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Nabhan M, Egan D, Kreileder M, Zhernovkov V, Timosenko E, Slidel T, Dovedi S, Glennon K, Brennan D, Kolch W. Deciphering the tumour immune microenvironment cell by cell. Immunooncol Technol 2023; 18:100383. [PMID: 37234284 PMCID: PMC10206805 DOI: 10.1016/j.iotech.2023.100383] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Immune checkpoint inhibitors (ICIs) have rejuvenated therapeutic approaches in oncology. Although responses tend to be durable, response rates vary in many cancer types. Thus, the identification and validation of predictive biomarkers is a key clinical priority, the answer to which is likely to lie in the tumour microenvironment (TME). A wealth of data demonstrates the huge impact of the TME on ICI response and resistance. However, these data also reveal the complexity of the TME composition including the spatiotemporal interactions between different cell types and their dynamic changes in response to ICIs. Here, we briefly review some of the modalities that sculpt the TME, in particular the metabolic milieu, hypoxia and the role of cancer-associated fibroblasts. We then discuss recent approaches to dissect the TME with a focus on single-cell RNA sequencing, spatial transcriptomics and spatial proteomics. We also discuss some of the clinically relevant findings these multi-modal analyses have yielded.
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Affiliation(s)
- M. Nabhan
- Systems Biology Ireland, School of Medicine, University College Dublin, Belfield, Ireland
| | - D. Egan
- Systems Biology Ireland, School of Medicine, University College Dublin, Belfield, Ireland
| | - M. Kreileder
- Systems Biology Ireland, School of Medicine, University College Dublin, Belfield, Ireland
| | - V. Zhernovkov
- Systems Biology Ireland, School of Medicine, University College Dublin, Belfield, Ireland
| | - E. Timosenko
- ICC, Research and Early Development, Oncology R&D, AstraZeneca, Cambridge, , UK
| | - T. Slidel
- Oncology Data Science, Research and Early Development, Oncology R&D, AstraZeneca, Cambridge, UK
| | - S. Dovedi
- ICC, Research and Early Development, Oncology R&D, AstraZeneca, Cambridge, , UK
| | - K. Glennon
- UCD Gynaecological Oncology Group, UCD School of Medicine Mater Misericordiae University Hospital, Dublin, Ireland
| | - D. Brennan
- Systems Biology Ireland, School of Medicine, University College Dublin, Belfield, Ireland
- UCD Gynaecological Oncology Group, UCD School of Medicine Mater Misericordiae University Hospital, Dublin, Ireland
| | - W. Kolch
- Systems Biology Ireland, School of Medicine, University College Dublin, Belfield, Ireland
- Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Ireland
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2
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Arrow P, Piggott S, Jamieson L, Brennan D, Tonmukayakul U, Kularatna S, Atkinson D, Nanda S. Dental enamel defects and dental caries of primary teeth among Indigenous children in Western Australia. Aust Dent J 2023; 68:35-41. [PMID: 36461644 PMCID: PMC10952132 DOI: 10.1111/adj.12948] [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] [Accepted: 11/16/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Teeth affected with enamel defects (EDs) are at an increased risk of dental caries. In spite of improving oral health status overall in Australia, Indigenous Australians still experience higher rates of dental caries than non-Indigenous Australians. This study reports on the prevalence of EDs and dental caries experience among Indigenous children in the Kimberley region of Western Australia. METHODS Health status of all the primary teeth (ICDAS II criteria) and the presence of EDs on index teeth (modified Dental Defects of Enamel index; DDE) of young Indigenous children who participated in a 2-arm intervention trial was recorded. Generalized estimating equations were used to estimate the association between EDs and dental caries and effect estimates were presented as odds ratios and associated 95% confidence intervals. RESULTS Person-level prevalence, from 237 children (mean age 3.6 years, standard deviation 1.7) assessed for EDs, was 58% and tooth-level prevalence was 24%. Teeth affected with demarcated or diffuse defects were associated with a twofold higher odds of having caries experience, odds ratio (OR) 2.5, 95% confidence interval (CI) 1.7-3.7 and OR 2.7, 95% CI 1.7-4.0 respectively. CONCLUSIONS The presence of EDs among young Indigenous children was associated with a higher odds of caries experience among affected teeth.
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Affiliation(s)
- P Arrow
- Dental Health ServicesDepartment of HealthPerthWestern AustraliaAustralia
- Dental SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
- Australian Research Centre for Population Oral HealthUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - S Piggott
- Dental Health ServicesDepartment of HealthPerthWestern AustraliaAustralia
| | - L Jamieson
- Australian Research Centre for Population Oral HealthUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - D Brennan
- Australian Research Centre for Population Oral HealthUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - U Tonmukayakul
- Institute for Health TransformationDeakin UniversityGeelongAustralia
| | - S Kularatna
- School of Public Health and Social WorkQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - D Atkinson
- Rural Clinical SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - S Nanda
- Department of HealthPerthWestern AustraliaAustralia
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3
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Gaggi NL, Ware JB, Dolui S, Brennan D, Torrellas J, Wang Z, Whyte J, Diaz-Arrastia R, Kim JJ. Temporal dynamics of cerebral blood flow during the first year after moderate-severe traumatic brain injury: A longitudinal perfusion MRI study. Neuroimage Clin 2023; 37:103344. [PMID: 36804686 PMCID: PMC9969322 DOI: 10.1016/j.nicl.2023.103344] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 02/01/2023] [Accepted: 02/04/2023] [Indexed: 02/13/2023]
Abstract
Traumatic brain injury (TBI) is associated with alterations in cerebral blood flow (CBF), which may underlie functional disability and precipitate TBI-induced neurodegeneration. Although it is known that chronic moderate-severe TBI (msTBI) causes decreases in CBF, the temporal dynamics during the early chronic phase of TBI remain unknown. Using arterial spin labeled (ASL) perfusion magnetic resonance imaging (MRI), we examined longitudinal CBF changes in 29 patients with msTBI at 3, 6, and 12 months post-injury in comparison to 35 demographically-matched healthy controls (HC). We investigated the difference between the two groups and the within-subject time effect in the TBI patients using whole-brain voxel-wise analysis. Mean CBF in gray matter (GM) was lower in the TBI group compared to HC at 6 and 12 months post-injury. Within the TBI group, we identified widespread regional decreases in CBF from 3 to 6 months post-injury. In contrast, there were no regions with decreasing CBF from 6 to 12 months post-injury, indicating stabilization of hypoperfusion. There was instead a small area of increase in CBF observed in the right precuneus. These CBF changes were not accompanied by cortical atrophy. The change in CBF was correlated with change in executive function from 3 to 6 months post-injury in TBI patients, suggesting functional relevance of CBF measures. Understanding the time course of TBI-induced hypoperfusion and its relationship with cognitive improvement could provide an optimal treatment window to benefit long-term outcome.
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Affiliation(s)
- Naomi L Gaggi
- City University of New York (CUNY) School of Medicine, Townsend Harris Hall, 160 Convent Avenue, Convent Avenue, New York, NY 10031, United States; City University of New York (CUNY) Graduate Center, 365 5(th) Avenue, New York, NY 10016, United States.
| | - Jeffrey B Ware
- University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Sudipto Dolui
- University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Daniel Brennan
- City University of New York (CUNY) School of Medicine, Townsend Harris Hall, 160 Convent Avenue, Convent Avenue, New York, NY 10031, United States; City University of New York (CUNY) Graduate Center, 365 5(th) Avenue, New York, NY 10016, United States.
| | - Julia Torrellas
- City University of New York (CUNY) School of Medicine, Townsend Harris Hall, 160 Convent Avenue, Convent Avenue, New York, NY 10031, United States.
| | - Ze Wang
- University of Maryland School of Medicine, 655 W Baltimore St. S, Baltimore, MD 21201, United States.
| | - John Whyte
- Moss Rehabilitation Research Institute, 50 Township Line Road, Elkins Park, PA 19027, United States.
| | - Ramon Diaz-Arrastia
- University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Junghoon J Kim
- City University of New York (CUNY) School of Medicine, Townsend Harris Hall, 160 Convent Avenue, Convent Avenue, New York, NY 10031, United States; City University of New York (CUNY) Graduate Center, 365 5(th) Avenue, New York, NY 10016, United States.
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4
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Tolcher A, Hong D, Vandross A, Amaravadi R, Psoinos C, Brennan D, Sherman M, Ruiz-Soto R, Viswanathan L, Sprott K, Reu F, Weekes C. 450O Initial monotherapy results of a phase I first-in-human study of ULK1/2 inhibitor DCC-3116 alone and in combination with MAPK pathway inhibition. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.579] [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: 11/01/2022] Open
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5
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Chan S, Howell M, Johnson DW, Hawley CM, Tong A, Craig JC, Cao C, Blumberg E, Brennan D, Campbell SB, Francis RS, Huuskes BM, Isbel NM, Knoll G, Kotton C, Mamode N, Muller E, Biostat EMPM, An HPH, Tedesco-Silva H, White DM, Viecelli AK. Critically important outcomes for infection in trials in kidney transplantation: An international survey of patients, caregivers and health professionals. Clin Transplant 2022; 36:e14660. [PMID: 35362617 DOI: 10.1111/ctr.14660] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/07/2022] [Accepted: 03/29/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Infections are a common complication following kidney transplantation, but are reported inconsistently in clinical trials. This study aimed to identify the infection outcomes of highest priority for patients/caregivers and health professionals to inform a core outcome set to be reported in all kidney transplant clinical trials. METHODS In an international online survey, participants rated the absolute importance of 16 infections and 8 severity dimensions on 9-point Likert Scales, with 7-9 being critically important. Relative importance was determined using a best-worst scale. Means and proportions of the Likert-scale ratings and best-worst preference scores were calculated. RESULTS 353 healthcare professionals (19 who identified as both patients/caregiver and healthcare professionals) and 220 patients/caregivers (190 patients, 22 caregivers, 8 who identified as both) from 55 countries completed the survey. Both healthcare professionals and patients/caregivers rated bloodstream (mean 8.4 and 8.5 respectively; aggregate 8.5), kidney/bladder (mean 7.9 and 8.4; aggregate 8.1) and BK virus (mean 8.1 and 8.6; aggregate 8.3) as the top 3 most critically important infection outcomes, whilst infectious death (mean 8.8 and 8.6; aggregate 8.7), impaired graft function (mean 8.4 and 8.7; aggregate 8.5) and admission to the intensive care unit (mean 8.2 and 8.3; aggregate 8.2) were the top 3 severity dimensions. Relative importance (best-worst) scores were consistent. CONCLUSIONS Healthcare professionals and patients/caregivers consistently identified bloodstream infection, kidney/bladder infections and BK virus as the three most important infection outcomes, and infectious death, admission to intensive care unit and infection impairing graft function as the three most important infection severity outcomes. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Samuel Chan
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia
| | - Martin Howell
- Sydney School of Public Health, Faculty of Medicine and Health.,Centre for Kidney Research, The Children's Hospital at Westmead, Australia
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia
| | - Carmel M Hawley
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia
| | - Allison Tong
- Sydney School of Public Health, Faculty of Medicine and Health.,Centre for Kidney Research, The Children's Hospital at Westmead, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Christopher Cao
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Emily Blumberg
- Division of Infectious Diseases, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniel Brennan
- Division of Nephrology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Scott B Campbell
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Ross S Francis
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Brooke M Huuskes
- Centre for Cardiovascular Biology and Disease Research, La Trobe University, Melbourne, Victoria, Australia
| | - Nicole M Isbel
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Greg Knoll
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa
| | - Camille Kotton
- Transplant and Immunocompromised Host Infectious Diseases Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nizam Mamode
- Department of Transplantation, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, United Kingdom
| | - Elmi Muller
- Department of Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Elaine M Pascoe M Biostat
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Ha Phan Hai An
- Department of Internal Medicine, Division of Nephrology, Viet Duc Hospital, Hanoi Medical University, Vietnam
| | - Helio Tedesco-Silva
- Division of Nephrology, Hospital do Rim, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | | | - Andrea K Viecelli
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia
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6
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Ghanbarzadegan A, Balasubramanian M, Luzzi L, Brennan D, Bastani P. A Scoping Review on the Role of Access toward achieving Universal Health Coverage in Oral Health. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.581] [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
Background
Improving access to health services is a way towards achieving Universal Health Coverage (UHC) in oral health. The purpose of this review was to map the determinants of access to dental services within a UHC framework.
Methods
Scoping review methods were adopted for the review. PUBMED, Scopus, ISI Web of Science and ProQuest were searched for academic literature on determinants of access to dental services in OCED countries. Articles published in the last 10 years were included. No restriction was placed on study methods; only articles in the English language were included. Qualitative synthesis was conducted, also including trend analysis and mapping exercise
Results
A total of 4320 articles were identified in the initial search; 60 articles were included in the qualitative synthesis. The results indicate 7 main themes as the determinants of access to dental services: family level, culture, health status, affordability of services, Social environment, geographic and transportation. Defined determinants of access to dental services, family-level factors, culture and geographical access to dental services, can fill the population axis of the UHC cube. Social environment determinants and affordability of services fill the gap of financial protection as another axis of the UHC cube and finally, availability of dental services and the individual's health status are aligned with the appropriateness of services, the third axis of the UHC cube.
Conclusions
This scoping review has identified family-level and cultural, health status, affordability, and availability of services, social environment, and geographic factors contributing towards the inequality in access towards dental services. In addition to considering these main determinants, it is important for policymakers to pay more attention to social and cultural access determinants.
Key messages
An exact definition of access to services should be defined and implemented in the dental literature. Health Policymakers besides considering the derived themes of access into dental services should pay attention to social and cultural access determinants.
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Affiliation(s)
- A Ghanbarzadegan
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - M Balasubramanian
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - L Luzzi
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - D Brennan
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - P Bastani
- Health Human Resources Research Centre, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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7
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Ghanbarzadegan A, Bastani P, Luzzi L, Brennan D. Inequalities in Utilisation and Provision of Dental Services: A Scoping Review. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.274] [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
Background
To explore the main determinants of inequality in both provision and utilisation of dental services in OECD countries.
Methods
Four databases were searched up to 8 Aug 2020 applying the relevant keywords. Thematic analysis was used for synthesizing and extracting data. Trend analysis was applied to determine the trends of the inequality determinants.
Results
Thematic analysis led to 53 sub-sub-themes, 13 sub-themes and 6 main-themes. The main themes represent the main inequality determinants for both utilisation and provision of dental services. The streamgraph illustrates that fewer studies have been conducted on social and cultural determinants, and in almost all determinants the trend of published articles has been increasing since 2007 except for health policies.
Conclusions
Inequality in the utilisation and provision of dental services is addressed by various factors including individual, social, cultural and economic determinants, health policies and availability of services. The first four determinants are related to utilisation and the last two are related to the provision of services. All these aspects must be considered to reduce inequality in dental services.
Key messages
Service Utilisation, Provision and access to service int the dental literature should be distiguished and redefined. Researchers and policymakers should pay attention simultaneously to all structured determinants of inequality in the dental services.
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Affiliation(s)
- A Ghanbarzadegan
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - P Bastani
- Health Human Resources Research Centre, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - L Luzzi
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - D Brennan
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
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8
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Keenan R, Riogh AN, Brennan D, McDonnell C, Morrin M, Davis N, Ferede A, Little D. Size does not matter; Skeletal muscle index is not a predictor of renal function following living donor nephrectomy. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00189-0] [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: 10/20/2022] Open
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9
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Fredette J, Kim T, McHugh D, Gissendaner J, Cherico A, Mapp A, Brennan D, Thundiyil J, Nomura J. A descriptive analysis of emergency medicine resident productivity over the course of training. AEM Educ Train 2021; 5:S44-S48. [PMID: 34616972 PMCID: PMC8480507 DOI: 10.1002/aet2.10679] [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: 03/15/2021] [Revised: 04/27/2021] [Accepted: 04/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The primary objective of emergency medicine (EM) residency training is to develop knowledgeable, procedurally competent, and highly efficient physicians. We aimed to determine current overall productivity statistics and if there is an average rate of productivity change for individual residents as they progress through their training. METHODS This was a retrospective review of EM resident productivity performed at two American Council of Graduate Medical Education-accredited, community-academic residency programs from July 2012 to June 2018. Productivity was defined by relative value units (RVU)/h, RVU/patient, and patients/h. Mixed-effects models for repeated-measures data were used to assess change in outcome over postgraduate year (PGY) levels. The models included the interaction between progressive PGY levels to assess whether there was a pattern of change between each training year. RESULTS A total of 102 unique EM residents were included in the analysis. All three productivity measures increased linearly between PGY levels. However, while each graduating class had linear improvement throughout training, the rates of change were not consistent from one class to the next. Furthermore, a consistent rate of change between PGY for individual residents could not be established. Productivity can increase, decrease, stay the same, or any combination as residents advance through their training. CONCLUSIONS Overall productivity of EM residents increases as they advance through their training. However, there is no consistent pattern of increase from one graduating class to the next and no reliable pattern of change for individual residents. Having increased granularity and understanding of productivity as it relates to individual residents will allow for more enhanced advisement of residents about their current productivity and their anticipated course through residency.
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Affiliation(s)
| | - Tae Kim
- ChristianaCareNewarkDelawareUSA
| | - Daniel McHugh
- ChristianaCareNewarkDelawareUSA
- Present address:
UPMC Pinnacle HarrisburgHarrisburgPennsylvaniaUSA
| | - Jamie Gissendaner
- ChristianaCareNewarkDelawareUSA
- Present address:
Aurora BayCare Medical CenterGreen BayWisconsinUSA
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10
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Brennan D, Wu T, Fan J. Morphometrical Brain Markers of Sex Difference. Cereb Cortex 2021; 31:3641-3649. [PMID: 33774662 DOI: 10.1093/cercor/bhab037] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 08/11/2020] [Revised: 01/22/2021] [Accepted: 02/06/2021] [Indexed: 01/02/2023] Open
Abstract
Many major neuropsychiatric pathologies, some of which appear in adolescence, show differentiated prevalence, onset, and symptomatology across the biological sexes. Therefore, mapping differences in brain structure between males and females during this critical developmental period may provide information about the neural mechanisms underlying the dimorphism of these pathologies. Utilizing a large dataset collected through the Adolescent Brain Cognitive Development study, we investigated the differences of adolescent (9-10 years old) male and female brains (n = 8325) by using a linear Support-Vector Machine Classifier to predict sex based on morphometry and image intensity values of structural brain imaging data. The classifier correctly classified the sex of 86% individuals with the insula, the precentral and postcentral gyri, and the pericallosal sulcus as the most discernable features. These results demonstrate the existence of complex, yet robustly measurable morphometrical brain markers of sex difference.
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Affiliation(s)
- Daniel Brennan
- Department of Psychology, The Graduate Center, The City University of New York, New York, NY 10016, USA
| | - Tingting Wu
- Department of Psychology, Queens College, The City University of New York, Queens, NY 11367, USA
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, Queens, NY 11367, USA
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11
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Knights R, Benayas J, Sabin K, Ng S, Wohlers A, Tijssen T, Demange D, Willms S, Brennan D. Initial testing of an inside-out type palladium membrane reactor for recovery of hydrogen from hydrocarbons or water. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112641] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Jamieson L, Do L, Kapellas K, Chrisopoulos S, Luzzi L, Brennan D, Ju X. Oral health changes among Indigenous and non-Indigenous Australians: findings from two national oral health surveys. Aust Dent J 2021; 66 Suppl 1:S48-S55. [PMID: 33899961 DOI: 10.1111/adj.12849] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Historically, Indigenous Australians experienced poorer oral health than non-Indigenous Australians. We aimed to ascertain if Indigenous Australian oral health improved relative to non-Indigenous oral health between the 2004-06 and 2017-18 National Surveys of Adult Oral Health (NSAOH). METHODS Both NSAOHs were population-based cross-sectional surveys of Australian adults aged 15 years or more. In both surveys, representative samples of adults were drawn through a three-stage, stratified sample design within metropolitan and regional areas in each state/territory. Frequencies of Indigenous and non-Indigenous self-reported and clinical oral health variables were ascertained, and differences were calculated between the 2004-06 and 2017-18 NSAOHs. Ninety-five per cent confidence intervals were calculated and weights were used to account for the complex sampling methodology of both surveys. RESULTS In 2004-06, 229 Indigenous and 13 882 non-Indigenous Australians provided self-report data, and 87 and 5418 of these had dental examinations, respectively. In 2017-18, 334 Indigenous and 15 392 non-Indigenous Australians provided self-report data, and 84 and 4937 of them had dental examinations respectively. Between the surveys, relative to their non-Indigenous counterparts, Indigenous Australians experienced greater levels of: inadequate dentition (4.2%), experience of toothache (4.8%), problem-based dental attendance (4.5%) and 1+ teeth decayed, missing or filled (4.4%). CONCLUSIONS The gap between poor self-reported and clinical oral health between Indigenous and non-Indigenous Australians was greater in the more recent survey.
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Affiliation(s)
- L Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - L Do
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - K Kapellas
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - S Chrisopoulos
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - L Luzzi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - D Brennan
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - X Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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13
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Brennan D, Murrough JW, Morris LS. Intrasubject functional connectivity related to self-generated thoughts. Brain Behav 2021; 11:e01860. [PMID: 33320436 PMCID: PMC7821575 DOI: 10.1002/brb3.1860] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION In psychiatric research, functional connectivity (FC) derived from resting-state functional MRI (rsfMRI) is often used to investigate brain abnormalities in psychiatric disorders. This approach assumes implicitly that FC can recover reliable maps of the functional architecture of the brain and that these profiles of connectivity reflect trait differences underlying pathology. However, evidence of FC related to self-generated thoughts (mind-wandering) stands in contrast with these assumptions, as FC may reflect thought patterns rather than functional architecture. METHODS Multi-factor analysis (MFA) was used to investigate the reported content of self-generated thoughts during high-field (7T) rsfMRI in a repeated sample of 22 healthy individuals. To investigate the relationship between these experiences and FC, individual scores for each of these dimensions were compared with whole-brain connectivity using the network-based statistic (NBS) method. RESULTS This analysis revealed three dimensions of thought content: self-referential thought, negative thoughts about one's surroundings, and thoughts in the form of imagery. A network of connections within the sensorimotor cortices negatively correlated with self-generated thoughts concerning the self was observed (p = .0081, .0486 FDR). CONCLUSION These results suggest a potentially confounding relationship between self-generated thoughts and FC, and contribute to the body of research concerning the functional representation of mind-wandering.
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Affiliation(s)
- Daniel Brennan
- Department of Psychology, Graduate School of Arts & Sciences, NYU, New York, NY, USA
| | - James W Murrough
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine of Mount Sinai, New York, NY, USA
| | - Laurel S Morris
- Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, Icahn School of Medicine of Mount Sinai, New York, NY, USA
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14
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Brennan D. Sarcosine in the management of schizophrenia. Br J Psychiatry 2020; 217:653. [PMID: 33100244 DOI: 10.1192/bjp.2020.172] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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15
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Massie AB, Boyarsky BJ, Werbel WA, Bae S, Chow EK, Avery RK, Durand CM, Desai N, Brennan D, Garonzik-Wang JM, Segev DL. Identifying scenarios of benefit or harm from kidney transplantation during the COVID-19 pandemic: A stochastic simulation and machine learning study. Am J Transplant 2020; 20:2997-3007. [PMID: 32515544 PMCID: PMC7300693 DOI: 10.1111/ajt.16117] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [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: 04/15/2020] [Revised: 05/12/2020] [Accepted: 05/31/2020] [Indexed: 01/25/2023]
Abstract
Clinical decision-making in kidney transplant (KT) during the coronavirus disease 2019 (COVID-19) pandemic is understandably a conundrum: both candidates and recipients may face increased acquisition risks and case fatality rates (CFRs). Given our poor understanding of these risks, many centers have paused or reduced KT activity, yet data to inform such decisions are lacking. To quantify the benefit/harm of KT in this context, we conducted a simulation study of immediate-KT vs delay-until-after-pandemic for different patient phenotypes under a variety of potential COVID-19 scenarios. A calculator was implemented (http://www.transplantmodels.com/covid_sim), and machine learning approaches were used to evaluate the important aspects of our modeling. Characteristics of the pandemic (acquisition risk, CFR) and length of delay (length of pandemic, waitlist priority when modeling deceased donor KT) had greatest influence on benefit/harm. In most scenarios of COVID-19 dynamics and patient characteristics, immediate KT provided survival benefit; KT only began showing evidence of harm in scenarios where CFRs were substantially higher for KT recipients (eg, ≥50% fatality) than for waitlist registrants. Our simulations suggest that KT could be beneficial in many centers if local resources allow, and our calculator can help identify patients who would benefit most. Furthermore, as the pandemic evolves, our calculator can update these predictions.
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Affiliation(s)
- Allan B. Massie
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Brian J. Boyarsky
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - William A. Werbel
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sunjae Bae
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Eric K.H. Chow
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois, USA
| | - Robin K. Avery
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Christine M. Durand
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Niraj Desai
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel Brennan
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Dorry L. Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
- Scientific Registry of Transplant Recipients, Minneapolis, Minnesota, USA
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Arrow P, Piggott S, Carter S, McPhee R, Atkinson D, Mackean T, Kularatna S, Tonmukayakul U, Brennan D, Nanda S, Palmer D, Jamieson L. Atraumatic Restorative Treatments in Australian Aboriginal Communities: A Cluster-randomized Trial. JDR Clin Trans Res 2020; 6:430-439. [PMID: 33016169 DOI: 10.1177/2380084420963949] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The management of early childhood caries (ECC) is challenging. OBJECTIVES A model of care based on Atraumatic Restorative Treatment and the Hall Technique (ART-HT) to manage ECC was evaluated among remote Aboriginal communities in Australia. METHODS Aboriginal communities in the North-West of Western Australia were invited to participate and consenting communities were randomized into early or delayed intervention for the management of ECC. Children were examined at baseline and at the 11-mo follow-up. The early intervention group (test) was provided with the ART-based dental care at baseline while the delayed intervention group (control) was advised to seek care through the usual care options available within the community. At follow-up, both groups were examined by calibrated examiners, and were offered care using the ART-HT approach. Changes from baseline to follow-up in caries experience were tested using paired tests. Multivariate analysis after multiple imputation of missing data used generalised estimating equation (GEE) controlling for clustering within communities. RESULTS A total of 25 communities and 338 children (mean age = 3.6 y, SD 1.7) participated in the study (test = 177). At follow-up, 231 children were examined (68% retention, test = 125). At follow-up, children in the test group had more filled teeth (test filled teeth = 1.2, control filled teeth = 0.2, P < 0.001) and decreased levels of decayed teeth (mean test = 0.7 fewer teeth with decay, mean control = 1.0 more tooth with decay, P < 0.001). GEE analysis controlled for baseline caries experience, age, sex, and community water fluoride levels found increased rates of untreated decayed teeth (RR = 1.4, P = 0.02) and decreased rates of filled teeth (RR = 0.2, P < 0.001) at follow-up among the control group. CONCLUSION A model of care relying on the principles of minimally invasive atraumatic approaches enabled the delivery of effective dental services to young children (<6 y) in remote Aboriginal Australian communities resulting in increased levels of care and improved oral health. KNOWLEDGE TRANSFER STATEMENT This cluster-randomized trial tested a multi-component model of dental care to young children with ECC in remote Aboriginal communities in Australia. The intervention, based on the atraumatic approaches using minimally invasive techniques encompassing preventive care, Atraumatic Restorative Treatment and the Hall Technique (ART-HT), delivered more restorative care and reduced the incidence of caries. This model of care was more effective than available standard care and should be incorporated into mainstream service delivery programs.
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Affiliation(s)
- P Arrow
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia.,Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - S Piggott
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia
| | - S Carter
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia
| | - R McPhee
- Kimberley Aboriginal Medical Services, Broome, Australia
| | - D Atkinson
- Rural Clinical School of Western Australia, University of Western Australia, Broome, Australia
| | - T Mackean
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, South Australia, Australia
| | - S Kularatna
- Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - U Tonmukayakul
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia
| | - D Brennan
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - S Nanda
- Health Department Western Australia, Office of Chief Dental Officer, Perth, Australia
| | - D Palmer
- Community Development, Community Development, Murdoch University, Perth, Australia
| | - L Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
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Wong M, Brennan D, Gaillard F. Unusual enhancement patterns from inadvertent arterial contrast injection during CT angiography. J Clin Neurosci 2020; 78:406-408. [PMID: 32360165 DOI: 10.1016/j.jocn.2020.04.094] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022]
Abstract
Investigation of cerebrovascular incidents typically involve non-contrast intracranial computed tomography (CT) and CT angiography (CTA) of the arch of aorta to vertex with or without CT perfusion. Though rare, inadvertent direct arterial contrast injection is a potentially serious complication which can alter contrast distribution and timing resulting in non-diagnostic intracranial studies. If unnoticed, they can be misinterpreted as pathology leading to further unnecessary investigations, increasing patient radiation dose and delaying appropriate management. To date, there have been two documented case reports describing arterial contrast injection in cerebral CTA or CT perfusion. We describe two further cases of arterial contrast administration. Furthermore, by describing various contrast enhancement patterns in normal and variant anatomy - such as bovine aortic arch, vertebral artery dominance, posterior inferior cerebellar artery (PICA) continuation of vertebral artery and fetal posterior communicating artery (PCOM) - we hope to improve clinician recognition of inadvertent arterial contrast injection in a timely fashion.
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Affiliation(s)
- Monica Wong
- Radiology Department, Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia
| | - Daniel Brennan
- Radiology Department, Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia
| | - Frank Gaillard
- Radiology Department, Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry, and Health Sciences at the University of Melbourne, Parkville, Melbourne, Victoria, Australia.
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18
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Mulligan K, Egan S, Brennan D, O’Meara Y, O’Toole S. Doctor-Patient Communication in an Outpatient Setting. Ir Med J 2019; 112:934. [PMID: 31411016] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Aim To evaluate doctor patient communication within gynaecological oncology services in Ireland. Methods An anonymous and confidential 20 question survey was designed by the patient advocacy group ISGOPPI and distributed in three gynaecological oncology outpatient clinics in tertiary referral centres. Results A total of 84 patients completed the survey in the 3 Dublin hospitals. Doctors surveyed ranged from senior house officer to consultant level. Overall women were very satisfied with the communication they had received from their doctor. 85% felt that they the doctor listened to them and took their opinion into account. 84% of patients felt that the doctor’s body language was appropriate throughout the consultation. One of the main issues for women surveyed was waiting times. 33% of women waited over an hour to see their doctor and over 30% of women did not receive contact details of the clinical nurse specialist. Conclusion Overall our study shows that patients in gynae-oncology clinics are satisfied with the communication from their doctors. The main issues for patients were waiting times and contact details for follow up questions.
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Affiliation(s)
- K Mulligan
- Catherine McCauley education and research institute, Eccles Street, Dublin 1
| | - S Egan
- UCD School of medicine, Belfield, Dublin 4
| | - D Brennan
- Catherine McCauley education and research institute, Eccles Street, Dublin 1
| | - Y O’Meara
- Departments of Obstetrics and Gynaecology/Histopathology, School of medicine, Trinity College Dublin, Dublin 2
| | - S O’Toole
- Departments of Obstetrics and Gynaecology/Histopathology, School of medicine, Trinity College Dublin, Dublin 2
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19
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Kutaiba N, Richmond D, Morey M, Brennan D, Rotella JA, Ardalan Z, Goodwin M. Incidental hepatic steatosis on unenhanced computed tomography performed for suspected renal colic: Gaps in reporting and documentation. J Med Imaging Radiat Oncol 2019; 63:431-438. [PMID: 30874372 DOI: 10.1111/1754-9485.12873] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 11/25/2018] [Accepted: 02/17/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Hepatic steatosis is a common incidental finding on computed tomography (CT) in patients presenting to the emergency department (ED). The aims of our study were to assess the prevalence of hepatic steatosis in ED patients with suspected renal colic and to assess documentation in radiology reports and medical charts correlated with alanine transaminase (ALT) levels. METHODS Over 18 months from January 2016 to June 2017, all unenhanced CTs performed for suspected renal colic were reviewed. Quantitative assessment measuring hepatic and splenic attenuation in Hounsfield Units was performed. Hepatic steatosis was defined using multiple CT criteria including liver/spleen (L/S) ratio. Radiology reports, medical charts and ALT levels, if collected within 24 h of CT, were reviewed. RESULTS A total of 1290 patients were included with a median age 52.5 years (range 16-98) and male predominance (835 [64.7%]). A total of 336 (26%) patients had hepatic steatosis measured by L/S ratio of ≤ 1.0. Ninety-four patients (28%) had radiology reports noting steatosis. Documentation in medical charts was noted in 18 of the 94 patients (19.1%) for whom steatosis was reported. Liver enzymes were available for 704 (54.6%) patients. There was a significantly higher mean ALT level in patients with hepatic steatosis (42.2 U/L; 95% CI 38.4-46.0) compared to patients without (28.8 U/L; 95% CI 25.7-31.9) (P < 0.0001). CONCLUSION Our findings highlight multiple gaps in the reporting and evaluation of hepatic steatosis among radiologists and emergency clinicians alike. Recognising and reporting this incidental finding may impact health outcomes.
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Affiliation(s)
- Numan Kutaiba
- Radiology Department, Austin Health, Melbourne, Victoria, Australia
| | | | - Matthew Morey
- Radiology Department, Austin Health, Melbourne, Victoria, Australia
| | - Daniel Brennan
- Radiology Department, Austin Health, Melbourne, Victoria, Australia
| | - Joe-Anthony Rotella
- Emergency Department, Austin Health, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
| | - Zaid Ardalan
- Gastroenterology Department, Austin Health, Melbourne, Victoria, Australia.,Gastroenterology Department, Alfred Health and Monash University, Melbourne, Victoria, Australia
| | - Mark Goodwin
- Radiology Department, Austin Health, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
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20
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McCausland D, McCallion P, Brennan D, McCarron M. The exercise of human rights and citizenship by older adults with an intellectual disability in Ireland. J Intellect Disabil Res 2018; 62:875-887. [PMID: 30125431 DOI: 10.1111/jir.12543] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 04/30/2018] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The UN Convention on the Rights of Persons with Disabilities (CRPD) provides the benchmark for assessing human rights and citizenship for people with disabilities. This emphasises autonomy, choice, independence, equality and participation for individuals as its fundamental guiding principles. METHODS This paper explores the exercise of human rights and citizenship for older adults with intellectual disabilities (ID) in Ireland, including choice-making, advocacy and political participation. Cross-sectional data (n = 701) is drawn from wave 2 of the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing. Rates of participation are reported, along with bivariate associations across a range of demographic, personal and social variables, while factors associated with level of choice-making and voting are explored. RESULTS We found very low rates of choice-making, advocacy and political participation amongst this population. Two factors of choice were explored: key life choice and everyday choice. Some commonalities were identified between the two factors, yet key differences were also noted. Type of residence was the strongest predictor of key life choice yet not significant in everyday choice, while the reverse was true for functioning in activities of daily living. Other factors were also significant in determining choice, including level of ID, contact with family, functional limitation, literacy, age, having friends and respondent type. CONCLUSIONS Low rates of participation reported here impinge on the rights of older adults with ID under the principles of the UN CRPD. Choice-making emerged as a multi-factorial phenomenon, with different factors important depending on the type of choice involved. This encourages a nuanced and personalised response from policy and support services to overcome individual challenges to participation as equal citizens. The significance of respondent type also highlights the difficulty of including self-report, supported and proxy participants in ID research.
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Affiliation(s)
- D McCausland
- IDS-TILDA, School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - P McCallion
- School of Social Work, Temple University, Philadelphia, PA, USA
| | - D Brennan
- School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - M McCarron
- Faculty of Health Sciences, Trinity College, Dublin 2, Ireland
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21
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Wilkinson M, Brennan D. Ovarian Cancer Screening Editorial. Ir Med J 2018; 111:798. [PMID: 30547506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- M Wilkinson
- Mater Misericordiae Hospital, Eccles St., Dublin 7
- The Conway Institute, University College Dublin, Belfield Dublin 4
| | - D Brennan
- Mater Misericordiae Hospital, Eccles St., Dublin 7
- The Conway Institute, University College Dublin, Belfield Dublin 4
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22
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Beauchamp K, Ryan G, Gibney B, Walsh T, Brennan D. A Borderline Ovarian Tumour in a Patient with Classic Bladder Exstrophy; a Case Report. Ir Med J 2018; 111:695. [PMID: 29952444] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 37-year-old Romanian lady presented with a large pelvic mass, urosepsis and deteriorating renal function. She had undergone separation from her conjoined twin. Imaging revealed grossly abnormal anatomy and a suspicious pelvic mass. Examination was consistent with classic bladder exstrophy. Postoperative histology showed borderline ovarian tumour (BTO).
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Affiliation(s)
- K Beauchamp
- Mater Misericordiae University Hospital Dublin
| | - G Ryan
- Mater Misericordiae University Hospital Dublin
| | - B Gibney
- Mater Misericordiae University Hospital Dublin
| | - T Walsh
- Mater Misericordiae University Hospital Dublin
| | - D Brennan
- Mater Misericordiae University Hospital Dublin
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23
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Halloran PF, Reeve J, Akalin E, Aubert O, Bohmig GA, Brennan D, Bromberg J, Einecke G, Eskandary F, Gosset C, Duong Van Huyen JP, Gupta G, Lefaucheur C, Malone A, Mannon RB, Seron D, Sellares J, Weir M, Loupy A. Real Time Central Assessment of Kidney Transplant Indication Biopsies by Microarrays: The INTERCOMEX Study. Am J Transplant 2017; 17:2851-2862. [PMID: 28449409 DOI: 10.1111/ajt.14329] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [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: 02/08/2017] [Revised: 04/13/2017] [Accepted: 04/14/2017] [Indexed: 01/25/2023]
Abstract
The authors conducted a prospective trial to assess the feasibility of real time central molecular assessment of kidney transplant biopsy samples from 10 North American or European centers. Biopsy samples taken 1 day to 34 years posttransplantation were stabilized in RNAlater, sent via courier overnight at ambient temperature to the central laboratory, and processed (29 h workflow) using microarrays to assess T cell- and antibody-mediated rejection (TCMR and ABMR, respectively). Of 538 biopsy samples submitted, 519 (96%) were sufficient for microarray analysis (average length, 3 mm). Automated reports were generated without knowledge of histology and HLA antibody, with diagnoses assigned based on Molecular Microscope Diagnostic System (MMDx) classifier algorithms and signed out by one observer. Agreement between MMDx and histology (balanced accuracy) was 77% for TCMR, 77% for ABMR, and 76% for no rejection. A classification tree derived to provide automated sign-outs predicted the observer sign-outs with >90% accuracy. In 451 biopsy samples where feedback was obtained, clinicians indicated that MMDx more frequently agreed with clinical judgment (87%) than did histology (80%) (p = 0.0042). In 81% of feedback forms, clinicians reported that MMDx increased confidence in management compared with conventional assessment alone. The authors conclude that real time central molecular assessment is feasible and offers a useful new dimension in biopsy interpretation. ClinicalTrials.gov NCT#01299168.
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Affiliation(s)
- P F Halloran
- Alberta Transplant Applied Genomics Centre, Edmonton, AB, Canada.,Division of Nephrology and Transplant Immunology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - J Reeve
- Alberta Transplant Applied Genomics Centre, Edmonton, AB, Canada
| | - E Akalin
- Montefiore Medical Center, Bronx, NY
| | - O Aubert
- Paris Translational Research Center for Organ Transplantation, INSERM, Uss-S970, Paris, France
| | - G A Bohmig
- Medizinische Universität Wien, Vienna, Austria
| | - D Brennan
- Washington University at St. Louis, St. Louis, MO
| | - J Bromberg
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - G Einecke
- Medizinische Hochschule Hannover, Hannover, Germany
| | - F Eskandary
- Medizinische Universität Wien, Vienna, Austria
| | - C Gosset
- Paris Translational Research Center for Organ Transplantation, INSERM, Uss-S970, Paris, France.,Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - J-P Duong Van Huyen
- Paris Translational Research Center for Organ Transplantation, INSERM, Uss-S970, Paris, France
| | - G Gupta
- Virginia Commonwealth University, Richmond, VA
| | - C Lefaucheur
- Paris Translational Research Center for Organ Transplantation, INSERM, Uss-S970, Paris, France.,Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - A Malone
- Washington University at St. Louis, St. Louis, MO
| | - R B Mannon
- University of Alabama at Birmingham, Birmingham, AL
| | - D Seron
- Hospital Universitari Vall D'Hebron, Barcelona, Spain
| | - J Sellares
- Hospital Universitari Vall D'Hebron, Barcelona, Spain
| | - M Weir
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - A Loupy
- Paris Translational Research Center for Organ Transplantation, INSERM, Uss-S970, Paris, France.,Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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Mohan S, Wilkinson M, Cotter M, Brennan D, O'Brien D. Achieving Equipoise in Cytoreductive Surgery for a Large Pelvic Mass. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.147] [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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Affiliation(s)
- C.A. Emlet
- Social Work, University of Washington, Tacoma, Washington,
- McMaster University, Hamilton, Ontario, Canada,
| | - L.M. Harris
- University of Louisville, Louisville, Kentucky,
| | - D. Brennan
- University of Toronto, Toronto, Ontario, Canada,
| | - C. Furlotte
- McMaster University, Hamilton, Ontario, Canada,
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Perevezentsev A, Bell A, Brennan D, Miller A, Healer A, Gentile C, Ciebiera L, Langish S. Detritiation of the JET Carbon Tiles by Flame Heating. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-42] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- A. Perevezentsev
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB, UK
| | - A. Bell
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB, UK
| | - D. Brennan
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB, UK
| | - A. Miller
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB, UK
| | - A. Healer
- EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB, UK
| | - C. Gentile
- Princeton Plasma Physics Laboratory, Princeton University, PO Box 451, Princeton, New Jersey, 08453, USA
| | - L. Ciebiera
- Princeton Plasma Physics Laboratory, Princeton University, PO Box 451, Princeton, New Jersey, 08453, USA
| | - S. Langish
- Princeton Plasma Physics Laboratory, Princeton University, PO Box 451, Princeton, New Jersey, 08453, USA
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Coad JP, Rubel M, Bekris N, Brennan D, Hole D, Likonen J, Vainonen-Ahlgren E. Distribution of Hydrogen Isotopes, Carbon and Beryllium on In-Vessel Surfaces in the Various JET Divertors. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a985] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- J. P. Coad
- EURATOM / UKAEA Fusion Association, Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - M. Rubel
- Alfvén Laboratory, Royal Institute of Technology, Association EURATOM-VR, 100 44 Stockholm, Sweden
| | - N. Bekris
- Tritium Laboratory, Forschungszentrum Karlsruhe, Association EURATOM, D-76021, Karlsruhe, Germany
| | - D Brennan
- EURATOM / UKAEA Fusion Association, Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - D. Hole
- School of Mathematical and Physical Sciences, University of Sussex, BN1 9QH Brighton, United Kingdom
| | - J. Likonen
- VTT Processes, Association EURATOM-TEKES, P.O. Box 1608, 02044 VTT, Finland
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Loarer T, Bucalossi J, Brennan D, Grisolia C, Matthews G, Morgan P, Philipps V, Stamp M. Fuel Retention over a Full Day of Experiments in JET. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T Loarer
- Association EURATOM-CEA, DSM-DRFC, CEA Cadarache, 13108 St Paul lez Durance, France.
| | - J Bucalossi
- Association EURATOM-CEA, DSM-DRFC, CEA Cadarache, 13108 St Paul lez Durance, France.
| | - D Brennan
- Euratom-UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3EA, UK
| | - C Grisolia
- Association EURATOM-CEA, DSM-DRFC, CEA Cadarache, 13108 St Paul lez Durance, France.
| | - G Matthews
- Euratom-UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3EA, UK
| | - Ph Morgan
- Euratom-UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3EA, UK
| | - V Philipps
- IPP, Forschungszentrum Juelich, D-52425 Juelich, Germany
| | - M Stamp
- Euratom-UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3EA, UK
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Day C, Brennan D, Camp P, Jensen HS, Jones G, Mack A, Miller A. Performance of ITER-Relevant Cryopump Panels for Tritiated Gases. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a873] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Chr. Day
- Forschungszentrum Karlsruhe, PO Box 3640, 76021 Karlsruhe, Germany
| | - D. Brennan
- EURATOM-UKAEA Association, Culham Science Centre, Abingdon OX14 43DB, UK
| | - P. Camp
- EURATOM-UKAEA Association, Culham Science Centre, Abingdon OX14 43DB, UK
| | - H. S. Jensen
- Forschungszentrum Karlsruhe, PO Box 3640, 76021 Karlsruhe, Germany
| | - G. Jones
- EURATOM-UKAEA Association, Culham Science Centre, Abingdon OX14 43DB, UK
| | - A. Mack
- Forschungszentrum Karlsruhe, PO Box 3640, 76021 Karlsruhe, Germany
| | - A. Miller
- EURATOM-UKAEA Association, Culham Science Centre, Abingdon OX14 43DB, UK
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King P, Butters J, Psaltis P, Brown A, Brennan D, Nicholls S. Incidence of Early Cardiovascular Events Following Acute Coronary Syndromes in Men and Women: Insights From VISTA-16. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.635] [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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Brennan D, Warrington K, Schmidt J, Crowson C, Koster M. FRI0354 Cardiopulmonary Involvement in Takayasu Arteritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5156] [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: 11/04/2022]
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Jones K, Brennan D, Parker E, Steffens M, Jamieson L. Are oral health-related self-efficacy, knowledge and fatalism indicators for non-toothbrush ownership in a homeless population? Community Dent Health 2016; 33:48-53. [PMID: 27149774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To determine if the social cognitive theory (SCT)-constructs of oral health-related efficacy, knowledge and fatalism were indicators of non-toothbrush ownership in a metropolitan-based homeless population in Australia. METHODS Self-report data were collected from a convenience sample of 248 homeless participants located in Adelaide, Australia. Log binomial regression was used to estimate the strength of the association of the SCT constructs efficacy, knowledge and fatalism with the frequency of non-ownership of a toothbrush before and after adjusting for selected characteristics and associated factors. RESULTS Of the study population (aged 17-78 years, 79% male) just over one-fifth (21%) did not own a toothbrush. In an unadjusted model, low self-efficacy (PR = 1.18) and low knowledge (1.27) were indicators for non-toothbrush ownership. These relationships were attenuated by 5.2% and 3.2% respectively after adjusting for social determinants, health factors, substance use and dental service utilisation-related factors, but remained statistically significant in the final model. CONCLUSIONS Poor oral health-related self-efficacy and knowledge were both indicators for non-ownership of a toothbrush among a homeless population. This relationship held even after adjustment for relevant social and behavioural factors. Fatalism was not an indicator for non-toothbrush ownership in this population.
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Java A, Edwards A, Rossi A, Pandey R, Gaut J, Delos Santos R, Miller B, Klein C, Brennan D. Cytomegalovirus-induced thrombotic microangiopathy after renal transplant successfully treated with eculizumab: case report and review of the literature. Transpl Int 2015; 28:1121-5. [PMID: 25864519 DOI: 10.1111/tri.12582] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [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: 02/05/2015] [Revised: 03/09/2015] [Accepted: 04/07/2015] [Indexed: 01/28/2023]
Abstract
De novo thrombotic microangiopathy (TMA) after renal transplant is rare. Cytomegalovirus (CMV)-related post-transplant TMA has only been reported in 6 cases. We report an unusual case of a 75-year-old woman who developed de novo TMA in association with CMV viremia. The recurrence of TMA with CMV viremia, the resolution with treatment for CMV, and the lack of correlation with a calcineurin inhibitor (CNI) in our case support CMV as the cause of the TMA. What is unique is that the use of eculizumab without plasmapheresis led to prompt improvement in renal function. After a failure to identify a genetic cause for TMA and the clear association with CMV, eculizumab was discontinued. This case provides insight into the pathogenesis and novel treatment of de novo TMA, highlights the beneficial effects of complement inhibitors in this disease, and shows that they can be safely discontinued once the inciting etiology is addressed.
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Affiliation(s)
- Anuja Java
- Department of Transplant Nephrology, Washington University School of Medicine, St. Louis, MO, USA
| | - Angelina Edwards
- Department of Transplant Nephrology, Washington University School of Medicine, St. Louis, MO, USA
| | - Ana Rossi
- Department of Transplant Nephrology, Washington University School of Medicine, St. Louis, MO, USA
| | - Richa Pandey
- Department of Transplant Nephrology, Washington University School of Medicine, St. Louis, MO, USA
| | - Joseph Gaut
- Department of Pathology, Washington University School of Medicine, St. Louis, MO, USA
| | - Rowena Delos Santos
- Department of Transplant Nephrology, Washington University School of Medicine, St. Louis, MO, USA
| | - Brent Miller
- Department of Transplant Nephrology, Washington University School of Medicine, St. Louis, MO, USA
| | - Christina Klein
- Department of Transplant Nephrology, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel Brennan
- Department of Transplant Nephrology, Washington University School of Medicine, St. Louis, MO, USA
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Hackethal A, Brennan D, Rao A, Land R, Obermair A, Nicklin J, Garrett A, Nascimento M, Crandon A, Perrin L, Chetty N. Consideration for safe and effective gynaecological laparoscopy in the obese patient. Arch Gynecol Obstet 2014; 292:135-41. [DOI: 10.1007/s00404-014-3600-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 12/11/2014] [Indexed: 12/22/2022]
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Hawkes AL, Quinn M, Gebski V, Armes J, Brennan D, Janda M, Obermair A. Improving treatment for obese women with early stage cancer of the uterus: rationale and design of the levonorgestrel intrauterine device ± metformin ± weight loss in endometrial cancer (feMME) trial. Contemp Clin Trials 2014; 39:14-21. [PMID: 24999075 DOI: 10.1016/j.cct.2014.06.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [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: 04/06/2014] [Revised: 06/18/2014] [Accepted: 06/24/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Endometrial adenocarcinoma (EC) is the most common gynaecologic cancer. Up to 90% of EC patients are obese which poses a health threat to patients post-treatment. Standard treatment for EC includes hysterectomy, although this has significant side effects for obese women at high risk of surgical complications and for women of childbearing age. This trial investigates the effectiveness of non-surgical or conservative treatment options for obese women with early stage EC. The primary aim is to determine the efficacy of: levonorgestrel intrauterine device (LNG-IUD); with or without metformin (an antidiabetic drug); and with or without a weight loss intervention to achieve a pathological complete response (pCR) in EC at six months from study treatment initiation. The secondary aim is to enhance understanding of the molecular processes and to predict a treatment response by investigating EC biomarkers. METHODS An open label, three-armed, randomised, phase-II, multi-centre trial of LNG-IUD ± metformin ± weight loss intervention. 165 participants from 28 centres are randomly assigned in a 3:3:5 ratio to the treatment arms. Clinical, quality of life and health behavioural data will be collected at baseline, six weeks, three and six months. EC biomarkers will be assessed at baseline, three and six months. CONCLUSIONS There is limited prospective evidence for conservative treatment for EC. Trial results could benefit patients and reduce health system costs through a reduction in hospitalisations and through lower incidence of adverse events currently observed with standard treatment.
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Affiliation(s)
- A L Hawkes
- School of Public Health and Social Work, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - M Quinn
- Royal Women's Hospital Royal Women's Hospital, Melbourne, Victoria, Australia
| | - V Gebski
- National Health and Medical Research Council Clinical Trials Centre, Sydney, New South Wales, Australia
| | - J Armes
- Pathology, Mater Adult Hospital, South Brisbane, Queensland, Australia
| | - D Brennan
- Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - M Janda
- School of Public Health and Social Work, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - A Obermair
- School of Public Health and Social Work, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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Jones K, Parker E, Mills H, Brennan D, Jamieson LM. Development and psychometric validation of a Health Literacy in Dentistry scale (HeLD). Community Dent Health 2014; 31:37-43. [PMID: 24741892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Oral health literacy is emerging as a new public health challenge and poor oral health literacy is increasingly seen as an important predictor of poor oral health outcomes. Within Indigenous populations, there may be benefits to research in using a culturally acceptable, internally consistent and valid instrument to assess oral health literacy. We translated a general health literacy measure, the Health Literacy Management (HeLM) scale to make a dentally relevant scale; Health Literacy in Dentistry (HeLD). OBJECTIVE This study describes the development and assessment of the reliability and validity of the HeLD in an Indigenous Australian population. DESIGN AND METHODS The 29 item HeLD scale assesses the components of oral health literacy. The reliability and validity of the seven HeLD subscales were evaluated in a convenience sample of 209 Indigenous Australians with mean age 35 years (range 17-81) and of which 139 were female. RESULTS The scale was supported by exploratory factor analysis and established seven distinct and internally consistent domains of oral health literacy: Communication, Access, Receptivity, Understanding, Utilisation, Support and Economic Barriers (Cronbach's alpha = 0.91). Discriminative ability was confirmed by HeLD associations with socio-demographic variables and self-reported health ratings in the expected direction. The convergent validity and predictive validity were confirmed by HeLD scores being significantly associated with toothbrush ownership, use of a toothbrush, time since last dental visit and knowledge of the effect of cordial on the teeth. CONCLUSIONS The HeLD appears to be an internally valid and reliable instrument and can be used for measuring oral health literacy among rural Indigenous Australian adults.
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O’ Connor K, Brennan D, O’ Loughlin K, Wilson L, Pillay D, Clarke M, Casey P, Malone K, Lane A. Attitudes towards patients with mental illness in Irish medical students. Ir J Med Sci 2013; 182:679-85. [DOI: 10.1007/s11845-013-0955-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 04/11/2013] [Indexed: 12/19/2022]
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Daly E, Brennan D, Dowling S, Plant G. What do general practitioners think of the new professional competence scheme? Ir Med J 2012; 105:114-115. [PMID: 22708225] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The Irish Medical Practitioners Act 2007 places a statutory obligation on all registered Medical Practitioners to maintain their professional competence by participating in a recognised Professional Competence Scheme. A questionnaire survey was conducted among 48 GPs attending educational meetings to see if doctors had concerns about the Professional Competence Scheme and to ask if they felt they had the necessary time, skills and knowledge to carry out an audit. Twenty-eight GPs (58%) had concerns regarding their participation in the Professional Competence Scheme; 75% were concerned about the time required, and 67% felt they needed further education about the scheme. Although 73% of doctors reported that they understand how to undertake a clinical audit and 50% reported they have carried out an audit in practice, 60% have never had any teaching on audit and 85% would like teaching in this area. Only 48% of the group surveyed felt that audit was practical in their current practice. Doctors have some concerns about the new Professional Competence Scheme, including the audit component. In particular, they report a requirement for more teaching in this area, and are concerned about the time involved.
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Affiliation(s)
- E Daly
- South Eastern GP Training Scheme, Waterford Regional Hospital, Dunmore Rd, Waterford
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Shireen R, Brennan D, Flannelly G, Fennelly D, Lenehan P, Foley M. Survival in women with ovarian cancer before and after the introduction of adjuvant paclitaxel; a 25-year, single institution review. Ir Med J 2012; 105:47-50. [PMID: 22455239] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Adjuvant chemotherapy regime for ovarian cancer patients remains to be a contentious issue. The aim of this study was to compare the overall and progression-free survival of women with ovarian cancer before and after introduction of paclitaxel in our unit in 1992. A sample of 112 women who received adjuvant therapy following surgery for ovarian cancer was collected, 68 (61%) received platinum+alkylating agent before 1992 and later 44 (39%) received platinum+paclitaxel. Five-year survival was same in both treatment groups when there was no macroscopic disease after surgery (78% versus 70%) and when residual disease was <2 cm (50% versus 40%). Survival was greater in women with residual disease >2 cm in the platinum+paclitaxel group (50% versus 24%), (p = 0.04). However, progression-free survival was similar in both groups irrespective of stage or residual volume of disease. Therefore consideration to selective use of paclitaxel could reduce patient morbidity and costs significantly.
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Affiliation(s)
- R Shireen
- Department of Obstetrics, National Maternity Hospital, Holles St., Dublin 2
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Su Y, Li J, Witkiewicz AK, Brennan D, Neill T, Talarico J, Radice GL. N-cadherin haploinsufficiency increases survival in a mouse model of pancreatic cancer. Oncogene 2011; 31:4484-9. [PMID: 22158044 DOI: 10.1038/onc.2011.574] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Pancreatic ductal adenocarcinoma (PDA) is often detected at a late stage, hence the identification of new therapies that have potential to block tumor progression is critical for this lethal disease. N-cadherin upregulation has been observed in many cancers including PDA, however, a causal role for this cell adhesion receptor in disease progression has yet to be defined. The concomitant expression of oncogenic Kras(G12D) and mutant p53 (Trp53(R172H)) in the murine pancreas results in metastatic PDA that recapitulates the cognate features of human pancreatic cancer providing an excellent animal model to identify genes required for tumor progression. Here we determine the consequences of genetically manipulating N-cadherin expression in a mouse model of PDA. Remarkably, mice with reduced N-cadherin expression (that is, Ncad(-/+)) survived 25% longer (177 vs 142 days, P<0.05) than animals expressing two wild-type N-cadherin (Cdh2) alleles. The survival benefit is likely due to a cumulative effect of N-cadherin's role in different aspects of tumorigenesis including tumor-cell survival, growth, migration and invasion. Interestingly, reduced hedgehog signaling may contribute to the better prognosis for the Ncad(-/+) mice. Moreover, the matrix metalloproteinase MMP-7, associated with poor prognosis in PDA, was reduced in Ncad(-/+) tumors. Finally, Ncad(-/+) tumor cells exhibited decreased FGF-stimulated ERK1/2 activation consistent with N-cadherin's ability to promote FGFR signaling. These data support a critical role for N-cadherin in PDA and its potential prognostic value. Additionally, this study provides in vivo genetic evidence that the cell-surface protein N-cadherin represents a promising therapeutic target for the treatment of pancreatic cancer.
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Affiliation(s)
- Y Su
- Department of Medicine, Center for Translational Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Abstract
This paper considers the processes through which historical narratives are shaped. Interest in this area emerged from the author's struggle to understand contemporary mental health nursing in Ireland, and to situate this profession within its historical context and trajectory. It is argued that both the historical narrative and contemporary image of Irish mental health nursing are heavily influenced by the methodologies adopted by historians working in this area. The 'progressive historical approach', which remains the predominant methodological tradition adopted in nursing history, is firstly considered in this paper. The limitations of this approach are explored and an 'interpretive historical approach' is suggested as methodological counterpoint to the progressive tradition. 'Critical perspectives' are also considered and contextualized with reference to interpretive schools of thought. It is proposed that a fusion of the interpretive and critical approaches can offer a sound theoretical basis for the development of contemporary histories of nursing that transcends progressive narratives of altruistic caring interventions.
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Affiliation(s)
- D Brennan
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland.
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Lyon C, Papa L, Ramirez J, Brennan D, Morgan K. 286 Resource Utilization in Local versus Non-local Patients in a Pediatric Emergency Department. Ann Emerg Med 2011. [DOI: 10.1016/j.annemergmed.2011.06.316] [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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Bruno M, Brennan D, Redpath MB, Bowens G, Murphy J, Love B, Gilleece A, O'Neill E. Peripheral-venous-catheter-related Staphylococcus aureus bacteraemia: a multi-factorial approach to reducing incidence. J Hosp Infect 2011; 79:173-4. [PMID: 21741116 DOI: 10.1016/j.jhin.2011.04.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 04/26/2011] [Indexed: 11/30/2022]
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Rashedi N, Brennan D, Kastelein J, Nissen S, Nicholls S. 217 IMPACT OF CHOLESTERYL ESTER TRANSFER PROTEIN INHIBITION ON NUCLEAR MAGNETIC RESONANCE DERIVED LIPOPROTEIN PARTICLE PARAMETERS. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70218-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Madigan K, Egan P, Brennan D, Hill S, Maguire B, Horgan F, Flood C, Kinsella A, O'Callaghan E. A randomised controlled trial of carer-focussed multi-family group psychoeducation in bipolar disorder. Eur Psychiatry 2011; 27:281-4. [PMID: 21334858 DOI: 10.1016/j.eurpsy.2010.12.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [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] [Received: 07/20/2010] [Revised: 12/15/2010] [Accepted: 12/16/2010] [Indexed: 12/12/2022] Open
Abstract
In a RCT of family psychoeducation, 47 carers of 34 patients were allocated to one of three groups; Multifamily Group Psychoeducation, Solution Focussed Group Therapy or Treatment as Usual. Carers in both the MFGP intervention and the SFGP arm demonstrated greater knowledge and reduction in burden than those in the TAU arm.
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Affiliation(s)
- K Madigan
- Cluain Mhuire Family Centre, Newtownpark Avenue, Blackrock, Co. Dublin and Health Research Board, Dublin 2, Ireland
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Marcolongo M, Dinardo NJ, Hickok N, Tuan R, Pourezzaei K, Beard R, Brennan D, Heipp P, Phan T. Osteoblast Attachment on Biomaterials as a Function of Surface Charge. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-550-121] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractBioactive materials such as calcium phosphate ceramics and bioactive glasses enhance bone tissue formation and then bond to bone tissue. In our work, we question what particular surface feature or features of bioactive materials are responsible for the bone tissue response. In this study we have uncoupled surface charge from surface chemistry, energy, and topography and have examined osteoblast adhesion to titanium surfaces of varying surface charge. We have shown that a negative surface charge promotes osteoblast adhesion by approximately 60% over a neutral surface and that conversely, a positive surface charge inhibits osteoblast adhesion by about 20%. Continued examination of surface characteristics that control cellular responses are warranted with the eventual goal of applying those desirable surface characteristics to any structural biomaterial for bone implant or tissue engineering applications.
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Abstract
BACKGROUND Dentine hypersensitivity is a frequent clinical presentation though inadequately comprehended by dentists. The objective of this study was to describe Australian dentists' perception on the occurrence, predisposing factors, triggers, diagnosis and management of dentine hypersensitivity. METHODS Eight hundred dentists were randomly selected using the Australian Dental Association membership list and invited to participate in a questionnaire-based survey. RESULTS Out of 295 responding dentists, 284 private practitioners were included in the final analysis. Most dentists perceived that the occurrence of dentine hypersensitivity was <20% and commonest among 30-49 year olds. According to them, abrasion and gingival recession were the main predisposing factors whilst cold stimuli were the commonest trigger. A differential diagnosis-based approach was adopted by a majority to diagnose dentine hypersensitivity although routine screening was resorted to by a few. Most dentists were aware of the current mechanisms underlying dentine hypersensitivity whereas the majority perceived that ongoing predisposing factors was the main reason for dentine tubules to remain exposed. The commonest management strategy employed by most dentists was to prescribe desensitizing agents for home use. CONCLUSIONS Australian dentists' perception of dentine hypersensitivity is generally consistent with the current scientific consensus on this subject.
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Affiliation(s)
- N Amarasena
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, South Australia, Australia.
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Caldara R, Jenkins R, Brennan D, Condon B, Hadley D, Mayer E. Gaze direction is in the eye of the Superior Temporal Sulcus. J Vis 2010. [DOI: 10.1167/8.6.403] [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] Open
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Bishop P, King K, Crowe T, Bayturan O, Feiten L, Brennan D, Clair D, Kashyap V, Nicholls S. Abstract: 1496 DIFFERENT PATTERNS OF ARTERIAL REMODELING AND CALCIFICATION ASSOCIATED WITH ATHEROSCLEROSIS IN CORONARY AND PERIPHERAL VASCULAR TERRITORIES. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70108-4] [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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Roth W, Setnik B, Zietsch M, Burst A, Breitenbach J, Sellers E, Brennan D. Ethanol effects on drug release from Verapamil Meltrex®, an innovative melt extruded formulation. Int J Pharm 2009; 368:72-5. [DOI: 10.1016/j.ijpharm.2008.09.052] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Revised: 09/30/2008] [Accepted: 09/30/2008] [Indexed: 11/15/2022]
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