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Article ; Online: Multiple Sclerosis Diagnostic Criteria: Moving Ahead or Walking in Place?

Cutter, Gary R / Koch, Marcus W

2021 Volume 98, Issue 1, Page(s) 12–13

MeSH term(s)	Disability Evaluation ; Humans ; Multiple Sclerosis/diagnosis ; Walking
Language	English
Publishing date	2021-10-29
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	207147-2
ISSN	1526-632X ; 0028-3878
ISSN (online)	1526-632X
ISSN	0028-3878
DOI	10.1212/WNL.0000000000013014
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Article ; Online: Vascular Access-Related Distal Ischemia Requiring Intervention: Frequency, Risk Factors, and Consequences.

Allon, Michael / Cutter, Gary R / Young, Carlton J

Clinical journal of the American Society of Nephrology : CJASN

2023 Volume 18, Issue 12, Page(s) 1592–1598

Abstract: Background: Distal ischemia is a rare complication in patients undergoing placement of an arteriovenous (AV) fistula or AV graft. There are limited studies on its frequency, risk factors, clinical consequences, or feasibility of subsequent access.: ... ...

Abstract	Background: Distal ischemia is a rare complication in patients undergoing placement of an arteriovenous (AV) fistula or AV graft. There are limited studies on its frequency, risk factors, clinical consequences, or feasibility of subsequent access. Methods: A prospective vascular access database from a large academic medical center was queried retrospectively to identify 1498 patients (mean age 56±15 years, 48% female patients, 73% Black patients) undergoing placement of at least one vascular access from 2011 to 2020. For patients who developed access-related distal ischemia requiring surgical intervention, we determined the frequency of distal ischemia, clinical risk factors, and subsequent outcomes. Results: Severe access-related distal ischemia occurred in 28 patients (1.9%; 95% confidence interval, 1.3% to 2.7%). The frequency was 0.2% for forearm AV fistulas, 0.9% for upper arm AV fistulas, 2.4% for forearm AV grafts, 2.2% for upper arm AV grafts, and 2.8% for thigh AV grafts. Risk factors independently associated with distal ischemia included female sex (odds ratio [OR], 3.64 [95% confidence interval, 1.52 to 8.72]), peripheral vascular disease (OR, 6.28 [2.84 to 13.87]), and coronary artery disease (OR, 2.37 [1.08 to 5.23]). Surgical interventions included ligation, excision, plication (banding), and other surgical procedures. Five patients developed tissue necrosis. A subsequent AV graft was placed in 13 patients, of whom only one (8%) developed distal ischemia requiring intervention. Conclusions: Access-related distal ischemia requiring intervention was rare in this study and more common in women and patients with peripheral vascular disease or coronary artery disease. In some cases, a subsequent vascular access could be placed with a low likelihood of recurrent distal ischemia.
MeSH term(s)	Humans ; Female ; Adult ; Middle Aged ; Aged ; Male ; Treatment Outcome ; Coronary Artery Disease/complications ; Arteriovenous Shunt, Surgical/adverse effects ; Retrospective Studies ; Prospective Studies ; Renal Dialysis/adverse effects ; Risk Factors ; Ischemia/etiology ; Ischemia/surgery ; Peripheral Vascular Diseases/complications ; Fistula/complications ; Vascular Patency
Language	English
Publishing date	2023-09-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2226665-3
ISSN	1555-905X ; 1555-9041
ISSN (online)	1555-905X
ISSN	1555-9041
DOI	10.2215/CJN.0000000000000310
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Article ; Online: If Thymectomy Reduces the Risk of Progression of Ocular to Generalized Myasthenia Gravis, Who Should Receive it?

Cutter, Gary R / Sanders, Donald B

Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics

2021 Volume 18, Issue 4, Page(s) 2419–2420

Abstract: In this issue of Neurotherapeutics, Li et.al. report a large retrospective study of the beneficial effects of thymectomy on the progression of ocular myasthenia gravis (OMG) to generalized MG (GMG) (Huanhuan et al. in Neurotherapeutics XX, 2021). This ... ...

Abstract	In this issue of Neurotherapeutics, Li et.al. report a large retrospective study of the beneficial effects of thymectomy on the progression of ocular myasthenia gravis (OMG) to generalized MG (GMG) (Huanhuan et al. in Neurotherapeutics XX, 2021). This paper demonstrates a more than 50% reduction in the risk of GMG when a thymectomy was performed on these patients. The authors conclude with the recommendation that well-designed clinical trials be performed to evaluate the potential that thymectomy in OMG reduces the burden of GMG.
MeSH term(s)	Humans ; Myasthenia Gravis/surgery ; Retrospective Studies ; Thymectomy
Language	English
Publishing date	2021-10-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2316693-9
ISSN	1878-7479 ; 1933-7213
ISSN (online)	1878-7479
ISSN	1933-7213
DOI	10.1007/s13311-021-01139-x
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Article ; Online: The Non-Inferiority Complex: What Do Non-Inferiority Trials Tell Us?

Assimon, Magdalene M / Cutter, Gary R / Bargman, Joanne M

Journal of the American Society of Nephrology : JASN

2022 Volume 33, Issue 4, Page(s) 674–676

MeSH term(s)	Research Design
Language	English
Publishing date	2022-03-31
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1085942-1
ISSN	1533-3450 ; 1046-6673
ISSN (online)	1533-3450
ISSN	1046-6673
DOI	10.1681/ASN.2021050681
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Article ; Online: Randomized Controlled Trial of the Behavioral Intervention for Physical Activity in Multiple Sclerosis Project: Response Heterogeneity and Predictors of Change.

Silveira, Stephanie L / Motl, Robert W / Sandroff, Brian M / Pilutti, Lara A / Cutter, Gary R

International journal of behavioral medicine

2024

Abstract: ... correlated with baseline MVPA (r = - .33 and r = - .34, p = .0004 and p = .0001) in both conditions and ... walking impairment (r = - .188, p = .047) and race (r = .233, p = .014) in the behavioral intervention ...

Abstract	Background: We reported that a social cognitive theory-based (SCT), Internet-delivered behavioral intervention increased device-measured minutes/day of moderate-to-vigorous physical activity (MVPA) over a 6-month period among persons with multiple sclerosis (MS). This paper examined the pattern and predictors of heterogeneity in change for MVPA. Based on previous research, we hypothesized that mild MS disability, fewer MS symptoms, lower baseline MVPA, and positive SCT characteristics (e.g., high exercise self-efficacy) would be associated with greater change in MVPA. Method: Persons with MS (N = 318) were randomized into behavioral intervention (n = 159) or attention/social contact control (n = 159) conditions that were administered via Internet websites and supported with behavioral coaching. Demographic, clinical, symptom, behavioral, and SCT data were from before the 6-month period of delivering the conditions, and MVPA data were from before and after the 6-month period. We examined heterogeneity based on waterfall plots, box plots, and the Levene statistic. We identified predictors of MVPA change using bivariate correlation and multiple, linear regression analyses per condition. Results: The Levene statistic indicated statistically significant heterogeneity of variances for MVPA change between conditions (p = .003), and the waterfall plots and box plots indicated greater heterogeneity in MVPA change for the behavioral intervention. MVPA change score was correlated with baseline MVPA (r = - .33 and r = - .34, p = .0004 and p = .0001) in both conditions and walking impairment (r = - .188, p = .047) and race (r = .233, p = .014) in the behavioral intervention condition. The regression analysis indicated that baseline MVPA (Standardized B = - .449, p = .000002), self-reported walking impairment (Standardized B = - .310, p = .0008), and race (Standardized B = .215, p = .012) explained 25.6% of variance in MVPA change for the behavioral intervention condition. Conclusion: We provide evidence for walking impairment, baseline MVPA, and race as predictors of the heterogeneity in the pattern of MVPA change with a behavioral intervention.
Language	English
Publishing date	2024-02-07
Publishing country	England
Document type	Journal Article
ZDB-ID	1187972-5
ISSN	1532-7558 ; 1070-5503
ISSN (online)	1532-7558
ISSN	1070-5503
DOI	10.1007/s12529-024-10265-7
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Article ; Online: Do physical activity, cardiorespiratory fitness, and subcortical brain structures explain reduced walking performance in older adults with multiple sclerosis?

Baird, Jessica F / Cutter, Gary R / Motl, Robert W

Multiple sclerosis and related disorders

2022 Volume 60, Page(s) 103702

Abstract: ... of the thalamus and putamen (r range 0.34-0.65). Regression analyses indicated that MVPA (β=0.007094) partially ...

Abstract	Background: As adults with multiple sclerosis (MS) age, walking speed and endurance progressively decline, yet there is limited understanding of factors that explain such age-related declines. The current study examined subcortical brain structures, cardiorespiratory fitness, and moderate-to-vigorous physical activity (MVPA) as explanations for reduced walking performance in older adults with MS. Methods: Older adults with MS (n = 29, 62.8 ± 5.8 years) and age-and-sex matched controls (n = 28, 63.8 ± 5.5 years) completed measures of walking speed (Timed-25 ft Walk) and walking endurance (Six-minute Walk), cardiorespiratory fitness, device-measured MVPA, and underwent an MRI to provide composite volumes of the thalamus, caudate, putamen, and pallidum. We used a mediator variable framework to describe group differences, determine correlations in the overall sample, and identify variables that explain reduced walking performance. Results: Compared to controls, older adults with MS had worse walking speed (p<0.001) and endurance (p<0.001), lower fitness (p = 0.04), lower levels of MVPA (p = 0.001), and smaller composite volumes of the thalamus (p=<0.001), putamen (p = 0.04), and pallidum (p = 0.007). In the overall sample, both measures of walking performance were significantly correlated with fitness, MVPA, and volumes of the thalamus and putamen (r range 0.34-0.65). Regression analyses indicated that MVPA (β=0.007094) partially explained the group differences in walking speed, and fitness (β=7.7640) and MVPA (β=17.5797) partially explained the group differences in walking endurance. Conclusions: Collectively, these results suggest that cardiorespiratory fitness and MVPA, but not subcortical brain structures, may be modifiable targets of future interventions for improving walking in older adults with MS.
MeSH term(s)	Aged ; Brain/diagnostic imaging ; Cardiorespiratory Fitness ; Exercise ; Humans ; Multiple Sclerosis/diagnostic imaging ; Walking
Language	English
Publishing date	2022-02-20
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2645330-7
ISSN	2211-0356 ; 2211-0348
ISSN (online)	2211-0356
ISSN	2211-0348
DOI	10.1016/j.msard.2022.103702
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Article ; Online: Clinical trials: To catch a crook, you might try statistics.

Cutter, Gary R

Nature reviews. Neurology

2016 Volume 13, Issue 1, Page(s) 9–10

MeSH term(s)	Data Interpretation, Statistical ; Humans ; Randomized Controlled Trials as Topic ; Systematic Reviews as Topic
Language	English
Publishing date	2016-12-16
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	2491514-2
ISSN	1759-4766 ; 1759-4758
ISSN (online)	1759-4766
ISSN	1759-4758
DOI	10.1038/nrneurol.2016.194
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Article ; Online: Sales to Apparently Intoxicated Customers in Three States with Different Histories of Responsible Beverage Service Training.

Buller, David B / Woodall, W Gill / Saltz, Robert / Martinez, Lila / Small, Annelise / Chirico, Noah / Cutter, Gary R

Journal of studies on alcohol and drugs

2024

Abstract: Objective: Most states prohibit sales of alcohol to customers who are apparently intoxicated and many require training in responsible beverage service (RBS), with the aim of reducing driving while intoxicated (DWI) and other harms. Sales to apparently ... ...

Abstract	Objective: Most states prohibit sales of alcohol to customers who are apparently intoxicated and many require training in responsible beverage service (RBS), with the aim of reducing driving while intoxicated (DWI) and other harms. Sales to apparently intoxicated patrons were assessed in on-site alcohol sales establishments and compared across three states. Methods: A sample of 180 licensed on-site alcohol establishments was selected in California (n=60), New Mexico (n=60), and Washington state (n=60). States had different RBS training histories, content, and procedures. Research confederates, trained to feign cues of intoxication, visited each establishment twice. The pseudo-intoxicated patron (PP) ordered an alcoholic beverage while displaying intoxication cues. Sale of alcohol was the primary outcome. Results: At 179 establishments assessed, PPs were served alcohol during 56.5% of 356 visits (35.6% of establishments served and 22.6% did not serve at both visits). Alcohol sales were less frequent in New Mexico (47.9% of visits; odds ratio [OR]=0.374, p=0.008) and Washington state (49.6%; OR=0.387, p=0.012) than in California (72.0%). Servers less consistently refused service at both visits (6.8%) in California than New Mexico (33.9%) or Washington (27.1%) (χ2(4, N=177)=16.72, p=0.002). Alcohol sales were higher when intoxication cues were less obvious (p<0.001). Conclusions: Over-service of alcohol to apparently intoxicated customers was frequent and likely elevated risk of DWI and other harms. The lower sales in New Mexico and Washington than California may show that a policy approach prohibiting sales to intoxicated customers combined with well-established RBS training can reduce over-service. Further efforts are needed to reduce over-service.
Language	English
Publishing date	2024-01-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2266450-6
ISSN	1938-4114 ; 1934-2683 ; 1937-1888 ; 0096-882X
ISSN (online)	1938-4114 ; 1934-2683
ISSN	1937-1888 ; 0096-882X
DOI	10.15288/jsad.23-00258
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Article: Attitudes of people with multiple sclerosis toward brain donation.

Marrie, Ruth Ann / Kosowan, Leanne / Cutter, Gary R / Fox, Robert J / Salter, Amber

Frontiers in neurology

2023 Volume 14, Page(s) 1115303

Abstract: Objective: Research directly examining brain tissue has played an important role in understanding the pathology and pathogenesis of multiple sclerosis (MS) and other diseases of the central nervous system. Such research relies heavily on donations of ... ...

Abstract	Objective: Research directly examining brain tissue has played an important role in understanding the pathology and pathogenesis of multiple sclerosis (MS) and other diseases of the central nervous system. Such research relies heavily on donations of post-mortem brain tissue yet little is known about the attitudes of people with multiple sclerosis (MS) about brain donation. We aimed to assess the attitudes of people with MS toward brain donation, their preferences related to discussions of brain donation, and factors associated with attitudes toward brain donation including sociodemographic and clinical characteristics, health literacy and religiosity. Methods: In a cross-sectional study, we surveyed participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry regarding their attitudes toward brain donation, reasons for participating or not participating in brain donation, and related communication preferences. We used multivariable logistic regression analyses to test factors associated with attitudes regarding brain donation. Results: Most of the 4,520 participants were women (80.8%), self-identified as white (88.1%), with a post-secondary education, functional health literacy and moderate-severe disability. Sixty-two percent of participants would consider brain donation. Factors associated with considering brain donation included female gender, having a post-secondary education, being physically active, having moderate-severe disability and more comorbidities, and alcohol intake. Seventy-five percent of participants indicated that they preferred to receive information regarding brain donations from physicians. Conclusion: Two-thirds of people with MS would consider brain donation. People with MS desire to hear about brain donation from their health care providers rather than other sources.
Language	English
Publishing date	2023-01-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1115303
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Article ; Online: Stretching is not essential for managing MS spasticity: A randomized controlled trial.

Hugos, Cinda L / Joos, Sandra K / Perumean-Chaney, Suzanne E / Cutter, Gary R / Cameron, Michelle H

Multiple sclerosis (Houndmills, Basingstoke, England)

2023 Volume 30, Issue 1, Page(s) 89–102

Abstract: Background: Clinical practice, expert opinion, and evidence-based guidelines recommend daily stretching as first-line treatment for multiple sclerosis (MS) spasticity, but this has not been evaluated by fully powered clinical trials.: Objective: To ... ...

Abstract	Background: Clinical practice, expert opinion, and evidence-based guidelines recommend daily stretching as first-line treatment for multiple sclerosis (MS) spasticity, but this has not been evaluated by fully powered clinical trials. Objective: To determine whether MS Spasticity: Take Control (STC), a guideline-based program of spasticity education and stretching exercises has different effects on the impact of spasticity than a control program of different spasticity education and range of motion (ROM) exercises. Methods: Ambulatory people with self-reported MS spasticity were randomly assigned to STC or ROM, delivered in same duration, facilitator-led, group classes, face-to-face (F2F) initially and later virtually, due to coronavirus disease 2019 (COVID-19). Multiple Sclerosis Spasticity Scale (MSSS) scores were compared between groups at 1 (primary outcome) and 6 months after interventions. Results: A total of 231 people enrolled. There was no significant difference in MSSS scores between STC and ROM at 1 month (mean difference = 0.28, 95% (confidence interval (CI)) = [-9.45 to 10.01], Conclusion: Education with stretching exercises, the first-line recommended treatment for MS spasticity, and education with ROM exercises may both improve MS spasticity to a similar degree. This study debunks the belief that stretching is essential to managing MS spasticity.
MeSH term(s)	Humans ; Muscle Spasticity/etiology ; Muscle Spasticity/therapy ; Exercise Therapy ; Multiple Sclerosis/complications ; Multiple Sclerosis/therapy ; Self Report
Language	English
Publishing date	2023-12-23
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1290669-4
ISSN	1477-0970 ; 1352-4585
ISSN (online)	1477-0970
ISSN	1352-4585
DOI	10.1177/13524585231215960
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