The Relationship of Exercise, Psychosocial Factors, and Social Participation Among Adults Aging With Long-Term Physical Disability: A Cross-Sectional Study
(2024) American Journal of Health Promotion, .
Morgan, K.A.a , Desai, R.H.a , Trocinski, C.W.a , Hollingsworth, H.a , Dashner, J.a , Putnam, M.b , Stark, S.L.a
a Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
b School of Social Work, Simmons University, Boston, MA, United States
Abstract
Purpose: This study investigated the relationships among exercise engagement, psychosocial factors, and social participation for adults aging with physical disabilities (AAwPD). Design: A cross-sectional study within a community-based cohort study of participation among AAwPD was conducted. Setting: A comprehensive survey was administered online or via telephone. Participants: Participants were 474 individuals between the ages of 45-65, primarily living in the Midwestern United States, who reported living with a physical disability for at least 5 years. Method: Survey questions created based on prior consolidation of activity domains assessed exercise engagement. Psychosocial health and social participation were measured using the Patient Reported Outcomes Measurement Information System. Chi-square tests, t-tests, and a general linear model were used to examine differences between exercisers and non-exercisers. Results: Participants who exercised reported less pain (P <.001), fatigue (P <.001), and depression (P <.001) and greater self-efficacy for management of chronic conditions (P =.002), satisfaction with participation in social roles and activities (P <.001), and ability to participate in social roles and activities (P <.001) compared with non-exercising participants. Conclusions: AAwPD who exercised reported fewer secondary conditions and greater social participation. Although causal relationships cannot be drawn, and the frequency, duration, and intensity of exercise were not examined, this study lays important groundwork for future research to determine the health and participation benefits of exercise for AAwPD. Future studies should also focus on the development of exercise interventions to support successful aging with disability. © The Author(s) 2024.
Author Keywords
aging; exercise; physical disability; social participation
Document Type: Article
Publication Stage: Article in Press
Source: Scopus
Safety and effectiveness of diazepam nasal spray in male and female patients: Post hoc analysis of data from a phase 3 safety study
(2024) Epilepsia Open, .
Wheless, J.W.a , Hogan, R.E.b , Davis, C.S.c , Carrazana, E.d e , Rabinowicz, A.L.d
a Le Bonheur Children’s Hospital, University of Tennessee Health Science Center, Memphis, TN, United States
b Washington University in St. Louis, St. Louis, MO, United States
c CSD Biostatistics, Oro Valley, AZ, United States
d Neurelis, Inc., San Diego, CA, United States
e University of Hawaii John A. Burns School of Medicine, Honolulu, HI, United States
Abstract
Sex differences in drug pharmacokinetics include variations in the expression of the cytochrome P450 enzymes, which are involved in the metabolism of benzodiazepines. It is unclear whether sex influences outcomes associated with intranasally administered drugs. A post hoc analysis of sex differences was conducted to evaluate the effectiveness and safety of diazepam nasal spray, which included examining changes in the number of days between seizure clusters over time (SEIzure interVAL [SEIVAL]). Diazepam nasal spray is approved for acute treatment of seizure clusters in patients with epilepsy aged ≥6 years. Data from a phase 3 safety study were used to determine the proportion of second doses used within 24 h (ie, a proxy for effectiveness) and SEIVAL. Adverse events were recorded. Of 163 treated patients, 89 were female, and 74 were male. Approximately 16% of both sexes self-administered the study drug. A slightly higher proportion of seizure clusters was treated with a second dose in female (14.7%) than male (9.4%) patients. SEIVAL increased significantly and substantially over a year for all patients. The safety profile was generally similar between the sexes. These results suggest that potential sex differences in benzodiazepine pharmacokinetics do not meaningfully influence outcomes associated with diazepam nasal spray. Plain Language Summary: Some drugs may have differences in absorption and metabolism between genders that could translate into differences in safety and effectiveness. This safety study looked at diazepam nasal spray for treating seizure clusters in patients at least 6 years old. It found that safety was about the same for females and males. For both groups, most clusters stopped after only 1 dose of the drug, and the time between treated clusters got longer over a year. © 2024 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.
Author Keywords
acute repetitive seizures; benzodiazepines; diazepam; gender; intranasal; sex
Funding details
Neurelis
Document Type: Article
Publication Stage: Article in Press
Source: Scopus
Gene–environment interactions: Epstein–Barr virus infection and risk of pediatric-onset multiple sclerosis
(2024) Multiple Sclerosis Journal, .
Ziaei, A.a q , Solomon, O.b , Casper, T.C.c , Waltz, M.c , Weinstock-Guttman, B.d , Aaen, G.e , Wheeler, Y.f , Graves, J.g , Benson, L.h , Gorman, M.h , Rensel, M.i , Mar, S.j , Lotze, T.k , Greenberg, B.l , Chitnis, T.m , Waldman, A.T.n , Krupp, L.o , James, J.A.p , Hart, J.a , Barcellos, L.F.b , Waubant, E.a
a University of California San Francisco, San Francisco, CA, United States
b Division of Epidemiology and Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
c The University of Utah, Salt Lake City, UT, United States
d Buffalo General Hospital, State University of New York at Buffalo, Buffalo, NY, United States
e Loma Linda University Children’s Hospital, Loma Linda, CA, United States
f The University of Alabama at Birmingham, Birmingham, AL, United States
g University of California San Diego, San Diego, CA, United States
h Pediatric Multiple Sclerosis and Related Disorders Program, Boston Children’s Hospital, Boston, MA, United States
i Cleveland Clinic, Cleveland, OH, United States
j Washington University in St. Louis, St. Louis, MO, United States
k Texas Children’s Hospital, Houston, TX, United States
l The University of Texas Southwestern Medical Center, Dallas, TX, United States
m Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
n Division of Child Neurology, The Children’s Hospital of Philadelphia, Philadelphia, PA, United States
o New York University Medical Center, New York, NY, United States
p Oklahoma Medical Research Foundation, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
q Department of Pathology & Laboratory Medicine, University of California, Irvine Medical Center (UCIMC), Orange, CA, United States
Abstract
Background and Objective: Prior Epstein–Barr virus (EBV) infection is associated with an increased risk of pediatric-onset multiple sclerosis (POMS) and adult-onset multiple sclerosis (MS). It has been challenging to elucidate the biological mechanisms underlying this association. We examined the interactions between candidate human leukocyte antigen (HLA) and non-HLA variants and childhood EBV infection as it may provide mechanistic insights into EBV-associated MS. Methods: Cases and controls were enrolled in the Environmental and Genetic Risk Factors for Pediatric MS study of the US Network of Pediatric MS Centers. Participants were categorized as seropositive and seronegative for EBV-viral capsid antigen (VCA). The association between prior EBV infection and having POMS was estimated with logistic regression. Interactions between EBV serostatus, major HLA MS risk factors, and non-HLA POMS risk variants associated with response to EBV infection were also evaluated with logistic regression. Models were adjusted for sex, age, genetic ancestry, and the mother’s education. Additive interactions were calculated using relative risk due to interaction (RERI) and attributable proportions (APs). Results: A total of 473 POMS cases and 702 controls contributed to the analyses. Anti-VCA seropositivity was significantly higher in POMS cases compared to controls (94.6% vs 60.7%, p < 0.001). There was evidence for additive interaction between childhood EBV infection and the presence of the HLA-DRB1*15 allele (RERI = 10.25, 95% confidence interval (CI) = 3.78 to 16.72; AP = 0.61, 95% CI = 0.47 to 0.75). There was evidence for multiplicative interaction (p < 0.05) between childhood EBV infection and the presence of DRB1*15 alleles (odds ratio (OR) = 3.43, 95% CI = 1.06 to 11.07). Among the pediatric MS variants also associated with EBV infection, we detected evidence for additive interaction (p = 0.02) between prior EBV infection and the presence of the GG genotype in risk variant (rs2255214) within CD86 (AP = 0.30, 95% CI = 0.03 to 0.58). Conclusion: We report evidence for interactions between childhood EBV infection and DRB1*15 and the GG genotype of CD86 POMS risk variant. Our results suggest an important role of antigen-presenting cells (APCs) in EBV-associated POMS risk. © The Author(s), 2024.
Author Keywords
CD68; DRB1*15; Epstein–Barr virus; gene–environment interaction; multiple sclerosis; Pediatric onset
Funding details
National Multiple Sclerosis SocietyNMSSHC-1509-06233, UM1AI144292
Multiple Sclerosis International FederationMSIF
Document Type: Article
Publication Stage: Article in Press
Source: Scopus