Medicine and Health Sciences Commons^™

Likely Community Transmission Of Covid-19 Infections Between Neighboring, Persistent Hotspots In Ontario, Canada, Ben C. Shirley, Eliseos J. Mucaki, Peter Rogan

Biochemistry Publications

Introduction: This study aimed to produce community-level geo-spatial mapping of confirmed COVID-19 cases in Ontario Canada in near real-time to support decision-making. This was accomplished by area-to-area geostatistical analysis, space-time integration, and spatial interpolation of COVID-19 positive individuals.
Methods: COVID-19 cases and locations were curated for geostatistical analyses from March 2020 through June 2021, corresponding to the first, second, and third waves of infections. Daily cases were aggregated according to designated forward sortation area (FSA), and postal codes (PC) in municipal regions Hamilton, Kitchener/Waterloo, London, Ottawa, Toronto, and Windsor/Essex county. Hotspots were identified with area-to-area tests including Getis-Ord Gi*, Global …

Likely Community Transmission Of Covid-19 Infections Between Neighboring, Persistent Hotspots In Ontario, Canada [Version 1; Peer Review: Awaiting Peer Review], Elisios J. Mucaki, Ben C. Shirley, Peter K. Rogan

Research Articles

This study aimed to produce community-level geo-spatial mapping of confirmed COVID-19 cases in Ontario Canada in near real-time to support decision-making. This was accomplished by area-to-area geostatistical analysis, space-time integration, and spatial interpolation of COVID-19 positive individuals.

Putative Concussion Biomarkers Identified In Adolescent Male Athletes Using Targeted Plasma Proteomics, Michael R. Miller, Michael Robinson, Lisa Fischer, Alicia Dibattista, Maitray A. Patel, Mark Daley, Robert Bartha, Gregory A. Dekaban, Ravi S. Menon, J. Kevin Shoemaker, Eleftherios P. Diamandis, Ioannis Prassas, Douglas D. Fraser

Medical Biophysics Publications

Sport concussions can be difficult to diagnose and if missed, they can expose athletes to greater injury risk and long-lasting neurological disabilities. Discovery of objective biomarkers to aid concussion diagnosis is critical to protecting athlete brain health. To this end, we performed targeted proteomics on plasma obtained from adolescent athletes suffering a sports concussion. A total of 11 concussed male athletes were enrolled at our academic Sport Medicine Concussion Clinic, as well as 24 sex-, age- and activity-matched healthy control subjects. Clinical evaluation was performed and blood was drawn within 72 h of injury. Proximity extension assays were performed for …

A Case Analysis Of Partnered Research On Palliative Care For Refugees In Jordan And Rwanda, Sonya De Laat, Olive Wahoush, Rania Jaber, Wejdan Khater, Emmanuel Musoni, Ibraheem Abu Siam, Lisa Schwartz, Matthew Hunt, Lynda Redwood-Campbell, Laurie Elit, Elysée Nouvet, Rachel Yantzi, Kevin Bezanson, Carrie Bernard, Takhliq Amir, Ani Chénier, Gautham Krishnaraj, Corinne Schusterwallace

Health Studies Publications

© 2021, The Author(s). Background: This case analysis describes dilemmas and challenges of ethical partnering encountered in the process of conducting a research study that explored moral and practical dimensions of palliative care in humanitarian crisis settings. Two contexts are the focus of this case analysis: Jordan, an acute conflict-induced refugee situation, and Rwanda, a protracted conflict-induced refugee setting. The study’s main goal was to better understand ways humanitarian organizations and health care providers might best support ethically and contextually appropriate palliative care in humanitarian contexts. An unintended outcome of the research was learning lessons about ethical dimensions of transnational …

Restructuring Training (Participation House Support Services), Victoria Lun, Do Yeon Oh, Nadir Saeed, Joe Thorne, Alexander Trusler

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

Participation House Support Services (PHSS) is a non-profit organization with over 60 locations across Ontario that serves individuals with complex medical, physical, and developmental needs with the goal of including them in the community. The scope of the project covers members of the PHSS organization and the London community that they serve by addressing problems with burnout and culture of resentment that the Coordinators of the organization face. After initial discussions with the community partner, qualitative research was done via focus groups with PHSS Coordinators and training staff. An agreed-upon solution of restructuring the training process was developed, as training …

Increasing Civic Engagement And Awareness Of Poverty & Homelessness Through Social Media (Project Hope London), Vanessa Chan, Sairam Gajavelli, Majid Khan, Iris Kwon, Masum Patel

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

As the Project Hope London (PHL) Social Media Team, the purpose of our project was to utilize social media to support PHL in their goal of helping to improve the overall health of individuals experiencing homelessness. We aimed to broaden the organization’s audience through Instagram as this popular platform has the potential to reach younger demographics, such as the Western student body, and local businesses. Our team took control of their Instagram page to revitalize their social media presence. We redesigned the bio, curated posts with modern aesthetics, and ran a social media campaign to further boost engagement with the …

A Wicked Problem: The Implementation Of Clinical Guidelines Application To Optimize Patient Care (Uhn Openlab), Ardavan Bonyadi Behrouz, Nelson Chang, Jasmine Luo, Daniel Olteanu, Naomi Smith

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

The purpose of our partnership with the UHN OpenLab was to discover the barriers involved with automating the sporadic release of clinical practice guidelines (CPGs) into the Innovate Guidelines Application (IGA). The problem is considered wicked—interlocking challenges cannot be addressed by a single solution. Accordingly, the goal was to explore the barriers of stakeholders and specialization groups, general guideline issues, and the considerations of healthcare professionals and public perception. An initial literature review was conducted to discover unidentified problems before a first draft of the systems map was created. Subsequently, connections were formed across problems and each was categorized based …

A Physician’S Guide To Clinical Documentation Improvement: Aligning Cdi To Health Information Practice (Canadian Health Information Management Association), Noor Baldawi, Jacky Cheung, Georgia Diamanakis, Alvina Jiwani, Zexi Wang

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

The field of clinical documentation improvement (CDI) is emerging alongside the need for more accurate health care information that is reflective of the health status of Canadians. Health information management professionals and physicians play a critical role in the collection, transformation, protection, and distribution of clinical documentation. The quality of health data is dependent on the physician’s specificity in clinical documentation of patient health records, as this information is converted into data by coding specialists. Coded medical information, and associated hospital data, provides information surrounding patient severity of disease, a hospital’s expected length of stay, and a hospital’s mortality rate. …

Discovering Body Positivity & Self-Image (Gender Equality Coalition Of Ontario), Ella Clarke, Morolayo Ilori, Melanie Peck, Hannah Polley, Mili Shah

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

Body image refers to the way we perceive our bodies, and it can positively or negatively impact physical and mental health (Alleva et al., 2015). Unfortunately, negative body image is becoming more common with some studies finding that 65% of young people are dissatisfied with their bodies (Linardon et al., 2021). This can lead to a variety of psychological and behavioral problems and disorders such as body dysmorphia or eating disorders (Alleva et al., 2015). However, many of these consequences associated with negative body image can be circumvented by learning to foster positive body images through building self-esteem (Jessie’s Legacy, …

Addressing Workplace Mental Health During Covid-19 (Global Minds Collective), Candace Brooks-Dasilva, Ashlee Jiang, Priya Modi, Komal Patel, Lilian Raphael

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

We aimed to produce novel, comprehensive tools to support The Global MINDS Collective’s mission of co-creating unique workplace infrastructures conducive to employee mental wellness. Our Systems Map uses a multifactorial and intersectional approach to analyze how the COVID-19 pandemic has changed employees’ mental and psychosocial wellness. A systems thinking approach was used to connect ideas from literature and industry resources to expand on concepts such as workplace diversity, burnout, and current practices. The interconnected nature of the systems map allowed us to identify “leverage points,” which were topics with a high degree of connectivity that could be targeted for high-impact …

Supporting Pregnant Persons: The Benefits Of Opening A Birth Centre In London, Ontario (Dynamic Doulas Of London), Alisha George, Megan Harris, Allison Kirkpatrick, Lianna Mathew, Amel Sassi

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

No abstract provided.

Determining The Impacts Of The Sunshine Foundation's Dream-Like Experiences For Children With Severe Physical Disabilities, Jason Chan, Hannah Sendzik, Reya Siby, Sneh Sunder, Matthieu Trudell

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

The Sunshine Foundation is a charity dedicated to providing dream-like experiences to children and families with severe physical disabilities with the hopes to foster optimism, independence and hope, and improve mental health. However, they lack empirical evidence to illustrate the positive long-term impacts that their wishes provide. Thus, our main goal was to generate quantifiable data to highlight the positive impacts of the program, in order to improve donor interest, raise awareness, and ultimately be able to reach more children nation-wide. We intended to do this through a literature review and present concrete statistical findings through a multi-media deliverable in …

Alignment Of The United Nations Sustainable Development Goals And The London Plan (Citystudio London), Jack Adams, Trent Arnold, Rachel Jairam, Amani Khan

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

The goal of our project was to map the City of London Plan to the UN’s Sustainability and Development Goals. An aim of the project was to present the contents in the City of London Plan in a more understandable and accessible way for London citizens and city counsellors to be able to engage with. Another aim was to measure the similarities and discrepancies of the London Plan and the UNs SDGs in a quantifiable way that could be easily examined by the city when creating future city plans. Our deliverables were a 1-minute video pitch, an excel spreadsheet that …

Improving Senior Fitness Programs & Dementia Care (Canadian Centre For Activity & Aging), Nidaal Abid, Tarannum Khan, Serena Lai, Kyle Lam, Madeline Macrae, Karen Wong

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

Our team worked alongside the Canadian Centre for Activity and Aging (CCAA) to improve senior fitness programs and dementia care through volunteering at weekly exercise classes, assisting with fitness assessments, and creating two tangible deliverables. Our first deliverable was a Wordle; a tool for visualizing the modifiable risk factors of dementia. By consulting existing literature, we concluded that hearing loss, low education status, depression, and smoking were the main modifiable risk factors. This Wordle will be used for future research and educational purposes. Our next deliverables targeted the fitness aspect of the CCAA. We helped facilitate weekly instructor-led fitness classes …

A Complete Guide To Incorporation (Project Hope London), Kevin Dong, Karen Guirguis, Rozmin Jasani, Samuel Luo, Sahara Rosha

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

Our team worked with Project Hope (PH)–a grassroots organization that supports London’s population experiencing homelessness via needs-based outreach, community building, and housing support. PH serves 250 individuals/week at outreach and intends to expand this number and explore larger-scale projects such as affordable housing initiatives. However, to attain these goals, PH needs more funding–which it has struggled to obtain due to its lack of Registered Charity (RC) status. RCs are the only not-for-profit organizations that can issue tax receipts to monetary donors, and several commercial donors only donate to RCs for this reason. Thus, our deliverable intends to streamline PH’s progress …

Stakeholders Surrounding Assisted & Affordable Housing (The Unity Project), Jiyoon Choi, Mahir Rahman, Adesh Suchit, Kenneth Wong

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

Our team worked with the Unity Project, a registered charity in London that provides emergency shelter and supportive housing, to address the current needs of the organization based on a research and evidence-based approach. Specifically, we aimed to support their goals relating to the need for improved affordable housing solutions in London and the current divide between the different stakeholders involved. We provided two main deliverables: a) a report and slide deck that outline the positions of key stakeholders involved with affordable housing, and b) a set of three infographics that provide information that connects the homeless community to useful …

Embracing Culture At The Centre Of Hope Food Bank (Salvation Army), Angela Chen, Ewan Kelly, Caitlin Lee, Sumin Shin

Medical Sciences 4300A: Addressing Healthcare Misconceptions Using Scientific Inquiry

The purpose of our project was to expand the food options provided at the Centre of Hope (COH) to better reflect the cultural diversity that exists within the London community. Overall, our project aimed to provide all individuals with the opportunity to consume food they are familiar and comfortable with, using a food choice-model system. This involved the creation of four deliverables: a comprehensive list of food options specific to the major minority groups in London, a culturally-specific food preference survey (physical and online versions, to improve accessibility), and a flyer with a QR code to encourage survey responses. The …

A Critical Narrative Inquiry To Understand The Impacts Of An Overdose Prevention Site On The Lives Of Site Users, Abe Oudshoorn, Michelle Sangster Bouck, Melissa Mccann, Shamiram Zendo, Helene Berman, Jordan Banninga, Marlene J. Le Ber, Zayya Zendo

Nursing Publications

© 2021, The Author(s). Background: Globally, communities are struggling to gain support for harm reduction strategies being implemented to address the impacts of substance use. A key part of this discussion is understanding and engaging with people who use drugs to help shape community harm reduction strategies. This study focused on how an overdose prevention site has influenced the lives of people who use drugs. Methods: A critical narrative method was utilized, centred on photo-narratives. Twenty-seven individuals accessing an overdose prevention site were recruited to participate in preliminary interviews. Sixteen participants subsequently took photographs to describe the impact of the …

Health Service Experiences And Preferences Of Frail Home Care Clients And Their Family And Friend Caregivers During The Covid-19 Pandemic, Lori E. Weeks, Sue Nesto, Bradley Hiebert, Grace Warner, Wendy Luciano, Kathleen Ledoux, Lorie Donelle

Nursing Publications

Objective: The COVID-19 pandemic has brought about a major upheaval in the lives of older adults and their family/friend caregivers, including those utilizing home care services. In this article, we focus on results from a qualitative component added to a pragmatic randomized controlled trial that focuses on the experiences of our study participants during COVID-19. A total of 29 participants responded to the COVID-19 related questions focused on their health services experiences and preferences from March-June 2020 including 10 home care clients and 19 family/friend caregivers in the provinces of Ontario and Nova Scotia, Canada. Results: Many participants were affected …

Parents’ Report Of Canadian Elementary School Children’S Physical Activity And Screen Time During The Covid-19 Pandemic: A Longitudinal Study, Emma Ostermeier, Patricia Tucker, Andrew Clark, Jamie A. Seabrook, Jason Gilliland

Paediatrics Publications

COVID-19 public health protocols have altered children’s daily routines, limiting their physical activity opportunities. The purpose of this study was to examine how the COVID-19 pandemic affected children’s (ages 10–12 years) physical activity and screen time, and to explore the impact of gender, socioeconomic status (SES), and public health constraints (i.e., facility use and social interaction) on the changes in children’s health behaviors. Online surveys were disseminated to parents at two time points: before COVID-19 (May 2019 to February 2020) and during COVID-19 (November to December 2020). Wilcoxon signed-rank tests were used to assess changes in physical activity and screen …

Choosing Wisely Canada – Pediatric Otolaryngology Recommendations, Mitchell Mcdonough, Kalpesh Hathi, Gerard Corsten, Christopher J. Chin, Paolo Campisi, Jonathan Cavanagh, Neil Chadha, M. Elise Graham, Murad Husein, Liane B. Johnson, Jodi Jones, Bruce Korman, John Manoukian, Lily H.P. Nguyen, Doron D. Sommer, Julie Strychowsky, Trina Uwiera, Warren Yunker, Paul Hong

Paediatrics Publications

The Choosing Wisely Canada campaign raises awareness amongst physicians and patients regarding unnecessary or inappropriate tests and treatments. Using an online survey, members of the Pediatric Otolaryngology Subspecialty Group within the Canadian Society of Otolaryngology – Head & Neck Surgery developed a list of nine evidence based recommendations to help physicians and patients make treatment decisions regarding common pediatric otolaryngology presentations: (1) Don’t routinely order a plain film x-ray in the evaluation of nasal fractures; (2) Don’t order imaging to distinguish acute bacterial sinusitis from an upper respiratory infection; (3) Don’t place tympanostomy tubes in most children for a single …

Placental Infarction And Intrauterine Growth Restriction Following Sars-Cov-2 Infection, Stephanie Moltner, Barbra De Vrijer, Harrison Banner

Paediatrics Publications

No abstract provided.

The Intranasal Dexmedetomidine Plus Ketamine For Procedural Sedation In Children, Adaptive Randomized Controlled Non-Inferiority Multicenter Trial (Ketodex): A Statistical Analysis Plan, Anna Heath, Juan David Rios, Eleanor Pullenayegum, Petros Pechlivanoglou, Martin Offringa, Maryna Yaskina, Rick Watts, Shana Rimmer, Terry P. Klassen, Kamary Coriolano, Naveen Poonai, Darcy Beer, Scott Sawyer, Maala Bhatt, April Kam, Quynh Doan, Vikram Sabhaney, Serena Hickes, Samina Ali, Karly Stillwell, Tannis Erickson, Chelsea Bowkett, Chelsea Bowkett, Carolyn Shimmin, Brendon Foot, Candace Mcgahern, Redjana Carciurmaruj, Jeannine Schellenberg

Paediatrics Publications

Background: Procedural sedation and analgesia (PSA) is frequently required to perform closed reductions for fractures and dislocations in children. Intravenous (IV) ketamine is the most commonly used sedative agent for closed reductions. However, as children find IV insertion a distressing and painful procedure, there is need to identify a feasible alternative route of administration. There is evidence that a combination of dexmedetomidine and ketamine (ketodex), administered intranasally (IN), could provide adequate sedation for closed reductions while avoiding the need for IV insertion. However, there is uncertainty about the optimal combination dose for the two agents and whether it can provide …

Root Canals Shaped By Nickel-Titanium Instrumentation With Automated Computerized Numerical Control Systems, Liming Wang, Wenxiang Li, Yeon Jee Yoo, Shin Hye Chung, Soram Oh, Hiran Perinpanayagam, Kee Yeon Kum, Yu Gu

Dentistry Publications

Background: To investigate the efficacy of a nickel-titanium (NiTi) file with an automated computerized numerical control (CNC) system for root canal shaping. Methods: The movement of the automated device and the insertion angle were investigated. In Experiment 1, simulated resin root canals were randomly divided into four groups (n = 20): manual downward movement using a handpiece (Group 1), vertical downward movement by CNC (Group 2), reciprocating up and down movement by CNC (Group 3), and spiral up and down movement by CNC (Group 4). In Experiment 2, five different insertion angles of the NiTi file were evaluated (n = …

The Fatigue Paradox: Team Perceptions Of Physician Fatigue, Emily Field, Lorelei Lingard, Richard Cherry, Julie Ann Van Koughnett, Sandra Deluca, Taryn Taylor

Obstetrics & Gynaecology Publications

OBJECTIVES: Ongoing calls to implement fatigue risk management in residency education assume a shared understanding of physician fatigue as a workplace hazard, yet we lack empirical evidence that all health care team members maintain this assumption. Thus, this study seeks to explore how health care team members understand the role of physician fatigue in an effort to inform the implementation of fatigue risk management in residency training and medical practice.

METHODS: This study uses constructivist grounded theory to explore perceptions of workplace fatigue and its impact on clinical practice. We conducted individual semi-structured interviews with physicians, nurses and senior residents …

Expansion Of Myeloid-Derived Suppressor Cells Contributes To Metabolic Osteoarthritis Through Subchondral Bone Remodeling, Lixia Zhang, Cameron L. Kirkwood, Jiho Sohn, Ashley Lau, Mary Bayers-Thering, Supinder Kour Bali, Sridhar Rachala, John M. Marzo, Mark J. Anders, Frank Beier, Keith L. Kirkwood

Bone and Joint Institute

Background: Osteoarthritis (OA) subsequent to acute joint injury accounts for a significant proportion of all arthropathies. Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of myeloid progenitor cells classically known for potent immune-suppressive activity; however, MDSCs can also differentiate into osteoclasts. In addition, this population is known to be expanded during metabolic disease. The objective of this study was to determine the role of MDSCs in the context of OA pathophysiology. Methods: In this study, we examined the differentiation and functional capacity of MDSCs to become osteoclasts in vitro and in vivo using mouse models of OA and in MDSC …

Enacting Contextually Responsive Scholarship: Centring Occupation In Participatory Action Research With Children In India, Tanya Elizabeth Benjamin-Thomas, Debbie Laliberte Rudman, David Mark Thomas

Occupational Therapy Publications

Occupation-based scholars are striving to mobilize socially responsive scholarship to address occupational injustices from local to global scales. Moving forward involves expanding beyond Western, Anglophonic, female, able-bodied, adult perspectives on occupation, with critically informed participatory methodologies providing one key means to incorporate diverse perspectives on occupation and occupational justice. Drawing upon a participatory action research project with children with disabilities from rural South India, this paper puts forward an understanding of participatory action research as an occupational process (i.e., embodying a variety of occupations) and an occupation-based process (i.e., informed by an occupational lens). We forefront how ‘occupation’ was centered …

Diet-Induced Obesity Leads To Behavioral Indicators Of Pain Preceding Structural Joint Damage In Wild-Type Mice, Geoffrey J. Kerr, Bethia To, Ian White, Magali Millecamps, Frank Beier, Matthew W. Grol, Laura S. Stone, Cheryle A. Séguin

Bone and Joint Institute

Introduction: Obesity is one of the largest modifiable risk factors for the development of musculoskeletal diseases, including intervertebral disc (IVD) degeneration and back pain. Despite the clinical association, no studies have directly assessed whether diet-induced obesity accelerates IVD degeneration, back pain, or investigated the biological mediators underlying this association. In this study, we examine the effects of chronic consumption of a high-fat or high-fat/high-sugar (western) diet on the IVD, knee joint, and pain-associated outcomes. Methods: Male C57BL/6N mice were randomized into one of three diet groups (chow control; high-fat; high-fat, high-sugar western diet) at 10 weeks of age and remained …

Repetitive Mild Traumatic Brain Injury In Mice Triggers A Slowly Developing Cascade Of Long-Term And Persistent Behavioral Deficits And Pathological Changes, Xiaoyun Xu, Matthew Cowan, Flavio Beraldo, Amy Schranz, Patrick Mccunn, Nicole Geremia, Zalman Brown, Maitray Patel, Karen L. Nygard, Reza Khazaee, Lihong Lu, Xingyu Liu, Michael J. Strong, Gregory A. Dekaban, Ravi Menon, Robert Bartha, Mark Daley, Haojie Mao, Vania Prado, Marco A.M. Prado, Lisa Saksida, Tim Bussey, Arthur Brown

Medical Biophysics Publications

We have previously reported long-term changes in the brains of non-concussed varsity rugby players using magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI) and functional magnetic imaging (fMRI). Others have reported cognitive deficits in contact sport athletes that have not met the diagnostic criteria for concussion. These results suggest that repetitive mild traumatic brain injuries (rmTBIs) that are not severe enough to meet the diagnostic threshold for concussion, produce long-term consequences. We sought to characterize the neuroimaging, cognitive, pathological and metabolomic changes in a mouse model of rmTBI. Using a closed-skull model of mTBI that when scaled to human leads …

Higher Csf Stnfr1-Related Proteins Associate With Better Prognosis In Very Early Alzheimer’S Disease, William T. Hu, Tugba Ozturk, Alexander Kollhoff, Whitney Wharton, J. Christina Howell, Michael Weiner, Paul Aisen, Ronald Petersen, Clifford R. Jack, William Jagust, John Q. Trojanowki, Arthur W. Toga, Laurel Beckett, Robert C. Green, Andrew J. Saykin, John Morris, Richard J. Perrin, Leslie M. Shaw, Zaven Kachaturian, Maria Carrillo, William Potter, Lisa Barnes, Marie Bernard, Hector González, Carole Ho, John K. Hsiao, Eliezer Masliah, Donna Masterman, Ozioma Okonkwo, Laurie Ryan, Nina Silverberg, Adam Fleisher

Medical Biophysics Publications

Neuroinflammation is associated with Alzheimer’s disease, but the application of cerebrospinal fluid measures of inflammatory proteins may be limited by overlapping pathways and relationships between them. In this work, we measure 15 cerebrospinal proteins related to microglial and T-cell functions, and show them to reproducibly form functionally-related groups within and across diagnostic categories in 382 participants from the Alzheimer’s Disease Neuro-imaging Initiative as well participants from two independent cohorts. We further show higher levels of proteins related to soluble tumor necrosis factor receptor 1 are associated with reduced risk of conversion to dementia in the multi-centered (p = 0.027) and …