Shari Ling - Academia.edu (original) (raw)

Papers by Shari Ling

Nature Clinical Practice Rheumatology, 2008

The journals of gerontology. Series A, Biological sciences and medical sciences, 2016

Clinical Pharmacology & Therapeutics, 2006

BACKGROUND: Ebastine, a nonsedative H 1 receptor antagonist, is completely metabolized to the dea... more BACKGROUND: Ebastine, a nonsedative H 1 receptor antagonist, is completely metabolized to the dealkylated metabolite and carebastine, an active metabolite via hydroxylation (M-OH). The conversion of M-OH to carebastine and Des-BP pathway are mainly catalyzed by CYP3A4, whereas the oxidation of ebastine to M-OH is exclusively mediated by CYP2J2.

The Journal of infectious diseases, Jan 31, 2015

Telomeres provide a key mechanism for protecting the integrity of chromosomes and their attritio... more Telomeres provide a key mechanism for protecting the integrity of chromosomes and their attrition after cell division and during aging are evident in lymphocytes. However, the significance of telomere shortening in age-associated decline of immune function is unknown. We selected 22 HLA-A2(+) healthy older adults who have relatively short or long telomere lengths to compare their antibody response against the influenza vaccine, and their CD8(+) T cell response against an influenza antigen. B cells from individuals with a robust antibody response to the influenza vaccine had significantly longer telomeres than those with a poor antibody response. Monocyte-derived antigen-presenting cells of both short and long telomere groups induced similar expansions of influenza M1-specific CD8(+) T cells. Vaccination did not increase M1-specific CD8(+) T cells in blood, however, M1-specific CD8(+) T cells from the long telomere group exhibited significantly better expansion in vitro compared t...

Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society, 2009

To determine whether computer-based analysis can detect features predictive of osteoarthritis (OA... more To determine whether computer-based analysis can detect features predictive of osteoarthritis (OA) development in radiographically normal knees. A systematic computer-aided image analysis method weighted neighbor distances using a compound hierarchy of algorithms representing morphology (WND-CHARM) was used to analyze pairs of weight-bearing knee X-rays. Initial X-rays were all scored as normal Kellgren-Lawrence (KL) grade 0, and on follow-up approximately 20 years later either developed OA (defined as KL grade=2) or remained normal. The computer-aided method predicted whether a knee would change from KL grade 0 to grade 3 with 72% accuracy (P<0.00001), and to grade 2 with 62% accuracy (P<0.01). Although a large part of the predictive signal comes from the image tiles that contained the joint, the region adjacent to the tibial spines provided the strongest predictive signal. Radiographic features detectable using a computer-aided image analysis method can predict the future de...

American Journal of Hypertension, 2010

Central arterial stiffness, a hallmark of arterial aging, 1 is associated with increased risk of ... more Central arterial stiffness, a hallmark of arterial aging, 1 is associated with increased risk of cardiovascular events, allcause and cardiovascular mortality. 2,3 Obesity, an established risk factor for morbidity and mortality, has reached epidemic proportions in the United States, with an estimated prevalence of 34%, or over 72 million Americans ages ≥20 years. 4 Obesity is an important risk factor for arterial stiffness, 5 but the mechanisms for this association are poorly understood. Adipose tissues produce several hormones such as leptin, adiponectin, and resistin. Leptin was initially identified as having important roles in regulating appetite and energy metabolism; however, leptin and other adipokines are increasingly being recognized as exerting pleiotropic effects in various organ systems, including the vasculature. For example, adipokines are associated with factors known to modulate arterial stiffness such as inflammation, sympathetic activity of the autonomic nervous system, hypertrophy, and proliferation of vascular smooth muscle cells, cell adhesion molecules, hyperglycemia, and hyperinsulinemia (see refs. 6,7). Indeed, generally small studies conducted in highly selected populations have reported associations between arterial stiffness, and leptin or adiponectin. We hypothesized that adipo kines may explain the association between obesity and arterial stiffness. Therefore, the purpose of this study was to examine the influence of adipokines such as leptin, adiponectin, or resistin, independent of other factors known to affect vascular stiffness, on the relationship between abdominal adiposity and pulse wave velocity (PWV).

Objective: To verify what information from oral glucose tolerance testing (OGTT) independently pr... more Objective: To verify what information from oral glucose tolerance testing (OGTT) independently predicts mortality.

The Journal of rheumatology, 2003

To examine associations between osteoarthritis (OA) of the knee and early functional limitations ... more To examine associations between osteoarthritis (OA) of the knee and early functional limitations in a cohort of high-functioning older women, and evaluate the contributions of muscle strength, body weight, and pain severity to these limitations. Methods. Cross sectional analyses were conducted on baseline data of the Women's Health and Aging Study II (WHAS II), an observational study of disability transitions in a cohort of women aged 70-79 upon entry and who were representative of the one-third highest-functioning community-resident women. Standardized questionnaires and examinations were used to assess knee OA features, medication use, pain severity, knee extensor muscle strength, and body weight. Functional limitation was assessed using validated performance measures and self-report measures of task modification and task difficulty. Sixty-nine women classified as "symptomatic" for knee OA, 48 with "asymptomatic/intermittently symptomatic," knee OA, and 285...

American Journal of Hypertension, 2011

Background-Arterial stiffening is one of the hallmarks of vascular aging, and is an important ris... more Background-Arterial stiffening is one of the hallmarks of vascular aging, and is an important risk factor for cardiovascular morbidity and mortality. Aging is also associated with bone demineralization. Accumulating evidence indicate that arterial stiffness and bone demineralization might share common pathways. The aims of this study were to evaluate whether the association between arterial stiffness and bone demineralization is independent of age, and to explore putative mechanisms that may mediate their relationship.

Background: The link between socioeconomic status (SES), de- pression, dietary quality, and centr... more Background: The link between socioeconomic status (SES), de- pression, dietary quality, and central adiposity remains unclear. Objective: Pathways linking SES to dietary quality and central adiposity through depressive symptoms were examined across sex-ethnicity groups. Design: Extensive data on US adults aged 30-64 y from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used in

Osteoarthritis and Cartilage, 2007

Objective: Osteoarthritis (OA) and vascular stiffening may share elements of common pathogenesis,... more Objective: Osteoarthritis (OA) and vascular stiffening may share elements of common pathogenesis, but their potential relatedness has been the focus of little prior inquiry. We tested the hypothesis that these two aging-associated conditions are related to each other.

Geriatric Nursing, 2000

This study was conducted to determine which pain severity and location instruments were most usef... more This study was conducted to determine which pain severity and location instruments were most useful in the nursing home setting. Pain severity and location were assessed monthly for 1 year in 37 participants enrolled in a restorative rehabilitation program. Pain location was determined by the residents' indications on a diagram, a doll, and their body. Pain severity was determined by resident response to verbal, visual analog, faces, and word scales. Cognitively impaired residents had greater difficulty using all instruments. The McGill Word Scale was used most to determine pain severity. Pointing to themselves most frequently determined pain location among residents. New strategies are needed for pain assessment in the elderly, especially the cognitively impaired elderly, and a combination of instruments to assess pain in the latter group may be necessary.

Gait & Posture, 2011

Biomechanical analysis of lower extremity activities while walking at different speeds and in cha... more Biomechanical analysis of lower extremity activities while walking at different speeds and in challenging conditions may help to identify specific gait patterns associated with knee osteoarthritis (knee-OA). We hypothesized that individuals with asymptomatic knee-OA have lower ankle activity, while individuals with symptomatic knee-OA have similar or higher ankle activity compared to individuals without knee-OA, and that such differences are enhanced during challenging gait tasks. We tested this hypothesis by examining gait characteristics in multiple gait tasks using data from 153 Baltimore Longitudinal Study of Aging (BLSA) participants (112 without knee-OA, 41 with knee-OA; 53 -87 years, 52 % women). All participants who could walk unassisted were evaluated in the BLSA gait lab while walking at self-selected speed (usualwalking), at maximum speed (fast-walking) and again at self-selected speed after 30-minutes of walking activities (usual-walking-after-30min). Knee range of motion was lower for knee-OA participants in the fast-walking and usual-walking-after-30min tasks (p < 0.030). Ankle range of motion for symptomatic knee-OA was greater compared to asymptomatic knee-OA for all walking tasks (p < 0.050). Symptomatic knee-OA had greater generative MWE of the ankle compared to asymptomatic knee-OA (p = 0.034), while keeping similar absorptive MWE of the knee when compared to no-OA controls (p = 0.151). Symptomatic knee-OA individuals seem to adapt an ankle kinematic gait pattern aimed at avoiding knee pain, by enhancing forward propulsion so to minimize knee joint load. Whether these conditions represent subsequent steps in the causal pathway from knee-OA to changes in gait is still not clear.

Diabetes Care, 2008

Research Design and Methods-1401 initially non-diabetic participants from the Baltimore Longitudi... more Research Design and Methods-1401 initially non-diabetic participants from the Baltimore Longitudinal Study of Aging, aged 17-95 years, with one or more OGTT (median=2, range 1-8) with insulin and glucose measurements measured every 20 minutes over 2 hours. Proportional hazard using the longitudinally collected data and Bayesian model averaging were used to examine the association of OGTT measurements individually and grouped with mortality adjusting for covariates.

Circulation, 2011

Background-Registry studies have suggested improvements in door-to-balloon times, but a national ... more Background-Registry studies have suggested improvements in door-to-balloon times, but a national assessment of the trends in door-to-balloon times is lacking. Moreover, we do not know whether improvements in door-to-balloon times were shared equally among patient and hospital groups.

Arthritis & Rheumatism, 2006

To assess the impact of lower extremity osteoarthritis (OA) on transitions to mobility difficulty... more To assess the impact of lower extremity osteoarthritis (OA) on transitions to mobility difficulty, and to assess the influence of pain, excess weight, and quadriceps strength on these transitions. Methods. We analyzed longitudinal data acquired from 199 participants in the Women's Health and Aging Study II (ages 70 -79 years) who initially reported no lower extremity limitation (e.g., difficulty walking one-quarter mile) or difficulty in activities of daily living (ADL; e.g., transferring). Prevalent lower extremity OA was determined from validated algorithms encompassing multiple data sources. Markov transition models were created to analyze the first transition from no difficulty at baseline to lower extremity limitations, ADL difficulty, or both 18, 36, and 72 months later. Results. Compared with women without OA (n ‫؍‬ 140), a higher proportion of women with lower extremity OA (n ‫؍‬ 59) initially reported pain on most days and more severe pain while walking (P < 0.05). Women with OA were also heavier, with a higher proportion being obese or overweight (P < 0.001). Lower extremity OA, higher body mass index, and lower knee extensor strength independently increased the risk of transition to combined lower extremity and ADL difficulty first over 72 months. Conclusion. Lower extremity OA increased the likelihood of developing difficulty in both lower extremity tasks and ADL over 72 months in a cohort of initially high functioning older women. Two modifiable factors, higher relative weight and lower knee extensor strength, substantially impacted these transitions, and therefore warrant increased attention in the management of lower extremity OA.

Arthritis & Rheumatism, 2008

Objective-To compare measures of body fat and lean mass and the prevalence of abnormal body compo... more Objective-To compare measures of body fat and lean mass and the prevalence of abnormal body composition phenotypes (sarcopenia, overfat, and sarcopenic obesity) in men and women with rheumatoid arthritis (RA) versus matched controls, and to explore the disease-related predictors of abnormal body composition in patients with RA.

Archives of Internal Medicine, 2011

Delays in treatment time are commonplace for patients with ST-segment elevation acute myocardial ... more Delays in treatment time are commonplace for patients with ST-segment elevation acute myocardial infarction who must be transferred to another hospital for percutaneous coronary intervention. Experts have recommended that door-in to door-out (DIDO) time (ie, time from arrival at the first hospital to transfer from that hospital to the percutaneous coronary intervention hospital) should not exceed 30 minutes. We sought to describe national performance in DIDO time using a new measure developed by the Centers for Medicare &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Medicaid Services. We report national median DIDO time and examine associations with patient characteristics (age, sex, race, contraindication to fibrinolytic therapy, and arrival time) and hospital characteristics (number of beds, geographic region, location [rural or urban], and number of cases reported) using a mixed effects multivariable model. Among 13,776 included patients from 1034 hospitals, only 1343 (9.7%) had a DIDO time within 30 minutes, and DIDO exceeded 90 minutes for 4267 patients (31.0%). Mean estimated times (95% CI) to transfer based on multivariable analysis were 8.9 (5.6-12.2) minutes longer for women, 9.1 (2.7-16.0) minutes longer for African Americans, 6.9 (1.6-11.9) minutes longer for patients with contraindication to fibrinolytic therapy, shorter for all age categories (except &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;75 years) relative to the category of 18 to 35 years, 15.3 (7.3-23.5) minutes longer for rural hospitals, and 14.4 (6.6-21.3) minutes longer for hospitals with 9 or fewer transfers vs 15 or more in 2009 (all P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Among patients presenting to emergency departments and requiring transfer to another facility for percutaneous coronary intervention, the DIDO time rarely met the recommended 30 minutes.

The American Journal of Medicine, 2012

Background-Substantial hospital-level variation in the risk of readmission after hospitalization ... more Background-Substantial hospital-level variation in the risk of readmission after hospitalization for heart failure (HF) or acute myocardial infarction (AMI) has been reported. Prior studies have documented considerable state-level variation in rates of discharge to skilled nursing facilities (SNFs) but evaluation of hospital-level variation in SNF rates and its relationship to hospital-level readmission rates is limited.