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Duboscq C, Sueldo E, Rosa C, Zirpoli M, Ceresetto J, Baques A, Arias M. High variability in Factor IX one-stage assay in samples spiked with nonacog beta pegol among different pairs of reagent/detection system. Int J Lab Hematol 2024; 46:128-134. [PMID: 37704365 DOI: 10.1111/ijlh.14171] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION Haemophilia B (HB) is an X-linked hereditary bleeding disorder characterized by coagulation factor IX (FIX) deficiency. To improve the quality of life of patients and adherence to treatment, recombinant factor concentrates modified to extend their half-life have been developed, called extended half-life factors (EHL: extended half-life). Nonacog beta pegol (N9-GP) is a glycopegylated recombinant human FIX molecule that has a half-life of 93 h with a single dose and has shown a higher recovery percentage than other molecules. To diagnose and monitor the treatment of haemophiliac patients, FIX activity is determined with the one-stage clotting assay (OSA) and/or the chromogenic assay. The objective of this work, carried out in three centres, was to measure the recovery of N9-PG with 10 different activated partial thromboplastin time (APTT) reagents on three platforms, in samples spiked in vitro with N9-GP, at four different concentration levels. METHODS It was measured the recovery of N9-GP with 10 different APTT reagents (polyphenol, ellagic acid, silice dioxide, colloidal silica as APTT activator on three platforms, in sample spiked in vitro with N9-GP. RESULTS The results show heterogeneity in the activity of N9-GP measured by OSA with the different APTT reagents when the calibrations were performed with the specific calibrator of each coagulometer. A recovery percentage between 87% and 108% was obtained only with polyphenol and ellagic acid as activator in the three platforms evaluated. The other reagents studied overestimate or underestimate, with no clear profile. When a calibration curve was performed with a calibrator prepared from the N9-GP vial, all APTT reagents met the established recovery requirement. CONCLUSION APTT reagents with polyphenol or ellagic acid as activator would be the only ones appropriate when using the commercially available OSA with specific calibrator to monitor patients treated with N9-GP.
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Affiliation(s)
- C Duboscq
- Servicio Hematología, Hospital Británico, Buenos Aires, Argentina
| | - E Sueldo
- Laboratorio de Hematología Y Hemostasia, Hospital Dr. César Milstein, Buenos Aires, Argentina
| | - C Rosa
- Laboratorio Central Hospital, Hospital Universitario Austral, Buenos Aires, Argentina
| | - M Zirpoli
- Laboratorio Central Hospital, Hospital Universitario Austral, Buenos Aires, Argentina
| | - J Ceresetto
- Servicio Hematología, Hospital Británico, Buenos Aires, Argentina
| | - A Baques
- Servicio de Hemofilia, Dr. César Milstein, Buenos Aires, Argentina
| | - M Arias
- Laboratorio de Hematología Y Hemostasia, Hospital Dr. César Milstein, Buenos Aires, Argentina
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McNeely J, McLeman B, Gardner T, Nesin N, Amarendran V, Farkas S, Wahle A, Pitts S, Kline M, King J, Rosa C, Marsch L, Rotrosen J, Hamilton L. Implementation of substance use screening in rural federally-qualified health center clinics identified high rates of unhealthy alcohol and cannabis use among adult primary care patients. Addict Sci Clin Pract 2023; 18:56. [PMID: 37726839 PMCID: PMC10510292 DOI: 10.1186/s13722-023-00404-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 07/31/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Screening for substance use in rural primary care clinics faces unique challenges due to limited resources, high patient volumes, and multiple demands on providers. To explore the potential for electronic health record (EHR)-integrated screening in this context, we conducted an implementation feasibility study with a rural federally-qualified health center (FQHC) in Maine. This was an ancillary study to a NIDA Clinical Trials Network study of screening in urban primary care clinics (CTN-0062). METHODS Researchers worked with stakeholders from three FQHC clinics to define and implement their optimal screening approach. Clinics used the Tobacco, Alcohol, Prescription Medication, and Other Substance (TAPS) Tool, completed on tablet computers in the waiting room, and results were immediately recorded in the EHR. Adult patients presenting for annual preventive care visits, but not those with other visit types, were eligible for screening. Data were analyzed for the first 12 months following implementation at each clinic to assess screening rates and prevalence of reported unhealthy substance use, and documentation of counseling using an EHR-integrated clinical decision support tool, for patients screening positive for moderate-high risk alcohol or drug use. RESULTS Screening was completed by 3749 patients, representing 93.4% of those with screening-eligible annual preventive care visits, and 18.5% of adult patients presenting for any type of primary care visit. Screening was self-administered in 92.9% of cases. The prevalence of moderate-high risk substance use detected on screening was 14.6% for tobacco, 30.4% for alcohol, 10.8% for cannabis, 0.3% for illicit drugs, and 0.6% for non-medical use of prescription drugs. Brief substance use counseling was documented for 17.4% of patients with any moderate-high risk alcohol or drug use. CONCLUSIONS Self-administered EHR-integrated screening was feasible to implement, and detected substantial alcohol, cannabis, and tobacco use in rural FQHC clinics. Counseling was documented for a minority of patients with moderate-high risk use, possibly indicating a need for better support of primary care providers in addressing substance use. There is potential to broaden the reach of screening by offering it at routine medical visits rather than restricting to annual preventive care visits, within these and other rural primary care clinics.
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Affiliation(s)
- Jennifer McNeely
- Department of Population Health, Section on Tobacco, Alcohol and Drug Use, New York University Grossman School of Medicine, 180 Madison Ave., 17th Floor, New York, NY, 10016, USA.
| | - Bethany McLeman
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Evergreen Center, Suite 315, Lebanon, NH, 03766, USA
| | - Trip Gardner
- Penobscot Community Health Care (PCHC), 103 Maine Avenue, Bangor, ME, 04401, USA
| | - Noah Nesin
- Penobscot Community Health Care (PCHC), 103 Maine Avenue, Bangor, ME, 04401, USA
| | - Vijay Amarendran
- Penobscot Community Health Care (PCHC), 103 Maine Avenue, Bangor, ME, 04401, USA
| | - Sarah Farkas
- Department of Psychiatry, New York University Grossman School of Medicine, 1 Park Ave, New York, NY, 10016, USA
| | - Aimee Wahle
- The Emmes Company, 401 N. Washington St., Rockville, MD, 20850, USA
| | - Seth Pitts
- The Emmes Company, 401 N. Washington St., Rockville, MD, 20850, USA
| | - Margaret Kline
- The Emmes Company, 401 N. Washington St., Rockville, MD, 20850, USA
| | - Jacquie King
- The Emmes Company, 401 N. Washington St., Rockville, MD, 20850, USA
| | - Carmen Rosa
- National Institute on Drug Abuse, c/o NIH Mail Center, NIDA 3@FN MSC 6022, 16071 Industrial Drive-Dock 11, Gaithersburg, MD, 20892, USA
| | - Lisa Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Evergreen Center, Suite 315, Lebanon, NH, 03766, USA
| | - John Rotrosen
- Department of Psychiatry, New York University Grossman School of Medicine, 1 Park Ave, New York, NY, 10016, USA
| | - Leah Hamilton
- Department of Population Health, Section on Tobacco, Alcohol and Drug Use, New York University Grossman School of Medicine, 180 Madison Ave., 17th Floor, New York, NY, 10016, USA
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Seattle, WA, 98101, USA
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Rosa C, Nascimento VP, Pizolotto W, Pasqualotto CV, Rodrigues LB, Daroit L, Pilotto F. Effect of Ammonia Gas in Poultry Litter Contaminated with Salmonella Heidelberg. Braz J Poult Sci 2023. [DOI: 10.1590/1806-9061-2022-1631] [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] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- C Rosa
- Federal University of Rio Grande do Sul, Brazil
| | | | | | | | | | - L Daroit
- University of Passo Fundo, Brazil
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Venier F, Jamont W, McLennan K, Rosa C. Intra- and inter-operator variability of refractometric total proteins measurement of canine plasma. J S Afr Vet Assoc 2022; 93:176-178. [PMID: 36412080 DOI: 10.36303/jsava.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Refractometric total proteins are commonly used in practice as a quick and inexpensive way to measure total protein concentration in bodily fluids. Little information is available about how the operator performing the measurement affects the results. The aim of our study was to determine the inter- and intra-operator variability of refractometric total proteins measured on canine plasma using a temperature-compensated handheld refractometer. A pooled sample of canine lithium-heparin plasma was created using leftover samples from dogs presented to our hospital. The sample was then divided into three aliquots. Total proteins of these aliquots were measured by veterinary nurses, interns, residents and specialists working at our hospital. Statistical analysis revealed excellent inter-operator (ICC 0.99, CI 95%: 0.971-1.00) and intra-operator (ICC 0.997, CI 95%: 0.990- 0.999) variability. Having different operators measuring refractometric total plasma proteins in practice should not affect the results. This suggests different operators can be used when monitoring total plasma proteins of a patient over time and when designing a study that involves this test.
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Affiliation(s)
- F Venier
- Northwest Veterinary Specialists, United Kingdom
| | - W Jamont
- Northwest Veterinary Specialists, United Kingdom
| | - K McLennan
- Department of Biological Sciences, University of Chester, United Kingdom
| | - C Rosa
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, South Africa
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Rosa C, Chaudhuri K, Kasavkar G, Price-Forbes A, Banerjee S. AB0716 Characteristics of 4 cases of PL - 7 positive antisynthatase syndrome: interstitial lung disease being a more common feature then myositis. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAnti synthetase syndrome is a heterogeneous group of auto immune diseases characterised by antibodies against aminoacyl t RNA synthetase, associated with interstitial lung disease, myositis, arthritis and Raynaud’s phenomenon. Anti PL 7 antibody is rare, present in only 1-4% patients with anti synthetase syndrome.ObjectivesTo describe clinical characteristics PL – 7 positive patients with antisynthatase syndrome.MethodsIn this retrospective study, cohort of patients with inflammatory myositis were screened for anti PL-7 antibody positivity and 4 cases were detected. Diagnosis was made based on either 2017 EULAR/ ACR classification criteria and/ or Bohan and Peter criteria. [1, 2] Clinical manifestations, investigations including antibody profile, treatment and treatment response were described.ResultsOf the 4 patients, 3 were female and age of onset varied from 36 to 69 years. Only 1 patient presented with proximal muscle weakness while three patients with dyspnoea. Joint involvement and Raynaud’s phenomenon was present in 2 patients. Two patients had scleroderma spectrum manifestations. Three patients had elevated CK during the disease course with maximum values being 228, 594 and 1200 with only one having muscle weakness. One patient had dermatomyositis and 2 patients had mechanic‘s hand.HRCT patterns were usual interstitial pneumonia(UIP), nonspecific interstitial pneumonia(NSIP) and fibrosing NSIP with organising pneumonia. Three patients had anti Ro antibodies. All patients were treated with steroids, one each received Cyclophosphamide and Azathioprine initially however all the patients ended up with Mycophenolate mofetil—which controlled disease effectively without flare.Table 1.Patient 1Patient 2Patient 3Patient 4Age at onset69 years52 years36 years55 yearsGenderMaleFemaleFemaleFemalePresentationShortness of breathShoulder weaknessArthritis and shortness of breathShortness of breathMuscleNo weaknessNo weaknessNo weaknessMaximum CK (U/L)2285941200105Raynaud’sPresentAbsentPresentJointArthritis - presentAbsentPresentAbsentSkinSkin tightnessScelrodactylyNail fold capillaries dilationAbsentSkin tightnessScelrodactylyNail fold capillaries dilationMechanic’s hands, facial pigmentationMechanic’s handLungPresentAbsentPresentPresentAntibodiesANA+Anti Ro+PL - 7 +ANA+, anti Ro & La +, anti Ro52+PL – 7+ANA negativeanti Ro52+PL – 7+ANA negativePL – 7 +HRCTUIPNo ILDNSIPFibrosing NSIP, COPLung functionFEV153%Not availableFEV136%FEV165%FVC47%FVC35%FVC82%FEV1/FVC113%FEV1/FVC103%FEV1/FVC83%DLCO34%DLCO49%DLCO50%EMGNot doneChronic myopathyNot doneNot doneMuscle biopsyNot doneNot availableNot doneNot doneTreatmentPrednisolone andIV cyclophosphamide initially (side effects)Later on Mycophenolate MofetilStable diseasePrednisoloneInitially AzathioprineLater MMF due to relapsing disease while of AZAMMF and Prednisolone—clinical responsePrednisolone and Mycophenolate-response with normalisation of PFTPulmonary hypertensionPresentAbsentPresentAbsentConclusionIn Anti PL – 7 positive patients, interstitial lung disease is much more common than myositis. Mechanic’s hands and scleroderma overlap appear to be a common association. Additionally, antibody positivity with Anti Ro/Ro52 was also noted. One patient had features of dermatomyositis including facial rash which is extremely rare for PL7. All of these patients responded very well to Mycophenolate.References[1]Lundberg IE, Tjärnlund A, Bottai M, et al. 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups [published correction appears in Ann Rheum Dis. 2018 Sep;77(9):e64]. Ann Rheum Dis. 2017;76(12):1955-1964. doi:10.1136/annrheumdis-2017-211468[2]Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975;292(7):344-347. doi:10.1056/NEJM197502132920706Disclosure of InterestsNone declared
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Borgia M, Nuzzo M, Ursini L, Rosa C, Di Guglielmo F, Lucarelli M, Fasciolo D, Genovesi D. PD-0744 Tangential fields in pN+ sentinel nodes breast cancer with or without axillary dissection. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02939-5] [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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Drum JN, Madureira G, Macêdo MCG, Rosa C, Seneda M, Campos DB, Wiltbank MC, Sartori R, Ortega MS. 54 Evidence of sexual dimorphism in transcriptome of in vitro- versus in vivo-derived bovine embryos. Reprod Fertil Dev 2021; 34:262. [PMID: 35231309 DOI: 10.1071/rdv34n2ab54] [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: 11/23/2022] Open
Affiliation(s)
- J N Drum
- Division of Animal Sciences, University of Missouri, Columbia, MO, USA
| | - G Madureira
- Department of Animal Sciences, University of São Paulo, Piracicaba, SP, Brazil
| | - M C G Macêdo
- Department of Agricultural Sciences, Federal University of Paraiba, Areia, PB, Brazil
| | - C Rosa
- State University of Londrina, Londrina, PR, Brazil
| | - M Seneda
- State University of Londrina, Londrina, PR, Brazil
| | - D B Campos
- Department of Agricultural Sciences, Federal University of Paraiba, Areia, PB, Brazil
| | - M C Wiltbank
- Department of Animal and Dairy Science, University of Wisconsin-Madison, Madison, WI, USA
| | - R Sartori
- Department of Animal Sciences, University of São Paulo, Piracicaba, SP, Brazil
| | - M S Ortega
- Division of Animal Sciences, University of Missouri, Columbia, MO, USA
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Di Guglielmo F, Ursini L, Nuzzo M, Rosa C, Di Tommaso M, Trignani M, Borgia M, Allajbej A, Patani F, Di Carlo C, Porreca A, Di Nicola M, Genovesi D, Caravatta L. PO-1137 A prospective study on Quality of life in patients treated with radiotherapy for early breast cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07588-5] [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: 10/20/2022]
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Rosa C, Di Guglielmo F, Gasparini L, Caravatta L, Di Tommaso M, Pieragostino D, Del Boccio P, Cicalini I, Genovesi D. OC-0402 Metabolomics as predictor of treatment response in neoadjuvant chemoradiation for rectal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06889-4] [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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Fasciolo D, Fasciolo D, Rosa C, Marchione M, Borgia M, Lucarelli M, Vinciguerra A, Augurio A, Caravatta L, Genovesi D. PO-1381 Toxicity outcomes of salvage versus adjuvant radiotherapy for prostate cancer using VMAT and IMRT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07832-4] [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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Borgia M, Rosa C, Ursini L, Nuzzo M, Di Tommaso M, Di Guglielmo F, Brocco D, Grassadonia A, Tavoletta S, Grossi S, Genovesi D, Caravatta L. PO-1147 Whole breast Radiotherapy in cT1-2 cN0 with pN+ sentinel nodes: preliminary results of LISEN trial. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07598-8] [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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Marcucci S, Caravatta L, Rosa C, Nuzzo M, Di Tommaso M, Taraborrelli M, Di Carlo C, Di Guglielmo F, Gasparini L, Adorante N, Genovesi D. PO-1970 4D-CBCT (Symmetry Elekta X-ray) for ITV generation in thoracic stereotactic radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08421-8] [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: 11/16/2022]
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Rosa C, Di Guglielmo F, Gasparini L, Caravatta L, Di Tommaso M, Martino G, Castaldi P, Genovesi D. PD-0838 Rectal cancer volume delineation between morphological and functional images: CT, T2/DWIMRI, PET-CT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07117-6] [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: 10/20/2022]
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McNeely J, Adam A, Rotrosen J, Wakeman SE, Wilens TE, Kannry J, Rosenthal RN, Wahle A, Pitts S, Farkas S, Rosa C, Peccoralo L, Waite E, Vega A, Kent J, Craven CK, Kaminski TA, Firmin E, Isenberg B, Harris M, Kushniruk A, Hamilton L. Comparison of Methods for Alcohol and Drug Screening in Primary Care Clinics. JAMA Netw Open 2021; 4:e2110721. [PMID: 34014326 PMCID: PMC8138691 DOI: 10.1001/jamanetworkopen.2021.10721] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
IMPORTANCE Guidelines recommend that adult patients receive screening for alcohol and drug use during primary care visits, but the adoption of screening in routine practice remains low. Clinics frequently struggle to choose a screening approach that is best suited to their resources, workflows, and patient populations. OBJECTIVE To evaluate how to best implement electronic health record (EHR)-integrated screening for substance use by comparing commonly used screening methods and examining their association with implementation outcomes. DESIGN, SETTING, AND PARTICIPANTS This article presents the outcomes of phases 3 and 4 of a 4-phase quality improvement, implementation feasibility study in which researchers worked with stakeholders at 6 primary care clinics in 2 large urban academic health care systems to define and implement their optimal screening approach. Site A was located in New York City and comprised 2 clinics, and site B was located in Boston, Massachusetts, and comprised 4 clinics. Clinics initiated screening between January 2017 and October 2018, and 93 114 patients were eligible for screening for alcohol and drug use. Data used in the analysis were collected between January 2017 and October 2019, and analysis was performed from July 13, 2018, to March 23, 2021. INTERVENTIONS Clinics integrated validated screening questions and a brief counseling script into the EHR, with implementation supported by the use of clinical champions (ie, clinicians who advocate for change, motivate others, and use their expertise to facilitate the adoption of an intervention) and the training of clinic staff. Clinics varied in their screening approaches, including the type of visit targeted for screening (any visit vs annual examinations only), the mode of administration (staff-administered vs self-administered by the patient), and the extent to which they used practice facilitation and EHR usability testing. MAIN OUTCOMES AND MEASURES Data from the EHRs were extracted quarterly for 12 months to measure implementation outcomes. The primary outcome was screening rate for alcohol and drug use. Secondary outcomes were the prevalence of unhealthy alcohol and drug use detected via screening, and clinician adoption of a brief counseling script. RESULTS Patients of the 6 clinics had a mean (SD) age ranging from 48.9 (17.3) years at clinic B2 to 59.1 (16.7) years at clinic B3, were predominantly female (52.4% at clinic A1 to 64.6% at clinic A2), and were English speaking. Racial diversity varied by location. Of the 93,114 patients with primary care visits, 71.8% received screening for alcohol use, and 70.5% received screening for drug use. Screening at any visit (implemented at site A) in comparison with screening at annual examinations only (implemented at site B) was associated with higher screening rates for alcohol use (90.3%-94.7% vs 24.2%-72.0%, respectively) and drug use (89.6%-93.9% vs 24.6%-69.8%). The 5 clinics that used a self-administered screening approach had a higher detection rate for moderate- to high-risk alcohol use (14.7%-36.6%) compared with the 1 clinic that used a staff-administered screening approach (1.6%). The detection of moderate- to high-risk drug use was low across all clinics (0.5%-1.0%). Clinics with more robust practice facilitation and EHR usability testing had somewhat greater adoption of the counseling script for patients with moderate-high risk alcohol or drug use (1.4%-12.5% vs 0.1%-1.1%). CONCLUSIONS AND RELEVANCE In this quality improvement study, EHR-integrated screening was feasible to implement in all clinics and unhealthy alcohol use was detected more frequently when self-administered screening was used at any primary care visit. The detection of drug use was low at all clinics, as was clinician adoption of counseling. These findings can be used to inform the decision-making of health care systems that are seeking to implement screening for substance use. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02963948.
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Affiliation(s)
- Jennifer McNeely
- Department of Population Health, New York University Grossman School of Medicine, New York
- Department of Medicine, Division of General Internal Medicine, New York University Grossman School of Medicine, New York
| | - Angéline Adam
- Department of Psychiatry, University Hospital Lausanne, Lausanne, Switzerland
| | - John Rotrosen
- Department of Psychiatry, New York University Grossman School of Medicine, New York
| | - Sarah E. Wakeman
- Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston
| | | | - Joseph Kannry
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | | | - Sarah Farkas
- Department of Psychiatry, New York University Grossman School of Medicine, New York
| | - Carmen Rosa
- National Institute on Drug Abuse, Bethesda, Maryland
| | - Lauren Peccoralo
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Eva Waite
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Aida Vega
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jennifer Kent
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Catherine K. Craven
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Elizabeth Firmin
- Department of Psychiatry, Massachusetts General Hospital, Boston
| | | | - Melanie Harris
- Department of Population Health, New York University Grossman School of Medicine, New York
| | - Andre Kushniruk
- School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
| | - Leah Hamilton
- Department of Population Health, New York University Grossman School of Medicine, New York
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Miranda MN, Rosa C, Peres A, Maia R. Sedimentation assessment and effects in Venda Nova dam reservoir (Portugal). Sci Total Environ 2021; 766:144261. [PMID: 33421777 DOI: 10.1016/j.scitotenv.2020.144261] [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] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/30/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
Sediment quantity and quality in dam reservoirs is often neglected and usually only water quality is monitored in many countries, such as in Portugal. Nevertheless, there are risks associated to sedimentation in dam reservoirs, particularly considering that many dams in the world are ageing into an overextended lifetime. The present study was conducted with the goal to understand how sedimentation monitoring in Portuguese dam reservoirs could be attained, as that information is essential to tackle any sedimentation effects that may have occurred. A dam reservoir in the north of Portugal, the Venda Nova reservoir, was selected for the study. First, historical relevant data was compiled and then new data for sediment and water quality analysis was collected. The results show that since the reservoir was filled, after the dam construction conclusion in 1951, the reservoir morphology has been affected by the sedimentation at different rates and underwent multiple transformations from 1946 (before the dam construction) to 2004 (last topobathymetric survey). An expressive morphology transformation detected in 1984 led to an intervention to remove some of the accumulated material. It was verified, as well, that the asymmetrical contamination of the sediments and water is still strongly influenced by a nearby mine even if now inactive. The methodology applied, if periodically used, will be helpful to understand the sedimentation phenomena in Portuguese and other European dam reservoirs where reservoir sedimentation has been overlooked, and can play a key role to improve river continuity and to comply with the Environmental Quality Standards under the EU Water Framework Directive (2000/60/EC).
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Affiliation(s)
- M N Miranda
- Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias s/n, 4200-465 Porto, Portugal.
| | - C Rosa
- EDP Labelec, Rua Cidade de Goa, n° 4, 2685-039 Sacavém, Portugal
| | - A Peres
- EDP - Gestão da Produção de Energia S. A., Rua Ofélia Diogo da Costa, n° 39, 4°, 4149-022 Porto, Portugal
| | - R Maia
- Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias s/n, 4200-465 Porto, Portugal
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Torres A, Santos I, Rosa C, Monteiro S, Rodrigues F, Figueiredo A, Santos T, Ribeiro O, Queirós A, Pereira A, Silva C. Integrated efforts to promote mental health care during the SARS-CoV-2 pandemic: Reflecting on the experience of a university helpline. Eur Psychiatry 2021. [PMCID: PMC9528517 DOI: 10.1192/j.eurpsy.2021.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The SARS-CoV-2 pandemic is affecting numerous dimensions of our society since the beginning of the outbreak. A significant increase in emotional distress was expected in the general population, particularly among the high-risk groups such as the oldest, chronic patients, healthcare professionals, and psychopathology vulnerable people. There was an urgent need to adapt and create solutions to promote mental health. Given the recommendations to minimize face-to-face interactions, several helplines were widely developed. Objectives In this work, we aim to reflect on the experience of a university helpline, that integrated efforts with the regional mental health care services. Methods
A University helpline was created to give support to the regional community outside academia. The team was created on an online teamwork platform, to communicate through the chat, carry videoconference meetings, and store useful files. A Manchester screening decision tree was adopted, to define a set of guidelines to provide support to the callers, based mainly on the guidelines defined by the Order of Portuguese Psychologists. Liaison with the mental health care services, including other specific helplines, was established. Results Notwithstanding all the efforts, the number of received calls was scarce, similarly to helplines created by other national universities and by other entities. Conclusions A new approach to psychological intervention in crisis is needed, maintaining integrated efforts, and taking advantage of the opportunity to foster personalized mental health care in the digital era. It is important to continuously assess the value of integrated efforts in patient care and to the healthcare system.
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Rosa C, Marsch LA, Winstanley EL, Brunner M, Campbell ANC. Using digital technologies in clinical trials: Current and future applications. Contemp Clin Trials 2020; 100:106219. [PMID: 33212293 DOI: 10.1016/j.cct.2020.106219] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/05/2020] [Accepted: 11/10/2020] [Indexed: 12/20/2022]
Abstract
In 2015, we provided an overview of the use of digital technologies in clinical trials, both as a methodological tool and as a mechanism to deliver interventions. At that time, there was limited guidance and limited use of digital technologies in clinical research. However, since then smartphones have become ubiquitous and digital health technologies have exploded. This paper provides an update to our earlier publication and an overview of how technology has been used in the past five years in clinical trials, providing examples with varying levels of technological integration and across different health conditions. Digital technology integration ranges from the incorporation of artificial intelligence in diagnostic devices to the use of real-world data (e.g., electronic health records) for study recruitment. Clinical trials can now be conducted entirely virtually, eliminating the need for in-person interaction. Much of the published research demonstrates how digital approaches can improve the design and implementation of clinical trials. While challenges remain, progress over the last five years is encouraging, and barriers can be overcome with careful planning.
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Affiliation(s)
- Carmen Rosa
- National Institutes of Health, National Institute on Drug Abuse, Bethesda, MD, USA.
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, USA.
| | - Erin L Winstanley
- West Virginia University, School of Medicine and Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, Morgantown, West Virginia, USA; West Virginia University, School of Medicine, Department of Neuroscience Morgantown, West Virginia, USA.
| | - Meg Brunner
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA.
| | - Aimee N C Campbell
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY, USA.
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Rosa C, Di Tommaso M, Seccia B, Delli Pizzi A, Cianci R, Basilico R, Di Pilla A, Taraborrelli M, Caravatta L, Genovesi D. PO-1093: Defecography for sphincter evaluation in rectal cancer patients irradiated with dose intensification. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01110-5] [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: 10/22/2022]
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19
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Rosa C, Gasparini L, Di Guglielmo F, Delli Pizzi A, Seccia B, Cianci R, Basilico R, Augurio A, Ursini L, Porreca A, Di Nicola M, Caravatta L, Genovesi D. OC-0567: T2 and Apparent Diffusion Coefficient MRI for Cervical cancer delineation: agreement between volumes. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00589-2] [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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20
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Winhusen T, Lofwall M, Jones HE, Wilder C, Lindblad R, Schiff DM, Wexelblatt S, Merhar S, Murphy SM, Greenfield SF, Terplan M, Wachman EM, Kropp F, Theobald J, Lewis M, Matthews AG, Guille C, Silverstein M, Rosa C. Medication treatment for opioid use disorder in expectant mothers (MOMs): Design considerations for a pragmatic randomized trial comparing extended-release and daily buprenorphine formulations. Contemp Clin Trials 2020; 93:106014. [PMID: 32353544 PMCID: PMC7184985 DOI: 10.1016/j.cct.2020.106014] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 01/17/2023]
Abstract
Opioid use disorder (OUD) in pregnant women has increased significantly in recent years. Maintaining these women on sublingual (SL) buprenorphine (BUP) is an evidence-based practice but BUP-SL is associated with several disadvantages that an extended-release (XR) BUP formulation could eliminate. The National Drug Abuse Treatment Clinical Trials Network (CTN) is conducting an intent-to-treat, two-arm, open-label, pragmatic randomized controlled trial, Medication treatment for Opioid-dependent expectant Mothers (MOMs), to compare mother and infant outcomes of pregnant women with OUD treated with BUP-XR, relative to BUP-SL. A second aim is to determine the relative economic value of utilizing BUP-XR. Approximately 300 pregnant women with an estimated gestational age (EGA) of 6-30 weeks, recruited from 12 sites, will be randomized in a 1:1 ratio to BUP-XR or BUP-SL, balancing on site, EGA, and BUP-SL status (taking/not taking) at the time of randomization. Participants will be provided with study medication and attend weekly medication visits through 12 months postpartum. Participants will be invited to participate in two sub-studies to evaluate the: 1) mechanisms by which BUP-XR may improve mother and infant outcomes; and 2) effects of prenatal exposure to BUP-XR versus BUP-SL on infant neurodevelopment. This paper describes the key design decisions for the main trial made during protocol development. This Investigational New Drug (IND) trial uniquely uses pragmatic features where feasible in order to maximize external validity, hence increasing the potential to inform clinical practice guidelines and address multiple knowledge gaps for treatment of this patient population.
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Affiliation(s)
- Theresa Winhusen
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA.
| | - Michelle Lofwall
- Departments of Behavioral Science and Psychiatry, University of Kentucky College of Medicine, Center on Drug and Alcohol Research, 845 Angliana Avenue, Lexington, KY 40508, USA
| | - Hendrée E Jones
- UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina Chapel Hill, 410 North Greensboro St., Carrboro, NC 27510, USA
| | - Christine Wilder
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA
| | - Robert Lindblad
- The Emmes Company, LLC, 401 N Washington Street, Suite 700, Rockville, MD 20850, USA
| | - Davida M Schiff
- Division of General Academic Pediatrics, MassGeneral Hospital for Children, 125 Nashua St Suite 860, Boston, MA 02114, USA
| | - Scott Wexelblatt
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45229, USA
| | - Stephanie Merhar
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45229, USA
| | - Sean M Murphy
- Department of Healthcare Policy & Research, Weill Cornell Medical College, 425 East 61st Street Suite 301, New York, NY 10065, USA
| | - Shelly F Greenfield
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Division of Alcohol, Drug and Addictions and the Division of Women's Mental Health, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA
| | - Mishka Terplan
- Friends Research Institute,1040 Park Ave Suite 103, Baltimore, MD 21201, USA
| | - Elisha M Wachman
- Department of Pediatrics, Boston Medical Center, 801 Albany Street, Boston, MA 02119, USA
| | - Frankie Kropp
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA
| | - Jeff Theobald
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA
| | - Mitra Lewis
- The Emmes Company, LLC, 401 N Washington Street, Suite 700, Rockville, MD 20850, USA
| | - Abigail G Matthews
- The Emmes Company, LLC, 401 N Washington Street, Suite 700, Rockville, MD 20850, USA
| | - Connie Guille
- Department of Psychiatry and Behavioral Science, Medical University of South Carolina, 67 President St., MSC 861, Charleston, SC 29425, USA
| | - Michael Silverstein
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, 88 East Newton Street, Boston, MA 02118, USA
| | - Carmen Rosa
- Center for the Clinical Trials Network, National Institute on Drug Abuse, 6001 Executive Blvd, Bethesda, MD 20892, USA
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21
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de la Torre R, Carbó M, Pujadas M, Biel S, Mesa MD, Covas MI, Expósito M, Espejo JA, Sanchez-Rodriguez E, Díaz-Pellicer P, Jimenez-Valladares F, Rosa C, Pozo O, Fitó M. Pharmacokinetics of maslinic and oleanolic acids from olive oil - Effects on endothelial function in healthy adults. A randomized, controlled, dose-response study. Food Chem 2020; 322:126676. [PMID: 32305871 DOI: 10.1016/j.foodchem.2020.126676] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 09/27/2018] [Revised: 02/20/2020] [Accepted: 03/21/2020] [Indexed: 11/19/2022]
Abstract
To date, pharmacokinetics of maslinic (MA) and oleanolic (OA) acids, at normal dietary intakes in humans, have not been evaluated, and data concerning their bioactive effects are scarce. We assessed MA and OA pharmacokinetics after ingestion of olive oils (OOs) with high and low triterpenic acid contents, and specifically the effect of triterpenes on endothelial function. We performed a double-blind, dose-response, randomized, cross-over nutritional intervention in healthy adults, and observed that MA and OA increased in biological fluids in a dose-dependent manner. MA bioavailability was greater than that of OA, and consumption of pentacyclic triterpenes was associated with improved endothelial function. To the best of our knowledge, this is the first time MA pharmacokinetics, and effects on endothelial function in vivo, have been reported in humans.
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Affiliation(s)
- Rafael de la Torre
- Integrative Pharmacology and Systems Neuroscience Research Group, IMIM (Hospital del Mar Research Institute), Dr. Aiguader 88, 08003 Barcelona, Spain; UniversitatPompeuFabra (CEXS-UPF), Dr. Aiguader 88, 08003 Barcelona, Spain; CIBER de Fisiopatología Obesidad y Nutrición (CIBEROBN), Santiago de Compostela 15706, Spain.
| | - Marceli Carbó
- UniversitatPompeuFabra (CEXS-UPF), Dr. Aiguader 88, 08003 Barcelona, Spain.
| | - Mitona Pujadas
- Integrative Pharmacology and Systems Neuroscience Research Group, IMIM (Hospital del Mar Research Institute), Dr. Aiguader 88, 08003 Barcelona, Spain; CIBER de Fisiopatología Obesidad y Nutrición (CIBEROBN), Santiago de Compostela 15706, Spain.
| | - Sarah Biel
- Fundación Pública Andaluza para la Investigación Biosanitaria de Andalucía Oriental "Alejandro Otero" (FIBAO), Granada, Spain.
| | - María-Dolores Mesa
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, Health Science Technological Park, University of Granada, Avenida del Conocimiento s/n. 18100 Armilla, Granada, Spain; Instituto de Investigación Biosanitariaibs GRANADA, Complejo Hospitalario Universitario de Granada, Granada 18014, Spain.
| | - María-Isabel Covas
- CIBER de Fisiopatología Obesidad y Nutrición (CIBEROBN), Santiago de Compostela 15706, Spain; NUPROAS (Nutritional Project Assessment), Handesbolag (NUPROAS HB), Nacka, Sweden
| | - Manuela Expósito
- Fundación Pública Andaluza para la Investigación Biosanitaria de Andalucía Oriental "Alejandro Otero" (FIBAO), Granada, Spain.
| | | | - Estefanía Sanchez-Rodriguez
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, Health Science Technological Park, University of Granada, Avenida del Conocimiento s/n. 18100 Armilla, Granada, Spain
| | - Patricia Díaz-Pellicer
- Integrative Pharmacology and Systems Neuroscience Research Group, IMIM (Hospital del Mar Research Institute), Dr. Aiguader 88, 08003 Barcelona, Spain
| | | | - Carmen Rosa
- Fundación Pública Andaluza para la Investigación Biosanitaria de Andalucía Oriental "Alejandro Otero" (FIBAO), Granada, Spain.
| | - Oscar Pozo
- Integrative Pharmacology and Systems Neuroscience Research Group, IMIM (Hospital del Mar Research Institute), Dr. Aiguader 88, 08003 Barcelona, Spain.
| | - Montserrat Fitó
- CIBER de Fisiopatología Obesidad y Nutrición (CIBEROBN), Santiago de Compostela 15706, Spain; Cardiovascular Risk and Nutrition Research Group, IMIM (Hospital del Mar Research Institute), Dr. Aiguader 88, 08003 Barcelona, Spain.
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22
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Silva JR, Da Silva R, Fernández-Navarro P, Rosa C, Gonçalves MM. Understanding Extreme Violent Behavior in Ultra Firms: Exploring Identity Fusion from a Dialogical Perspective. Journal of Constructivist Psychology 2020. [DOI: 10.1080/10720537.2019.1676342] [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: 10/24/2022]
Affiliation(s)
- J. R. Silva
- INPP–Portucalense Institute for Human Development, Department of Psychology and Education, Portucalense University, Porto, Portugal
| | - R. Da Silva
- International Development Department, University of Birmingham, Birmingham, UK and CEI-IUL—Center for International Studies, ISCTE—Instituto Universitário de Lisboa, Lisbon, Portugal
| | - P. Fernández-Navarro
- CIPsi–Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal
| | - C. Rosa
- Department of Education and Psychology and CINTESIS.UA—Center for Health Technology and Services Research, University of Aveiro, Aveiro, Portugal
| | - M. M. Gonçalves
- CIPsi–Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal
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23
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Rosa C, Gasparini L, Di Biase S, Di Carlo C, Allajbej A, Patani F, Fasciolo D, Vinciguerra A, Caravatta L, Genovesi D. EP-1460 Internal Margin evaluation in prone or supine rectal cancer patients using CBCT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31880-8] [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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24
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Caravatta L, Cellini F, Simoni N, Rosa C, Niespolo R, Lupattelli M, Picardi V, Macchia G, Sainato A, Mantello G, Dionisi F, Rosetto M, Fusco V, Navarria F, De Paoli A, Guido A, Vecchi C, Basilico R, Cianci R, Pizzi AD, Di Nicola M, Mattiucci G, Valentini V, Morganti A, Genovesi D. PO-0809 Gross Tumor Volume delineation in pancreatic cancer using MRI: final results of a multicenter study. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31229-0] [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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25
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Gasparini L, Rosa C, Di Biase S, Di Carlo C, Allajbej A, Patani F, Fasciolo D, Porreca A, Di Nicola M, Caravatta L, Genovesi D. EP-1647 Neoadjuvant chemoradiotherapy in elderly rectal cancer patients in a mono-institutional experience. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32067-5] [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: 11/26/2022]
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26
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Di Biase S, Patani F, Fasciolo D, Rosa C, Di Carlo C, Allajbej A, Gasparini L, Delli Pizzi A, Trignani M, Caravatta L, Genovesi D. EP-1238 Inter-observer variability in target delineation for brain metastases in stereotactic radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31658-5] [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: 11/15/2022]
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27
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Caravatta L, Fiorica F, Alitto A, Rosa C, Nardangeli A, Munoz F, Bianco L, Giaccherini L, Timon G, Dionisi F, Massaccesi M. EP-1464 A systematic literature review of rectal re-irradiation: tolerance and outcomes. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31884-5] [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: 11/26/2022]
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28
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Di Carlo C, Patani F, Fasciolo D, Di Biase S, Rosa C, Allajbej A, Gasparrini L, Di Marino P, De Tursi M, Caravatta L, Trignani M, Genovesi D. PO-1074 Radiotherapy and immuno-check point inhibitors for brain metastases. A mono-institutional analysis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31494-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: 11/16/2022]
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Allajbej A, Patani F, Di Biase S, Fasciolo D, Di Carlo C, Rosa C, Gasparini L, Di Francesco M, Falcone G, Quaternato G, Croce A, Di Pilla A, Trignani M, Caravatta L, Genovesi D. PO-0727 Voice outcome following radiotherapy or laser microsurgery in patients with early glottic cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31147-8] [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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30
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Caravatta L, Fiorica F, Dionisi F, Rosa C, Boldrini L, Lupattelli M, Genovesi D, Massaccesi M. EP-1432 Re-irradiation of abdominal malignancies: toxicity, cumulative dose and outcome. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31852-3] [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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Altaibej A, Patani F, Di Biase S, Fasciolo D, Di Carlo C, Rosa C, Gasparini L, Di Francesco M, Falcone G, Quaternato G, Croce A, Di Pilla A, Trignani M, Genovesi D. PO-145 Voice outcome in patients with early glottic cancer following radiotherapy versus laser microsurgery. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30311-1] [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: 11/28/2022]
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Rosa C, Caravatta L, Trignani M, Patani F, Di Carlo C, Vecchi C, Marcucci S, Genovesi D. EP-1495: Cone beam computed tomography for movement evaluation of GTV and mesorectum in rectal cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31804-8] [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: 10/14/2022]
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Rosa C, Di Tommaso M, Caravatta L, Taraborrelli M, Augurio A, Di Biase S, Zecca I, Di Nicola M, Genovesi D. EP-1491: Neoadjuvant chemoradiotherapy in rectal cancer patients in a 15-year single institutional experience. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31800-0] [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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34
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Rosa C, Caravatta L, Di Tommaso M, Cianci R, Delli Pizzi A, Vinciguerra A, Zecca I, Di Nicola M, Genovesi D. EP-1493: T2 and Diffusion weighted MRI for GTV delineation in rectal cancer: agreement between volumes. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31802-4] [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: 11/16/2022]
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35
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Caravatta L, Cellini F, Simoni N, Rosa C, Niespolo R, Lupattelli M, Picardi V, Macchia G, Sainato A, Mantello G, Dionisi F, Rosetto M, Guida C, Basilico R, De Paoli A, Boz G, Fusco V, Mattiucci G, Morganti A, Genovesi D. PO-0775: MRI for GTV delineation in pancreatic cancer: preliminary results of a multi-institutional study. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31085-5] [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: 10/14/2022]
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Perrotti F, Del Boccio P, Pieragostino D, Caravatta L, Di Tommaso M, Rosa C, Di Perna M, Sacchetta P, Genovesi D. PO-0978: Potential predictive biomarkers to chemoradiotherapy response in rectal cancer: a lipidomic study. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31414-7] [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: 10/19/2022]
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Di Carlo C, Di Biase S, Caravatta L, Caponigro G, Rosa C, Di Biase M, Perrotti F, Trignani M, Vinciguerra A, Augurio A, Giancaterino S, De Nicola A, Falco M, Genovesi D. EP-1123: To contour or not contour hippocampus in stereotactic brain radiotherapy? A dosimetric study. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31559-1] [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: 11/17/2022]
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Biel S, Mesa MD, de la Torre R, Espejo JA, Fernández-Navarro JR, Fitó M, Sánchez-Rodriguez E, Rosa C, Marchal R, Alche JDD, Expósito M, Brenes M, Gandul B, Calleja MA, Covas MI. The NUTRAOLEOUM Study, a randomized controlled trial, for achieving nutritional added value for olive oils. BMC Complement Altern Med 2016; 16:404. [PMID: 27770787 PMCID: PMC5075414 DOI: 10.1186/s12906-016-1376-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 10/13/2016] [Indexed: 12/04/2022]
Abstract
Background Virgin olive oil, a recognized healthy food, cannot be consumed in great quantities. We aim to assess in humans whether an optimized virgin olive oil with high phenolic content (OVOO, 429 mg/Kg) and a functional one (FOO), both rich in phenolic compounds (429 mg/Kg) and triterpenic acids (389 mg/kg), could provide health benefits additional to those supplied a by a standard virgin olive oil (VOO). Methods/design A randomized, double-blind, crossover, controlled study will be conducted. Healthy volunteers (aged 20 to 50) will be randomized into one of three groups of daily raw olive oil consumption: VOO, OVOO, and FOO (30 mL/d). Olive oils will be administered over 3-week periods preceded by 2-week washout ones. The main outcomes will be markers of lipid and DNA oxidation, inflammation, and vascular damage. A bioavailability and dose-response study will be nested within this sustained- consumption one. It will be made up of 18 volunteers and be performed at two stages after a single dose of each olive oil. Endothelial function and nitric oxide will be assessed at baseline and at 4 h and 6 h after olive oil single dose ingestion. Discussion For the first time the NUTRAOLEUM Study will provide first level evidence on the health benefits in vivo in humans of olive oil triterpenes (oleanolic and maslinic acid) in addition to their bioavailability and disposition. Trial registration The Trial has been registered in ClinicalTrials.gov ID: NCT02520739.
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Lindblad R, Hu L, Oden N, Wakim P, Rosa C, VanVeldhuisen P. Mortality Rates Among Substance Use Disorder Participants in Clinical Trials: Pooled Analysis of Twenty-Two Clinical Trials Within the National Drug Abuse Treatment Clinical Trials Network. J Subst Abuse Treat 2016; 70:73-80. [PMID: 27692192 DOI: 10.1016/j.jsat.2016.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 07/28/2016] [Accepted: 08/08/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Most substance use disorders (SUD) treatment clinical trials are too short and small to reliably estimate the incidence of rare events like death. OBJECTIVE The aim of this study is to estimate the overall mortality rates among a SUD treatment-seeking population by pooling participants from multiple clinical trials conducted through the National Institute on Drug Abuse (NIDA)-sponsored National Drug Abuse Treatment Clinical Trials Network (CTN). PARTICIPANTS Drug and or alcohol users (N=9866) who sought treatment and participated in one of the twenty-two CTN trials. MEASUREMENTS Data were collected through randomized clinical trials in national community treatment programs for SUD. Pooled analysis was performed to assess age- and gender-standardized mortality rate(s) (SM rate(s)), and mortality ratio(s) (SM ratio(s)) of CTN trial participants compared to the U.S. general population. RESULTS The age- and gender-SM rate among CTN trials participants was 1403 (95% CI: 862-2074) per 100,000 person years (PY) compared to 542 (95% CI: 541-543) per 100,000 PY among the U.S. general population in 2005. By gender, age-adjusted SM ratio for female CTN trial participants was over five times (SM ratio=5.35, 95% CI: 3.31-8.19)), and for male CTN trial participants, it was over three times (SM ratio=3.39, 95% CI: 2.25-4.90) higher than their gender comparable peers in the U.S. general population. CONCLUSIONS Age and gender-standardized mortality rates and ratios among NIDA CTN SUD treatment-seeking clinical trial participants are higher than the age and gender comparable U.S. general population. The overall mortality rates of CTN trial participants are similar to in-treatment mortality reported in large U.S. and non-U.S. cohorts of opioid users. Future analysis with additional CTN trial participants and risk times will improve the stability of estimates, especially within subgroups based on primary substance of abuse. These SUD mortality rates can be used to facilitate safety monitoring within SUD clinical trials.
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Affiliation(s)
| | - Lian Hu
- The Emmes Corporation, Rockville, MD, United States
| | - Neal Oden
- The Emmes Corporation, Rockville, MD, United States
| | - Paul Wakim
- Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Carmen Rosa
- Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
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Rosa C, Campbell ANC, Miele GM, Brunner M, Winstanley EL. Using e-technologies in clinical trials. Contemp Clin Trials 2015; 45:41-54. [PMID: 26176884 PMCID: PMC4648297 DOI: 10.1016/j.cct.2015.07.007] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [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: 04/12/2015] [Revised: 06/26/2015] [Accepted: 07/05/2015] [Indexed: 02/03/2023]
Abstract
Clinical trials have been slow to incorporate e-technology (digital and electronic technology that utilizes mobile devices or the Internet) into the design and execution of studies. In the meantime, individuals and corporations are relying more on electronic platforms and most have incorporated such technology into their daily lives. This paper provides a general overview of the use of e-technologies in clinical trials research, specifically within the last decade, marked by rapid growth of mobile and Internet-based tools. Benefits of and challenges to the use of e-technologies in data collection, recruitment and retention, delivery of interventions, and dissemination are provided, as well as a description of the current status of regulatory oversight of e-technologies in clinical trials research. As an example of ways in which e-technologies can be used for intervention delivery, a summary of e-technologies for treatment of substance use disorders is presented. Using e-technologies to design and implement clinical trials has the potential to reach a wide audience, making trials more efficient while also reducing costs; however, researchers should be cautious when adopting these tools given the many challenges in using new technologies, as well as threats to participant privacy/confidentiality. Challenges of using e-technologies can be overcome with careful planning, useful partnerships, and forethought. The role of web- and smartphone-based applications is expanding, and the increasing use of those platforms by scientists and the public alike make them tools that cannot be ignored.
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Affiliation(s)
- Carmen Rosa
- National Institutes of Health, National Institute on Drug Abuse, Bethesda, MD, USA.
| | - Aimee N C Campbell
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; Mount Sinai St. Luke's Hospital Department of Psychiatry and Behavioral Health, New York, NY, USA.
| | - Gloria M Miele
- Columbia University College of Physicians and Surgeons, Department of Psychiatry, New York, NY, USA.
| | - Meg Brunner
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA.
| | - Erin L Winstanley
- The James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA.
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Margaria P, Ciuffo M, Rosa C, Turina M. Evidence of a tomato spotted wilt virus resistance-breaking strain originated through natural reassortment between two evolutionary-distinct isolates. Virus Res 2015; 196:157-61. [DOI: 10.1016/j.virusres.2014.11.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 11/11/2014] [Accepted: 11/12/2014] [Indexed: 02/03/2023]
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Seymour J, Horstmann-Dehn L, Rosa C, Lopez J. Occurrence and genotypic analysis of Trichinella species in Alaska marine-associated mammals of the Bering and Chukchi seas. Vet Parasitol 2014; 200:153-64. [DOI: 10.1016/j.vetpar.2013.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 11/13/2013] [Accepted: 11/18/2013] [Indexed: 10/26/2022]
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Rosa C, McCarthy E, Duong K, Hoover G, Moorman G. First Report of the Spittlebug Lepyronia quadrangularis and the Leafhopper Latalus sp. as Vectors of the Elm Yellows Associated Phytoplasma, Candidatus Phytoplasma ulmi in North America. Plant Dis 2014; 98:154. [PMID: 30708602 DOI: 10.1094/pdis-06-13-0628-pdn] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Elm yellows (EY) is a lethal disease of American (Ulmus americana L.) and other elm species (1). On the Pennsylvania State University campus, EY, together with Dutch elm disease, has killed 82 of about 400 mature elms since 2007, the year of first EY detection. Candidatus Phytoplasma ulmi, associated with EY, has been reported to be transmitted by the whitebanded elm leafhopper Scaphoideus luteolus Van Duzee, the meadow spittlebug Philaenus spumarius L., and the leafhopper Allygus atomarius Fabricius (1) in North America, but correlation of these insects with EY in the eastern United States has not been reported. Three Cicadellidae collections using sweep nets and aspirators were performed from July to September 2012 on branches of an EY infected red elm (U. rubra Muh; 40°48.408'N, 77°52.208'W) and on vegetation within a 0.5 km radius. The red elm is in close proximity to trees, shrubs, and a managed meadow and has repeatedly tested positive for EY since 2007. During each collection, about 200 cicadellids were captured in BioQuip No-See-Um catch bags with cups, and the bags were hung around the red elm branches, forcing the insects to feed on the infected tree for 24 h. Insects were transferred to BugDorm rearing tents containing wild grasses, elm seedlings, cowpeas, celery, carrots, and basil, all grown from seed, and were kept for 3 weeks in a controlled environment chamber at 28°C and 70% humidity with a 16-h photoperiod. Insects easily recognized in the same species or individual insects of uncertain identity were then isolated for about 1 week in cages each containing one 6-month-old healthy American elm seedling (grown from seed in growth chamber). Up to 10 morphospecies were found in each collection, with 1 to 20 individuals per morphospecies. The total number of unique morphospecies used in the three transmission trials and later identified as different species was 8. Dead insects collected daily were stored in 80% ethanol and later identified to genus or species level. About 70% insect mortality was recorded, but about 60 individuals from each collection survived the change of diet and environment. After 3 months, individual elm seedlings were tested by RT-PCR (3) for the presence of phytoplasmas using universal primers fU5/rU3 (2). PCR products were visualized on 1.5% agarose gel, and if DNA was amplified, it was cloned and sequenced. Three of 30 seedlings tested positive for phytoplasmas and sequencing of the cloned products (24 clones were sequenced per transformation, per each of the three positive seedlings) confirmed that only Ca. P. ulmi was present in the 3 infected seedlings but not in the remaining 27 or in 46 unexposed control seedlings. The 3 seedlings were each exposed to a single insect and the same insects that were used in the transmission trial were identified. One spittlebug (Cercopidae) Lepyronia quadrangularis Say, one P. spumarius, and one leafhopper in the genus Latalus (Cicadellidae: Deltocephalinae) were identified as vectors. The phytoplasma-positive seedlings showed stunting and yellowing, and died shortly after testing. Other insects captured and identified in the survey were A. atomarius, Neophilaenus lineatus L., Metcalfa pruinosa Say, Amblysellus curtisii Fitch and individuals in the genera Draeculacephala, Elymana, Empoasca, Mesamia, Stroggylocephalus, and Ceratagallia. S. luteolus was not captured during this sampling but was captured on yellow sticky traps and in light traps in previous years at other locations on the campus. This is the first report suggesting that L. quadrangularis and Latalus sp. can serve as natural vectors of EY. References: (1) P. Herath et al. Plant Dis. 94:1355, 2010. (2) H. Lorenz et al. Phytopathology 85:771, 1995. (3) P. Margaria et al. Plant Dis. 91:1496, 2007.
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Affiliation(s)
- C Rosa
- Department of Entomology, The Pennsylvania State University, University Park
| | - E McCarthy
- Department of Entomology, The Pennsylvania State University, University Park
| | - K Duong
- Department of Biology, University of Kentucky, Lexington
| | - G Hoover
- Department of Entomology, The Pennsylvania State University, University Park
| | - G Moorman
- Department of Plant Pathology and Environmental Microbiology, The Pennsylvania State University, University Park
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Kellar NM, Keliher J, Trego ML, Catelani KN, Hanns C, George JCC, Rosa C. Variation of bowhead whale progesterone concentrations across demographic groups and sample matrices. ENDANGER SPECIES RES 2013. [DOI: 10.3354/esr00537] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Rosa C, Ghitza U, Tai B. Selection and utilization of assessment instruments in substance abuse treatment trials: the National Drug Abuse Treatment Clinical Trials Network experience. Subst Abuse Rehabil 2012; 3:81-89. [PMID: 22904649 PMCID: PMC3419495 DOI: 10.2147/sar.s31836] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Based on recommendations from a US Institute of Medicine report, the National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN) in 1999, to accelerate the translation of science-based addiction treatment research into community-based practice, and to improve the quality of addiction treatment, using science as the vehicle. One of the CTN's primary tasks is to serve as a platform to forge bi-directional communications and collaborations between providers and scientists, to enhance the relevance of research, which generates empirical results that impact practice. Among many obstacles in moving research into real-world settings, this commentary mainly describes challenges and iterative experiences in regard to how the CTN develops its research protocols, with focus on how the CTN study teams select and utilize assessment instruments, which can reasonably balance the interests of both research scientists and practicing providers when applied in CTN trials. This commentary also discusses the process by which the CTN further selects a core set of common assessment instruments that may be applied across all trials, to allow easier cross-study analyses of comparable data.
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Affiliation(s)
- Carmen Rosa
- Center for the Clinical Trials Network, National Institute on Drug Abuse, Bethesda, MD, USA
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Greenfield SF, Rosa C, Putnins SI, Green CA, Brooks AJ, Calsyn DA, Cohen LR, Erickson S, Gordon SM, Haynes L, Killeen T, Miele G, Tross S, Winhusen T. Gender research in the National Institute on Drug Abuse National Treatment Clinical Trials Network: a summary of findings. Am J Drug Alcohol Abuse 2011; 37:301-12. [PMID: 21854272 DOI: 10.3109/00952990.2011.596875] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The National Institute of Drug Abuse's National Drug Abuse Treatment Clinical Trials Network (CTN) was established to foster translation of research into practice in substance abuse treatment settings. The CTN provides a unique opportunity to examine in multi-site, translational clinical trials, the outcomes of treatment interventions targeting vulnerable subgroups of women; the comparative effectiveness of gender-specific protocols to reduce risk behaviors; and gender differences in clinical outcomes. OBJECTIVES To review gender-related findings from published CTN clinical trials and related studies from January 2000 to March 2010. METHODS CTN studies were selected for review if they focused on treatment outcomes or services for special populations of women with substance use disorders (SUDs) including those with trauma histories, pregnancy, co-occurring eating and other psychiatric disorders, and HIV risk behaviors; or implemented gender-specific protocols. The CTN has randomized 11,500 participants (41% women) across 200 clinics in 24 randomized controlled trials in community settings, of which 4 have been gender-specific. RESULTS This article summarizes gender-related findings from CTN clinical trials and related studies, focusing on trauma histories, pregnancy, co-occurring eating and other psychiatric disorders, and HIV risk behaviors. CONCLUSIONS These published studies have expanded the evidence base regarding interventions for vulnerable groups of women with SUDs as well as gender-specific interventions to reduce HIV risk behaviors in substance-using men and women. The results also underscore the complexity of accounting for gender in the design of clinical trials and analysis of results. SCIENTIFIC SIGNIFICANCE To fully understand the relevance of gender-specific moderators and mediators of outcome, it is essential that future translational studies adopt more sophisticated approaches to understanding and measuring gender-relevant factors and plan sample sizes that are adequate to support more nuanced analytic methods.
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Abstract
BACKGROUND Recruitment and retention in randomized clinical trials are difficult in general and particularly so in trials of substance abuse treatments. Understanding trial design characteristics that could affect recruitment and retention rates would help in the design of future trials. OBJECTIVE To test whether any of the following factors are associated with recruitment or retention: type of intervention, type of therapy, duration of treatment, total duration of trial, number of treatment sessions, number of follow-up visits, number of primary assessments, timing of primary assessments, number of case report form (CRF) pages at baseline, and number of CRF pages for the entire trial. METHODS Recruitment and retention data from 24 Clinical Trials Network (CTN) trials conducted and completed between 2001 and 2010 were analyzed using single-factor analysis of variance and single-predictor regression methods to test their association with trial design characteristics. RESULTS Almost all of the analyses performed did not show statistically significant patterns between recruitment and retention rates and the trial design characteristics considered. CONCLUSION In CTN trials, the relationship between assessment burden on participants and length of trial, on the one hand, and recruitment and retention, on the other, is not as strong and direct as expected. Other factors must impinge on the conduct of the trial to influence trial participation. SCIENTIFIC SIGNIFICANCE Researchers may deem slightly more justifiable to permit inclusion of some of the design features that previously were assumed to have a strong, negative influence on recruitment and retention, and should consider other strategies that may have a stronger, more direct effect on trial participation.
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Affiliation(s)
- Paul G Wakim
- Center for the Clinical Trials Network, National Institute on Drug Abuse, Bethesda, MD 20892-9557, USA.
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Thomas LR, Rosa C, Forcehimes A, Donovan DM. Research partnerships between academic institutions and American Indian and Alaska Native Tribes and organizations: effective strategies and lessons learned in a multisite CTN study. Am J Drug Alcohol Abuse 2011; 37:333-8. [PMID: 21854275 DOI: 10.3109/00952990.2011.596976] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Community Based and Tribally Based Participatory Research (CBPR/TPR) are approaches that can be successful for developing ethical and effective research partnerships between academic institutions and Tribes and Native organizations. OBJECTIVES The NIDA Clinical Trials Network funded a multi-site, exploratory study using CBPR/TPR to begin to better understand substance abuse issues of concern to some Tribes and Native organizations as well as strengths and resources that exist in these communities to address these concerns. Attention was paid to the development and maintenance of research partnerships in each of the sites. METHODS Each of the five partnerships is briefly described and common as well as unique challenges and successes are identified. RESULTS A summary of the common themes for developing these collaborative research efforts is provided. CONCLUSION True, collaborative research partnerships require a great deal of time and effort in order to develop mutual trust, understanding, knowledge, and collaboration that will guide research that is rigorous as well as ethical, effective, and culturally appropriate. SCIENTIFIC SIGNIFICANCE As AIAN communities become increasingly sophisticated partners in, and consumers of, research, CBPR and TPR are emerging as effective, ethical, culturally appropriate, and acceptable approaches. This can serve to improve the science we engage in with AIAN communities, add to the scarce literature regarding AIAN communities, and better serve AIAN communities in addressing health disparities and improving health.
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Affiliation(s)
- Lisa Rey Thomas
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, 98105-4631, USA.
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Casagrande M, Martella D, Ruggiero MC, Maccari L, Paloscia C, Rosa C, Pasini A. Assessing Attentional Systems in Children with Attention Deficit Hyperactivity Disorder. Arch Clin Neuropsychol 2011; 27:30-44. [DOI: 10.1093/arclin/acr085] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lindblad R, Campanella M, Styers D, Kothari P, Sparenborg S, Rosa C. Strategies for safety reporting in substance abuse trials. Am J Drug Alcohol Abuse 2011; 37:440-5. [PMID: 21854288 DOI: 10.3109/00952990.2011.602996] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Reporting all adverse events (AEs) and serious adverse events (SAEs) in substance use disorder (SUD) clinical trials has yielded limited relevant safety information and has been burdensome to research sites. OBJECTIVE This article describes a new strategy utilizing standard data elements for AE and SAEs that defines a threshold to reduce unnecessary safety reporting burden in SUD clinical trials and describes retrospective review and prospective preliminary data on the strategy's safety reporting impact. METHODS We developed a new strategy to standardize safety reporting and tailor reporting to the trial intervention risk. Protocols and safety data from 17 SUD clinical trials were reviewed. Retrospective analysis of five of these studies and prospective application to new studies is described. RESULTS Across the 17 previously completed trials, a total of 11,220 AEs and 1330 SAEs were reported in the 6737 participants. Wide variability in AE and SAE reporting rates were noted based on trial type and inconsistent reporting strategies. Application of the new, tailored safety strategy retrospectively and prospectively reduces reporting burden of irrelevant safety events. CONCLUSION Comparison of the previous reporting strategies used in SUD trials to the new strategy demonstrates a more consistent safety system with a reduction in safety reporting burden while maintaining appropriate safety monitoring. SCIENTIFIC SIGNIFICANCE Safety assessments should be tailored to the participant risks based on the trial intervention. The current strategies could be applied to safety assessments across all clinical trials in SUDs.
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