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Background: Limited available data indicate that dementia prevalence rates among Aboriginal and Torres Strait Islander (hereafter Aboriginal) peoples are 3-5 times higher than the overall Australian population. Effective, pragmatic and scalable interventions are urgently required to address this disproportionate burden of dementia in Aboriginal populations.
Methods: Kaat Koort is a pragmatic two-arm parallel-group randomized controlled trial which will recruit a sample of 354 participants from two Aboriginal community-controlled health services in the south-west of Western Australia. Eligible participants are aged 35-60 years with risk factors for cardiovascular disease. Participants will be randomized in a 1:1 ratio to receive either a 12-month multifactorial lifestyle intervention (guided by Aboriginal Health Practitioners) that involves cardiovascular risk management, a lifestyle program targeting diet and physical activity, and support for smoking cessation and depression, or usual care (control). The primary endpoints are change in (i) systolic, and (ii) diastolic blood pressure. Secondary endpoints are changes in other cardiovascular risk factors (elevated blood pressure, HDL cholesterol, HbA1c, waist circumference, and absolute cardiovascular risk score), cognitive functioning, and adherence to Australian dietary and physical activity guidelines. Outcomes will be collected at baseline, and 6- and 12-months post-baseline.
Discussion: This trial aims to determine the efficacy of a multifactorial lifestyle intervention in reducing blood pressure among Aboriginal people aged 35-60 years at risk of dementia.
Trial Registration Number: ACTRN12621001022853; Australian New Zealand Clinical Trial Registry identifier.
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http://dx.doi.org/10.1016/j.conctc.2025.101457 | DOI Listing |
World J Pediatr Congenit Heart Surg
September 2025
Postgraduate Program in Health Sciences, Medical School, Federal University of Amazonas (UFAM), Manaus, Amazonas, Brazil.
To analyze in-hospital mortality in children undergoing congenital heart interventions in the only public referral center in Amazonas, North Brazil, between 2014 and 2022. This retrospective cohort study included 1041 patients undergoing cardiac interventions for congenital heart disease, of whom 135 died during hospitalization. Records were reviewed to obtain demographic, clinical, and surgical data.
View Article and Find Full Text PDFJ Med Screen
September 2025
Institute of Cardiovascular Science, University College London, London, UK.
It is claimed that polygenic risk scores will transform disease prevention, but a typical polygenic risk score for a common disease only detects 11% of affected individuals at a 5% false positive rate. This level of screening performance is not useful. Claims to the contrary are either due to incorrect interpretation of the data or other influences.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla.
Importance: Janus kinase (JAK) inhibitors are highly effective medications for several immune-mediated inflammatory diseases (IMIDs). However, safety concerns have led to regulatory restrictions.
Objective: To compare the risk of adverse events with JAK inhibitors vs tumor necrosis factor (TNF) antagonists in patients with IMIDs in head-to-head comparative effectiveness studies.
JAMA Cardiol
September 2025
Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, New York.
Importance: Transthyretin cardiac amyloidosis (ATTR-CA) is an underdiagnosed but treatable cause of heart failure (HF) in older individuals that occurs in the context of normal wild-type (ATTRwt-CA) or an abnormal inherited (ATTRv-CA) TTR gene variant. While the most common inherited TTR variant, V142I, occurs in 3% to 4% of self-identified Black Americans and is associated with excess morbidity and mortality, the prevalence of ATTR-CA in this at-risk population is unknown.
Objective: To define the prevalence of ATTR-CA and proportions attributable to ATTRwt-CA or ATTRv-CA among older Black and Caribbean Hispanic individuals with HF.
Int J Surg
September 2025
Department of Pharmacy, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, Henan, China.
Background: Antiplatelet therapy is a cornerstone in the management of atherosclerotic cardiovascular disease. However, the risk profile of central nervous system (CNS) hematomas associated with antiplatelet agents remains incompletely characterized.
Methods: We analyzed CNS-related hematoma adverse event (hAE) reports across the four antiplatelet drugs, using data from the U.