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ImportanceNomenclature in the field of neurodegenerative diseases presents a challenging problem. Inconsistent use of terms such as Alzheimer disease and dementia has compromised progress in clinical care, research, and development of therapeutics. Dementia-associated stigma further contributes to inconsistent and imprecise language. The result is a lack of clarity that produces confusion with patients and the general public and presents communication challenges among researchers. Therefore, the Advisory Council on Research, Care, and Services of the National Plan to Address Alzheimer’s Disease authorized a committee to make recommendations for improvement.ObjectiveTo establish a systematic neurodegenerative disease framework for information collection and communication to standardize language usage for research, clinical, and public health purposes.Evidence ReviewThe Dementia Nomenclature Initiative organized into 3 major stakeholder working groups: clinicians, researchers, and the public (including individuals living with dementia and family caregivers). To inform the work, the initiative completed a narrative literature review of dementia nomenclature evolution over the last century across the PubMed, CINAHL, PsycInfo, and Scopus databases (January 1, 2000, through July 31, 2020). Initiative working groups used the results as a foundation for understanding current challenges with dementia nomenclature and implications for research, clinical practice, and public understanding. The initiative obtained additional input via focus groups with individuals living with dementia and caregivers, with separate groups for race and ethnicity (American Indian or Alaska Native, Asian or Pacific Islander, Black or African American, Hispanic or Latino, and White) as an initial assessment of the meaning of dementia-related terms to these groups.FindingsFrom working group deliberations, the literature review, and focus group input, the initiative developed a framework clearly separating the clinical syndromic presentation experienced by affected individuals from possible underlying pathophysiologies. In the framework, domains of clinical impairment, such as cognitive, behavioral, motor, and other neurologic features, are graded by level of impairment between none and severe. Next, biomarker information describes underlying disease processes, explains the syndrome, and identifies possible disease labels: Alzheimer disease, frontotemporal degeneration, dementia with Lewy bodies, or vascular cognitive impairment dementia.Conclusions and RelevanceThe Dementia Nomenclature Initiative established a framework to guide communication about cognitive impairment among older adults. Wider testing and refinement of the framework will subsequently improve the information used in communicating about cognitive impairment and the way in which the information is used in clinical, research, and public settings.

AbstractBackgroundDiabetes mellitus (DM) in children and adolescents is typically caused by type 1 DM, followed by type 2 DM and maturity‐onset diabetes of the young (MODY). We report an unusual Asian Indian family in which three members presented with DM at ages 15, 20, and 30, but not fitting the typical clinical picture of type 1 DM, type 2 DM, or MODY. The primary objective was to elucidate the molecular genetic basis of DM in this family.MethodsThe proband, a 22‐year‐old man, had short stature, gray hair, osteoporosis, and markedly reduced subcutaneous fat on the body, especially on the extremities along with acanthosis nigricans, and developed myxoid malignant peripheral nerve sheath tumor. Detailed family history revealed multiple loops of consanguinity. The proband underwent whole‐genome sequencing, and seven relatives underwent whole‐exome sequencing.ResultsThe proband and three additional family members were found to have the homozygous c.561A>G nucleotide variant of WRN RecQ‐like helicase (WRN) gene consistent with the diagnosis of Werner's syndrome. The c.561A>G variant induces a new splicing site on exon 6 resulting in a truncated WRN protein, p.Lys187Trpfs*13.ConclusionOur report brings to attention the onset of DM during childhood or early adulthood in patients with Werner's syndrome who typically develop type 2 DM around the age of 30–40 years. Presence of consanguinity among parents, dysmorphic features, and malignancy should prompt consideration of diagnosis of Werner's syndrome.

PURPOSE To provide evidence-based recommendations to practicing clinicians on the management of patients with small-cell lung cancer. METHODS An Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, community oncology, research methodology, and advocacy experts were convened to conduct a literature search, which included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2022. Outcomes of interest included response rates, overall survival, disease-free survival or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 95 relevant studies to inform the evidence base for this guideline. RECOMMENDATIONS Evidence-based recommendations were developed to address systemic therapy options, timing of therapy, treatment in patients who are older or with poor performance status, role of biomarkers, and use of myeloid-supporting agents in patients with small-cell lung cancer. Additional information is available at www.asco.org/thoracic-cancer-guidelines .

Abstract Brown, FSA, Fields, JB, Jagim, AR, Baker, RE, and Jones, MT. Analysis of in-season external load and sport performance in women’s collegiate basketball. J Strength Cond Res 38(2): 318–324, 2024—Quantifying and monitoring athlete workload throughout a competitive season is a means to manage player readiness. Therefore, the purpose of the current study was to quantify practice and game external loads and to assess the relationship between such loads and basketball-specific performance metrics across a women's collegiate basketball season. Thirteen National Collegiate Athletic Association Division I women basketball athletes (age 20.08 ± 1.55 years) wore Global Positioning Systems sensors equipped with triaxial accelerometers for 29 games and 66 practices during the 2019–20 season. A multivariate analysis of variance was used to assess differences in external load between high- and low-minute players and across quarters within games ( p < 0.05). Bivariate Pearson correlation coefficients were run to determine relationships between external loads and metrics of basketball performance. Findings indicated that high- and low-minute athletes experienced different loads during games and practices ( p < 0.001). External loads differed by quarter, such that player load (PL) was highest in Q4 ( p = 0.007), PL·min −1 was highest in Q1 and lowest in Q4 ( p < 0.001), and explosive ratio (i.e., ratio of PL and explosive efforts) was lowest in Q3 ( p = 0.45). Relationships existed between PL·min −1 and field goals ( r = 0.41; p = 0.02) and between the explosive ratio and free throws ( r = 0.377 p = 0.04). These results can be used to inform design of training sessions with the intent to prepare athletes for the demands of the competitive season. It is recommended that future research continue to explore the relationship of sport-specific performance metrics and athlete external load.

Abstract Magee, MK, Fields, JB, Jagim, AR, and Jones, MT. Fat-free mass index in a large sample of National Collegiate Athletic Association men and women athletes from a variety of sports. J Strength Cond Res 38(2): 311–317, 2024—Fat-free mass index (FFMI) can be used to categorize fat-free mass (FFM) relative to height. Normative values have been established in a variety of sports, as has suggested lower and upper thresholds of FFMI. However, FFMI has not been reported in a large sample of athletes, representing both sexes and multiple sport types. The purpose of this study was to evaluate differences in FFMI and establish normative values across a large sample of collegiate sports. A total of 1,961 athletes (men: n = 596, 10 sports; women: n = 1,365, 8 sports) participated. Height and mass were measured using a stadiometer and calibrated digital scale, respectively. Fat-free mass was assessed with air displacement plethysmography and used to calculate FFMI. Kruskal-Wallis test and one-way analysis of variance evaluated differences in FFMI in women's and men's sports, respectively. When collapsed across sport type and stratified by sex, men had a higher FFMI (21.5 ± 1.9 kg·m −2 vs. 17.9 ± 1.8 kg·m −2 ; p < 0.001). Differences occurred in FFMI across sport. In women, basketball athletes had the highest FFMI (18.9 kg·m −2 ) and highest 99th percentile for FFMI, whereas rowers had the lowest (16.9 kg·m −2 ). In men, throwers had the highest FFMI (25.7 kg·m −2 ) and highest 99th percentile, whereas volleyball athletes had the lowest (19.9 kg·m −2 ). Differences in FFMI may be attributable to dietary habits and physiological demands of respective sports. These results can provide information relative to differences in FFMI values across sports. In addition, sport-specific normative values can be used as benchmarks and targets for training, nutrition, and goal setting.

AbstractBackgroundTobacco use is associated with adverse outcomes among patients diagnosed with cancer. Socioeconomic determinants influence access and utilization of tobacco treatment; little is known about the relationship between neighborhood socioeconomic disadvantage (NSD) and tobacco assessment, assistance, and cessation among patients diagnosed with cancer.MethodsA modified Cancer Patient Tobacco Use Questionnaire (C‐TUQ) was administered to patients enrolled in nine ECOG‐ACRIN clinical trials. We examined associations of NSD with (1) smoking status, (2) receiving tobacco cessation assessment and support, and (3) cessation behaviors. NSD was classified by tertiles of the Area Deprivation Index. Associations between NSD and tobacco variables were evaluated using logistic regression.ResultsA total of 740 patients completing the C‐TUQ were 70% male, 94% White, 3% Hispanic, mean age 58.8 years. Cancer diagnoses included leukemia 263 (36%), lymphoma 141 (19%), prostate 131 (18%), breast 79 (11%), melanoma 69 (9%), myeloma 53 (7%), and head and neck 4 (0.5%). A total of 402 (54%) never smoked, 257 (35%) had formerly smoked, and 81 (11%) were currently smoking. Patients in high disadvantaged neighborhoods were approximately four times more likely to report current smoking (odds ratio [OR], 3.57; 95% CI, 1.69–7.54; p = .0009), and more likely to report being asked about smoking (OR, 4.24; 95% CI, 1.64–10.98; p = .0029), but less likely to report receiving counseling (OR, 0.11; 95% CI, 0.02–0.58; p = .0086) versus those in the least disadvantaged neighborhoods.ConclusionsGreater neighborhood socioeconomic disadvantage was associated with smoking but less cessation support. Increased cessation support in cancer care is needed, particularly for patients from disadvantaged neighborhoods.