T / McGarvey, Lorcan P / Hollywood, Mark A / Martin, S Lorraine

International journal of molecular sciences

2021 Volume 22, Issue 11

Abstract: Trypsin-like proteases (TLPs) belong to a family of serine enzymes with primary substrate specificities for the basic residues, lysine and arginine, in the P1 position. Whilst initially perceived as soluble enzymes that are extracellularly secreted, a ... ...

Abstract	Trypsin-like proteases (TLPs) belong to a family of serine enzymes with primary substrate specificities for the basic residues, lysine and arginine, in the P1 position. Whilst initially perceived as soluble enzymes that are extracellularly secreted, a number of novel TLPs that are anchored in the cell membrane have since been discovered. Muco-obstructive lung diseases (MucOLDs) are characterised by the accumulation of hyper-concentrated mucus in the small airways, leading to persistent inflammation, infection and dysregulated protease activity. Although neutrophilic serine proteases, particularly neutrophil elastase, have been implicated in the propagation of inflammation and local tissue destruction, it is likely that the serine TLPs also contribute to various disease-relevant processes given the roles that a number of these enzymes play in the activation of both the epithelial sodium channel (ENaC) and protease-activated receptor 2 (PAR2). More recently, significant attention has focused on the activation of viruses such as SARS-CoV-2 by host TLPs. The purpose of this review was to highlight key TLPs linked to the activation of ENaC and PAR2 and their association with airway dehydration and inflammatory signalling pathways, respectively. The role of TLPs in viral infectivity will also be discussed in the context of the inhibition of TLP activities and the potential of these proteases as therapeutic targets.
MeSH term(s)	Animals ; COVID-19/enzymology ; COVID-19/pathology ; Epithelial Sodium Channels/metabolism ; Humans ; Lung Diseases, Obstructive/enzymology ; Lung Diseases, Obstructive/pathology ; Receptor, PAR-2/metabolism ; SARS-CoV-2/metabolism ; Trypsin/metabolism
Chemical Substances	Epithelial Sodium Channels ; F2RL1 protein, human ; Receptor, PAR-2 ; Trypsin (EC 3.4.21.4)
Language	English
Publishing date	2021-05-29
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms22115817
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