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Aiyegbusi OL, McMullan C, Hughes SE, Turner GM, Subramanian A, Hotham R, Davies EH, Frost C, Alder Y, Agyen L, Buckland L, Camaradou J, Chong A, Jeyes F, Kumar S, Matthews KL, Moore P, Ormerod J, Price G, Saint-Cricq M, Stanton D, Walker A, Haroon S, Denniston AK, Calvert MJ. Considerations for patient and public involvement and engagement in health research. Nat Med 2023; 29:1922-1929. [PMID: 37474660 DOI: 10.1038/s41591-023-02445-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/07/2023] [Indexed: 07/22/2023]
Abstract
Patient and public involvement and engagement (PPIE) can provide valuable insights into the experiences of those living with and affected by a disease or health condition. Inclusive collaboration between patients, the public and researchers can lead to productive relationships, ensuring that health research addresses patient needs. Guidelines are available to support effective PPIE; however, evaluation of the impact of PPIE strategies in health research is limited. In this Review, we evaluate the impact of PPIE in the 'Therapies for Long COVID in non-hospitalised individuals' (TLC) Study, using a combination of group discussions and interviews with patient partners and researchers. We identify areas of good practice and reflect on areas for improvement. Using these insights and the results of a survey, we synthesize two checklists of considerations for PPIE, and we propose that research teams use these checklists to optimize the impact of PPIE for both patients and researchers in future studies.
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Affiliation(s)
- Olalekan Lee Aiyegbusi
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK.
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) West Midlands, University of Birmingham, Birmingham, UK.
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK.
| | - Christel McMullan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) West Midlands, University of Birmingham, Birmingham, UK
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
- Centre for Trauma Science Research, University of Birmingham, Birmingham, UK
| | - Sarah E Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) West Midlands, University of Birmingham, Birmingham, UK
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
| | - Grace M Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
- Centre for Trauma Science Research, University of Birmingham, Birmingham, UK
| | | | - Richard Hotham
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | | | | | - Lisa Agyen
- CPROR, University of Birmingham, Birmingham, UK
| | | | | | - Amy Chong
- CPROR, University of Birmingham, Birmingham, UK
| | | | | | | | | | | | - Gary Price
- CPROR, University of Birmingham, Birmingham, UK
| | | | | | - Anita Walker
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) West Midlands, University of Birmingham, Birmingham, UK
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
| | - Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Melanie J Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) West Midlands, University of Birmingham, Birmingham, UK
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
- Centre for Trauma Science Research, University of Birmingham, Birmingham, UK
- Midlands Health Data Research UK, Birmingham, UK
- DEMAND Hub, University of Birmingham, Birmingham, UK
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Routen A, O'Mahoney L, Aiyegbusi OL, Alder Y, Banerjee A, Buckland L, Brightling C, Calvert M, Camaradou J, Chaturvedi N, Chong A, Dalrymple E, Eggo RM, Elliott P, Evans RA, Gibson A, Haroon S, Herrett E, Houchen-Wolloff L, Hughes SE, Jeyes F, Matthews K, McMullan C, Morley J, Shafran R, Smith N, Stanton D, Stephenson T, Sterne J, Turner GM, Ward H, Khunti K. Patient and public involvement within epidemiological studies of long COVID in the UK. Nat Med 2023; 29:771-773. [PMID: 36932242 DOI: 10.1038/s41591-023-02251-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Affiliation(s)
- Ash Routen
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK.
| | - Lauren O'Mahoney
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Olalekan Lee Aiyegbusi
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre (BBRC), University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Oxford-Birmingham Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, Birmingham, UK
| | - Yvonne Alder
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Amitava Banerjee
- Institute of Health Informatics, Faculty of Population Health Sciences, University College London (UCL), London, UK
| | - Lewis Buckland
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Chris Brightling
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Melanie Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre (BBRC), University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Oxford-Birmingham Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre (SRMRC), University of Birmingham, Birmingham, UK
| | - Jenny Camaradou
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Nishi Chaturvedi
- Department of Population Science and Experimental Medicine, UCL, London, UK
| | - Amy Chong
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Emma Dalrymple
- Great Ormond Street Institute of Child Health, UCL, London, UK
| | - Rosalind M Eggo
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Paul Elliott
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Rachael A Evans
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Andy Gibson
- Department of Health and Social Sciences, University of West England, Bristol, UK
| | - Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Emily Herrett
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Sarah E Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre (BBRC), University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Oxford-Birmingham Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, Birmingham, UK
| | - Flic Jeyes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Karen Matthews
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Christel McMullan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre (BBRC), University of Birmingham, Birmingham, UK
- NIHR Oxford-Birmingham Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, Birmingham, UK
- Department of Population Science and Experimental Medicine, UCL, London, UK
- Centre for Trauma Science Research, University of Birmingham, Birmingham, UK
| | - Jessica Morley
- Bennett Institute for Applied Data Science, University of Oxford, Oxford, UK
| | - Roz Shafran
- Great Ormond Street Institute of Child Health, UCL, London, UK
| | | | - David Stanton
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Jonathan Sterne
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Grace M Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Helen Ward
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
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Turner GM, McMullan C, Aiyegbusi OL, Hughes SE, Walker A, Jeyes F, Adler Y, Chong A, Buckland L, Stanton D, Davies EH, Haroon S, Calvert M. Co-production of a feasibility trial of pacing interventions for Long COVID. Res Involv Engagem 2023; 9:18. [PMID: 36997975 PMCID: PMC10061378 DOI: 10.1186/s40900-023-00429-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The high incidence of COVID-19 globally has led to a large prevalence of Long COVID but there is a lack of evidence-based treatments. There is a need to evaluate existing treatments for symptoms associated with Long COVID. However, there is first a need to evaluate the feasibility of undertaking randomised controlled trials of interventions for the condition. We aimed to co-produce a feasibility study of non-pharmacological interventions to support people with Long COVID. METHODS A consensus workshop on research prioritisation was conducted with patients and other stakeholders. This was followed by the co-production of the feasibility trial with a group of patient partners, which included the design of the study, the selection of interventions, and the production of dissemination strategies. RESULTS The consensus workshop was attended by 23 stakeholders, including six patients. The consensus from the workshop was to develop a clinical trial platform that focused on testing different pacing interventions and resources. For the co-production of the feasibility trial, patient partners selected three pacing resources to evaluate (video, mobile application, and book) and co-designed feasibility study processes, study materials and undertook usability testing of the digital trial platform. CONCLUSION In conclusion, this paper reports the principles and process used to co-produce a feasibility study of pacing interventions for Long COVID. Co-production was effective and influenced important aspects of the study.
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Affiliation(s)
- Grace M Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | - Christel McMullan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
- Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK.
- NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK.
- NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK.
- NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK.
| | - Olalekan Lee Aiyegbusi
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
| | - Sarah E Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
| | - Anita Walker
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
| | - Felicity Jeyes
- Patient Partner, Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | - Yvonne Adler
- Patient Partner, Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | - Amy Chong
- Patient Partner, Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | - Lewis Buckland
- Patient Partner, Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | - David Stanton
- Patient Partner, Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | | | - Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Melanie Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
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Herselman R, Lalloo V, Ueckermann V, van Tonder DJ, de Jager E, Spijkerman S, van der Merwe W, du Pisane M, Hattingh F, Stanton D, Hofmeyr R. Adapted full-face snorkel masks as an alternative for COVID-19 personal protection during aerosol generating procedures in South Africa: A multi-centre, non-blinded in-situ simulation study. Afr J Emerg Med 2021; 11:436-441. [PMID: 34540572 PMCID: PMC8435371 DOI: 10.1016/j.afjem.2021.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/24/2021] [Accepted: 08/04/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION SARS-CoV-2 has resulted in increased worldwide demand for personal protective equipment (PPE). With pressure from ongoing epidemic and endemic episodes, we assessed an adapted snorkel mask that provides full-face protection for healthcare workers (HCWs), particularly during aerosol-generating procedures. These masks have a custom-made adaptor which allows the fitment of standard medical respiratory filters. The aim of this study was to evaluate the fit, seal and clinical usability of these masks. METHODS This multicentre, non-blinded in-situ simulation study recruited fifty-two HCWs to don and doff the adapted snorkel mask. Negative pressure seal checks and a qualitative fit test were performed. The HCWs completed intubation and extubation of a manikin in a university skills training laboratory, followed by a web-based questionnaire on the clinical usability of the masks. RESULTS Whilst fit and usability data were generally satisfactory, two of the 52 participants (3.8%) felt that the mask did not span the correct distance from the nose to the chin, and 3 of 34 participants (8.8%) who underwent qualitative testing with a Bitrex test failed. The majority of users reported no fogging, humidity or irritation. It was reportedly easy to speak while wearing the mask, although some participants perceived that they were not always understood. Twenty-one participants (40%) experienced a subjective physiological effect from wearing the mask; most commonly a sensation of shortness of breath. DISCUSSION A fit-tested modified full-face snorkel mask may offer benefit as a substitute for N95 respirators and face shields. It is, however, important to properly select the correct mask based on size, fit testing, quality of the three-dimensional (3D) printed parts and respiratory filter to be used. Additionally, HCWs should be trained in the use of the mask, and each mask should be used by a single HCW and not shared.
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Affiliation(s)
- Ronel Herselman
- Head of Department, Undergraduate and Surgical Skills Laboratories, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Vidya Lalloo
- Division of Emergency Medicine, Faculty of Health Sciences, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - Veronica Ueckermann
- Department Internal Medicine, University of Pretoria and Steve Biko Academic Hospital, South Africa
| | - Daniel J. van Tonder
- Faculty Operations, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Edwin de Jager
- Faculty Operations, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Sandra Spijkerman
- Head of Department of Anaesthesiology, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - Wanda van der Merwe
- Undergraduate Skills Laboratory, Faculty of Health Sciences, University of Pretoria, South Africa
| | - Marizane du Pisane
- Division of Infectious Diseases, Faculty of Health Sciences, University of Pretoria, South Africa
| | | | - David Stanton
- Netcare Education, Faculty of Emergency and Critical Care, South Africa
| | - Ross Hofmeyr
- Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, and Groote Schuur Hospital, Cape Town, South Africa
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Böttiger BW, Lockey A, Aickin R, Carmona M, Cassan P, Castrén M, Chakra Rao S, De Caen A, Escalante R, Georgiou M, Hoover A, Kern KB, Khan AMS, Levi C, Lim SH, Nadkarni V, Nakagawa NV, Nation K, Neumar RW, Nolan JP, Mellin-Olsen J, Pagani J, Sales M, Semeraro F, Stanton D, Toporas C, van Grootven H, Wang TL, Wijesuriya N, Wong G, Perkins GD. Up to 206 Million People Reached and Over 5.4 Million Trained in Cardiopulmonary Resuscitation Worldwide: The 2019 International Liaison Committee on Resuscitation World Restart a Heart Initiative. J Am Heart Assoc 2020; 9:e017230. [PMID: 32750297 PMCID: PMC7792236 DOI: 10.1161/jaha.120.017230] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sudden out‐of‐hospital cardiac arrest is the third leading cause of death in industrialized nations. Many of these lives could be saved if bystander cardiopulmonary resuscitation rates were better. “All citizens of the world can save a life—CHECK—CALL—COMPRESS.” With these words, the International Liaison Committee on Resuscitation launched the 2019 global “World Restart a Heart” initiative to increase public awareness and improve the rates of bystander cardiopulmonary resuscitation and overall survival for millions of victims of cardiac arrest globally. All participating organizations were asked to train and to report the numbers of people trained and reached. Overall, social media impact and awareness reached up to 206 million people, and >5.4 million people were trained in cardiopulmonary resuscitation worldwide in 2019. Tool kits and information packs were circulated to 194 countries worldwide. Our simple and unified global message, “CHECK—CALL—COMPRESS,” will save hundreds of thousands of lives worldwide and will further enable many policy makers around the world to take immediate and sustainable action in this most important healthcare issue and initiative.
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Affiliation(s)
- Bernd W Böttiger
- Department of Anaesthesiology and Intensive Care Medicine University Hospital of Cologne Germany
| | - Andrew Lockey
- Emergency Department Calderdale Royal Hospital Halifax United Kingdom
| | - Richard Aickin
- Australian and New Zealand Committee on Resuscitation Melbourne Australia
| | - Maria Carmona
- Disciplina de Anestesiologia Universidade de São Paulo São Paulo Brazil
| | - Pascal Cassan
- Global First Aid Reference Centre International Federation of the Red Cross and Red Crescent Paris France
| | - Maaret Castrén
- Department of Emergency Medicine and Services Helsinki University Hospital and Helsinki University Helsinki Finland
| | - Ssc Chakra Rao
- Chairman of the Indian Resuscitation Council Kakinada India
| | - Allan De Caen
- Pediatric Critical Care Medicine Stollery Children's Hospital Edmonton Canada.,Heart and Stroke Foundation of Canada Ottawa Canada
| | - Raffo Escalante
- Unidad de Cuidados Intensivos Instituto Nacional de Salud del Niño Universidad Peruana de Ciencias Aplicadas-Centro de Simulación Clínica Chair InterAmerican Heart Foundation/Emergency Cardiovascular Care Lima Peru
| | | | - Amber Hoover
- ECC Science American Heart Association Dallas TX
| | - Karl B Kern
- Division of Cardiology Department of Medicine University of Arizona Tucson AZ
| | - Abdul Majeed S Khan
- Clinical Associate Professor Internal Medicine Chairman of the National Cardiopulmonary Resuscitation Committee Saudi Heart Association Umm Alqura University Mecca Saudi Arabia
| | | | - Swee H Lim
- Department of Emergency Medicine and Education Singapore General Hospital Yong Loo Lin School of Medicine and Duke-National University of Singapore Medical School National University of Singapore Singapore
| | - Vinay Nadkarni
- Department of Anesthesiology Critical Care and Pediatrics University of Pennsylvania Perelman School of Medicine The Children's Hospital of Philadelphia PA
| | - Naomi V Nakagawa
- Department of Physical Therapy Communication Science and Speech and Occupational Therapy University of São Paulo Medical School São Paulo Brazil
| | - Kevin Nation
- New Zealand Resuscitation Council Wellington New Zealand
| | - Robert W Neumar
- Department of Emergency Medicine University of Michigan Medical School Ann Arbor MI
| | - Jerry P Nolan
- Warwick Clinical Trials Unit University of Warwick Warwick United Kingdom.,Department of Anaesthesia and Intensive Care Medicine Royal United Hospital Bath United Kingdom
| | | | - Jacopo Pagani
- Chairman of the National Health & Care Committee Italian Red Cross Rome Italy
| | | | - Federico Semeraro
- Department of Anaesthesia Intensive Care and Emergency medical services, Maggiore Hospital Bologna Italy
| | - David Stanton
- Resuscitation Council of Southern Africa Clinical Leadership Netcare 911 Johannesburg South Africa
| | | | - Heleen van Grootven
- European Resuscitation Council and International Liaison Committee on Resuscitation Niel Belgium
| | - Tzong-Luen Wang
- Resuscitation Council of Asia National Resuscitation Council of Taiwan Chang Bing Show Chwang Memorial Hospital Lukang Township Taiwan.,Medical and Law School Fu-Jen Catholic University New Taipei City Taiwan
| | - Nilmini Wijesuriya
- Department of Anaesthesiology College of Anaesthesiologists and Intensivists of Sri Lanka Colombo North Teaching Hospital Colombo Sri Lanka
| | - Gillian Wong
- Heart and Stroke Foundation of Canada Vancouver British Columbia Canada
| | - Gavin D Perkins
- Warwick Clinical Trials Unit and University Hospitals Birmingham National Health Service Foundation Trust University of Warwick Coventry United Kingdom
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Hempenstall AJ, Smith S, Stanton D, Hanson J. Melioidosis in the Torres Strait Islands, Australia: Exquisite Interplay between Pathogen, Host, and Environment. Am J Trop Med Hyg 2020; 100:517-521. [PMID: 30675834 DOI: 10.4269/ajtmh.18-0806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Burkholderia pseudomallei, a bacterium that lives in the soil of the tropics, causes the disease melioidosis. This retrospective study investigated the temporospatial epidemiology of the 49 laboratory-confirmed melioidosis cases in the Torres Straits Islands of tropical Australia between 1997 and 2017. An identifiable risk factor for the disease was present in 43/49 (88%) cases and in 35/36 (97%) cases with complete clinical data. The mean incidence of melioidosis varied across the region, from 0/100,000 persons/year in the Eastern Island Cluster to 116.1/100,000 persons/year in the Near Western Island Cluster. An environmental suitability score for the growth of B. pseudomallei-constructed using the rainfall, vegetation, and soil type on each island-correlated with disease incidence (Spearman's rho 0.51; P = 0.035). Melioidosis is an opportunistic disease that occurs in patients with specific risk factors, but its incidence is also strongly influenced by environmental factors that favor the growth of the causative organism.
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Affiliation(s)
| | - Simon Smith
- James Cook University, Cairns, Australia.,Department of Medicine, Cairns Hospital, Cairns, Australia
| | | | - Josh Hanson
- Department of Medicine, Cairns Hospital, Cairns, Australia.,The Kirby Institute, Sydney, Australia
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Jackson SM, Parsons M, Baseler M, Stanton D. Landscape management of the mahogany glider (Petaurus gracilis) across its distribution: subpopulations and corridor priorities. Aust Mammalogy 2020. [DOI: 10.1071/am19010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Key threatening processes to biodiversity include habitat loss and fragmentation, with populations restricted to small fragments of habitat being more prone to extinction. The mahogany glider (Petaurus gracilis) is endemic to sclerophyll woodland forests between Tully and Ingham in north Queensland and is one of Australia’s most endangered arboreal mammals due to these processes. The aim of this study was to identify the degree of habitat fragmentation of the remaining remnant vegetation of the mahogany glider, identify subpopulations within its distribution and identify key wildlife corridors for restoration to facilitate the movement of this species within and between subpopulations. Ten glider subpopulations, spread over 998 habitat fragments, were identified, of which only five subpopulations may currently be considered to be viable. To assist in providing habitat connectivity between and within the subpopulations, 55 corridors were identified for restoration that had an average length of 8.25 km. The average number of gaps greater than 30 m was 3.4 per corridor, with the average length of these gaps being 523 m. This study confirmed a high degree of habitat fragmentation across the distribution of the mahogany glider and highlighted the need to strengthen the remaining subpopulations by restoring habitat connectivity between the remaining habitat fragments.
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Soar J, Maconochie I, Wyckoff MH, Olasveengen TM, Singletary EM, Greif R, Aickin R, Bhanji F, Donnino MW, Mancini ME, Wyllie JP, Zideman D, Andersen LW, Atkins DL, Aziz K, Bendall J, Berg KM, Berry DC, Bigham BL, Bingham R, Couto TB, Böttiger BW, Borra V, Bray JE, Breckwoldt J, Brooks SC, Buick J, Callaway CW, Carlson JN, Cassan P, Castrén M, Chang WT, Charlton NP, Cheng A, Chung SP, Considine J, Couper K, Dainty KN, Dawson JA, de Almeida MF, de Caen AR, Deakin CD, Drennan IR, Duff JP, Epstein JL, Escalante R, Gazmuri RJ, Gilfoyle E, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Holmberg MJ, Hood N, Hosono S, Hsieh MJ, Isayama T, Iwami T, Jensen JL, Kapadia V, Kim HS, Kleinman ME, Kudenchuk PJ, Lang E, Lavonas E, Liley H, Lim SH, Lockey A, Lofgren B, Ma MHM, Markenson D, Meaney PA, Meyran D, Mildenhall L, Monsieurs KG, Montgomery W, Morley PT, Morrison LJ, Nadkarni VM, Nation K, Neumar RW, Ng KC, Nicholson T, Nikolaou N, Nishiyama C, Nuthall G, Ohshimo S, Okamoto D, O’Neil B, Yong-Kwang Ong G, Paiva EF, Parr M, Pellegrino JL, Perkins GD, Perlman J, Rabi Y, Reis A, Reynolds JC, Ristagno G, Roehr CC, Sakamoto T, Sandroni C, Schexnayder SM, Scholefield BR, Shimizu N, Skrifvars MB, Smyth MA, Stanton D, Swain J, Szyld E, Tijssen J, Travers A, Trevisanuto D, Vaillancourt C, Van de Voorde P, Velaphi S, Wang TL, Weiner G, Welsford M, Woodin JA, Yeung J, Nolan JP, Fran Hazinski M. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation 2019; 140:e826-e880. [DOI: 10.1161/cir.0000000000000734] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.
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Böttiger BW, Lockey A, Aickin R, Bertaut T, Castren M, de Caen A, Censullo E, Escalante R, Gent L, Georgiou M, Kern KB, Khan AMS, Lim SH, Nadkarni V, Nation K, Neumar RW, Nolan JP, Rao SSCC, Stanton D, Toporas C, Wang TL, Wong G, Perkins GD. Over 675,000 lay people trained in cardiopulmonary resuscitation worldwide - The "World Restart a Heart (WRAH)" initiative 2018. Resuscitation 2019; 138:15-17. [PMID: 30836172 DOI: 10.1016/j.resuscitation.2019.02.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 02/24/2019] [Indexed: 11/29/2022]
Affiliation(s)
- B W Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany.
| | - A Lockey
- Emergency Department, Calderdale Royal Hospital, Halifax, United Kingdom
| | - R Aickin
- Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand
| | - T Bertaut
- American Heart Association, Dallas, TX, USA
| | - M Castren
- Department of Emergency Medicine and Services, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - A de Caen
- Pediatric Critical Care Medicine, Stollery Children's Hospital, Edmonton, Canada
| | - E Censullo
- American Heart Association, Dallas, TX, USA
| | - R Escalante
- Unidad de Cuidados Intensivos, Instituto Nacional de Salud del Niño, Universidad Peruana de Ciencias Aplicadas - Centro de Simulación Clínica, InterAmerican Heart Foundation/Emergency Cardiovascular Care, Lima, Peru
| | - L Gent
- American Heart Association, Dallas, TX, USA
| | - M Georgiou
- American Medical Center, Nicosia, Cyprus
| | - K B Kern
- Department of Medicine, Division of Cardiology, University of Arizona, Tucson, AZ, USA
| | - A M S Khan
- Saudi Heart Association (SHA), KSA, Umm Alqura University, Saudi Arabia
| | - S H Lim
- Department of Emergency Medicine and Education, Singapore General Hospital, Yong Loo Lin School of Medicine and Duke-NUS Medical School, National University of Singapore, Singapore
| | - V Nadkarni
- Department of Anaesthesia, Critical Care and Pediatrics, University of Pennsylvania Perelman School of Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - K Nation
- New Zealand Resuscitation Council, Wellington, New Zealand
| | - R W Neumar
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
| | - J P Nolan
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, United Kingdom
| | - S S C C Rao
- Indian Society of Anaesthesiology (ISA), Founder Family Benevolent Fund, Care Emergency Hospital, Kakinada, India
| | - D Stanton
- Resuscitation Council of Southern Africa, Netcare 911, South Africa
| | - C Toporas
- Heart and Stroke Foundation of Canada, Toronto, Canada
| | - T-L Wang
- Resuscitation Council of Asia, National Resuscitation Council of Taiwan, Chang Bing Show Chwang Memorial Hospital, Taiwan, Medical and Law School, Fu-Jen Catholic University, Taiwan
| | - G Wong
- Heart and Stroke Foundation of Canada, Vancouver, Canada
| | - G D Perkins
- Warwick Clinical Trials Unit and University Hospitals Birmingham NHS Foundation Trust, University of Warwick, Coventry, United Kingdom
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Kleinman ME, Perkins GD, Bhanji F, Billi JE, Bray JE, Callaway CW, de Caen A, Finn JC, Hazinski MF, Lim SH, Maconochie I, Nadkarni V, Neumar RW, Nikolaou N, Nolan JP, Reis A, Sierra AF, Singletary EM, Soar J, Stanton D, Travers A, Welsford M, Zideman D. ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement. Circulation 2018; 137:e802-e819. [PMID: 29700123 DOI: 10.1161/cir.0000000000000561] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Despite significant advances in the field of resuscitation science, important knowledge gaps persist. Current guidelines for resuscitation are based on the International Liaison Committee on Resuscitation 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, which includes treatment recommendations supported by the available evidence. The writing group developed this consensus statement with the goal of focusing future research by addressing the knowledge gaps identified during and after the 2015 International Liaison Committee on Resuscitation evidence evaluation process. Key publications since the 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations are referenced, along with known ongoing clinical trials that are likely to affect future guidelines.
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Böttiger BW, Lockey A, Aickin R, Castren M, de Caen A, Escalante R, Kern KB, Lim SH, Nadkarni V, Neumar RW, Nolan JP, Stanton D, Wang TL, Perkins GD. "All citizens of the world can save a life" - The World Restart a Heart (WRAH) initiative starts in 2018. Resuscitation 2018; 128:188-190. [PMID: 29679697 DOI: 10.1016/j.resuscitation.2018.04.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 04/11/2018] [Accepted: 04/14/2018] [Indexed: 01/14/2023]
Abstract
"All citizens of the world can save a life". With these words, the International Liaison Committee on Resuscitation (ILCOR) is launching the first global initiative - World Restart a Heart (WRAH) - to increase public awareness and therefore the rates of bystander cardiopulmonary resuscitation (CPR) for victims of cardiac arrest. In most of the cases, it takes too long for the emergency services to arrive on scene after the victim's collapse. Thus, the most effective way to increase survival and favourable outcome in cardiac arrest by two- to fourfold is early CPR by lay bystanders and by "first responders". Lay bystander resuscitation rates, however, differ significantly across the world, ranging from 5 to 80%. If all countries could have high lay bystander resuscitation rates, this would help to save hundreds of thousands of lives every year. In order to achieve this goal, all seven ILCOR councils have agreed to participate in WRAH 2018. Besides schoolchildren education in CPR ("KIDS SAVE LIVES"), many other initiatives have already been developed in different parts of the world. ILCOR is keen for the WRAH initiative to be as inclusive as possible, and that it should happen every year on 16 October or as close to that day as possible. Besides recommending CPR training for children and adults, it is hoped that a unified global message will enable our policy makers to take action to address the inequalities in patient survival around the world.
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Affiliation(s)
- B W Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Straße 62, 50937 Köln, Cologne, Germany.
| | - A Lockey
- Emergency Department, Calderdale Royal Hospital, Halifax, United Kingdom
| | - R Aickin
- Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand
| | - M Castren
- Department of Emergency Medicine and Services, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - A de Caen
- Pediatric Critical Care Medicine, Stollery Children's Hospital, Edmonton, Canada
| | - R Escalante
- Unidad de Cuidados Intensivos, Instituto Nacional de Salud del Niño, Universidad Peruana de Ciencias Aplicadas - Centro de Simulación Clínica, Chair InterAmerican Heart Foundation/Emergency Cardiovascular Care, Lima, Peru
| | - K B Kern
- Department of Medicine, Division of Cardiology, University of Arizona, Tucson, AZ, USA
| | - S H Lim
- Department of Emergency Medicine and Education, Singapore General Hospital, Adjunct Associate Professor, Yong Loo Lin School of Medicine and Duke-NUS Medical School, National University of Singapore, Singapore
| | - V Nadkarni
- Department of Anesthesia, Critical Care and Pediatrics, University of Pennsylvania Perelman School of Medicine, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19063, USA
| | - R W Neumar
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
| | - J P Nolan
- Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, United Kingdom
| | - D Stanton
- Chair, Resuscitation Council of Southern Africa, Clinical Leadership, Netcare 911, South Africa
| | - T-L Wang
- Chairman, Resuscitation Council of Asia, CEO, National Resuscitation Council of Taiwan, Chang Bing Show Chwang Memorial Hospital, Taiwan, Medical and Law School, Fu-Jen Catholic University, Taiwan
| | - G D Perkins
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, United Kingdom
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Olasveengen TM, de Caen AR, Mancini ME, Maconochie IK, Aickin R, Atkins DL, Berg RA, Bingham RM, Brooks SC, Castrén M, Chung SP, Considine J, Couto TB, Escalante R, Gazmuri RJ, Guerguerian AM, Hatanaka T, Koster RW, Kudenchuk PJ, Lang E, Lim SH, Løfgren B, Meaney PA, Montgomery WH, Morley PT, Morrison LJ, Nation KJ, Ng KC, Nadkarni VM, Nishiyama C, Nuthall G, Ong GYK, Perkins GD, Reis AG, Ristagno G, Sakamoto T, Sayre MR, Schexnayder SM, Sierra AF, Singletary EM, Shimizu N, Smyth MA, Stanton D, Tijssen JA, Travers A, Vaillancourt C, Van de Voorde P, Hazinski MF, Nolan JP. 2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary. Resuscitation 2017; 121:201-214. [DOI: 10.1016/j.resuscitation.2017.10.021] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Olasveengen TM, de Caen AR, Mancini ME, Maconochie IK, Aickin R, Atkins DL, Berg RA, Bingham RM, Brooks SC, Castrén M, Chung SP, Considine J, Couto TB, Escalante R, Gazmuri RJ, Guerguerian AM, Hatanaka T, Koster RW, Kudenchuk PJ, Lang E, Lim SH, Løfgren B, Meaney PA, Montgomery WH, Morley PT, Morrison LJ, Nation KJ, Ng KC, Nadkarni VM, Nishiyama C, Nuthall G, Ong GYK, Perkins GD, Reis AG, Ristagno G, Sakamoto T, Sayre MR, Schexnayder SM, Sierra AF, Singletary EM, Shimizu N, Smyth MA, Stanton D, Tijssen JA, Travers A, Vaillancourt C, Van de Voorde P, Hazinski MF, Nolan JP. 2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary. Circulation 2017; 136:e424-e440. [PMID: 29114010 DOI: 10.1161/cir.0000000000000541] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The International Liaison Committee on Resuscitation has initiated a near-continuous review of cardiopulmonary resuscitation science that replaces the previous 5-year cyclic batch-and-queue approach process. This is the first of an annual series of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations summary articles that will include the cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation in the previous year. The review this year includes 5 basic life support and 1 pediatric Consensuses on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Each of these includes a summary of the science and its quality based on Grading of Recommendations, Assessment, Development, and Evaluation criteria and treatment recommendations. Insights into the deliberations of the International Liaison Committee on Resuscitation task force members are provided in Values and Preferences sections. Finally, the task force members have prioritized and listed the top 3 knowledge gaps for each population, intervention, comparator, and outcome question.
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Perkins GD, Neumar R, Monsieurs KG, Lim SH, Castren M, Nolan JP, Nadkarni V, Montgomery B, Steen P, Cummins R, Chamberlain D, Aickin R, de Caen A, Wang TL, Stanton D, Escalante R, Callaway CW, Soar J, Olasveengen T, Maconochie I, Wyckoff M, Greif R, Singletary EM, O'Connor R, Iwami T, Morrison L, Morley P, Lang E, Bossaert L. The International Liaison Committee on Resuscitation-Review of the last 25 years and vision for the future. Resuscitation 2017; 121:104-116. [PMID: 28993179 DOI: 10.1016/j.resuscitation.2017.09.029] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [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: 09/25/2017] [Accepted: 09/25/2017] [Indexed: 01/08/2023]
Abstract
2017 marks the 25th anniversary of the International Liaison Committee on Resuscitation (ILCOR). ILCOR was formed in 1992 to create a forum for collaboration among principal resuscitation councils worldwide. Since then, ILCOR has established and distinguished itself for its pioneering vision and leadership in resuscitation science. By systematically assessing the evidence for resuscitation standards and guidelines and by identifying national and regional differences, ILCOR reached consensus on international resuscitation guidelines in 2000, and on international science and treatment recommendations in 2005, 2010 and 2015. However, local variation and contextualization of guidelines are evident by subtle differences in regional and national resuscitation guidelines. ILCOR's efforts to date have enhanced international cooperation, and progressively more transparent and systematic collection and analysis of pertinent scientific evidence. Going forward, this sets the stage for ILCOR to pursue its vision to save more lives globally through resuscitation.
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Affiliation(s)
- Gavin D Perkins
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK.
| | - Robert Neumar
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Koenraad G Monsieurs
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Swee Han Lim
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Maaret Castren
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Jerry P Nolan
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Vinay Nadkarni
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Bill Montgomery
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Petter Steen
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Richard Cummins
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Douglas Chamberlain
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Richard Aickin
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Allan de Caen
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Tzong-Luen Wang
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - David Stanton
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Raffo Escalante
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Clifton W Callaway
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Jasmeet Soar
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Theresa Olasveengen
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Ian Maconochie
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Myra Wyckoff
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Robert Greif
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Eunice M Singletary
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Robert O'Connor
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Taku Iwami
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Laurie Morrison
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Peter Morley
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Eddy Lang
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
| | - Leo Bossaert
- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
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- Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, University of Warwick, Coventry, CV4 7AL, UK
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Stanton D, Hardcastle T, Muhlbauer D, van Zyl D. Cervical collars and immobilisation: A South African best practice recommendation. Afr J Emerg Med 2017; 7:4-8. [PMID: 30456099 PMCID: PMC6234176 DOI: 10.1016/j.afjem.2017.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 11/22/2016] [Accepted: 01/10/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The consequences of spinal injury as a result of trauma can be devastating. Spinal immobilisation using hard trauma boards and rigid cervical collars has traditionally been the standard response to suspected spinal injury patients even though the risk may be extremely low. Recently, adverse events due to the method of immobilisation have challenged the need for motion restriction in all trauma patients. International guidelines have been published for protection of the spine during transport and this article brings those guidelines into the South African context. RECOMMENDATIONS Trauma patients need to be properly assessed using both an approved list of high and low risk factors, as well as a thorough examination. They should then be managed accordingly. Internationally validated assessment strategies have been developed, and should be used as part of the patient assessment. The method of motion restriction should be selected to suit the situation. The use of a vacuum mattress is the preferable technique, with the use of a trauma board being the least desirable. CONCLUSION The need for motion restriction in suspected spinal injury should be properly evaluated and appropriate action taken. Not all trauma patients require spinal motion restriction.
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Affiliation(s)
- D. Stanton
- Netcare Education, Faculty of Emergency and Critical Care, South Africa
| | - T. Hardcastle
- University of Kwazulu Natal, Trauma Surgery Training Unit, Inkosi Albert Luthuli Central Hospital Trauma Service and Trauma ICU, South Africa
| | - D. Muhlbauer
- Department of Emergency Medical Care and Rescue, Durban University of Technology, South Africa
| | - D. van Zyl
- Life Flora Hospital Advanced Life Support Unit, South Africa
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Travers AH, Perkins GD, Berg RA, Castren M, Considine J, Escalante R, Gazmuri RJ, Koster RW, Lim SH, Nation KJ, Olasveengen TM, Sakamoto T, Sayre MR, Sierra A, Smyth MA, Stanton D, Vaillancourt C. Part 3: Adult Basic Life Support and Automated External Defibrillation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2016; 132:S51-83. [PMID: 26472859 DOI: 10.1161/cir.0000000000000272] [Citation(s) in RCA: 153] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This review comprises the most extensive literature search and evidence evaluation to date on the most important international BLS interventions, diagnostics, and prognostic factors for cardiac arrest victims. It reemphasizes that the critical lifesaving steps of BLS are (1) prevention, (2) immediate recognition and activation of the emergency response system, (3) early high-quality CPR, and (4) rapid defibrillation for shockable rhythms. Highlights in prevention indicate the rational and judicious deployment of search-and-rescue operations in drowning victims and the importance of education on opioid-associated emergencies. Other 2015 highlights in recognition and activation include the critical role of dispatcher recognition and dispatch-assisted chest compressions, which has been demonstrated in multiple international jurisdictions with consistent improvements in cardiac arrest survival. Similar to the 2010 ILCOR BLS treatment recommendations, the importance of high quality was reemphasized across all measures of CPR quality: rate, depth, recoil, and minimal chest compression pauses, with a universal understanding that we all should be providing chest compressions to all victims of cardiac arrest. This review continued to focus on the interface of BLS sequencing and ensuring high-quality CPR with other important BLS interventions, such as ventilation and defibrillation. In addition, this consensus statement highlights the importance of EMS systems, which employ bundles of care focusing on providing high-quality chest compressions while extricating the patient from the scene to the next level of care. Highlights in defibrillation indicate the global importance of increasing the number of sites with public-access defibrillation programs. Whereas the 2010 ILCOR Consensus on Science provided important direction for the “what” in resuscitation (ie, what to do), the 2015 consensus has begun with the GRADE methodology to provide direction for the quality of resuscitation. We hope that resuscitation councils and other stakeholders will be able to translate this body of knowledge of international consensus statements to build their own effective resuscitation guidelines.
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Perkins GD, Travers AH, Berg RA, Castren M, Considine J, Escalante R, Gazmuri RJ, Koster RW, Lim SH, Nation KJ, Olasveengen TM, Sakamoto T, Sayre MR, Sierra A, Smyth MA, Stanton D, Vaillancourt C, Bierens JJ, Bourdon E, Brugger H, Buick JE, Charette ML, Chung SP, Couper K, Daya MR, Drennan IR, Gräsner JT, Idris AH, Lerner EB, Lockhat H, Løfgren B, McQueen C, Monsieurs KG, Mpotos N, Orkin AM, Quan L, Raffay V, Reynolds JC, Ristagno G, Scapigliati A, Vadeboncoeur TF, Wenzel V, Yeung J. Part 3: Adult basic life support and automated external defibrillation. Resuscitation 2015; 95:e43-69. [DOI: 10.1016/j.resuscitation.2015.07.041] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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McCann N, ter Wengel PO, Stanton D. Biosphere: Modelling genetics within ecosystems. Nature 2013; 495:47. [PMID: 23467162 DOI: 10.1038/495047d] [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: 11/09/2022]
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Mecci A, Kneeland C, Stanton D, Whisker L, Iqbal M, Sandhu F, Harries S, Jones L, Clarke D. 267. Impact of Introducing Intra-operative Assessment of Sentinel Lymph Node (SLN) with OSNA (One Step Nucleic Acid Amplification) – Single Centre Series. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.06.268] [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] Open
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Liu V, Dashper S, Parashos P, Liu SW, Stanton D, Shen P, Chivatxaranukul P, Reynolds EC. Antibacterial efficacy of casein-derived peptides against Enterococcus faecalis. Aust Dent J 2012; 57:339-43. [DOI: 10.1111/j.1834-7819.2012.01711.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ma Z, Song H, Zhong J, Stanton D, Wei Y, Sun Y. Short Communication: molecular characterisation of the wild yak (Bos grunniens mutus) melanocortin receptor-4 (MC4R) gene and a comparative analysis with that of otherBovinaespecies. Journal of Applied Animal Research 2012. [DOI: 10.1080/09712119.2012.662775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Curran K, Njeuhmeli E, Mirelman A, Dickson K, Adamu T, Cherutich P, Mahler H, Fimbo B, Mavuso TK, Albertini J, Fitzgerald L, Bock N, Reed J, Castor D, Stanton D. Voluntary medical male circumcision: strategies for meeting the human resource needs of scale-up in southern and eastern Africa. PLoS Med 2011; 8:e1001129. [PMID: 22140364 PMCID: PMC3226463 DOI: 10.1371/journal.pmed.1001129] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Voluntary medical male circumcision (VMMC) reduces female-to-male HIV transmission by approximately 60%; modeling suggests that scaling up VMMC to 80% of men 15- to 49-years-old within five years would avert over 3.3 million new HIV infections in 14 high priority countries/regions in southern and eastern Africa by 2025 and would require 20.33 million circumcisions. However, the shortage of health professionals in these countries must be addressed to reach these proposed coverage levels. To identify human resource approaches that are being used to improve VMMC volume and efficiency, we looked at previous literature and conducted a program review. We identified surgical efficiencies, non-surgical efficiencies, task shifting, task sharing, temporary redeployment of public sector staff during VMMC campaign periods, expansion of the health workforce through recruitment of unemployed, recently retired, newly graduating, or on-leave health care workers, and the use of volunteer medical staff from other countries as approaches that address human resource constraints. Case studies from Kenya, Tanzania, and Swaziland illustrate several innovative responses to human resource challenges. Although the shortage of skilled personnel remains a major challenge to the rapid scale-up of VMMC in the 14 African priority countries/regions, health programs throughout the region may be able to replicate or adapt these approaches to scale up VMMC for public health impact.
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Edgil D, Stankard P, Forsythe S, Rech D, Chrouser K, Adamu T, Sakallah S, Thomas AG, Albertini J, Stanton D, Dickson KE, Njeuhmeli E. Voluntary medical male circumcision: logistics, commodities, and waste management requirements for scale-up of services. PLoS Med 2011; 8:e1001128. [PMID: 22140363 PMCID: PMC3226460 DOI: 10.1371/journal.pmed.1001128] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 10/19/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The global HIV prevention community is implementing voluntary medical male circumcision (VMMC) programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President's Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. METHODS AND FINDINGS This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. CONCLUSIONS Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in "Voluntary Medical Male Circumcision: Modeling the Impact and Cost of Expanding Male Circumcision for HIV Prevention in Eastern and Southern Africa." Program planners and policy makers should consider the significant contribution of supply chain and waste management to VMMC program costs as they determine future resource needs for VMMC programs.
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Affiliation(s)
- Dianna Edgil
- United States Agency for International Development, Washington, District of Columbia, USA.
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Clark JM, Kociok-Köhn G, Harnett NJ, Hill MS, Hill R, Molloy KC, Saponia H, Stanton D, Sudlow A. Formation of PbS materials from lead xanthate precursors. Dalton Trans 2011; 40:6893-900. [DOI: 10.1039/c1dt10273g] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Pena-Rossi C, Schreiber S, Golubovic G, Mertz-Nielsen A, Panes J, Rachmilewitz D, Shieh MJ, Simanenkov VI, Stanton D, Graffner H. Clinical trial: a multicentre, randomized, double-blind, placebo-controlled, dose-finding, phase II study of subcutaneous interferon-beta-la in moderately active ulcerative colitis. Aliment Pharmacol Ther 2008; 28:758-67. [PMID: 19145731 DOI: 10.1111/j.1365-2036.2008.03778.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Ulcerative colitis (UC) pathophysiology is characterized by an imbalance between pro- and anti-inflammatory cytokines. Interferon (IFN)-beta-1a has potent immunoregulatory properties, including stimulation of host defence mechanisms and thus represents a potential treatment. AIM To extend pilot data and identify a suitable dose of IFN-beta-1a to achieve endoscopically confirmed remission (ECR) in patients with moderately active UC and to evaluate safety. METHODS In this multicentre, double-blind, placebo-controlled trial, adults with moderately active UC were randomized to IFN-beta-1a 44 or 66 microg, or placebo, subcutaneously three times weekly for 8 weeks, with a 4-week follow-up. RESULTS Endoscopically-confirmed remission was observed in 23.4% [95% confidence interval (CI): 13.8-35.7] of placebo patients, 29.2% (95% CI: 18.6-41.8) of the IFN-beta-la 44 microg group and 20.0% (950% CI: 11.1-31.8) of the 66 microg group (P = 0.45). Improvements with IFN-beta-1a 44 microg were greater than with placebo for most secondary efficacy outcomes, although significance was not achieved. Placebo response rates were higher than expected from previous trials. Adverse events were similar to the known safety profile of IFN treatment. CONCLUSIONS Interferon-beta-1a was generally well tolerated at the doses tested, but a significant therapeutic benefit in patients with UC was not observed.
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Affiliation(s)
- C Pena-Rossi
- New Therapies, Merck Serono International S.A., Geneva, Switzerland.
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26
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Abstract
The benefits of new methods of prevention of HIV could be jeopardised if they are not accompanied by efforts to change risky behaviour
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Affiliation(s)
- Michael M Cassell
- Office of HIV/AIDS, United States Agency for International Development, Washington, DC 20523-3700, USA.
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Nanitsos EK, Acosta GB, Saihara Y, Stanton D, Liao LP, Shin JW, Rae C, Balcar VJ. Effects of glutamate transport substrates and glutamate receptor ligands on the activity of Na-/K(+)-ATPase in brain tissue in vitro. Clin Exp Pharmacol Physiol 2005; 31:762-9. [PMID: 15566390 DOI: 10.1111/j.1440-1681.2004.04090.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
1. It has been suggested that Na+/K(+)-ATPase and Na(+)-dependent glutamate transport (GluT) are tightly linked in brain tissue. In the present study, we have investigated Na+/K(+)-ATPase activity using Rb+ uptake by 'minislices' (prisms) of the cerebral cortex. This preparation preserves the morphology of neurons, synapses and astrocytes and is known to possess potent GluT that has been well characterized. Uptake of Rb+ was determined by estimating Rb+ in aqueous extracts of the minislices, using atomic absorption spectroscopy. 2. We determined the potencies of several known substrates/inhibitors of GluT, such as L-trans-pyrrolidine-2,4-dicarboxylate (LtPDC), DL-threo-3-benzyloxyaspartic acid, (2S,3S,4R)-2-(carboxycyclopropyl)-glycine (L-CCG III) and L-anti,endo-3,4-methanopyrrolidine dicarboxylic acid, as inhibitors of [3H]-L-glutamate uptake by cortical prisms. In addition, we established the susceptibility of GluT, measured as [3H]-L-glutamate uptake in brain cortical prisms, to the inhibition of Na+/K(+)-ATPase by ouabain. Then, we tested the hypothesis that the Na+/K(+)-ATPase (measured as Rb+ uptake) can respond to changes in the activity of GluT produced by using GluT substrates as GluT-specific pharmacological tools. 3. The Na+/K(+)-ATPase inhibitor ouabain completely blocked Rb+ uptake (IC50 = 17 micromol/L), but it also potently inhibited a fraction of GluT (approximately 50% of [3H]-L-glutamate uptake was eliminated; IC50 < 1 micromol/L). 4. None of the most commonly used GluT substrates and inhibitors, such as L-aspartate, D-aspartate, L-CCG III and LtPDC (all at 500 micromol/L), produced any significant changes in Rb+ uptake. 5. The N-methyl-D-aspartate (NMDA) receptor agonists (R,S)-(tetrazol-5-yl)-glycine and NMDA decreased Rb+ uptake in a manner compatible with their known neurotoxic actions. 6. None of the agonists or antagonists for any of the other major classes of glutamate receptors caused significant changes in Rb+ uptake. 7. We conclude that, even if a subpopulation of glutamate transporters in the rat cerebral cortex may be intimately linked to a fraction of Na+/K(+)-ATPase, it is not possible, under the present experimental conditions, to detect regulation of Na+/K(+)-ATPase by GluT.
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Affiliation(s)
- Ellas K Nanitsos
- School of Medical Sciences and Institute for Biomedical Research, The University of Sydney, New South Wales, Australia
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Abstract
BACKGROUND Experimental evidence suggests that substances able to interact with voltage-dependent Ca2+ channels (VDCCs) might be beneficial in glaucoma management. It was therefore of significance to show that beta-adrenoceptor antagonists used in glaucoma directly interact with L-type VDCCs. In the present study, the affinity of several antiglaucoma drugs (betaxolol, carteolol, levobunolol, timolol, brimonidine, dorzolamide, latanoprost and pilocarpine) for these and other VDCCs was investigated using radioligand binding assays. Experiments were also carried out to assess the effect of antiglaucoma drugs on the NMDA-stimulated Ca2+ influx into isolated rat retinas. METHODS Competition radioligand binding studies to L-, N- and P/Q-type VDCCs were performed in rat cortical homogenates. The effects of antiglaucoma drugs on the NMDA-stimulated influx of 45Ca2+ were studied in isolated rat retinas. RESULTS Only beta-adrenoceptor antagonists significantly interacted with radioligand binding to L-type VDCCs, with betaxolol displaying the highest potency. None of the antiglaucoma drugs tested showed any significant affinity for either N- or P/Q-type VDCCs. Only beta-adrenoceptor antagonists attenuated the NMDA-stimulated 45Ca2+ influx into isolated rat retinas, with betaxolol exhibiting at least 10 times higher potency than timolol. Brimonidine, dorzolamide, latanoprost and pilocarpine did not elicit any significant effect on the NMDA-stimulated 45Ca2+ influx. Additional experiments strongly suggested that the effect of betaxolol on the NMDA-stimulated 45Ca2+ resulted from inhibition of L-type VDCCs. CONCLUSION Of the antiglaucoma drugs investigated, betaxolol displays the greatest L-type VDCC-blocking activity and this may be of clinical relevance. Such a characteristic could account for some of its described ocular actions.
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Affiliation(s)
- J Melena
- Nuffield Laboratory of Ophthalmology, Oxford University, UK
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Abstract
The study examined whether the simultaneous presentation of different map displays can aid situational awareness in spatial tasks relying on ego-centred and world-centred reference frames. Two commonly used aircraft displays, track-up and north-up maps, were compared with a dual aircraft display consisting of both track-up and north-up maps. Participants took part in two tasks: one relied on an ego-centred reference frame (ERF) and the other on a world-centred reference frame (WRF). The ERF task involved left/right judgements with respect to the aircraft's current heading while in the WRF task participants were asked to identify the compass heading associated with a landmark. A moderate amount of training resulted in a significant improvement with the dual maps in both the WRF task (relative to track-up maps) and the ERF task (relative to north-up maps). The findings are discussed with reference to how attention is allocated to visual displays.
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Affiliation(s)
- M Tlauka
- Department of Psychology, University of Leicester, UK.
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Abstract
OBJECTIVE To define the prevalence of gonorrhea, chlamydial infection, and high-risk sexual behavior in an HIV primary care clinic. DESIGN Subjects enrolling in this cross-sectional study answered a brief interviewer-administered questionnaire and provided a urine sample for gonorrhea and chlamydia testing. SETTING A large urban HIV primary care clinic. PARTICIPANTS HIV-infected patients presenting for a scheduled medical visit from June 1997 to April 1998. MAIN OUTCOME MEASURES Prevalence of self-reported high-risk sexual behavior and gonorrhea and chlamydial infection. RESULTS Of 691 patients consenting to the study over a 10-month period, 58% reported sexual activity in the past 90 days, 7.4% reported multiple sexual partners in the past month, and 34.6% did not use a condom at last sexual encounter. Overall, 4.6% reported a history of either gonorrhea or a chlamydial infection in the past year. Of 637 giving a urine sample for testing, the prevalence of chlamydial infection was 2.4%; the prevalence of gonorrhea was 1.6%. Overall, 7.5% of those screened had either current or recent (within 1 year) gonorrhea or chlamydial infection. Current or recent gonorrhea or chlamydial infection was not associated with age, gender, HIV transmission risk, CD4 cell count, HIV viral load, symptoms, or self-reported risk behavior. CONCLUSION High-risk sexual behavior and unrecognized sexually transmitted diseases (STD) are common among HIV-infected persons followed in primary medical care. Enhanced detection of treatable STD among this population coupled with improved risk-reduction counselling may be important clinical practice measures that can curb the spread of HIV.
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Affiliation(s)
- E J Erbelding
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Stanton D, Foreman N, Wilson PN. Uses of virtual reality in clinical training: developing the spatial skills of children with mobility impairments. Stud Health Technol Inform 1999; 58:219-32. [PMID: 10350923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
In this chapter we review some of the ways in which the skills learned in virtual environments (VEs) transfer to real situations, and in particular how information about the spatial layouts of virtual buildings acquired from the exploration of three-dimensional computer-simulations transfers to their real equivalents. Four experiments are briefly described which examined VR use by disabled children. We conclude that spatial information of the kind required for navigation transfers effectively from virtual to real situations. Spatial skills in disabled children showed progressive improvement with repeated exploration of virtual environments. The results are discussed in relation to the potential future benefits of VR in special needs education and training.
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Affiliation(s)
- D Stanton
- Dept. of Psychology, University of Reading, Whiteknights, UK
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Kempers K, Castello B, Bruno J, Stanton D, Foote J. The dermal-fat graft: indications/complications. Int J Oral Maxillofac Surg 1999. [DOI: 10.1016/s0901-5027(99)81085-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- P N Wilson
- Department of Psychology, University of Leicester, UK
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Abstract
Virtual reality, or virtual environment computer technology, generates simulated objects and events with which people can interact. Existing and potential applications for this technology in the field of disability and rehabilitation are discussed. The main benefits identified for disabled people are that they can engage in a range of activities in a simulator relatively free from the limitations imposed by their disability, and they can do so in safety. Evidence that the knowledge and skills acquired by disabled individuals in simulated environments can transfer to the real world is presented. In particular, spatial information and life skills learned in a virtual environment have been shown to transfer to the real world. Applications for visually impaired people are discussed, and the potential for medical interventions and the assessment and treatment of neurological damage are considered. Finally some current limitations of the technology, and ethical concerns in relation to disability, are discussed.
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Affiliation(s)
- P N Wilson
- Department of Psychology, University of Leicester, UK
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Affiliation(s)
- D L Suskind
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, USA
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37
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Abstract
The origins of arthropods and the phylogenetic relationships among their three major living groups (atelocerates, crustaceans and chelicerates) are vigorously contended. To help resolve this, we determined mitochondrial gene arrangements for a chelicerate, a myriapod, two crustaceans, an onychophoran, a mollusc and an annelid, and compared them with published gene orders of other species. The result strongly supports the monophyly of Arthropoda and of Mandibulata (atelocerates plus crustaceans) and refutes the Uniramia (atelocerates plus onychophorans). Gene arrangement comparisons are emerging as a powerful new tool for resolving ancient phylogenetic relationships.
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Affiliation(s)
- J L Boore
- Department of Biology, University of Michigan, Ann Arbor 48109-1048, USA
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Abstract
BACKGROUND Guidelines for drug therapy in human immunodeficiency virus (HIV) disease are based primarily on the stage of the disease. To determine whether sociodemographic characteristics of patients influence drug therapy in practice, we analyzed the use of antiretroviral therapy and prophylactic therapy for Pneumocystis carinii pneumonia (PCP) in an urban population infected with HIV. METHODS All patients presenting for the first time to our HIV clinic from March 1990 through December 1992 were enrolled. Data on sociodemographic and clinical variables and on drug use were collected at the time of presentation and after six months. We asked whether patients with CD4+ cell counts of 500 or less per cubic millimeter were receiving antiretroviral therapy at the time of presentation, and whether patients with CD4+ cell counts of 200 or less per cubic millimeter were receiving PCP prophylaxis. RESULTS Among the 838 patients enrolled, 656 (79 percent) were blacks, 167 (20 percent) were non-Hispanic whites, and 15 (2 percent) were Asian or Hispanic descent or were not racially classified. There were no racial differences in the stage of HIV disease at the time of presentation. However, there were racial disparities in the receipt of antiretroviral therapy: 63 percent of eligible whites but only 48 percent of eligible blacks received such therapy (P = 0.003). PCP prophylaxis was received by 82 percent of eligible whites but only 58 percent of eligible blacks (P < 0.001). There were no significant differences in the receipt of drug therapy with respect to age, sex, mode of HIV transmission, type of insurance, income, education, or place of residence. In a logistic-regression analysis, race was the feature most strongly associated with the receipt of drug therapy. When blacks were compared with whites, the adjusted relative odds were 0.59 (95 percent confidence interval, 0.38 to 0.93) for the receipt of an antiretroviral agent and 0.27 (95 percent confidence interval, 0.13 to 0.56) for the receipt of PCP prophylaxis. CONCLUSIONS Among patients infected with HIV, blacks were significantly less likely than whites to have received antiretroviral therapy or PCP prophylaxis when they were first referred to an HIV clinic. This disparity suggests a need for culturally specific interventions to ensure uniform access to care, including drug therapy, and uniform standards of care.
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Affiliation(s)
- R D Moore
- Johns Hopkins University School of Medicine, Baltimore, MD 21205
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Abstract
OBJECTIVE To assess the accuracy of three clinical case definitions for advanced HIV disease: the World Health Organization (WHO) case definition, and the original and revised Caracas case definitions. DESIGN Retrospective chart review. SETTING A clinic for patients with all stages of HIV infection at the Johns Hopkins Hospital, Baltimore, [correction of Bethesda] Maryland, USA, a tertiary care university hospital. PATIENTS, PARTICIPANTS Two hundred and twenty-four HIV-positive adults who underwent initial evaluation between 1 January 1990 and 31 December 1990. MAIN OUTCOME MEASURES A score for each definition was assigned based on initial evaluation. The sensitivity, specificity, and predictive values were calculated using the Centers for Disease Control (CDC) staging criteria, and results were correlated with total CD4 cell counts. RESULTS The sensitivities of the WHO, and the original and revised Caracas definitions were 40, 67, and 60%, respectively, using CDC disease stage IV as a positive standard. Specificities were between 99 and 100%, using CDC stage II-III disease as a negative standard. Mean CD4 cell counts for patients with positive scores were 184, 160, and 158 x 10(6)/l, respectively, compared to 191 x 10(6)/l for CDC stage IV patients. Sensitivity was lower when the positive standard was expanded to include all patients with CD4 cell counts less than 200 x 10(6)/l. CONCLUSIONS In our study population, case definitions were specific, but only moderately sensitive for advanced HIV disease. Prospective studies should be conducted in diverse geographic regions, using lymphocyte or CD4 cell counts when possible.
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Affiliation(s)
- J E Gallant
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
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40
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Abstract
Treatment of porcine heparin with the ferrous-EDTA complex and ascorbic acid for 24 h at 37 degrees C results in the degradation of most of the glycosaminoglycan to smaller fragments. About 65% of the products comprise oligosaccharides composed of less than 30 sugar units. The extent of depolymerization is decreased significantly if ascorbate or EDTA is not included in the reaction mixture. Gel filtration of the reaction products yielded fractions with narrow chain length ranges. The sulfate content of the fractions and their electrophoretic mobilities on cellulose acetate indicate that the components have equivalent charge densities. Depolymerization products with 20 or more sugar units retain significant anticoagulant potencies as measured by their effect in accelerating the neutralization of factor Xa by antithrombin.
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Affiliation(s)
- B Lahiri
- Department of Biochemistry and Molecular Biology, New York Medical College, Valhalla 10595
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41
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Abstract
Perfluoroisobutene (PFIB) is a hydrophobic reactive gas produced by the pyrolysis of polytetrafluoroethane which induces pulmonary oedema similar to that induced by phosgene when inhaled. When a lethal dose is inhaled by Porton strain rats total non-protein thiol (NPSH) and glutathione (GSH) in the lung are reduced by between 30 and 49%, respectively. If the endogenous levels of thiols in the lung are reduced by pretreatment with buthionine sulfoximine (BSO) 16 hr before exposure to PFIB, the rats become more susceptible to the effects of the gas. The effect of BSO pretreatment on toxicity was prevented by pretreatment 30 min before exposure, with 5 mmol/kg N-acetylcysteine (NAc). NAc increased the levels of cysteine (CySH) in the lung by 150% and GSH was unaffected. Similarly pretreatment with 3 mmol/kg CySH also protected against toxicity and raised CySH levels by 100%. A series of cysteine esters and cystine dimethyl ester (CDME) have been synthesised which selectively raise lung levels of CySH in the rat lungs after intraperitoneal (i.p.) injection. The methyl ester and CDME raised lung levels of CySH by 4000 and 2000%, respectively, 10 min after i.p. injection whilst GSH levels remained unchanged. Cysteine isopropyl ester raised lung levels of CySH by 10,600% but liver levels by only 1400%. All esters except the t-butyl ester (CTBE) also raised maximal plasma levels of NPSH by up to 500%; however, when NAc was injected plasma levels increased by over 1500%. Rats treated with these esters at 3 mmol/kg and with NAc at 5 mmol/kg were protected against lethal doses of PFIB in all cases except when CTBE was used. It appears that these cysteine esters may distribute preferentially into the lung, unlike NAc. The selective enhancement of pulmonary CySH levels may provide a method for the protection of lungs against inhaled reactive toxicants by increasing intracellular CySH. Levels of CySH may also be raised in epithelial lining fluid thus reducing access of gaseous toxicants to pulmonary tissue.
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Affiliation(s)
- A F Lailey
- Biology Division, Chemical and Biological Defence Establishment, Porton Down, Salisbury, Wiltshire, U.K
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Stanton D. Electronic anesthesia garners approval from dental researchers. Dentist 1988; 66:34. [PMID: 3265096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Lou DY, Martinez A, Stanton D. Surface profile measurement with a dual-beam optical system. Appl Opt 1984; 23:746. [PMID: 18204636 DOI: 10.1364/ao.23.000746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Corn M, Kotsko N, Stanton D. Mass-transfer coefficient for sulphur dioxide and nitrogen dioxide removal in cat upper respiratory tract. Ann Occup Hyg 1976; 19:1-12. [PMID: 970840 DOI: 10.1093/annhyg/19.1.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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45
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Corn M, Kotsko N, Stanton D, Bell W, Thomas AP. Response of cats to inhaled mixtures of SO 2 and SO 2 -NaCl aerosol in air. Arch Environ Health 1972; 24:248-56. [PMID: 5014214 DOI: 10.1080/00039896.1972.10666079] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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46
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Stanton D, Vetter HJ. The mental health specialist as consultant in a chronic disease hospital. Psychiatr Q 1968; 42:Suppl:282-96. [PMID: 5748002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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