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Aharonian F, Benkhali FA, Aschersleben J, Ashkar H, Backes M, Martins VB, Batzofin R, Becherini Y, Berge D, Bernlöhr K, Bi B, Böttcher M, Boisson C, Bolmont J, de Lavergne MDB, Borowska J, Bouyahiaoui M, Breuhaus M, Brose R, Brown AM, Brun F, Bruno B, Bulik T, Burger-Scheidlin C, Caroff S, Casanova S, Cecil R, Celic J, Cerruti M, Chand T, Chandra S, Chen A, Chibueze J, Chibueze O, Cotter G, Dai S, Mbarubucyeye JD, Djannati-Ataï A, Dmytriiev A, Doroshenko V, Egberts K, Einecke S, Ernenwein JP, Filipovic M, Fontaine G, Füßling M, Funk S, Gabici S, Ghafourizadeh S, Giavitto G, Glawion D, Glicenstein JF, Grolleron G, Haerer L, Hinton JA, Hofmann W, Holch TL, Holler M, Horns D, Jamrozy M, Jankowsky F, Jardin-Blicq A, Joshi V, Jung-Richardt I, Kasai E, Katarzyński K, Khatoon R, Khélifi B, Klepser S, Kluźniak W, Komin N, Kosack K, Kostunin D, Kundu A, Lang RG, Le Stum S, Leitl F, Lemière A, Lenain JP, Leuschner F, Lohse T, Luashvili A, Lypova I, Mackey J, Malyshev D, Malyshev D, Marandon V, Marchegiani P, Marcowith A, Martí-Devesa G, Marx R, Mehta A, Mitchell A, Moderski R, Mohrmann L, Montanari A, Moulin E, Murach T, Nakashima K, de Naurois M, Niemiec J, Noel AP, Ohm S, Olivera-Nieto L, de Ona Wilhelmi E, Ostrowski M, Panny S, Panter M, Parsons RD, Peron G, Prokhorov DA, Pühlhofer G, Punch M, Quirrenbach A, Reichherzer P, Reimer A, Reimer O, Ren H, Renaud M, Reville B, Rieger F, Rowell G, Rudak B, Ricarte HR, Ruiz-Velasco E, Sahakian V, Salzmann H, Santangelo A, Sasaki M, Schäfer J, Schüssler F, Schwanke U, Shapopi JNS, Sol H, Specovius A, Spencer S, Stawarz L, Steenkamp R, Steinmassl S, Steppa C, Streil K, Sushch I, Suzuki H, Takahashi T, Tanaka T, Taylor AM, Terrier R, Tsirou M, Tsuji N, Unbehaun T, van Eldik C, Vecchi M, Veh J, Venter C, Vink J, Wach T, Wagner SJ, Werner F, White R, Wierzcholska A, Wong YW, Zacharias M, Zargaryan D, Zdziarski AA, Zech A, Zouari S, Żywucka N. Acceleration and transport of relativistic electrons in the jets of the microquasar SS 433. Science 2024; 383:402-406. [PMID: 38271522 DOI: 10.1126/science.adi2048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 12/04/2023] [Indexed: 01/27/2024]
Abstract
SS 433 is a microquasar, a stellar binary system that launches collimated relativistic jets. We observed SS 433 in gamma rays using the High Energy Stereoscopic System (H.E.S.S.) and found an energy-dependent shift in the apparent position of the gamma-ray emission from the parsec-scale jets. These observations trace the energetic electron population and indicate that inverse Compton scattering is the emission mechanism of the gamma rays. Our modeling of the energy-dependent gamma-ray morphology constrains the location of particle acceleration and requires an abrupt deceleration of the jet flow. We infer the presence of shocks on either side of the binary system, at distances of 25 to 30 parsecs, and that self-collimation of the precessing jets forms the shocks, which then efficiently accelerate electrons.
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Affiliation(s)
- F Aharonian
- Dublin Institute for Advanced Studies, Dublin D02 XF86, Ireland
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - F Ait Benkhali
- Landessternwarte, Universität Heidelberg, Heidelberg D-69117, Germany
| | - J Aschersleben
- Kapteyn Astronomical Institute, University of Groningen, Groningen 9747 AD, Netherlands
| | - H Ashkar
- Laboratoire Leprince-Ringuet, École Polytechnique, Centre national de la recherche scientifique, Institut Polytechnique de Paris, Palaiseau F-91128, France
| | - M Backes
- Department of Physics, University of Namibia, Windhoek 10005, Namibia
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | | | - R Batzofin
- Institut für Physik und Astronomie, Universität Potsdam, Potsdam 14476, Germany
| | - Y Becherini
- Laboratoire Astroparticule et Cosmologie, Université de Paris, Centre national de la recherche scientifique, Paris F-75013, France
- Department of Physics and Electrical Engineering, Linnaeus University, Växjö 351 95, Sweden
| | - D Berge
- Deutsches Elektronen-Synchrotron, Zeuthen D-15738, Germany
- Institut für Physik, Humboldt-Universität zu Berlin, Berlin D-12489, Germany
| | - K Bernlöhr
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - B Bi
- Institut für Astronomie und Astrophysik, Universität Tübingen, Tübingen D-72076, Germany
| | - M Böttcher
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Boisson
- Laboratoire Univers et Théories, Observatoire de Paris, Université Paris Sciences et Lettres, CNRS, Université de Paris, Meudon 92190, France
| | - J Bolmont
- Laboratoire de Physique Nucléaire et de Hautes Energies, Sorbonne Université, Université Paris Diderot, Université Paris Cité, Institut national de physique nucléaire et de physique des particules, Centre national de la recherche scientifique, Paris F-75252, France
| | - M de Bony de Lavergne
- Laboratoire d'Annecy de Physique des Particules, Centre national de la recherche scientifique, Institut national de physique nucléaire et de physique des particules, Université Savoie Mont Blanc, Annecy 74000, France
| | - J Borowska
- Institut für Physik, Humboldt-Universität zu Berlin, Berlin D-12489, Germany
| | - M Bouyahiaoui
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - M Breuhaus
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - R Brose
- Dublin Institute for Advanced Studies, Dublin D02 XF86, Ireland
| | - A M Brown
- Department of Physics, University of Oxford, Oxford OX1 3RH, UK
| | - F Brun
- Institute for Research on the Fundamental Laws of the Universe, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette F-91191, France
| | - B Bruno
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - T Bulik
- Astronomical Observatory, The University of Warsaw, Warsaw 00-478, Poland
| | | | - S Caroff
- Laboratoire d'Annecy de Physique des Particules, Centre national de la recherche scientifique, Institut national de physique nucléaire et de physique des particules, Université Savoie Mont Blanc, Annecy 74000, France
| | - S Casanova
- Instytut Fizyki J[Formula: see text]drowej, Polska Akademia Nauk, Kraków 31-342, Poland
| | - R Cecil
- Institut für Experimentalphysik, Universität Hamburg, Hamburg D-22761, Germany
| | - J Celic
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - M Cerruti
- Laboratoire Astroparticule et Cosmologie, Université de Paris, Centre national de la recherche scientifique, Paris F-75013, France
| | - T Chand
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - S Chandra
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - A Chen
- School of Physics, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - J Chibueze
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - O Chibueze
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - G Cotter
- Department of Physics, University of Oxford, Oxford OX1 3RH, UK
| | - S Dai
- School of Science, Western Sydney University, Penrith NSW 2751, Australia
| | | | - A Djannati-Ataï
- Laboratoire Astroparticule et Cosmologie, Université de Paris, Centre national de la recherche scientifique, Paris F-75013, France
| | - A Dmytriiev
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - V Doroshenko
- Institut für Astronomie und Astrophysik, Universität Tübingen, Tübingen D-72076, Germany
| | - K Egberts
- Institut für Physik und Astronomie, Universität Potsdam, Potsdam 14476, Germany
| | - S Einecke
- School of Physical Sciences, University of Adelaide, Adelaide 5005, Australia
| | - J-P Ernenwein
- Centre de Physique des Particules de Marseille, Aix Marseille Université, Centre national de la recherche scientifique, Institut national de physique nucléaire et de physique des particules, Marseille 13288, France
| | - M Filipovic
- School of Science, Western Sydney University, Penrith NSW 2751, Australia
| | - G Fontaine
- Laboratoire Leprince-Ringuet, École Polytechnique, Centre national de la recherche scientifique, Institut Polytechnique de Paris, Palaiseau F-91128, France
| | - M Füßling
- Deutsches Elektronen-Synchrotron, Zeuthen D-15738, Germany
| | - S Funk
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - S Gabici
- Laboratoire Astroparticule et Cosmologie, Université de Paris, Centre national de la recherche scientifique, Paris F-75013, France
| | - S Ghafourizadeh
- Landessternwarte, Universität Heidelberg, Heidelberg D-69117, Germany
| | - G Giavitto
- Deutsches Elektronen-Synchrotron, Zeuthen D-15738, Germany
| | - D Glawion
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - J-F Glicenstein
- Institute for Research on the Fundamental Laws of the Universe, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette F-91191, France
| | - G Grolleron
- Laboratoire de Physique Nucléaire et de Hautes Energies, Sorbonne Université, Université Paris Diderot, Université Paris Cité, Institut national de physique nucléaire et de physique des particules, Centre national de la recherche scientifique, Paris F-75252, France
| | - L Haerer
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - J A Hinton
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - W Hofmann
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - T L Holch
- Deutsches Elektronen-Synchrotron, Zeuthen D-15738, Germany
| | - M Holler
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, Innsbruck A-6020, Austria
| | - D Horns
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - M Jamrozy
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, Kraków 30-244, Poland
| | - F Jankowsky
- Landessternwarte, Universität Heidelberg, Heidelberg D-69117, Germany
| | - A Jardin-Blicq
- Laboratoir de de Physique des deux Infinis, Université Bordeaux, CNRS, Gradignan F-33170, France
| | - V Joshi
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - I Jung-Richardt
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - E Kasai
- Department of Physics, University of Namibia, Windhoek 10005, Namibia
| | - K Katarzyński
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Torun 87-100, Poland
| | - R Khatoon
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - B Khélifi
- Laboratoire Astroparticule et Cosmologie, Université de Paris, Centre national de la recherche scientifique, Paris F-75013, France
| | - S Klepser
- Deutsches Elektronen-Synchrotron, Zeuthen D-15738, Germany
| | - W Kluźniak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-716, Poland
| | - Nu Komin
- School of Physics, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - K Kosack
- Institute for Research on the Fundamental Laws of the Universe, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette F-91191, France
| | - D Kostunin
- Deutsches Elektronen-Synchrotron, Zeuthen D-15738, Germany
| | - A Kundu
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - R G Lang
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - S Le Stum
- Centre de Physique des Particules de Marseille, Aix Marseille Université, Centre national de la recherche scientifique, Institut national de physique nucléaire et de physique des particules, Marseille 13288, France
| | - F Leitl
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - A Lemière
- Laboratoire Astroparticule et Cosmologie, Université de Paris, Centre national de la recherche scientifique, Paris F-75013, France
| | - J-P Lenain
- Laboratoire de Physique Nucléaire et de Hautes Energies, Sorbonne Université, Université Paris Diderot, Université Paris Cité, Institut national de physique nucléaire et de physique des particules, Centre national de la recherche scientifique, Paris F-75252, France
| | - F Leuschner
- Institut für Astronomie und Astrophysik, Universität Tübingen, Tübingen D-72076, Germany
| | - T Lohse
- Institut für Physik, Humboldt-Universität zu Berlin, Berlin D-12489, Germany
| | - A Luashvili
- Laboratoire Univers et Théories, Observatoire de Paris, Université Paris Sciences et Lettres, CNRS, Université de Paris, Meudon 92190, France
| | - I Lypova
- Landessternwarte, Universität Heidelberg, Heidelberg D-69117, Germany
| | - J Mackey
- Dublin Institute for Advanced Studies, Dublin D02 XF86, Ireland
| | - D Malyshev
- Institut für Astronomie und Astrophysik, Universität Tübingen, Tübingen D-72076, Germany
| | - D Malyshev
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - V Marandon
- Institute for Research on the Fundamental Laws of the Universe, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette F-91191, France
| | - P Marchegiani
- School of Physics, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - A Marcowith
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, Centre national de la recherche scientifique, Institut national de physique nucléaire et de physique des particules, Montpellier F-34095, France
| | - G Martí-Devesa
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, Innsbruck A-6020, Austria
| | - R Marx
- Landessternwarte, Universität Heidelberg, Heidelberg D-69117, Germany
| | - A Mehta
- Deutsches Elektronen-Synchrotron, Zeuthen D-15738, Germany
| | - A Mitchell
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - R Moderski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-716, Poland
| | - L Mohrmann
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - A Montanari
- Landessternwarte, Universität Heidelberg, Heidelberg D-69117, Germany
| | - E Moulin
- Institute for Research on the Fundamental Laws of the Universe, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette F-91191, France
| | - T Murach
- Deutsches Elektronen-Synchrotron, Zeuthen D-15738, Germany
| | - K Nakashima
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - M de Naurois
- Laboratoire Leprince-Ringuet, École Polytechnique, Centre national de la recherche scientifique, Institut Polytechnique de Paris, Palaiseau F-91128, France
| | - J Niemiec
- Instytut Fizyki J[Formula: see text]drowej, Polska Akademia Nauk, Kraków 31-342, Poland
| | - A Priyana Noel
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, Kraków 30-244, Poland
| | - S Ohm
- Deutsches Elektronen-Synchrotron, Zeuthen D-15738, Germany
| | - L Olivera-Nieto
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | | | - M Ostrowski
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, Kraków 30-244, Poland
| | - S Panny
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, Innsbruck A-6020, Austria
| | - M Panter
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - R D Parsons
- Institut für Physik, Humboldt-Universität zu Berlin, Berlin D-12489, Germany
| | - G Peron
- Laboratoire Astroparticule et Cosmologie, Université de Paris, Centre national de la recherche scientifique, Paris F-75013, France
| | - D A Prokhorov
- Gravitation and Astroparticle Physics Amsterdam, Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam 1098 XH, Netherlands
| | - G Pühlhofer
- Institut für Astronomie und Astrophysik, Universität Tübingen, Tübingen D-72076, Germany
| | - M Punch
- Laboratoire Astroparticule et Cosmologie, Université de Paris, Centre national de la recherche scientifique, Paris F-75013, France
| | - A Quirrenbach
- Landessternwarte, Universität Heidelberg, Heidelberg D-69117, Germany
| | - P Reichherzer
- Institute for Research on the Fundamental Laws of the Universe, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette F-91191, France
| | - A Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, Innsbruck A-6020, Austria
| | - O Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, Innsbruck A-6020, Austria
| | - H Ren
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - M Renaud
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, Centre national de la recherche scientifique, Institut national de physique nucléaire et de physique des particules, Montpellier F-34095, France
| | - B Reville
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - F Rieger
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - G Rowell
- School of Physical Sciences, University of Adelaide, Adelaide 5005, Australia
| | - B Rudak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-716, Poland
| | - H Rueda Ricarte
- Institute for Research on the Fundamental Laws of the Universe, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette F-91191, France
| | - E Ruiz-Velasco
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - V Sahakian
- Yerevan Physics Institute, Yerevan 375036, Armenia
| | - H Salzmann
- Institut für Astronomie und Astrophysik, Universität Tübingen, Tübingen D-72076, Germany
| | - A Santangelo
- Institut für Astronomie und Astrophysik, Universität Tübingen, Tübingen D-72076, Germany
| | - M Sasaki
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - J Schäfer
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - F Schüssler
- Institute for Research on the Fundamental Laws of the Universe, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette F-91191, France
| | - U Schwanke
- Institut für Physik, Humboldt-Universität zu Berlin, Berlin D-12489, Germany
| | - J N S Shapopi
- Department of Physics, University of Namibia, Windhoek 10005, Namibia
| | - H Sol
- Laboratoire Univers et Théories, Observatoire de Paris, Université Paris Sciences et Lettres, CNRS, Université de Paris, Meudon 92190, France
| | - A Specovius
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - S Spencer
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - L Stawarz
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, Kraków 30-244, Poland
| | - R Steenkamp
- Department of Physics, University of Namibia, Windhoek 10005, Namibia
| | - S Steinmassl
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - C Steppa
- Institut für Physik und Astronomie, Universität Potsdam, Potsdam 14476, Germany
| | - K Streil
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - I Sushch
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - H Suzuki
- Department of Physics, Konan University, Higashinada-ku Kobe 658-8501, Japan, Japan
| | - T Takahashi
- Kavli Institute for the Physics and Mathematics of the Universe, The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa Chiba 277-8583, Japan
| | - T Tanaka
- Department of Physics, Konan University, Higashinada-ku Kobe 658-8501, Japan, Japan
| | - A M Taylor
- Deutsches Elektronen-Synchrotron, Zeuthen D-15738, Germany
| | - R Terrier
- Laboratoire Astroparticule et Cosmologie, Université de Paris, Centre national de la recherche scientifique, Paris F-75013, France
| | - M Tsirou
- Deutsches Elektronen-Synchrotron, Zeuthen D-15738, Germany
| | - N Tsuji
- The Institute of Physical and Chemical Research (RIKEN), Wako Saitama 351-0198, Japan
| | - T Unbehaun
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - C van Eldik
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - M Vecchi
- Kapteyn Astronomical Institute, University of Groningen, Groningen 9747 AD, Netherlands
| | - J Veh
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - C Venter
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - J Vink
- Gravitation and Astroparticle Physics Amsterdam, Anton Pannekoek Institute for Astronomy, University of Amsterdam, Amsterdam 1098 XH, Netherlands
| | - T Wach
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - S J Wagner
- Landessternwarte, Universität Heidelberg, Heidelberg D-69117, Germany
| | - F Werner
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - R White
- Max-Planck-Institut für Kernphysik, Heidelberg D-69117, Germany
| | - A Wierzcholska
- Instytut Fizyki J[Formula: see text]drowej, Polska Akademia Nauk, Kraków 31-342, Poland
| | - Yu Wun Wong
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen D-91058, Germany
| | - M Zacharias
- Landessternwarte, Universität Heidelberg, Heidelberg D-69117, Germany
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - D Zargaryan
- Dublin Institute for Advanced Studies, Dublin D02 XF86, Ireland
| | - A A Zdziarski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-716, Poland
| | - A Zech
- Dublin Institute for Advanced Studies, Dublin D02 XF86, Ireland
- Kapteyn Astronomical Institute, University of Groningen, Groningen 9747 AD, Netherlands
| | - S Zouari
- Laboratoire Astroparticule et Cosmologie, Université de Paris, Centre national de la recherche scientifique, Paris F-75013, France
| | - N Żywucka
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
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Liu M, Mitchell A, Palanisamy A, Singh PM. Role of cosyntropin in the prevention of post-dural puncture headache: a propensity-matched retrospective analysis. Int J Obstet Anesth 2023; 56:103922. [PMID: 37651920 DOI: 10.1016/j.ijoa.2023.103922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/08/2023] [Accepted: 07/30/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Post-dural puncture headache (PDPH) is a well-documented complication of accidental dural puncture in obstetric patients. Reports have shown successful treatment with adrenocorticotropic hormone (ACTH) but evidence remains low and limited. In this retrospective analysis, we assessed whether prophylactic administration of cosyntropin, a synthetic derivative of ACTH, reduced the incidence of PDPH after accidental dural puncture in parturients. METHOD The study population included 132 women with an accidental dural puncture over a three-year period (June 1, 2018 to Oct 31, 2021) at a large tertiary-care center. Patient electronic medical records were reviewed for patient characteristics, prophylactic administration of cosyntropin, PDPH diagnosis, and need for epidural blood patch. Typically, 1 mg of cosyntropin was administered as an intravenous bolus or infusion post-delivery. The propensity score was calculated based on the following factors: age, body mass index, and placement of an intrathecal catheter. Patients were matched allowing 10% variation in scores to reduce potential treatment assignment bias. RESULTS A total of 115 patients were included in the final analysis. Intravenous cosyntropin was administered to 65 patients (55.6%). Among those who received cosyntropin, 37 (56.9%) developed PDPH compared with 29 patients (58%) in the no-cosyntropin group (P = 0.08). Epidural blood patch was performed in 21 patients (56.8%) who received cosyntropin and 13 patients (61.7%) who did not (P = 0.70). CONCLUSION Prophylactic administration of cosyntropin is not associated with a reduced incidence of PDPH.
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Affiliation(s)
- M Liu
- Division of Obstetrical Anesthesiology, Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
| | - A Mitchell
- Division of Obstetrical Anesthesiology, Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
| | - A Palanisamy
- Division of Obstetrical Anesthesiology, Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA
| | - P M Singh
- Division of Obstetrical Anesthesiology, Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA.
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Tan IZ, Mitchell A, McNair H, Dunlop A, Herbert T, Nartey J, Lawes R, O'Connell N, De-Colle C, Han K, Hahn E, Nelms B, Russell N, Kirby A. A Multicenter Study of Clinical to Planning Target Volume Margins for Adjuvant Partial Breast Irradiation Delivered on the 1.5T MR-Linear Accelerator. Int J Radiat Oncol Biol Phys 2023; 117:e725. [PMID: 37786112 DOI: 10.1016/j.ijrobp.2023.06.2237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Adjuvant partial breast irradiation (APBI) for early-stage breast cancer patients delivered on a conventional Linac commonly uses a clinical to planning target volume (CTV-PTV) margin of 10 mm. Published data suggest this margin could be reduced using an MR-guided workflow. This study quantifies the CTV to PTV margin for APBI delivered on the 1.5T MR-Linac (MRL) using an Adapt to Position (ATP) workflow. MATERIALS/METHODS All target contouring was done as per the IMPORT LOW trial and MRL Consortium guidelines. The CTV is the tumor bed defined by surgical clips including postsurgical changes. A single center cohort of ten patients was used to assess delineation error on ProKnow DS v1.28.0 by measuring CTV contour displacements on the CT planning scans (pCT) delineated by five breast radiation oncologists. All other error components were measured on treatment planning software on another single center cohort of ten patients. Target deformation error was measured as surgical clip displacements between the pCT and daily pre-treatment (pre-Tx) MRI scans. Intrafraction motion was determined by the CTV displacement between pre- and post-treatment MRIs (post-Tx) in available paired images from five patients. Matching error was estimated as the interobserver variation of three MRL radiographers registering the pCT with daily pre-Tx MRI. Technical delivery accuracy was estimated using the results from routine quality assurance measurements. Beam penumbral width (p) was estimated from the clinical treatment plans. The systematic (Σ) and random errors (σ) for each component were calculated in the left/right (X), superior/inferior (Y) and anterior/posterior (Z) directions. The contribution of these errors to the PTV margin, M was calculated using van Herk's formula with α and β being 2.50 and 1.64 respectively. RESULTS For APBI using an MRL ATP workflow, a CTV-PTV margin of 5.7 to 7.6 mm is required to achieve a 90% confidence of CTV coverage by the 95% isodose. Individual error components are in. Table 1 delineation error remains the largest component of error. CONCLUSION A minimum CTV-PTV margin of 6-8 mm is required for APBI using an MRL ATP workflow. Although smaller than margins used in conventional Linacs, the clinical benefits (in terms of fibrosis risk) of treating APBI patients on an MRL are likely to be modest. Further margin reductions may be possible using an "Adapt to Shape" workflow with daily online recontouring.
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Affiliation(s)
- I Z Tan
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; Institute of Cancer Research, London, United Kingdom
| | - A Mitchell
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; Institute of Cancer Research, London, United Kingdom
| | - H McNair
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; Institute of Cancer Research, London, United Kingdom
| | - A Dunlop
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; Institute of Cancer Research, London, United Kingdom
| | - T Herbert
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - J Nartey
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - R Lawes
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | | | - C De-Colle
- Tübingen University Hospital, Tübingen, Germany
| | - K Han
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - E Hahn
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - B Nelms
- Canis Lupus LLC, Merrimac, WI
| | - N Russell
- Dutch Cancer Institute, Amsterdam, The Netherlands
| | - A Kirby
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom; Institute of Cancer Research, London, United Kingdom
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Westley R, Dunlop A, Alexander S, Mitchell A, Diamantopoulos S, Chick J, Hall E, Mohajer J, Tree A. Is the Motion Causing a Commotion? Two-Fraction Prostate SBRT on the MR-Linac. Int J Radiat Oncol Biol Phys 2023; 117:e449-e450. [PMID: 37785446 DOI: 10.1016/j.ijrobp.2023.06.1634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In HERMES (NCT04595019) men with localized prostate cancer are treated on the Unity MR-Linac platform (MRL, Elekta AB, Stockholm) and randomized between stereotactic body radiotherapy (SBRT) with 36.25 Gy in 5 fractions and 24 Gy in 2 fractions. Patients randomized to two fractions receive 24 Gy to the high risk PTV, 20 Gy to the low risk PTV and a boost of 27 Gy to the dominant intraprostatic lesion. This study explores dose received by the target and organs at risk (OARs) when considering intrafraction motion in two fraction SBRT. MATERIALS/METHODS Targets and OARs were delineated and a reference plan generated on Monaco v5.40.01 (Elekta). An Adapt-to-Shape (ATS) workflow was used. Contours were propagated to the session MRI (MRIsession) and edited accordingly. Prior to delivery, a verification MRI (MRIverif) was acquired with baseline shifts corrected for using the Adapt-to-Position (ATP-of-ATS) workflow. A post treatment MRI (MRIpost) was acquired after delivery. Men in the 2-fraction arm received each fraction in 2 sub-fractions sequentially on the same day, to mitigate intrafraction motion. The plans of 5 men receiving 2 fraction SBRT were analyzed. The targets, urethra, bladder and rectum were recontoured on the MRIverif and MRIpost. Delivered plans were recalculated on the corresponding MRIverif and MRIpost. The percentage of optimal and mandatory target dose constraints met were calculated. Accumulated OAR doses were calculated by averaging their respective dose statistics across all sub-fractions, conservatively assuming that the same area of the OAR receives the maximum dose each fraction. Analysis was carried out separately for MRIverif and MRIpost as the true 'delivered dose' most likely lies between these two estimates. RESULTS There was good coverage across all fractions. The mandatory constraints of CTVpsv V24.0 Gy > 95% and CTVsv V20.0 Gy > 95% were met in 100% of fractions and V2700cGy > 95% in 90% on the MRIpost. Table 3 shows OAR dose. CONCLUSION This work demonstrates that target coverage is good, even for the GTV where no margin is applied. With our conservative dose calculation approach, we found dose constraints are exceeded for some patients. However, treatment has been well tolerated, suggesting that that our current dose constraints may be cautious. Once Elekta's True Tracking and automated gating software is implemented at our center we will be able to further improve OAR clinical goal compliance.
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Affiliation(s)
- R Westley
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - A Dunlop
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - S Alexander
- Institute of Cancer Research, Sutton, United Kingdom
| | - A Mitchell
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | | | - J Chick
- The Royal Marsden, Sutton, United Kingdom
| | - E Hall
- The Institute of Cancer Research, Clinical Trials and Statistics Unit, London, United Kingdom
| | - J Mohajer
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - A Tree
- Radiotherapy and Imaging Division, Institute of Cancer Research, London, United Kingdom
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Welsh TJ, Mitchell A. Centrally acting antihypertensives and alpha-blockers in people at risk of falls: therapeutic dilemmas-a clinical review. Eur Geriatr Med 2023; 14:675-682. [PMID: 37436689 PMCID: PMC10447259 DOI: 10.1007/s41999-023-00813-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/07/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE The aim of this clinical review was to summarise the existing knowledge on the adverse effects of alpha-blockers and centrally acting antihypertensives, the effect these may have on falls risk, and guide deprescribing of these medications. METHODS Literature searches were conducted using PubMed and Embase. Additional articles were identified by searching reference lists and reference to personal libraries. We discuss the place of alpha-blockers and centrally acting antihypertensives in the treatment of hypertension and methods for deprescribing. RESULTS Alpha-blockers and centrally acting antihypertensives are no longer recommended for the treatment of hypertension unless all other agents are contraindicated or not tolerated. These medications carry a significant falls risk and non-falls risk-associated side effects. Tools to aid and guide de-prescribing and monitoring of the withdrawal of these medication classes are available to assist the clinician including information on reducing the risk of withdrawal syndromes. CONCLUSIONS Centrally acting antihypertensives and alpha-blockers increase the risk of falls through a variety of mechanisms-principally by increasing the risk of hypotension, orthostatic hypotension, arrhythmias and sedation. These agents should be prioritised for de-prescribing in older frailer individuals. We identify a number of tools and a withdrawal protocol to aid the clinician in identifying and de-prescribing these medications.
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Affiliation(s)
- T J Welsh
- University of Bristol, Bristol, UK
- RICE-The Research Institute for the Care of Older People, The RICE Centre, Royal United Hospital, Bath, UK
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - A Mitchell
- RICE-The Research Institute for the Care of Older People, The RICE Centre, Royal United Hospital, Bath, UK.
- Pharmacy Department, University Hospitals Plymouth NHS Trust, Plymouth, UK.
- Department of Life Sciences, University of Bath, Bath, UK.
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Wint W, Mitchell A, Alexander N, Ellerbeck J, Enticott G, Hogarth P, Prosser A, Lambert L, Hackett D, Tait N, Tiller J, Upton P. Challenges and opportunities of sharing animal health data for research and disease management: a case study of bovine tuberculosis. REV SCI TECH OIE 2023; 42:75-82. [PMID: 37232317 DOI: 10.20506/rst.42.3350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The sharing of animal disease data should be encouraged. The analysis of such data will broaden our knowledge of animal diseases and potentially provide insights into their management. However, the need to conform to data protection rules in the sharing of such data for analysis purposes often poses practical difficulties. This paper sets out the challenges and the methods used for the sharing of animal health data in England, Scotland and Wales - Great Britain - using bovine tuberculosis (bTB) data as a case study. The data sharing described is undertaken by the Animal and Plant Health Agency on behalf of the Department for Environment, Food and Rural Affairs and the Welsh and Scottish Governments. It should be noted that animal health data are held at the level of Great Britain (rather than the United Kingdom - which includes Northern Ireland), as Northern Ireland's Department of Agriculture, Environment and Rural Affairs has its own separate data systems. Bovine tuberculosis is the most significant and costly animal health problem facing cattle farmers in England and Wales. It can be devastating for farmers and farming communities and the control costs for taxpayers in Great Britain are over £150 million a year. The authors describe two methods of data sharing - first, where data are requested by, and delivered to, an academic institution for epidemiological or scientific analysis, and second, where data are proactively published in an accessible and meaningful way. They provide details of an example of the second method, namely, the free-to-access website ‘information bovine TB' (https://ibtb.co.uk), which publishes bTB data for the benefit of the farming community and veterinary health professionals.
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Ingle M, White I, Chick J, Stankiewicz H, Mitchell A, Barnes H, Herbert T, Nill S, Oelfke U, Huddart R, Ng-Cheng-Hin B, Hafeez S, Lalondrelle S, Dunlop A, Bhide S. Understanding the Benefit of Magnetic Resonance-guided Adaptive Radiotherapy in Rectal Cancer Patients: a Single-centre Study. Clin Oncol (R Coll Radiol) 2023; 35:e135-e142. [PMID: 36336579 DOI: 10.1016/j.clon.2022.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/01/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
AIMS Neoadjuvant chemoradiotherapy followed by surgery is the mainstay of treatment for patients with rectal cancer. Standard clinical target volume (CTV) to planning target volume (PTV) margins of 10 mm are used to accommodate inter- and intrafraction motion of target. Treating on magnetic resonance-integrated linear accelerators (MR-linacs) allows for online manual recontouring and adaptation (MRgART) enabling the reduction of PTV margins. The aim of this study was to investigate motion of the primary CTV (CTVA; gross tumour volume and macroscopic nodes with 10 mm expansion to cover microscopic disease) in order to develop a simultaneous integrated boost protocol for use on MR-linacs. MATERIALS AND METHODS Patients suitable for neoadjuvant chemoradiotherapy were recruited for treatment on MR-linac using a two-phase technique; only the five phase 1 fractions on MR-linac were used for analysis. Intrafraction motion of CTVA was measured between pre-treatment and post-treatment MRI scans. In MRgART, isotropically expanded pre-treatment PTV margins from 1 to 10 mm were rigidly propagated to post-treatment MRI to determine overlap with 95% of CTVA. The PTV margin was considered acceptable if overlap was >95% in 90% of fractions. To understand the benefit of MRgART, the same methodology was repeated using a reference computed tomography planning scan for pre-treatment imaging. RESULTS In total, nine patients were recruited between January 2018 and December 2020 with T3a-T4, N0-N2, M0 disease. Forty-five fractions were analysed in total. The median motion across all planes was 0 mm, demonstrating minimal intrafraction motion. A PTV margin of 3 and 5mm was found to be acceptable in 96 and 98% of fractions, respectively. When comparing to the computed tomography reference scan, the analysis found that PTV margins to 5 and 10 mm only acceptably covered 51 and 76% of fractions, respectively. CONCLUSION PTV margins can be reduced to 3-5 mm in MRgART for rectal cancer treatment on MR-linac within an simultaneous integrated boost protocol.
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Affiliation(s)
- M Ingle
- The Royal Marsden Hospital NHS Trust, London, UK; The Institute of Cancer Research, London, UK.
| | - I White
- Guys and St Thomas NHS Trust, London, UK
| | - J Chick
- The Royal Marsden Hospital NHS Trust, London, UK
| | | | - A Mitchell
- The Royal Marsden Hospital NHS Trust, London, UK
| | - H Barnes
- The Royal Marsden Hospital NHS Trust, London, UK
| | - T Herbert
- The Royal Marsden Hospital NHS Trust, London, UK
| | - S Nill
- The Institute of Cancer Research, London, UK
| | - U Oelfke
- The Institute of Cancer Research, London, UK
| | - R Huddart
- The Royal Marsden Hospital NHS Trust, London, UK; The Institute of Cancer Research, London, UK
| | | | - S Hafeez
- The Royal Marsden Hospital NHS Trust, London, UK; The Institute of Cancer Research, London, UK
| | - S Lalondrelle
- The Royal Marsden Hospital NHS Trust, London, UK; The Institute of Cancer Research, London, UK
| | - A Dunlop
- The Royal Marsden Hospital NHS Trust, London, UK
| | - S Bhide
- The Royal Marsden Hospital NHS Trust, London, UK; The Institute of Cancer Research, London, UK
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White L, Riley B, Seidel D, Davis K, Mitchell A, Abi-fares C, Basson W, Anstey C. Rib fracture-related morbidity and mortality for older persons in the era of fascial plane blocks: A cohort study. Trauma 2022. [DOI: 10.1177/14604086221125725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction Analgesia is key to successful conservative, nonsurgical management of patients admitted to the hospital with multiple rib fractures. Recently, new fascial plane regional anesthesia techniques have become widely available. We hypothesized that since the introduction of these new regional analgesia techniques, for patients over the age of 65 years, the effect of increasing numbers of rib fractures has been mitigated. Methods A retrospective study of patients admitted for the management of rib fractures between 2017 and 2020 was performed. Patients not admitted to the hospital, under the age of 65 years, or with chest trauma other than rib fractures were not eligible for inclusion. The primary outcome of interest was mortality. The secondary outcomes were the incidence of pneumonia and intensive care unit admission. Results were reported as the odds ratio and its 95% confidence interval and associated p-value. Statistical significance was set at [Formula: see text] < 0.05. Results Overall, 252 patients were included and 142 patients received a regional anesthesia. The mortality rate was 4% (n = 10) with no association between mortality and number of rib fractures ( p = 0.215). Twenty-four patients (9.5%) developed pneumonia during their hospital stay, again with no association with an increasing number of rib fractures. The intensive care unit admission rate was 13.1% (n = 33) and correlated with an increasing number of fractures (odds ratio = 1.15; 95% confidence interval = 1.01 to 1.31; p = 0.038). Conclusion Management including liberal utilization of regional anesthesia for at-risk patients appears to mitigate the effect of increasing numbers of rib fractures on the incidence of mortality and pneumonia.
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Affiliation(s)
- L.D. White
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast University Hospital, Birtinya, QLD, Australia
| | - B. Riley
- Intensive Care Department, The Alfred Hospital, Melbourne, VIC, Australia
| | - D. Seidel
- Department of Anaesthesia, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
| | - K. Davis
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast University Hospital, Birtinya, QLD, Australia
| | - A. Mitchell
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast University Hospital, Birtinya, QLD, Australia
| | - C. Abi-fares
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast University Hospital, Birtinya, QLD, Australia
| | - W. Basson
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast University Hospital, Birtinya, QLD, Australia
| | - C. Anstey
- School of Medicine, Griffith University, Birtinya, QLD, Australia
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Lawes R, Barnes H, Herbert T, Mitchell A, Nill S, Oelfke U, Pathmanathan A, Smith GA, Sritharan K, Tree A, McNair H, Dunlop A. MRI-guided adaptive radiotherapy for prostate cancer: When do we need to account for intra-fraction motion? Clin Transl Radiat Oncol 2022; 37:85-88. [PMID: 36118123 PMCID: PMC9471961 DOI: 10.1016/j.ctro.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 12/03/2022] Open
Abstract
A shift of the daily plan can mitigate target position changes that occur between daily MR acquisition and treatment for MR-linac radiotherapy, but increases the session time. We demonstrated that our workflow strategy and decision-making process, to determine whether a subsequent shift is necessary, is appropriate.
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Affiliation(s)
- R. Lawes
- Royal Marsden NHS Foundation Trust, United Kingdom
| | - H. Barnes
- Royal Marsden NHS Foundation Trust, United Kingdom
| | - T. Herbert
- Royal Marsden NHS Foundation Trust, United Kingdom
| | - A. Mitchell
- Royal Marsden NHS Foundation Trust, United Kingdom
| | - S. Nill
- Joint Department of Physics, Royal Marsden NHS Foundation Trust, and Institute of Cancer Research, United Kingdom
| | - U. Oelfke
- Joint Department of Physics, Royal Marsden NHS Foundation Trust, and Institute of Cancer Research, United Kingdom
| | - A. Pathmanathan
- Royal Marsden NHS Foundation Trust and Institute of Cancer Research, United Kingdom
| | | | - K. Sritharan
- Royal Marsden NHS Foundation Trust and Institute of Cancer Research, United Kingdom
| | - A. Tree
- Royal Marsden NHS Foundation Trust and Institute of Cancer Research, United Kingdom
| | - H.A. McNair
- Royal Marsden NHS Foundation Trust and Institute of Cancer Research, United Kingdom
| | - A. Dunlop
- Royal Marsden NHS Foundation Trust and Institute of Cancer Research, United Kingdom
- Joint Department of Physics, Royal Marsden NHS Foundation Trust, and Institute of Cancer Research, United Kingdom
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West H, Siddique M, Volpe L, Desai R, Lyasheva M, Dangas K, Tomlins P, Mitchell A, Kardos A, Casadei B, Channon K, Antoniades C. Automated deep learning quantification of epicardial adiposity on cardiac CT predicts atrial fibrillation risk immediately following cardiac surgery and long-term. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Epicardial adipose tissue (EAT) is a visceral fat deposit within the pericardial sac which surrounds the heart myocardium and coronary arteries. The automated quantification of EAT volume is possible from routine CCTA scans via a deep-learning approach. The use of automated EAT quantification for the assessment of atrial fibrillation (AF) risk in the post-operative period, and longer-term, has not been previously investigated.
Purpose
To apply a deep-learning approach for automated segmentation of EAT from routine CCTA scans to assess the immediate post-operative and long-term risk of AF conveyed by EAT.
Methods
A deep-learning automated EAT segmentation tool using a 3D Residual-U-Net neural network architecture for 3D volumetric segmentation of CCTA data was created and trained on over 2800 consecutive CCTA performed as part of clinical care in patients with stable chest pain from 2015 onwards within the European arm of the Oxford Risk Factors And Non Invasive Imaging (ORFAN) Study. External validation in 817patients demonstrated excellent correlation between machine and human expert (CCC = 0.972). The prognostic value of deep-learning derived EAT volume was assessed in the AdipoRedOx Study (n=253; UK patients undergoing cardiac surgery) against both immediate in-hospital outcomes and longer-term outcomes from UK-wide NHS data, with adjustment for AF risk factors.
Results
There were 97 cases of new-onset AF in the immediate post-operative period (38.3%). EAT volume was found to be an independent predictor of post-operative AF regardless of body mass index. Utilising the median EAT volume as the cut point, the adjusted hazard ratio (HR [95% CI]) for risk of new-onset post-operative AF in-hospital was 1.56 [1.09–3.85], p<0.01 (Figure 1A). In receiver-operator characteristic analysis EAT volume added significant incremental prognostic power for the discrimination of in-hospital post-operative AF over a traditional risk factor model ΔAUC=0.101, p<0.01 (Figure 1B).
Over a median follow-up period of 89 months there were 48 unique cases (19%) of confirmed AF found in nation-wide NHS hospital episode statistics data for the AdipoRedOx cohort. EAT volume was found to be a significant independent predictor of long-term AF. Utilising the median EAT volume as the cut point, the adjusted HR for risk of new-onset long-term AF following cardiac surgery was 1.25 [1.08–3.17], p<0.01 (Figure 1C).
Conclusions
Automatically segmented EAT volume measured using a deep learning network predicts risk of both short-term new onset AF following cardiac surgery, and long-term risk of AF in the 7 years following the surgery independently of BMI and AF risk factors. This suggests that EAT is a potent mediator of AF risk in the post cardiac surgery setting.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation - TG/19/2/34831EU Commission - 965286
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Affiliation(s)
- H West
- University of Oxford , Oxford , United Kingdom
| | - M Siddique
- University of Oxford , Oxford , United Kingdom
| | - L Volpe
- University of Oxford , Oxford , United Kingdom
| | - R Desai
- Northwestern University , Chicago , United States of America
| | - M Lyasheva
- University of Oxford , Oxford , United Kingdom
| | - K Dangas
- University of Oxford , Oxford , United Kingdom
| | - P Tomlins
- Caristo Diagnostics , Oxford , United Kingdom
| | - A Mitchell
- Oxford University Hospitals NHS Foundation Trust , Oxford , United Kingdom
| | - A Kardos
- Milton Keynes University Hospital NHS Trust , Milton Keynes , United Kingdom
| | - B Casadei
- University of Oxford , Oxford , United Kingdom
| | - K Channon
- University of Oxford , Oxford , United Kingdom
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Abdalla H, Aharonian F, Benkhali FA, Angüner EO, Armand C, Ashkar H, Backes M, Baghmanyan V, Martins VB, Batzofin R, Becherini Y, Berge D, Bernlöhr K, Bi B, Böttcher M, Bolmont J, de Lavergne MDB, Brose R, Brun F, Cangemi F, Caroff S, Cerruti M, Chand T, Chen A, Cotter G, Mbarubucyeye JD, Devin J, Djannati-Ataï A, Dmytriiev A, Doroshenko V, Egberts K, Fiasson A, de Clairfontaine GF, Fontaine G, Funk S, Gabici S, Giavitto G, Glawion D, Glicenstein JF, Grondin MH, Hinton JA, Hofmann W, Holch TL, Holler M, Horns D, Huang Z, Jamrozy M, Jankowsky F, Kasai E, Katarzyński K, Katz U, Khélifi B, Kluźniak W, Komin N, Kosack K, Kostunin D, Lamanna G, Lemoine-Goumard M, Lenain JP, Leuschner F, Lohse T, Luashvili A, Lypova I, Mackey J, Malyshev D, Malyshev D, Marandon V, Marchegiani P, Martí-Devesa G, Marx R, Maurin G, Meyer M, Mitchell A, Moderski R, Montanari A, Moulin E, Muller J, de Naurois M, Niemiec J, Noel AP, Ohm S, Olivera-Nieto L, Wilhelmi EDO, Ostrowski M, Panny S, Panter M, Parsons RD, Peron G, Poireau V, Prokoph H, Pühlhofer G, Punch M, Quirrenbach A, Reichherzer P, Reimer A, Reimer O, Renaud M, Rieger F, Rowell G, Rudak B, Ricarte HR, Ruiz-Velasco E, Sahakian V, Salzmann H, Santangelo A, Sasaki M, Schüssler F, Schutte HM, Schwanke U, Senniappan M, Shapopi JNS, Sol H, Specovius A, Spencer S, Stawarz Ł, Stegmann C, Steinmassl S, Steppa C, Takahashi T, Tanaka T, Terrier R, Thorpe-Morgan C, Tluczykont M, Tsirou M, Tsuji N, Uchiyama Y, van Eldik C, Veh J, Vink J, Wagner SJ, White R, Wierzcholska A, Wong YW, Zacharias M, Zargaryan D, Zdziarski AA, Zech A, Zhu SJ, Zouari S, Żywucka N. Search for Dark Matter Annihilation Signals in the H.E.S.S. Inner Galaxy Survey. Phys Rev Lett 2022; 129:111101. [PMID: 36154418 DOI: 10.1103/physrevlett.129.111101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/17/2022] [Accepted: 07/13/2022] [Indexed: 06/16/2023]
Abstract
The central region of the Milky Way is one of the foremost locations to look for dark matter (DM) signatures. We report the first results on a search for DM particle annihilation signals using new observations from an unprecedented γ-ray survey of the Galactic Center (GC) region, i.e., the Inner Galaxy Survey, at very high energies (≳100 GeV) performed with the H.E.S.S. array of five ground-based Cherenkov telescopes. No significant γ-ray excess is found in the search region of the 2014-2020 dataset and a profile likelihood ratio analysis is carried out to set exclusion limits on the annihilation cross section ⟨σv⟩. Assuming Einasto and Navarro-Frenk-White (NFW) DM density profiles at the GC, these constraints are the strongest obtained so far in the TeV DM mass range. For the Einasto profile, the constraints reach ⟨σv⟩ values of 3.7×10^{-26} cm^{3} s^{-1} for 1.5 TeV DM mass in the W^{+}W^{-} annihilation channel, and 1.2×10^{-26} cm^{3} s^{-1} for 0.7 TeV DM mass in the τ^{+}τ^{-} annihilation channel. With the H.E.S.S. Inner Galaxy Survey, ground-based γ-ray observations thus probe ⟨σv⟩ values expected from thermal-relic annihilating TeV DM particles.
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Affiliation(s)
- H Abdalla
- University of Namibia, Department of Physics, Private Bag 13301, Windhoek 10005, Namibia
| | - F Aharonian
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, D02 XF86 Dublin 2, Ireland
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
- High Energy Astrophysics Laboratory, RAU, 123 Hovsep Emin St Yerevan 0051, Armenia
| | - F Ait Benkhali
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - E O Angüner
- Aix Marseille Université, CNRS/IN2P3, CPPM, Marseille, France
| | - C Armand
- Université Savoie Mont Blanc, CNRS, Laboratoire d'Annecy de Physique des Particules-IN2P3, 74000 Annecy, France
| | - H Ashkar
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Backes
- University of Namibia, Department of Physics, Private Bag 13301, Windhoek 10005, Namibia
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - V Baghmanyan
- Instytut Fizyki Jádrowej PAN, ulica Radzikowskiego 152, 31-342 Kraków, Poland
| | | | - R Batzofin
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - Y Becherini
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - D Berge
- DESY, D-15738 Zeuthen, Germany
| | - K Bernlöhr
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - B Bi
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - M Böttcher
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - J Bolmont
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies, LPNHE, 4 Place Jussieu, F-75252 Paris, France
| | - M de Bony de Lavergne
- Université Savoie Mont Blanc, CNRS, Laboratoire d'Annecy de Physique des Particules-IN2P3, 74000 Annecy, France
| | - R Brose
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, D02 XF86 Dublin 2, Ireland
| | - F Brun
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - F Cangemi
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies, LPNHE, 4 Place Jussieu, F-75252 Paris, France
| | - S Caroff
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies, LPNHE, 4 Place Jussieu, F-75252 Paris, France
| | - M Cerruti
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - T Chand
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - A Chen
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - G Cotter
- University of Oxford, Department of Physics, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | | | - J Devin
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - A Djannati-Ataï
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - A Dmytriiev
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - V Doroshenko
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - K Egberts
- Institut für Physik und Astronomie, Universität Potsdam, Karl-Liebknecht-Strasse 24/25, D 14476 Potsdam, Germany
| | - A Fiasson
- Université Savoie Mont Blanc, CNRS, Laboratoire d'Annecy de Physique des Particules-IN2P3, 74000 Annecy, France
| | - G Fichet de Clairfontaine
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - G Fontaine
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - S Funk
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - S Gabici
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | | | - D Glawion
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - J F Glicenstein
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M-H Grondin
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J A Hinton
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - W Hofmann
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | | | - M Holler
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - D Horns
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - Zhiqiu Huang
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - M Jamrozy
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ulica Orla 171, 30-244 Kraków, Poland
| | - F Jankowsky
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - E Kasai
- University of Namibia, Department of Physics, Private Bag 13301, Windhoek 10005, Namibia
| | - K Katarzyński
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Grudziadzka 5, 87-100 Torun, Poland
| | - U Katz
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - B Khélifi
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - W Kluźniak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ulica Bartycka 18, 00-716 Warsaw, Poland
| | - Nu Komin
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - K Kosack
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | | | - G Lamanna
- Université Savoie Mont Blanc, CNRS, Laboratoire d'Annecy de Physique des Particules-IN2P3, 74000 Annecy, France
| | - M Lemoine-Goumard
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J-P Lenain
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies, LPNHE, 4 Place Jussieu, F-75252 Paris, France
| | - F Leuschner
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - T Lohse
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstrasse 15, D 12489 Berlin, Germany
| | - A Luashvili
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - I Lypova
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - J Mackey
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, D02 XF86 Dublin 2, Ireland
| | - D Malyshev
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - D Malyshev
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - V Marandon
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - P Marchegiani
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - G Martí-Devesa
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - R Marx
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - G Maurin
- Université Savoie Mont Blanc, CNRS, Laboratoire d'Annecy de Physique des Particules-IN2P3, 74000 Annecy, France
| | - M Meyer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - A Mitchell
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - R Moderski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ulica Bartycka 18, 00-716 Warsaw, Poland
| | - A Montanari
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - E Moulin
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J Muller
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - M de Naurois
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - J Niemiec
- Instytut Fizyki Jádrowej PAN, ulica Radzikowskiego 152, 31-342 Kraków, Poland
| | - A Priyana Noel
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ulica Orla 171, 30-244 Kraków, Poland
| | - S Ohm
- DESY, D-15738 Zeuthen, Germany
| | - L Olivera-Nieto
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | | | - M Ostrowski
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ulica Orla 171, 30-244 Kraków, Poland
| | - S Panny
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Panter
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - R D Parsons
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstrasse 15, D 12489 Berlin, Germany
| | - G Peron
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - V Poireau
- Université Savoie Mont Blanc, CNRS, Laboratoire d'Annecy de Physique des Particules-IN2P3, 74000 Annecy, France
| | | | - G Pühlhofer
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - M Punch
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - A Quirrenbach
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - P Reichherzer
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - O Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Renaud
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - F Rieger
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - G Rowell
- School of Physical Sciences, University of Adelaide, Adelaide 5005, Australia
| | - B Rudak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ulica Bartycka 18, 00-716 Warsaw, Poland
| | - H Rueda Ricarte
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - E Ruiz-Velasco
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - V Sahakian
- Yerevan Physics Institute, 2 Alikhanian Brothers Street 375036 Yerevan, Armenia
| | - H Salzmann
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - A Santangelo
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - M Sasaki
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - F Schüssler
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - H M Schutte
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - U Schwanke
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstrasse 15, D 12489 Berlin, Germany
| | - M Senniappan
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - J N S Shapopi
- University of Namibia, Department of Physics, Private Bag 13301, Windhoek 10005, Namibia
| | - H Sol
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - A Specovius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - S Spencer
- University of Oxford, Department of Physics, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - Ł Stawarz
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ulica Orla 171, 30-244 Kraków, Poland
| | - C Stegmann
- DESY, D-15738 Zeuthen, Germany
- Institut für Physik und Astronomie, Universität Potsdam, Karl-Liebknecht-Strasse 24/25, D 14476 Potsdam, Germany
| | - S Steinmassl
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - C Steppa
- Institut für Physik und Astronomie, Universität Potsdam, Karl-Liebknecht-Strasse 24/25, D 14476 Potsdam, Germany
| | - T Takahashi
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, 5-1-5 Kashiwa-no-Ha, Kashiwa, Chiba, 277-8583, Japan
| | - T Tanaka
- Department of Physics, Konan University, 8-9-1 Okamoto, Higashinada, Kobe, Hyogo 658-8501, Japan
| | - R Terrier
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - C Thorpe-Morgan
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - M Tluczykont
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - M Tsirou
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - N Tsuji
- RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Uchiyama
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima-ku, Tokyo 171-8501, Japan
| | - C van Eldik
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - J Veh
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - J Vink
- GRAPPA, Anton Pannekoek Institute for Astronomy, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, Netherlands
| | - S J Wagner
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - R White
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - A Wierzcholska
- Instytut Fizyki Jádrowej PAN, ulica Radzikowskiego 152, 31-342 Kraków, Poland
| | - Yu Wun Wong
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - M Zacharias
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - D Zargaryan
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, D02 XF86 Dublin 2, Ireland
- High Energy Astrophysics Laboratory, RAU, 123 Hovsep Emin St Yerevan 0051, Armenia
| | - A A Zdziarski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ulica Bartycka 18, 00-716 Warsaw, Poland
| | - A Zech
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - S J Zhu
- DESY, D-15738 Zeuthen, Germany
| | - S Zouari
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - N Żywucka
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
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Mitchell A, Ingle M, Smith G, Chick J, Diamantopoulos S, Goodwin E, Herbert T, Huddart R, McNair H, Oelfke U, Nill S, Dunlop A, Hafeez S. Feasibility of tumour-focused adaptive radiotherapy for bladder cancer on the MR-linac. Clin Transl Radiat Oncol 2022; 35:27-32. [PMID: 35571274 PMCID: PMC9092067 DOI: 10.1016/j.ctro.2022.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 11/23/2022] Open
Abstract
Bladder tumour-focused magnetic resonance image-guided adaptive radiotherapy using a 1.5 Tesla MR-linac is feasible. A full online workflow adapting to anatomy at each fraction is achievable in approximately 30 min. Intra-fraction bladder filling did not compromise target coverage with the class solution employed.
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Affiliation(s)
- A. Mitchell
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - M. Ingle
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - G. Smith
- The Royal Marsden NHS Foundation Trust, London, UK
| | - J. Chick
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Diamantopoulos
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - E. Goodwin
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - T. Herbert
- The Royal Marsden NHS Foundation Trust, London, UK
| | - R. Huddart
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - H. McNair
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - U. Oelfke
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Nill
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - A. Dunlop
- The Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Hafeez
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
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West H, Siddique M, Volpe L, Desai R, Lyasheva M, Dangas K, Tomlins P, Mitchell A, Kardos A, Casadei B, Channon K, Antoniades C. 410 Automated Deep Learning Quantification Of Epicardial Adiposity On Cardiac CT Predicts Atrial Fibrillation Risk Immediately Following Cardiac Surgery And Long-term. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Mitchell A, Lipecki J, Muter J, Lucas E, Makwana K, Fishwick K, Odendaal J, Hawkes A, Vrljicak P, Brosens J, Ott S. P-436 EndoTime: Non-categorical timing estimates for luteal endometrium. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Can expression measurements of a small panel of genes be used to develop a continuous, non-categorical model for the improvement of endometrial biopsy timing accuracy?
Summary answer
Measuring expression levels of six genes (IL2RB, IGFBP1, CXCL14, DPP4, GPX3, and SLC15A2) is sufficient to obtain and assess substantially more accurate timing estimates.
What is known already
Commercially available endometrial timing approaches based on gene expression require much larger gene sets and use a categorical approach that classifies samples as pre-receptive, receptive, or post-receptive.
Study design, size, duration
Gene expression was measured by RT-qPCR in different sample sets, comprising a total of 664 endometrial biopsies obtained 4 to 12 days after a self-reported positive home ovulation test. A further 36 endometrial samples were profiled by RT-qPCR as well as RNA-sequencing.
Participants/materials, setting, methods
A computational procedure, named ‘EndoTime’, was established that models the temporal profile of each gene and estimates the timing of each sample. Iterating these steps, temporal profiles are gradually refined as sample timings are being updated, and confidence in timing estimates is increased. After convergence, the method reports updated timing estimates for each sample while preserving the overall distribution of time points.
Main results and the role of chance
The Wilcoxon rank-sum test was used to confirm that ordering samples by EndoTime estimates yields sharper temporal expression profiles for held-out genes (not used when determining sample timings) than ordering the same expression values by patient-reported times (GPX3 : p < 0.005; CXCL14 : p < 2.7e-6; DPP4 : p < 3.7e-13). Pearson correlation between EndoTime estimates for the same sample set but based on RT-qPCR or RNA-sequencing data showed high degree of congruency between the two (p = 8.6e-10, R-squared = 0.687). Estimated timings did not differ significantly between control subjects and patients with recurrent pregnancy loss or recurrent implantation failure (p > 0.05).
Limitations, reasons for caution
Timing estimates are informed by glandular gene expression and will only represent the temporal state of other endometrial cell types if in synchrony with the epithelium. Additionally, methods that estimate the day of ovulation are still required as these data are essential inputs in our method.
Wider implications of the findings
Our method is the first to assay the temporal state of endometrial samples on a continuous domain, enabling accurate temporal profiling of any gene in luteal phase biopsies for a wide range of research applications and, potentially, clinical use. It is freely available, open-source software including supporting data sets.
Trial registration number
Not applicable
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Affiliation(s)
- A Mitchell
- The University of Warwick, Warwick Medical School , Warwick, United Kingdom
| | - J Lipecki
- The University of Warwick, School of Life Sciences , Warwick, United Kingdom
| | - J Muter
- The University of Warwick, Warwick Medical School , Warwick, United Kingdom
| | - E Lucas
- The University of Warwick, Warwick Medical School , Warwick, United Kingdom
| | - K Makwana
- The University of Warwick, Warwick Medical School , Warwick, United Kingdom
| | - K Fishwick
- The University of Warwick, Warwick Medical School , Warwick, United Kingdom
| | - J Odendaal
- The University of Warwick, Warwick Medical School , Warwick, United Kingdom
| | - A Hawkes
- The University of Warwick, Warwick Medical School , Warwick, United Kingdom
| | - P Vrljicak
- The University of Warwick, Warwick Medical School , Warwick, United Kingdom
| | - J Brosens
- The University of Warwick, Warwick Medical School , Warwick, United Kingdom
| | - S Ott
- The University of Warwick, Warwick Medical School , Warwick, United Kingdom
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15
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Janssens K, Mitchell A, Foulkes S, Head G, Saner N, Howden E, Claessen G, La Gerche A. Modest association between peak exercise blood pressure and ambulatory hypertension in endurance athletes. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
An exaggerated blood pressure (BP) response to exercise may be an early indicator of hypertension. However, it is common in endurance athletes and the association between systolic blood pressure (SBP) during exercise and hypertension is not well established in this group.
Purpose
To establish whether there is an association between exercise-induced hypertension (EIH) and clinical hypertension in endurance athletes.
Methods
250 current and former endurance athletes (16-80 years, 75% male) performed a maximal exercise test on a cycle ergometer with BP measured every 2 min. Athletes were diagnosed with EIH based on international guidelines (SBP ≥210mmHg males, ≥190mmHg females). The relationship between SBP and workload was determined by linear regression analysis. Office hypertension was identified from either supine SBP ≥140mmHg or diastolic BP ≥90mmHg, or if treated for hypertension. Gold-standard 24-hour ambulatory blood pressure monitoring (ABPM) was performed in a subset of 42 athletes with EIH and 9 athletes with a normotensive response to exercise (NRE).
Results
On average, peak exercise SBP values were universally high (221±26mmHg in males and 199±21mmHg in females). 71% of athletes (70% of males and 74% of females) met criteria for EIH of which 12% had a peak SBP≥250mmHg. EIH and NRE groups were of similar age, sex, body mass index (BMI) and fitness (Figure 1). The strongest determinant of peak exercise SBP was exercise workload (R=0.78, P<0.001), which remained significant after adjusting for age, sex, BMI and antihypertensive medication (p<0.001) In the full cohort, resting SBP was higher in the EIH group (EIH: 128±13mmHg vs NRE: 122±15mmHg, P=0.006 – Figure 1), however there was a similar prevalence of office hypertension between the EIH (19%) and NRE (15%) groups (P=0.59). This prevalence remained similar (EIH: 13% vs NRE: 10%, P=0.49) after excluding those being treated for hypertension (n=15). In the subset of athletes who underwent 24h ABPM (n=51), there were no diagnoses of clinical hypertension in NRE (n=9, Figure 1). Of the 42 athletes with EIH, a majority (n=32, 76%) were normotensive on ABPM. In the 10 athletes with EIH and hypertension on ABPM, the majority were classified with Grade 1 hypertension (n=5) or daytime hypertension (n=3). Interestingly only two of these athletes would have been identified with office BP measures (see Figure 2).
Conclusion
EIH is common in endurance athletes and is strongly associated with peak exercise workloads suggesting this may be a reflection of superior cardiovascular fitness. In a small proportion of athletes, EIH may be associated with mild hypertension.
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Affiliation(s)
- K Janssens
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - A Mitchell
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - S Foulkes
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - G Head
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - N Saner
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - E Howden
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - G Claessen
- Gasthuisberg University Hospital, Leuven, Belgium
| | - A La Gerche
- Baker Heart and Diabetes Institute, Melbourne, Australia
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16
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Alexander S, Chick J, Herbert T, Huddart R, Ingle M, Mitchell A, Nill S, Oelfke U, Dunlop A, Hafeez S. MO-0312 Systematic multi-disciplinary sequence evaluation for integration into the MR-linac workflow. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02344-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Sinclair AG, Mitchell A, Bhagwanji S. Assessing the impact on workflow of placing a pharmacy team in an emergency department. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac021.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
The ED in our tertiary referral Hospital was working at capacity and invited pharmacy to send a team for a period to assess the impact they might have on workflow and doctor time, by carrying out detailed (level 2) medicine reconciliations and resolving medicine related issues at the outset.
Aim
To assess the impact that allocating an experienced pharmacist (Independent prescriber) together with a pharmacy technician might have on workflow and patient safety in ED.
Methods
The pharmacy team were directed to managing patients’ medicines carrying out the more comprehensive level 2 (1) medicines reconciliation (MR). This is a more thorough level of MR than that usually carried out on admission by a doctor (Level 1 MR). The time taken to conduct each MR was recorded. Interventions made were categorised by the clinical pharmacist using the MERP index. Five doctors were surveyed and asked how long they usually took to conduct a level 1 MR.
Results
132 MRs were carried out over 5 days. The pharmacist conducted 65 MRs mean time per MR 13.8 minutes SD 6.84 CI 90% (+/- 0.11) and the technician conducted 67 MRs mean time 23.73 minutes SD 11.07 CI 90% (+/- 0.17). The doctor group took 15 minutes (estimated) to conduct a level 1 MR SD 34.85 CI 90% (+/- 0.81). 1013 interventions were made, 15 were judged to be significant in terms of harm or potential harm and a further 128 related to non-prescribing of critical items (see table). A 90% Confidence interval was used reflecting the significant variance in time that a medicine reconciliation can take.
Conclusion
This project had limitations; it was brief, and the number of doctors surveyed few. However, it was adjudged to be a success in terms of doctor time saved (33 hours) and patient safety identifying 14 harm or potential harm occurrences and 128 critical medicines omissions at the outset of the patient journey. Following the project, the trust recognised the impact the team had and has subsequently funded an ED pharmacy team.
References
(1) Improving the Quality of Meds Reconciliation: A Best Practice Resource and Toolkit: V1.1 June 17 Specialist Pharmacy Service. Accessed Oct 2021 Medicines_Reconciliation_Best_Practice_Standards_Toolkit_Vs1.1_June-15-links-updated-Aug-17.pdf (sps.nhs.uk)
(2) Types of Medication Errors | NCC MERP, accessed 7/10/2021. https://www.nccmerp.org/types-medication-errors
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Affiliation(s)
- A G Sinclair
- Pharmacy Department, University Hospitals Plymouth, Plymouth, UK
| | - A Mitchell
- Pharmacy Department, University Hospitals Plymouth, Plymouth, UK
| | - S Bhagwanji
- Pharmacy Department, University Hospitals Plymouth, Plymouth, UK
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18
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Mitchell A, Snowball J, Welsh TJ, Watson MC, McGrogan A. Safety of direct oral anticoagulants (DOACs) vs. warfarin for people aged ≥ 75 years with atrial fibrillation: a cohort study. International Journal of Pharmacy Practice 2022. [DOI: 10.1093/ijpp/riac021.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Warfarin significantly reduces the risk of stroke in people with atrial fibrillation (AF), but historically has been underused in older people due to complicated dosage regimens. DOACs offer an attractive alternative to warfarin and were shown to be non-inferior in randomised controlled trials, however older people were underrepresented in these trials and there have been few studies investigating outcomes specifically in this high risk group (1).
Aim
To compare the risk of major, non-major, gastrointestinal, and intracranial bleeding between warfarin and DOACs in people aged ≥ 75 years with AF.
Methods
A cohort of patients aged ≥ 75 years with a diagnosis of AF was extracted from the Clinical Practice Research Datalink (CPRD). Patients could enter the study on the date of their first prescription for warfarin or a DOAC between 1/1/2013 and 27/12/2017. Patients were censored on the date of the outcome, death, or leaving the general practice. Switching between anticoagulants and unexposed periods were measured using prescription mapping. Crude and adjusted hazard rates of the risk of bleeding were calculated using a Cox proportional hazards model with oral anticoagulant prescribing as a time varying covariate.
Results
The cohort included 10,149 patients in the warfarin group and 10,237 in the DOAC group. The groups had similar characteristics and the average age was 81 in the warfarin group and 82 in the DOAC group. The table summarises the results. Whilst major and non-major bleeding was similar between all DOACs and warfarin, rivaroxaban was associated with higher risk and apixaban lower risk when analysed separately. Risk of gastrointestinal bleeding was higher with all DOACs and rivaroxaban than warfarin but apixaban was not significantly different. Few intracranial events occurred (n=131).
Conclusion
The results indicate that DOACs as a group are not significantly different to warfarin, however when analysed separately, apixaban may be safer. While the study relies on prescription data and hence it is not known if patients were taking the medications, the large cohort studied is representative of older people who are prescribed these medications in UK primary care.
Reference
(1) Mitchell A, Watson MC, Welsh T, McGrogan A. Effectiveness and safety of direct oral anticoagulants versus vitamin K antagonists for people aged 75 years and over with atrial fibrillation: A systematic review and meta-analyses of observational studies. Journal of Clinical Medicine. 2019; 8 (554).
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Affiliation(s)
- A Mitchell
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
- Pharmacy Department, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - J Snowball
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - T J Welsh
- Research Institute for the Care of Older People (RICE), Bath, UK
- Institute of Clinical Neurosciences, University of Bristol, Bristol, UK
| | - M C Watson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - A McGrogan
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
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19
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Aharonian F, Ait Benkhali F, Angüner EO, Ashkar H, Backes M, Baghmanyan V, Barbosa Martins V, Batzofin R, Becherini Y, Berge D, Bernlöhr K, Bi B, Böttcher M, Boisson C, Bolmont J, de Bony de Lavergne M, Breuhaus M, Brose R, Brun F, Caroff S, Casanova S, Cerruti M, Chand T, Chen A, Cotter G, Damascene Mbarubucyeye J, Djannati-Ataï A, Dmytriiev A, Doroshenko V, Duffy C, Egberts K, Ernenwein JP, Fegan S, Feijen K, Fiasson A, Fichet de Clairfontaine G, Fontaine G, Füßling M, Funk S, Gabici S, Gallant YA, Ghafourizadeh S, Giavitto G, Giunti L, Glawion D, Glicenstein JF, Grondin MH, Hermann G, Hinton JA, Hörbe M, Hofmann W, Hoischen C, Holch TL, Holler M, Horns D, Huang Z, Jamrozy M, Jankowsky F, Jung-Richardt I, Kasai E, Katarzyński K, Katz U, Khangulyan D, Khélifi B, Klepser S, Kluźniak W, Komin N, Konno R, Kosack K, Kostunin D, Le Stum S, Lemière A, Lemoine-Goumard M, Lenain JP, Leuschner F, Lohse T, Luashvili A, Lypova I, Mackey J, Malyshev D, Malyshev D, Marandon V, Marchegiani P, Marcowith A, Martí-Devesa G, Marx R, Maurin G, Meyer M, Mitchell A, Moderski R, Mohrmann L, Montanari A, Moulin E, Muller J, Murach T, Nakashima K, de Naurois M, Nayerhoda A, Niemiec J, Priyana Noel A, O'Brien P, Ohm S, Olivera-Nieto L, de Ona Wilhelmi E, Ostrowski M, Panny S, Panter M, Parsons RD, Peron G, Pita S, Poireau V, Prokhorov DA, Prokoph H, Pühlhofer G, Punch M, Quirrenbach A, Reichherzer P, Reimer A, Reimer O, Renaud M, Reville B, Rieger F, Rowell G, Rudak B, Rueda Ricarte H, Ruiz-Velasco E, Sahakian V, Sailer S, Salzmann H, Sanchez DA, Santangelo A, Sasaki M, Schäfer J, Schüssler F, Schutte HM, Schwanke U, Senniappan M, Shapopi JNS, Simoni R, Sinha A, Sol H, Specovius A, Spencer S, Stawarz Ł, Steinmassl S, Steppa C, Takahashi T, Tanaka T, Taylor AM, Terrier R, Thorpe-Morgan C, Tsirou M, Tsuji N, Tuffs R, Uchiyama Y, Unbehaun T, van Eldik C, van Soelen B, Veh J, Venter C, Vink J, Wagner SJ, Werner F, White R, Wierzcholska A, Wong YW, Yusafzai A, Zacharias M, Zargaryan D, Zdziarski AA, Zech A, Zhu SJ, Zouari S, Żywucka N. Time-resolved hadronic particle acceleration in the recurrent nova RS Ophiuchi. Science 2022; 376:77-80. [PMID: 35271303 DOI: 10.1126/science.abn0567] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Recurrent novae are repeating thermonuclear explosions in the outer layers of white dwarfs, due to the accretion of fresh material from a binary companion. The shock generated when ejected material slams into the companion star's wind can accelerate particles. We report very-high-energy (VHE, [Formula: see text]) gamma rays from the recurrent nova RS Ophiuchi, up to a month after its 2021 outburst, observed using the High Energy Stereoscopic System. The VHE emission has a similar temporal profile to lower-energy GeV emission, indicating a common origin, with a two-day delay in peak flux. These observations constrain models of time-dependent particle energization, favoring a hadronic emission scenario over the leptonic alternative. Shocks in dense winds provide favorable environments for efficient acceleration of cosmic-rays to very high energies.
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Affiliation(s)
- F Aharonian
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, Dublin 2, Ireland
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
- High Energy Astrophysics Laboratory, Russian-Armenian University (RAU), 123 Hovsep Emin St Yerevan 0051, Armenia
| | - F Ait Benkhali
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - E O Angüner
- Aix Marseille Université, Centre national de la recherche scientifique (CNRS)/Institut National de Physique Nucléaire et Physique des Particules (IN2P3), Centre de Physique des Particules de Marseille (CPPM), Marseille, France
| | - H Ashkar
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - M Backes
- University of Namibia, Department of Physics, Private Bag 13301, Windhoek 10005, Namibia
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - V Baghmanyan
- Instytut Fizyki J[Formula: see text]drowej Polskiej Akademii Nauk (PAN), ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - V Barbosa Martins
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - R Batzofin
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - Y Becherini
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - D Berge
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - K Bernlöhr
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - B Bi
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - M Böttcher
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Boisson
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - J Bolmont
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 Place Jussieu, F-75252 Paris, France
| | - M de Bony de Lavergne
- Université Savoie Mont Blanc, CNRS, Laboratoire d'Annecy de Physique des Particules - IN2P3, 74000 Annecy, France
| | - M Breuhaus
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - R Brose
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, Dublin 2, Ireland
| | - F Brun
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commisariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - S Caroff
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 Place Jussieu, F-75252 Paris, France
| | - S Casanova
- Instytut Fizyki J[Formula: see text]drowej Polskiej Akademii Nauk (PAN), ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - M Cerruti
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - T Chand
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - A Chen
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - G Cotter
- University of Oxford, Department of Physics, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, UK
| | | | - A Djannati-Ataï
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - A Dmytriiev
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - V Doroshenko
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - C Duffy
- University of Oxford, Department of Physics, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, UK
| | - K Egberts
- Institut für Physik und Astronomie, Universität Potsdam, Karl-Liebknecht-Strasse 24/25, D 14476 Potsdam, Germany
| | - J-P Ernenwein
- Aix Marseille Université, Centre national de la recherche scientifique (CNRS)/Institut National de Physique Nucléaire et Physique des Particules (IN2P3), Centre de Physique des Particules de Marseille (CPPM), Marseille, France
| | - S Fegan
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - K Feijen
- School of Physical Sciences, University of Adelaide, Adelaide 5005, Australia
| | - A Fiasson
- Université Savoie Mont Blanc, CNRS, Laboratoire d'Annecy de Physique des Particules - IN2P3, 74000 Annecy, France
| | - G Fichet de Clairfontaine
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - G Fontaine
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - M Füßling
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - S Funk
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - S Gabici
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - Y A Gallant
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - S Ghafourizadeh
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - G Giavitto
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - L Giunti
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commisariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - D Glawion
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - J F Glicenstein
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commisariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M-H Grondin
- Université Bordeaux, CNRS, Laboratoire de Physique des Deux Infinis (LP2i), Bordeaux, Joint Research Unit (UMR 5797), F-33170 Gradignan, France
| | - G Hermann
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - J A Hinton
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - M Hörbe
- University of Oxford, Department of Physics, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, UK
| | - W Hofmann
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - C Hoischen
- Institut für Physik und Astronomie, Universität Potsdam, Karl-Liebknecht-Strasse 24/25, D 14476 Potsdam, Germany
| | - T L Holch
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - M Holler
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - D Horns
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - Zhiqiu Huang
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - M Jamrozy
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ul. Orla 171, 30-244 Kraków, Poland
| | - F Jankowsky
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - I Jung-Richardt
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - E Kasai
- University of Namibia, Department of Physics, Private Bag 13301, Windhoek 10005, Namibia
| | - K Katarzyński
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Grudziadzka 5, 87-100 Torun, Poland
| | - U Katz
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - D Khangulyan
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima-ku, Tokyo 171-8501, Japan
| | - B Khélifi
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - S Klepser
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - W Kluźniak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ul. Bartycka 18, 00-716 Warsaw, Poland
| | - Nu Komin
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - R Konno
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - K Kosack
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commisariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - D Kostunin
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - S Le Stum
- Aix Marseille Université, Centre national de la recherche scientifique (CNRS)/Institut National de Physique Nucléaire et Physique des Particules (IN2P3), Centre de Physique des Particules de Marseille (CPPM), Marseille, France
| | - A Lemière
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - M Lemoine-Goumard
- Université Bordeaux, CNRS, Laboratoire de Physique des Deux Infinis (LP2i), Bordeaux, Joint Research Unit (UMR 5797), F-33170 Gradignan, France
| | - J-P Lenain
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), 4 Place Jussieu, F-75252 Paris, France
| | - F Leuschner
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - T Lohse
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstr. 15, D 12489 Berlin, Germany
| | - A Luashvili
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - I Lypova
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - J Mackey
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, Dublin 2, Ireland
| | - D Malyshev
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - D Malyshev
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - V Marandon
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - P Marchegiani
- School of Physics, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2050 South Africa
| | - A Marcowith
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - G Martí-Devesa
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - R Marx
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - G Maurin
- Université Savoie Mont Blanc, CNRS, Laboratoire d'Annecy de Physique des Particules - IN2P3, 74000 Annecy, France
| | - M Meyer
- Universität Hamburg, Institut für Experimentalphysik, Luruper Chaussee 149, D 22761 Hamburg, Germany
| | - A Mitchell
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - R Moderski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ul. Bartycka 18, 00-716 Warsaw, Poland
| | - L Mohrmann
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - A Montanari
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commisariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - E Moulin
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commisariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J Muller
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - T Murach
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - K Nakashima
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - M de Naurois
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - A Nayerhoda
- Instytut Fizyki J[Formula: see text]drowej Polskiej Akademii Nauk (PAN), ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - J Niemiec
- Instytut Fizyki J[Formula: see text]drowej Polskiej Akademii Nauk (PAN), ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - A Priyana Noel
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ul. Orla 171, 30-244 Kraków, Poland
| | - P O'Brien
- Department of Physics and Astronomy, The University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - S Ohm
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - L Olivera-Nieto
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - E de Ona Wilhelmi
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - M Ostrowski
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ul. Orla 171, 30-244 Kraków, Poland
| | - S Panny
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Panter
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - R D Parsons
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstr. 15, D 12489 Berlin, Germany
| | - G Peron
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - S Pita
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - V Poireau
- Université Savoie Mont Blanc, CNRS, Laboratoire d'Annecy de Physique des Particules - IN2P3, 74000 Annecy, France
| | - D A Prokhorov
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, Netherlands
| | - H Prokoph
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - G Pühlhofer
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - M Punch
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - A Quirrenbach
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - P Reichherzer
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commisariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - O Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Renaud
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - B Reville
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - F Rieger
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - G Rowell
- School of Physical Sciences, University of Adelaide, Adelaide 5005, Australia
| | - B Rudak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ul. Bartycka 18, 00-716 Warsaw, Poland
| | - H Rueda Ricarte
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commisariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - E Ruiz-Velasco
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - V Sahakian
- Yerevan Physics Institute, 2 Alikhanian Brothers St., 375036 Yerevan, Armenia
| | - S Sailer
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - H Salzmann
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - D A Sanchez
- Université Savoie Mont Blanc, CNRS, Laboratoire d'Annecy de Physique des Particules - IN2P3, 74000 Annecy, France
| | - A Santangelo
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - M Sasaki
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - J Schäfer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - F Schüssler
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commisariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - H M Schutte
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - U Schwanke
- Institut für Physik, Humboldt-Universität zu Berlin, Newtonstr. 15, D 12489 Berlin, Germany
| | - M Senniappan
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - J N S Shapopi
- University of Namibia, Department of Physics, Private Bag 13301, Windhoek 10005, Namibia
| | - R Simoni
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, Netherlands
| | - A Sinha
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, CC 72, Place Eugène Bataillon, F-34095 Montpellier Cedex 5, France
| | - H Sol
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - A Specovius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - S Spencer
- University of Oxford, Department of Physics, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, UK
| | - Ł Stawarz
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, ul. Orla 171, 30-244 Kraków, Poland
| | - S Steinmassl
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - C Steppa
- Institut für Physik und Astronomie, Universität Potsdam, Karl-Liebknecht-Strasse 24/25, D 14476 Potsdam, Germany
| | - T Takahashi
- Kavli Institute for the Physics and Mathematics of the Universe (World Premier International Research Center Initiative (WPI)), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, 5-1-5 Kashiwa-no-Ha, Kashiwa, Chiba, 277-8583, Japan
| | - T Tanaka
- Department of Physics, Konan University, 8-9-1 Okamoto, Higashinada, Kobe, Hyogo 658-8501, Japan
| | - A M Taylor
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - R Terrier
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - C Thorpe-Morgan
- Institut für Astronomie und Astrophysik, Universität Tübingen, Sand 1, D 72076 Tübingen, Germany
| | - M Tsirou
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - N Tsuji
- Institute of Physical and Chemical Research (RIKEN), 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - R Tuffs
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - Y Uchiyama
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima-ku, Tokyo 171-8501, Japan
| | - T Unbehaun
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - C van Eldik
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - B van Soelen
- Department of Physics, University of the Free State, PO Box 339, Bloemfontein 9300, South Africa
| | - J Veh
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - C Venter
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - J Vink
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, Netherlands
| | - S J Wagner
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - F Werner
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - R White
- Max-Planck-Institut für Kernphysik, P.O. Box 103980, D 69029 Heidelberg, Germany
| | - A Wierzcholska
- Instytut Fizyki J[Formula: see text]drowej Polskiej Akademii Nauk (PAN), ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - Yu Wun Wong
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - A Yusafzai
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, Erwin-Rommel-Str. 1, D 91058 Erlangen, Germany
| | - M Zacharias
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - D Zargaryan
- Dublin Institute for Advanced Studies, 31 Fitzwilliam Place, Dublin 2, Ireland
- High Energy Astrophysics Laboratory, Russian-Armenian University (RAU), 123 Hovsep Emin St Yerevan 0051, Armenia
| | - A A Zdziarski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, ul. Bartycka 18, 00-716 Warsaw, Poland
| | - A Zech
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - S J Zhu
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738, Germany
| | - S Zouari
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - N Żywucka
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
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Janssens K, Foulkes S, Mitchell A, La Gerche A. Variability of Blood Pressure Response to Maximal Incremental Bicycle Ergometer Testing in Endurance Athletes Over a Two-year Time Period. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Schonrock N, Morales A, Mitchell A, Garcia J, McKnight D, Callis T, Moretz C, Vatta M, Aradhya S. Genetic Testing Outcomes in a Cohort of 21,159 Children With Heart Disease. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Haynes E, Marawili M, Marika M, Mitchell A, Walker R, Katzenellenbogen J, Bessarab D. Lived Experience of Rheumatic Heart Disease: Lessons for Cardiology From In-Depth Qualitative Study. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Cochrane A, Booth A, Walker I, Morgan S, Mitchell A, Barlow-Pay M, Hewitt C, Taylor B, Chapman C, Raftery J, Fleming J, Torgerson D, Parkes J. Examining the effectiveness of Gateway-an out-of-court community-based intervention to reduce recidivism and improve the health and well-being of young adults committing low-level offences: study protocol for a randomised controlled trial. Trials 2021; 22:939. [PMID: 34923999 PMCID: PMC8684788 DOI: 10.1186/s13063-021-05905-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young adult offenders represent a third of the UK prison population and are at risk of poor health outcomes including drug and alcohol misuse, self-harm and suicide. Court diversion interventions aim to reduce the negative consequences of formal criminal justice sanctions and focus resources on addressing the root causes of offending. Although diversions are widely used, evidence of their effectiveness has not yet been established. Hampshire Constabulary, working together with local charities, have developed the Gateway programme, an out-of-court intervention aimed at improving the life chances of young adults. Issued as a conditional caution, participants undertake a health and social care needs assessment, attend workshops encouraging analysis of own behaviour and its consequences and agree not to re-offend during the 16-week caution. METHODS This is a pragmatic, multi-site, parallel-group, superiority randomised controlled trial with a target sample size of 334. Participants are aged 18-24, reside in Hampshire and Isle of Wight and are being questioned for an eligible low-level offence. Police investigators offer potential participants a chance to receive the Gateway caution, and those interested are also invited to take part in the study. Police officers obtain Stage 1 consent and carry out an eligibility check, after which participants are randomised on a 1:1 basis either to receive Gateway or follow the usual process, such as court appearance or a different conditional caution. Researchers subsequently obtain Stage 2 consent and collect data at weeks 4 and 16, and 1 year post-randomisation. The primary outcome is the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Secondary outcomes include health status, alcohol and drug use, recidivism and resource use. The primary analysis will compare the WEMWBS score between the two groups at 12 months. DISCUSSION This pioneering trial aims to address the evidence gap surrounding diversion in 18-24-year-olds. The findings will inform law enforcement agencies, third sector organisations, policymakers and commissioners, as well as researchers working in related fields and with vulnerable target populations. TRIAL REGISTRATION International Standard Randomised Controlled Trial Register ( ISRCTN 11888938 ).
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Affiliation(s)
- A Cochrane
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - A Booth
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.
| | - I Walker
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - S Morgan
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - A Mitchell
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - M Barlow-Pay
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - C Hewitt
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - B Taylor
- Hampshire Constabulary, Southampton Central Police Station, Southampton, SO15 1AN, UK
| | - C Chapman
- Hampshire Constabulary, Southampton Central Police Station, Southampton, SO15 1AN, UK
| | - J Raftery
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - J Fleming
- Department of Sociology, Social Policy and Criminology, University of Southampton, Southampton, SO17 1BJ, UK
| | - D Torgerson
- York Trials Unit, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - J Parkes
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
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Lucke JA, Mooijaart SP, Heeren P, Singler K, McNamara R, Gilbert T, Nickel CH, Castejon S, Mitchell A, Mezera V, Van der Linden L, Lim SE, Thaur A, Karamercan MA, Blomaard LC, Dundar ZD, Chueng KY, Islam F, de Groot B, Conroy S. Providing care for older adults in the Emergency Department: expert clinical recommendations from the European Task Force on Geriatric Emergency Medicine. Eur Geriatr Med 2021; 13:309-317. [PMID: 34738224 PMCID: PMC8568564 DOI: 10.1007/s41999-021-00578-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/20/2021] [Indexed: 01/08/2023]
Abstract
Aim The aim was to develop expert clinical recommendations on Geriatric Emergency Medicine to be disseminated across Europe. Findings Eight posters with expert clinical guidelines on the most important topics in Geriatric Emergency Medicine are now available through https://posters.geriemeurope.eu/. Message Expert clinical recommendations for Geriatric Emergency Medicine in Europe were created and are ready for dissemination across Europe. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00578-1. Purpose Despite the rapidly expanding knowledge in the field of Geriatric Emergency Medicine in Europe, widespread implementation of change is still lacking. Many opportunities in everyday clinical care are missed to improve care for this susceptible and growing patient group. The aim was to develop expert clinical recommendations on Geriatric Emergency Medicine to be disseminated across Europe. Methods A group of multi-disciplinary experts in the field of Geriatric Emergency Medicine in Europe was assembled. Using a modified Delphi procedure, a prioritized list of topics related to Geriatric Emergency Medicine was created. Next, a multi-disciplinary group of nurses, geriatricians and emergency physicians performed a review of recent guidelines and literature to create recommendations. These recommendations were voted upon by a group of experts and placed on visually attractive posters. The expert group identified the following eight subject areas to develop expert recommendations on: Comprehensive Geriatric Assessment in the Emergency Department (ED), age/frailty adjusted risk stratification, delirium and cognitive impairment, medication reviews in the ED for older adults, family involvement, ED environment, silver trauma, end of life care in the acute setting. Results Eight posters with expert clinical recommendations on the most important topics in Geriatric Emergency Medicine are now available through https://posters.geriemeurope.eu/. Conclusion Expert clinical recommendations for Geriatric Emergency Medicine may help to improve care for older patients in the Emergency Department and are ready for dissemination across Europe. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00578-1.
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Affiliation(s)
- J A Lucke
- Department of Emergency Medicine, Spaarne Gasthuis, Haarlem, The Netherlands.
| | - S P Mooijaart
- Department of Internal Medicine, Section on Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - P Heeren
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.,Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.,Research Foundation Flanders, Brussels, Belgium
| | - K Singler
- Department of Geriatrics, Klinikum Nürnberg, Paracelsus Private, Medical University, Nuremberg, Germany.,Institute for Biomedicine of Ageing, Friedrich-Alexander-University, Erlangen-Nuremberg, Erlangen, Germany
| | - R McNamara
- Department of Emergency Medicine, St. Vincent's University Hospital, Dublin, Ireland
| | - T Gilbert
- Department of Geriatric Medicine, Lyon-Sud University Hospital, Lyon, France
| | - C H Nickel
- Emergency Medicine, University Hospital Basel, Basel, Switzerland
| | - S Castejon
- Department of Geriatrics and Palliative Care, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
| | - A Mitchell
- Department of Emergency Medicine, Sligo University Hospital, Sligo, Ireland
| | - V Mezera
- Geriatric Center, Pardubice Hospital, Pardubice, Czech Republic
| | - L Van der Linden
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium.,Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - S E Lim
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
| | - A Thaur
- Department of Emergency Medicine, Guy's and St.Thomas' NHS Foundation Trust, London, UK
| | - M A Karamercan
- Department of Emergency Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - L C Blomaard
- Department of Internal Medicine, Section on Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Z D Dundar
- Department of Emergency Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - K Y Chueng
- Accident and Emergency Department, United Christian Hospital, Kwun Tong, Hong Kong
| | - F Islam
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - B de Groot
- Department of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - S Conroy
- Geriatric Medicine, MRC Unit for Lifelong Health and Ageing at UCL, 5th Floor, 1-19 Torrington Place, London, WC1E 7HB, UK
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Colori A, Hawkins M, Mitchell A, Hiley C, Dubash S, Johnson U, Fenwick J, Mendes R, Carnell D, Wilson J. PO-1199 Cardiac disease and tumour below T7 confer poorer prognosis following radical radiotherapy for NSCLC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07650-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Alexander S, Lawes R, Adair Smith G, Barnes H, Hanson I, Herbert T, Huddart R, Lacey C, McNair H, Mitchell A, Nill S, Ockwell C, Oelfke U, Taylor H, Wetscherek A, Aitken K, Hunt A. PH-0164 Abdominal compression; development of a non-gated pancreas MRIgRT workflow. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07256-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Hafeez S, Dunlop A, Mitchell A, Nill S. Comment on Hunt et al., "Feasibility of magnetic resonance guided radiotherapy for the treatment of bladder cancer". Clin Transl Radiat Oncol 2021; 29:9-10. [PMID: 34027138 PMCID: PMC8122149 DOI: 10.1016/j.ctro.2021.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S. Hafeez
- Divsion of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
- Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, London, UK
| | - A. Dunlop
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, UK
| | - A. Mitchell
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, UK
| | - S. Nill
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, UK
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28
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Abdalla H, Aharonian F, Ait Benkhali F, Angüner EO, Arcaro C, Armand C, Armstrong T, Ashkar H, Backes M, Baghmanyan V, Barbosa Martins V, Barnacka A, Barnard M, Becherini Y, Berge D, Bernlöhr K, Bi B, Bissaldi E, Böttcher M, Boisson C, Bolmont J, de Bony de Lavergne M, Breuhaus M, Brun F, Brun P, Bryan M, Büchele M, Bulik T, Bylund T, Caroff S, Carosi A, Casanova S, Chand T, Chandra S, Chen A, Cotter G, Curyło M, Damascene Mbarubucyeye J, Davids ID, Davies J, Deil C, Devin J, Dirson L, Djannati-Ataï A, Dmytriiev A, Donath A, Doroshenko V, Dreyer L, Duffy C, Dyks J, Egberts K, Eichhorn F, Einecke S, Emery G, Ernenwein JP, Feijen K, Fegan S, Fiasson A, Fichet de Clairfontaine G, Fontaine G, Funk S, Füßling M, Gabici S, Gallant YA, Giavitto G, Giunti L, Glawion D, Glicenstein JF, Grondin MH, Hahn J, Haupt M, Hermann G, Hinton JA, Hofmann W, Hoischen C, Holch TL, Holler M, Hörbe M, Horns D, Huber D, Jamrozy M, Jankowsky D, Jankowsky F, Jardin-Blicq A, Joshi V, Jung-Richardt I, Kasai E, Kastendieck MA, Katarzyński K, Katz U, Khangulyan D, Khélifi B, Klepser S, Kluźniak W, Komin N, Konno R, Kosack K, Kostunin D, Kreter M, Lamanna G, Lemière A, Lemoine-Goumard M, Lenain JP, Leuschner F, Levy C, Lohse T, Lypova I, Mackey J, Majumdar J, Malyshev D, Malyshev D, Marandon V, Marchegiani P, Marcowith A, Mares A, Martí-Devesa G, Marx R, Maurin G, Meintjes PJ, Meyer M, Mitchell A, Moderski R, Mohrmann L, Montanari A, Moore C, Morris P, Moulin E, Muller J, Murach T, Nakashima K, Nayerhoda A, de Naurois M, Ndiyavala H, Niemiec J, Oakes L, O'Brien P, Odaka H, Ohm S, Olivera-Nieto L, de Ona Wilhelmi E, Ostrowski M, Panny S, Panter M, Parsons RD, Peron G, Peyaud B, Piel Q, Pita S, Poireau V, Priyana Noel A, Prokhorov DA, Prokoph H, Pühlhofer G, Punch M, Quirrenbach A, Raab S, Rauth R, Reichherzer P, Reimer A, Reimer O, Remy Q, Renaud M, Rieger F, Rinchiuso L, Romoli C, Rowell G, Rudak B, Ruiz-Velasco E, Sahakian V, Sailer S, Salzmann H, Sanchez DA, Santangelo A, Sasaki M, Scalici M, Schäfer J, Schüssler F, Schutte HM, Schwanke U, Seglar-Arroyo M, Senniappan M, Seyffert AS, Shafi N, Shapopi JNS, Shiningayamwe K, Simoni R, Sinha A, Sol H, Specovius A, Spencer S, Spir-Jacob M, Stawarz Ł, Sun L, Steenkamp R, Stegmann C, Steinmassl S, Steppa C, Takahashi T, Tam T, Tavernier T, Taylor AM, Terrier R, Thiersen JHE, Tiziani D, Tluczykont M, Tomankova L, Tsirou M, Tuffs R, Uchiyama Y, van der Walt DJ, van Eldik C, van Rensburg C, van Soelen B, Vasileiadis G, Veh J, Venter C, Vincent P, Vink J, Völk HJ, Wadiasingh Z, Wagner SJ, Watson J, Werner F, White R, Wierzcholska A, Wong YW, Yusafzai A, Zacharias M, Zanin R, Zargaryan D, Zdziarski AA, Zech A, Zhu SJ, Zorn J, Zouari S, Żywucka N, Evans P, Page K. Revealing x-ray and gamma ray temporal and spectral similarities in the GRB 190829A afterglow. Science 2021; 372:1081-1085. [PMID: 34083487 DOI: 10.1126/science.abe8560] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/07/2021] [Indexed: 11/02/2022]
Abstract
Gamma-ray bursts (GRBs), which are bright flashes of gamma rays from extragalactic sources followed by fading afterglow emission, are associated with stellar core collapse events. We report the detection of very-high-energy (VHE) gamma rays from the afterglow of GRB 190829A, between 4 and 56 hours after the trigger, using the High Energy Stereoscopic System (H.E.S.S.). The low luminosity and redshift of GRB 190829A reduce both internal and external absorption, allowing determination of its intrinsic energy spectrum. Between energies of 0.18 and 3.3 tera-electron volts, this spectrum is described by a power law with photon index of 2.07 ± 0.09, similar to the x-ray spectrum. The x-ray and VHE gamma-ray light curves also show similar decay profiles. These similar characteristics in the x-ray and gamma-ray bands challenge GRB afterglow emission scenarios.
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Affiliation(s)
| | - H Abdalla
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - F Aharonian
- Dublin Institute for Advanced Studies, Dublin 2, Ireland. .,Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.,High Energy Astrophysics Laboratory, Russian-Armenian University (RAU), Yerevan 0051, Armenia
| | - F Ait Benkhali
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - E O Angüner
- Aix Marseille Université, Centre national de la recherche scientifique (CNRS)/Institut National de Physique Nucléaire et Physique des Particules (IN2P3), Centre de Physique des Particules de Marseille (CPPM), Marseille, France
| | - C Arcaro
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Armand
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - T Armstrong
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - H Ashkar
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Backes
- University of Namibia, Department of Physics, Windhoek 10005, Namibia.,Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - V Baghmanyan
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | | | - A Barnacka
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - M Barnard
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - Y Becherini
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - D Berge
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - K Bernlöhr
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - B Bi
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - E Bissaldi
- Dipartimento Interateneo di Fisica, Politecnico di Bari, 70125 Bari, Italy.,Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125 Bari, Italy
| | - M Böttcher
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Boisson
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - J Bolmont
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - M de Bony de Lavergne
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - M Breuhaus
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - F Brun
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - P Brun
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Bryan
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - M Büchele
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - T Bulik
- Astronomical Observatory, The University of Warsaw, 00-478 Warsaw, Poland
| | - T Bylund
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - S Caroff
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Carosi
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - S Casanova
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.,Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | - T Chand
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - S Chandra
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - A Chen
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - G Cotter
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - M Curyło
- Astronomical Observatory, The University of Warsaw, 00-478 Warsaw, Poland
| | | | - I D Davids
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - J Davies
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - C Deil
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - J Devin
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - L Dirson
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - A Djannati-Ataï
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - A Dmytriiev
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - A Donath
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - V Doroshenko
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - L Dreyer
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Duffy
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - J Dyks
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - K Egberts
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany
| | - F Eichhorn
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - S Einecke
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - G Emery
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - J-P Ernenwein
- Aix Marseille Université, Centre national de la recherche scientifique (CNRS)/Institut National de Physique Nucléaire et Physique des Particules (IN2P3), Centre de Physique des Particules de Marseille (CPPM), Marseille, France
| | - K Feijen
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - S Fegan
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - A Fiasson
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - G Fichet de Clairfontaine
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - G Fontaine
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - S Funk
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Füßling
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - S Gabici
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - Y A Gallant
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - G Giavitto
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - L Giunti
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France.,Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - D Glawion
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - J F Glicenstein
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M-H Grondin
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J Hahn
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - M Haupt
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - G Hermann
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - J A Hinton
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - W Hofmann
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - C Hoischen
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany
| | - T L Holch
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - M Holler
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Hörbe
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - D Horns
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - D Huber
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Jamrozy
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - D Jankowsky
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - F Jankowsky
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - A Jardin-Blicq
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - V Joshi
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - I Jung-Richardt
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - E Kasai
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - M A Kastendieck
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - K Katarzyński
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, 87-100 Torun, Poland
| | - U Katz
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - D Khangulyan
- Department of Physics, Rikkyo University, Toshima-ku, Tokyo 171-8501, Japan.
| | - B Khélifi
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - S Klepser
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - W Kluźniak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - Nu Komin
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - R Konno
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - K Kosack
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - D Kostunin
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - M Kreter
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - G Lamanna
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Lemière
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - M Lemoine-Goumard
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J-P Lenain
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - F Leuschner
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - C Levy
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - T Lohse
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - I Lypova
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - J Mackey
- Dublin Institute for Advanced Studies, Dublin 2, Ireland
| | - J Majumdar
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - D Malyshev
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - D Malyshev
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - V Marandon
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - P Marchegiani
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - A Marcowith
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - A Mares
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - G Martí-Devesa
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - R Marx
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany.,Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - G Maurin
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - P J Meintjes
- Department of Physics, University of the Free State, Bloemfontein 9300, South Africa
| | - M Meyer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Mitchell
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R Moderski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - L Mohrmann
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Montanari
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Moore
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - P Morris
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - E Moulin
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J Muller
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - T Murach
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - K Nakashima
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Nayerhoda
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | - M de Naurois
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - H Ndiyavala
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - J Niemiec
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | - L Oakes
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - P O'Brien
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - H Odaka
- Department of Physics, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - S Ohm
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - L Olivera-Nieto
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | | | - M Ostrowski
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - S Panny
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Panter
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R D Parsons
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - G Peron
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - B Peyaud
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Q Piel
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - S Pita
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - V Poireau
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Priyana Noel
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - D A Prokhorov
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - H Prokoph
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - G Pühlhofer
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - M Punch
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden.,Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - A Quirrenbach
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - S Raab
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - R Rauth
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - P Reichherzer
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - O Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - Q Remy
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - M Renaud
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - F Rieger
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - L Rinchiuso
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Romoli
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.
| | - G Rowell
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - B Rudak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - E Ruiz-Velasco
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.
| | - V Sahakian
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - S Sailer
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - H Salzmann
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - D A Sanchez
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Santangelo
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - M Sasaki
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Scalici
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - J Schäfer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - F Schüssler
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France.
| | - H M Schutte
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - U Schwanke
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - M Seglar-Arroyo
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Senniappan
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - A S Seyffert
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - N Shafi
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - J N S Shapopi
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - K Shiningayamwe
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - R Simoni
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - A Sinha
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - H Sol
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - A Specovius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - S Spencer
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - M Spir-Jacob
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - Ł Stawarz
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - L Sun
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - R Steenkamp
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - C Stegmann
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany.,Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - S Steinmassl
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - C Steppa
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany
| | - T Takahashi
- Kavli Institute for the Physics and Mathematics of the Universe (World Premier International Research Center Initiative (WPI)), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Kashiwa, Chiba, 277-8583, Japan
| | - T Tam
- School of Physics and Astronomy, Sun Yat Sen University, Guangzhou 510275, People's Republic of China
| | - T Tavernier
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A M Taylor
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany.
| | - R Terrier
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - J H E Thiersen
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - D Tiziani
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Tluczykont
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - L Tomankova
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Tsirou
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R Tuffs
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - Y Uchiyama
- Department of Physics, Rikkyo University, Toshima-ku, Tokyo 171-8501, Japan
| | - D J van der Walt
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C van Eldik
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - C van Rensburg
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - B van Soelen
- Department of Physics, University of the Free State, Bloemfontein 9300, South Africa
| | - G Vasileiadis
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - J Veh
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - C Venter
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - P Vincent
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - J Vink
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - H J Völk
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - Z Wadiasingh
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - S J Wagner
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - J Watson
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - F Werner
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R White
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - A Wierzcholska
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland.,Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - Yu Wun Wong
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Yusafzai
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Zacharias
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa.,Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - R Zanin
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - D Zargaryan
- Dublin Institute for Advanced Studies, Dublin 2, Ireland.,High Energy Astrophysics Laboratory, Russian-Armenian University (RAU), Yerevan 0051, Armenia
| | - A A Zdziarski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - A Zech
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - S J Zhu
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany.
| | - J Zorn
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - S Zouari
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - N Żywucka
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - P Evans
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - K Page
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
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Mitchell A, England C, Atkinson C. Provision of dietary advice for people with an ileostomy: a survey in the UK and Ireland. Colorectal Dis 2020; 22:2222-2231. [PMID: 32668070 DOI: 10.1111/codi.15268] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/30/2020] [Indexed: 02/08/2023]
Abstract
AIM The aim was to explore whether people with an ileostomy in the UK and Ireland receive the dietary advice they require. METHOD An online survey with multiple-choice questions asked people with an ileostomy about the dietary advice they received and would have preferred to receive. Participants were recruited via websites of the Ileostomy and Internal Pouch Association and Crohn's and Colitis UK and via social media. People with a current ileostomy, age 16 years or over, and living in the UK or Ireland were eligible for inclusion. Responses were analysed using descriptive statistics. RESULTS In all, 291 eligible responses were received and included in the analysis; 201 (69%) received advice on diet for their ileostomy from a healthcare professional or the internet. Of the 90 who did not receive dietary advice, 82 (91%) would have liked advice. Stoma nurses were the most common source of dietary advice (55%), but many other sources were frequently reported. Most (62%) felt that at least some dietary advice they received was conflicting. Over half (55%) felt anxious about managing their diet with a new ileostomy, 39% were confused, and 31% frustrated. Of 291 respondents, 29% received advice from a dietitian compared to 60% who would have preferred advice from a dietitian. CONCLUSION Many people undergoing ileostomy surgery do not receive the dietary advice and support they require. Healthcare professionals working with people with an ileostomy should be mindful they are often anxious about their diet and require clear and consistent dietary advice and support.
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Affiliation(s)
- A Mitchell
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | - C England
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | - C Atkinson
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
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Mitchell A, England C, Atkinson C. A survey of dietary advice for people with an ileostomy. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bloom S, Mafunda N, Woolston B, Hayward M, Frempong J, Xu J, Mitchell A, Westergaard X, Rice J, Choksi N, Balskus E, Mitchell C, Kwon D. Lactobacillus iners growth inhibition by cystine uptake inhibitors is a target for shifting cervicovaginal microbiota towards lactobacillus crispatus-dominant communities. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2020.08.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chick J, Mitchell A, Sullivan J, Herbert T, Lawes R, McNair H, Schmidt M, Nill S, Kirby A, Oelfke U. PO-1766: A clinical solution for electron streaming shielding for partial breast treatments on Unity MRlinac. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01784-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hunt A, Hanson I, Dunlop A, Bower L, Barnes H, Chick J, Herbert T, Lawes R, McNair H, Mitchell A, Mohajer J, Morgan T, Smith G, Nill S, Oelfke U, Huddart R, Hafeez S. OC-0469: MR-guided online adaptive radiotherapy for muscle invasive bladder cancer: First UK experience. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Janssens K, Paratz E, Brosnan M, Lindqvist A, Mitchell A, Afridi A, Orchard J, Prior D, La Gerche A. You've got to be in it to win it: the importance of including female athletes in screening ECG cohorts. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
ECG screening is widely employed in athletic populations with the aim of identifying cardiac conditions associated with sudden death. Recommendations for athlete ECG interpretation are disproportionately reliant on data from male athletes and sex-specific differences have not been adequately elucidated.
Purpose
The aim of this study is to identify any different patterns in female athletic training response on ECG screening.
Methods
444 elite athletes (156 male rowers, 135 female rowers, 117 male cricketers, 36 female cricketers) underwent electrocardiogram (ECG) screening. Standard definitions were used to characterize abnormalities identified on ECG. Comparisons were made according to sex and endurance (rowing) vs skill-based (cricket) athletes (EA and SBA respectively).
Results
“Potentially pathological” T-wave inversion extending to V3 was more prevalent in female athletes (9.9% vs. 2.9%, P=0.002), especially amongst endurance athletes (11.9% female EA vs. 2.8% female SBA, P=0.004) (Figure 1). As compared with males, the QTc interval was longer in female athletes (418 vs. 402ms), the QRS duration was shorter (90 vs. 100 ms) and left ventricular hypertrophy on voltage criteria were less prevalent (9.9% vs. 33.3%, P<0.001 for all). First-degree heart block and incomplete right bundle branch block were more prevalent amongst male athletes.
Conclusion
Female athletes exhibit different training-related cardiac remodelling responses to exercise compared to males. A greater proportion of ostensibly healthy female athletes, especially female endurance athletes, have ECG changes that would be deemed “potentially pathological” according to current sex-agnostic guidelines.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Janssens
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - E Paratz
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - M Brosnan
- St Vincent's Hospital, National Centre for Sports Cardiology, Melbourne, Australia
| | - A Lindqvist
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - A Mitchell
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - A Afridi
- Harvard Medical School, Boston, United States of America
| | - J Orchard
- University of Sydney, Heart Research Institute, Sydney, Australia
| | - D Prior
- St Vincent's Hospital, National Centre for Sports Cardiology, Melbourne, Australia
| | - A La Gerche
- Baker Heart and Diabetes Institute, Melbourne, Australia
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Hunt A, Hanson I, Dunlop A, Barnes H, Bower L, Chick J, Cruickshank C, Hall E, Herbert T, Lawes R, McQuaid D, McNair H, Mitchell A, Mohajer J, Morgan T, Oelfke U, Smith G, Nill S, Huddart R, Hafeez S. Feasibility of magnetic resonance guided radiotherapy for the treatment of bladder cancer. Clin Transl Radiat Oncol 2020; 25:46-51. [PMID: 33015380 PMCID: PMC7522378 DOI: 10.1016/j.ctro.2020.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/03/2020] [Accepted: 09/06/2020] [Indexed: 12/15/2022] Open
Abstract
Whole bladder magnetic resonance image-guided radiotherapy using the 1.5 Telsa MR-linac is feasible. Full online adaptive planning workflow based on the anatomy seen at each fraction was performed. This was delivered within 45 min. Intra-fraction bladder filling did not compromise target coverage. Patients reported acceptable tolerance of treatment.
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Affiliation(s)
- A. Hunt
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - I. Hanson
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - A. Dunlop
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - H. Barnes
- The Royal Marsden NHS Foundation Trust, London, UK
| | - L. Bower
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - J. Chick
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - C. Cruickshank
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - E. Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - T. Herbert
- The Royal Marsden NHS Foundation Trust, London, UK
| | - R. Lawes
- The Royal Marsden NHS Foundation Trust, London, UK
| | - D. McQuaid
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - H. McNair
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - A. Mitchell
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - J. Mohajer
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - T. Morgan
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - U. Oelfke
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - G. Smith
- The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Nill
- The Joint Department of Physics at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK
| | - R. Huddart
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
| | - S. Hafeez
- The Institute of Cancer Research, London, UK
- The Royal Marsden NHS Foundation Trust, London, UK
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36
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Earp E, Mitchell A, Biswas A. A herpetiform eruption with unexpected immunofluorescence findings. Clin Exp Dermatol 2020; 46:207-209. [PMID: 33038038 DOI: 10.1111/ced.14461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/26/2020] [Accepted: 09/08/2020] [Indexed: 11/27/2022]
Affiliation(s)
- E Earp
- Department of Dermatology, Lauriston Building, Lauriston Place, Edinburgh, UK
| | - A Mitchell
- Department of Dermatology, Lauriston Building, Lauriston Place, Edinburgh, UK
| | - A Biswas
- Department of Pathology, Western General Hospital and The University of Edinburgh, Edinburgh, UK
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White L, Riley B, Malla U, Snels N, Mitchell A, Abi-Fares C, Basson W, Anstey C. Erector spinae block versus serratus anterior block in chest wall trauma, which is better?: A response and decision making guide. Am J Emerg Med 2020; 38:2221-2223. [DOI: 10.1016/j.ajem.2020.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/11/2020] [Indexed: 02/08/2023] Open
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38
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Akbaridoust F, de Silva CM, Szydzik C, Mitchell A, Marusic I, Nesbitt WS. Experimental fluid dynamics characterization of a novel micropump-mixer. Biomicrofluidics 2020; 14:044116. [PMID: 32849975 PMCID: PMC7442494 DOI: 10.1063/5.0012240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/11/2020] [Indexed: 06/11/2023]
Abstract
The application of lab-on-a-chip systems to biomedical engineering and medical biology is rapidly growing. Reciprocating micropumps show significant promise as automated bio-fluid handling systems and as active reagent-to-sample mixers. Here, we describe a thorough fluid dynamic analysis of an active micro-pump-mixer designed for applications of preclinical blood analysis and clinical diagnostics in hematology. Using high-speed flow visualization and micro-particle image velocimetry measurements, a parametric study is performed to investigate the fluid dynamics of six discrete modes of micropump operation. With this approach, we identify an actuation regime that results in optimal sample flow rates while concomitantly maximizing reagent-to-sample mixing.
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Affiliation(s)
| | - C. M. de Silva
- School of Mechanical and Manufacturing Engineering, The University of New South Wales, Sydney, New South Wales 2052, Australia
| | - C. Szydzik
- The Australian Centre for Blood Diseases, Monash University, Melbourne, Victoria 3004, Australia
| | - A. Mitchell
- School of Engineering, RMIT University, Melbourne, Victoria 3000, Australia
| | - I. Marusic
- Department of Mechanical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - W. S. Nesbitt
- The Australian Centre for Blood Diseases, Monash University, Melbourne, Victoria 3004, Australia
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Riley B, Malla U, Snels N, Mitchell A, Abi-Fares C, Basson W, Anstey C, White L. Erector spinae blocks for the management of rib fractures: A pilot matched study. J Clin Anesth 2020; 63:109780. [PMID: 32172153 DOI: 10.1016/j.jclinane.2020.109780] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 01/29/2020] [Accepted: 03/07/2020] [Indexed: 11/16/2022]
Affiliation(s)
- B Riley
- Department of Intensive Care Medicine, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
| | - U Malla
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
| | - N Snels
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
| | - A Mitchell
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
| | - C Abi-Fares
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
| | - W Basson
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
| | - C Anstey
- Department of Intensive Care Medicine, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia
| | - L White
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia.
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Honney K, Judd H, Mitchell A, Nash H, Ford J, Schweigart A, Griffiths B, Sira A. 53 Does the Community Geriatrician’s Role in Advanced Care Planning Help Community Dwellers Achieve Their Preferred Place of Care? Age Ageing 2020. [DOI: 10.1093/ageing/afz186.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Advanced Care Planning (ACP) is well established for patients with terminal cancer diagnoses but is poorly utilised when caring for elderly patients with other terminal illnesses. We aimed to assess the effectiveness of ACP in our older, community dwellers following a period of increased awareness.
Methods
A closed loop audit was undertaken, assessing deaths from a dementia care home within rural Norfolk, before and after implementation of an education and focus programme (cycle 1=Jan 2017-Jan 2018, cycle 2: Feb 2018-Jan-2019). Deceased patients were identified from care home records and data from electronic hospital and general practice records were analysed. Results were compared according to existing guidance outlined in the Palliative Gold Standards Framework (GSF) and Department of Health End of Life Care Strategy 2009. Compliance between cycles was compared using the chi-square test with p=.05 indicative of statistical significance.
Results
59 patients were included (median age=84, male=31). Results of the audit for each criterion are shown in table 1. More patients achieved their preferred place of care (PPOC) following the implementation of the education programme, with access to end of life medications significantly improving.
Conclusions
Increasing awareness and understanding of ACP in the community has been shown to improve compliance with GSF standards, particularly access to end of life medications. Further efforts are still required to improve care and a third cycle is scheduled for January 2020, following further training.
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Affiliation(s)
- K Honney
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - H Judd
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - A Mitchell
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - H Nash
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - J Ford
- Cambridge University Hospitals NHS Foundation Trust
| | - A Schweigart
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - B Griffiths
- Norfolk and Norwich University Hospitals NHS Foundation Trust
| | - A Sira
- Norfolk and Norwich University Hospitals NHS Foundation Trust
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41
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Russell CD, Jones ME, O'Shea DT, Simpson KJ, Mitchell A, Laurenson IF. Challenges in the diagnosis of leptospirosis outwith endemic settings: a Scottish single centre experience. J R Coll Physicians Edinb 2019; 48:9-15. [PMID: 29741518 DOI: 10.4997/jrcpe.2018.102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Leptospirosis is a zoonotic infection occurring worldwide but endemic in tropical countries. This study describes diagnostic testing for leptospirosis at our institution in Scotland over a 10-year period. Method We identified patients with blood samples referred to the Public Health England reference laboratory for leptospirosis testing between 2006 and 2016. Results A total of 480 samples were sent for IgM ELISA testing with 26 positive results from 14 patients. Two patients met criteria for 'confirmed' leptospirosis (microscopic agglutination test > 1:320 in one case and a positive PCR in the other) and the remaining 12 were 'probable' on the basis of IgM ELISA positivity, though 9 did not have microscopic agglutination testing performed. Nine infections were imported, mostly from Asia and with a history of fresh water exposure. Three co-infections (respiratory syncytial virus, influenza B and Campylobacter sp.) were identified. Conclusions Practical issues with microscopic agglutination testing (insufficient blood sent to reference laboratory) and PCR (travellers returning > 7 days after illness onset) represent challenges to the laboratory confirmation of a clinical diagnosis of leptospirosis. Co-infection and infectious/auto-immune causes of false positive serology should be evaluated.
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Affiliation(s)
- C D Russell
- CD Russell, Regional Infectious, Diseases Unit, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK,
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Davis K, Brown C, Mitchell A, Massey-Stokes M, Warren C, Kaluva M, Habiba N. The Baby Bites Texting Project: Development of a Pilot Program to Prevent Early Pediatric Obesity. J Acad Nutr Diet 2019. [DOI: 10.1016/j.jand.2019.08.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pathmanathan A, Bower L, Creasey H, Dunlop A, Hall E, Hanson I, Herbert T, Lawes R, McQuaid D, McNair H, Mitchell A, Smith G, Huddart R, Oelfke U, Nill S, Tree A. EP-1566 MR-guided online adaptive radiotherapy: First experience in the UK. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31986-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bertholet J, Hunt A, Dunlop A, Bird T, Mitchell A, Oelfke U, Nill S, Aitken K. EP-1856 Dose escalation potential for hypofractionated radiotherapy in locally advanced pancreatic cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32276-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Smith GA, Herbert T, Lawes R, Creasey H, Dunlop A, Mitchell A, Pathmanathan A, Bower L, Hanson I, McQuaid D, Huddart R, Oelfke U, Nill S, Tree A, McNair H. EP-2173 Bladder filling in patients undergoing prostate radiotherapy on the MR-linac. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32593-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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46
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Navaneetharaja N, Mitchell A, Honney K, MacMillan F, Aldus C, Lane K, Woodward M, Bailey S, May H, Patel M. 23EVALUATING THE FIRST OLDER PEOPLE’S EMERGENCY DEPARTMENT. Age Ageing 2019. [DOI: 10.1093/ageing/afy211.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - A Mitchell
- Norfolk and Norwich University Hospital, UK
| | - K Honney
- Norfolk and Norwich University Hospital, UK
| | | | - C Aldus
- University of East Anglia, School of Health Sciences, Norwich Research Park, UK
| | - K Lane
- University of East Anglia, School of Health Sciences, Norwich Research Park, UK
| | - M Woodward
- University of East Anglia, School of Health Sciences, Norwich Research Park, UK
| | - S Bailey
- Norfolk and Norwich University Hospital, UK
| | - H May
- Norfolk and Norwich University Hospital, UK
| | - M Patel
- Norfolk and Norwich University Hospital, UK
- University of East Anglia, School of Health Sciences, Norwich Research Park, UK
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47
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Honney K, Mitchell A, Nash H, Ford J. 48IS ADVANCED CARE PLANNING HELPING OLDER COMMUNITY DWELLERS ACHIEVE THEIR PREFERRED PLACE OF CARE? Age Ageing 2019. [DOI: 10.1093/ageing/afy211.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Honney
- Norfolk and Norwich University Hospital Trust
| | - A Mitchell
- Norfolk and Norwich University Hospital Trust
| | - H Nash
- West Suffolk Hospital, Bury St Edmunds
| | - J Ford
- Norfolk and Norwich University Hospital Trust
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48
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Bugaj LJ, Sabnis AJ, Mitchell A, Garbarino JE, Toettcher JE, Bivona TG, Lim WA. Cancer mutations and targeted drugs can disrupt dynamic signal encoding by the Ras-Erk pathway. Science 2018; 361:361/6405/eaao3048. [PMID: 30166458 DOI: 10.1126/science.aao3048] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 07/16/2018] [Indexed: 12/16/2022]
Abstract
The Ras-Erk (extracellular signal-regulated kinase) pathway encodes information in its dynamics; the duration and frequency of Erk activity can specify distinct cell fates. To enable dynamic encoding, temporal information must be accurately transmitted from the plasma membrane to the nucleus. We used optogenetic profiling to show that both oncogenic B-Raf mutations and B-Raf inhibitors can cause corruption of this transmission, so that short pulses of input Ras activity are distorted into abnormally long Erk outputs. These changes can reshape downstream transcription and cell fates, resulting in improper decisions to proliferate. These findings illustrate how altered dynamic signal transmission properties, and not just constitutively increased signaling, can contribute to cell proliferation and perhaps cancer, and how optogenetic profiling can dissect mechanisms of signaling dysfunction in disease.
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Affiliation(s)
- L J Bugaj
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - A J Sabnis
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA 94158, USA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA 94158, USA
| | - A Mitchell
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - J E Garbarino
- Howard Hughes Medical Institute, University of California, San Francisco, San Francisco, CA 94158, USA
| | - J E Toettcher
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA.
| | - T G Bivona
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA. .,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA 94158, USA.,Division of Hematology and Oncology, University of California, San Francisco, San Francisco, CA 94158, USA
| | - W A Lim
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA. .,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA 94158, USA.,Howard Hughes Medical Institute, University of California, San Francisco, San Francisco, CA 94158, USA.,Center for Systems and Synthetic Biology, University of California, San Francisco, San Francisco, CA 94158, USA
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49
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McCloskey OM, Woodman A, Mitchell A, Smyth J. THE CHALLENGE OF ACHIEVING ADEQUATE ORAL IMMUNOSUPPRESSION IN A RENAL TRANSPLANT RECIPIENT WHO DEVELOPS SHORT BOWEL SYNDROME (SBS). Ulster Med J 2018; 87:200-201. [PMID: 31061546 PMCID: PMC6500423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- OM McCloskey
- Corresponding author: McCloskey OM. Renal Unit, Ulster Hospital Dundonald. Belfast. Northern Ireland. E-mail:
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50
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Mitchell A, Wright G, Sampson SN, Martin M, Cummings K, Gaddy D, Watts AE. Clodronate improves lameness in horses without changing bone turnover markers. Equine Vet J 2018; 51:356-363. [DOI: 10.1111/evj.13011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 08/20/2018] [Indexed: 12/18/2022]
Affiliation(s)
- A. Mitchell
- Department of Large Animal Clinical Sciences Cornell University Ithaca New York USA
| | - G. Wright
- Department of Veterinary Pathobiology Cornell University Ithaca New York USA
| | - S. N. Sampson
- Department of Large Animal Clinical Sciences Cornell University Ithaca New York USA
| | - M. Martin
- Department of Large Animal Clinical Sciences Cornell University Ithaca New York USA
| | - K. Cummings
- Department of Population Medicine and Diagnostic Sciences Cornell University Ithaca New York USA
| | - D. Gaddy
- Department of Veterinary Integrative Biosciences Texas A&M University College Station Texas USA
| | - A. E. Watts
- Department of Large Animal Clinical Sciences Cornell University Ithaca New York USA
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