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Shields M, James D, McCormack L. Organisational challenges to wellbeing in nuclear medicine technologists: Professionalism, burnout and pragmatic growth. Radiography (Lond) 2024; 30:622-627. [PMID: 38330894 DOI: 10.1016/j.radi.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Occupational risk for burnout in nuclear medicine technologists globally, and particularly during disaster demands on the profession, is poorly researched. This idiographic study explored the lived experience of nuclear medicine technologists during COVID-19 in a regional city in Australia. METHODS Data was collected from five participants using semi-structured interviews and transcribed and analysed according to the protocols of Interpretative Phenomenological Analysis (IPA). RESULTS Four group experiential themes were identified: Systemic Contraindications, Professional Strengths and Limitations, Pragmatic Growth, and Covid Rollercoaster. For these participants a dichotomous health care system, impacted by COVID-19, risked career longevity and burnout. Through empathic connection with vulnerable patients, they redefined their priorities, re-engaged in supportive connections with colleagues, and sought new pathways. CONCLUSION Multiple workplace stressors compounded by COVID-19, risked mental wellbeing, in these participants. Nevertheless, these challenges provided opportunities for reflection around career trajectory and longevity precipitating personal growth, job satisfaction and work-life balance. IMPLICATIONS FOR PRACTICE This study provided a lens on the risk factors inherent for nuclear medicine technologists in Australia, exacerbated by the COVID-19 pandemic. Current, and disaster protective practices, to ensure wellbeing and prevent burnout risk are recommended for future research.
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Affiliation(s)
- M Shields
- The University of Newcastle, University Dr, Callaghan, NSW, 2308, Australia.
| | - D James
- The University of Newcastle, University Dr, Callaghan, NSW, 2308, Australia.
| | - L McCormack
- The University of Newcastle, University Dr, Callaghan, NSW, 2308, Australia.
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Almeida NMS, Bali SK, James D, Wang C, Wilson AK. Binding of Per- and Polyfluoroalkyl Substances (PFAS) to the PPARγ/RXRα-DNA Complex. J Chem Inf Model 2023; 63:7423-7443. [PMID: 37990410 DOI: 10.1021/acs.jcim.3c01384] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Nuclear receptors are the fundamental building blocks of gene expression regulation and the focus of many drug targets. While binding to DNA, nuclear receptors act as transcription factors, governing a multitude of functions in the human body. Peroxisome proliferator-activator receptor γ (PPARγ) and the retinoid X receptor α (RXRα) form heterodimers with unique properties and have a primordial role in insulin sensitization. This PPARγ/RXRα heterodimer has been shown to be impacted by per- and polyfluoroalkyl substances (PFAS) and linked to a variety of significant health conditions in humans. Herein, a selection of the most common PFAS (legacy and emerging) was studied utilizing molecular dynamics simulations for PPARγ/RXRα. The local and global structural effects of PFAS binding on the known ligand binding pockets of PPARγ and RXRα as well as the DNA binding domain (DBD) of RXRα were inspected. The binding free energies were predicted computationally and were compared between the different binding pockets. In addition, two electronic structure approaches were utilized to model the interaction of PFAS within the DNA binding domain, density functional theory (DFT) and domain-based pair natural orbital coupled cluster with perturbative triples (DLPNO-CCSD(T)) approaches, with implicit solvation. Residue decomposition and hydrogen-bonding analysis were also performed, detailing the role of prominent residues in molecular recognition. The role of l-carnitine is explored as a potential in vivo remediation strategy for PFAS interaction with the PPARγ/RXRα heterodimer. In this work, it was found that PFAS can bind and act as agonists for all of the investigated pockets. For the first time in the literature, PFAS are postulated to bind to the DNA binding domain in a nonspecific manner. In addition, for the PPARγ ligand binding domain, l-carnitine shows promise in replacing smaller PFAS from the pocket.
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Affiliation(s)
- Nuno M S Almeida
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48864, United States
| | - Semiha Kevser Bali
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48864, United States
| | - Deepak James
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48864, United States
| | - Cong Wang
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48864, United States
| | - Angela K Wilson
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48864, United States
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Kevser Bali S, Almeida NM, James D, Nair A, Wilson AK. The effect of PFASs on PPAR-gamma/RXR-alpha heterodimer. Biophys J 2023; 122:20a. [PMID: 36783016 DOI: 10.1016/j.bpj.2022.11.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Affiliation(s)
| | - Nuno M Almeida
- Chemistry, Michigan State University, East Lansing, MI, USA
| | - Deepak James
- Chemistry, Michigan State University, East Lansing, MI, USA
| | - Arohi Nair
- Chemistry, Michigan State University, East Lansing, MI, USA
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Dive A, Singhal R, Srivastava S, Shukre K, James D, Shetty S. Isolation and functional characterization of novel isoprene synthase from Artocarpus heterophyllus (jackfruit). 3 Biotech 2023; 13:24. [PMID: 36573156 PMCID: PMC9789294 DOI: 10.1007/s13205-022-03441-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Isoprene, a Natural Volatile Organic Compound (NVOC) is one of the chief by-products of plant metabolism with important applications in the synthesis of rubber and pharmaceuticals as a platform molecule. Isoprene was obtained earlier from petroleum sources; however, to synthesise it new fermentation-based strategies are being adopted. Bioinformatics tools were utilised to isolate the Isoprene Synthase (IspS) gene which converts the precursors Isopentenyl Diphosphate (IPP) and Dimethylallyl Diphosphate (DMAPP) into isoprene. Metabolic engineering strategies were to synthesise an isoprene-producing recombinant clone derived from Artocarpus heterophyllus (jackfruit). The functional characterization was done using the overexpression of the isoprene synthase gene in an Escherichia coli BL21 host. The recombinant clone, ISPS_GBL_001 (submitted to GenBank, National Centre for Biotechnology Information or NCBI) was used for fermentation in the batch and fed-batch mode to produce isoprene. Isoprene productivity of 0.08 g/g dextrose was obtained via the fed-batch mode maintaining the process parameters at optimum. The quantification and confirmation of isoprene was done using gas chromatography (GC) and GC-mass spectrometry (GC-MS) of the extracted sample, respectively. This study makes significant contribution to the ongoing research on bio-isoprene synthesis by highlighting a novel plant source of the IspS gene followed by, its successful expression in a recombinant host, validated by fermentation. Supplementary Information The online version contains supplementary material available at 10.1007/s13205-022-03441-7.
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Affiliation(s)
- Amol Dive
- Institute of Chemical Technology, Matunga, Mumbai, India
- Godavari Biorefineries Ltd., Mahape, Navi Mumbai, India
| | - Rekha Singhal
- Institute of Chemical Technology, Matunga, Mumbai, India
| | | | - Kedar Shukre
- Godavari Biorefineries Ltd., Mahape, Navi Mumbai, India
| | - Deepak James
- Godavari Biorefineries Ltd., Mahape, Navi Mumbai, India
| | - Sneha Shetty
- Godavari Biorefineries Ltd., Mahape, Navi Mumbai, India
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Verma S, James D, Lavanya J, Rawat A, Venkataseshan S, Aggarwal N. 577. Cord Blood Protective Antibodies Seroprevalence against Diphtheria, Pertussis, Measles, Mumps and Rubella at Birth among Healthy Term Indian Neonates. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
The resurgence of vaccine preventable diseases in young infants is a matter of concern worldwide. Cord blood antibodies seroprevalence against various vaccine preventable diseases could reflect protection rates among adults, which could be important in providing protection in early infancy of newborn baby. Tdap vaccination is not yet part of immunization program for pregnant women in India.
Methods
Apparently healthy term newborns, delivered at a tertiary care hospital in Northern India, over two-year period were enrolled after taking informed written consent from their parents, and their cord blood sample was collected at birth. Ethical clearance was obtained from Institute Ethics Committee before starting enrollment.
Results
A total of 160 newborns (M:F=86:74) were enrolled. In our study, antibodies (IgG) against diphtheria toxin (DT) were >0.1 IU/ml in 44.4% (71/160), 0.01 to 0.1 IU/ml in 53.1% (85/160) and < 0.01 IU/ml in 2.5% (4/160). Only 44.4% of them were fully protected at birth against diphtheria.
Antibodies (IgG) against pertussis toxin (PT) >40 U/ml were seen in 41.2% (66/160). Out of these 66 children, 23 had titers >100 U/ml. Total of 58.8% (94/160) children had antibodies < 40 U/ml. Out of these 94 children, 48 had titers < 20 U/ml. Since correlates of protection in pertussis are not defined; those having titers >100 U/ml i.e. 14.3% were most protected; while those having titers < 20 U/ml were least protected.
Antibodies (IgG) against measles antigen were >12 IU/ml in 88.8% (142/160). Antibodies (IgG) against mumps antigen were >12 IU/ml in 83.1% (133/160). Antibodies (IgG) against rubella antigen were >12 IU/ml in 83.7% (134/160).
Conclusion
Protective antibodies against diphtheria and pertussis toxins were less in the studied newborns at birth making them susceptible to these diseases in early infancy, before primary vaccination commences. Tdap vaccination for pregnant mothers in India could help in improving these titers and protection in early infancy. Protective antibodies against measles, mumps and rubella in studied newborns at birth were satisfactory. For further enhancing protection, especially against rubella, one dose of MMR vaccine may be advised for women in child bearing age.
Acknowledgement: PGI Intramural Research Grant
Disclosures
All Authors: No reported disclosures.
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Affiliation(s)
- Sanjay Verma
- PGIMER , Chandigarh, India, Chandigarh, Chandigarh , India
| | - Deepak James
- PGIMER , CHANDIGARH, INDIA, Chandigarh, Chandigarh , India
| | - Jula Lavanya
- PGIMER , CHANDIGARH, INDIA, Chandigarh, Chandigarh , India
| | - Amit Rawat
- PGIMER , CHANDIGARH, INDIA, Chandigarh, Chandigarh , India
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7
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James D, McQueen D. Best Practices for Partnering with Black Churches to Recruit African American Women into mHealth Weight Management Programs. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.06.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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8
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Ross P, Wasan H, Croagh D, Nikfarjam M, Nguyen N, Aghmesheh M, Nagrial A, Bartholomeusz D, Hendlisz A, Ajithkumar T, Iwuji C, Turner D, James D, Harris M. 1308P Comparison of tumour size on outcomes for patients with unresectable locally advanced pancreatic adenocarcinoma (LAPC) receiving P-32 microparticles with standard-of-care chemotherapy (SoC CT). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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9
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Jena A, James D, Singh AK, Dutta U, Sebastian S, Sharma V. Effectiveness and Durability of COVID-19 Vaccination in 9447 Patients With IBD: A Systematic Review and Meta-Analysis. Clin Gastroenterol Hepatol 2022; 20:1456-1479.e18. [PMID: 35189387 PMCID: PMC8856753 DOI: 10.1016/j.cgh.2022.02.030] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS The serological responses after severe acute respiratory syndrome coronavirus 2 vaccination may be attenuated in immunocompromised individuals. The study aimed to systematically evaluate the seroconversion rates after complete vaccination for coronavirus disease 2019 (COVID-19) in patients with inflammatory bowel disease (IBD). METHODS Electronic databases were searched to identify studies reporting response to COVID-19 vaccination in IBD. Pooled seroconversion rates after complete vaccination were calculated. Subgroup analysis for vaccine types was also performed. Pooled seroconversion rates for various drugs or classes were also estimated. The pooled rates of breakthrough infections in vaccinated IBD patients were estimated. The pooled neutralization rates after complete vaccination were also estimated. The studies reporting durability of titers were systematically assessed. RESULTS A total of 46 studies were included. The pooled seroconversion rate for complete vaccination (31 studies, 9447 patients) was 0.96 (95% confidence interval [CI], 0.94-0.97; I2 = 90%). When compared with healthy control subjects, the pooled relative risk of seroconversion was lower (0.98; 95% CI, 0.98-0.99; I2 = 39%). The pooled seroconversion rates were statistically similar among various drug classes. The pooled positivity of neutralization assays (8 studies, 771 participants) was 0.80 (95% CI, 0.70-0.87; I2 = 82%). The pooled relative risk of breakthrough infections in vaccinated IBD patients was similar to vaccinated control subjects (0.60; 95% CI, 0.25-1.42; I2 = 79%). Most studies suggested that titers fall after 4 weeks of COVID-19 vaccination, and the decay was higher in patients on anti-tumor necrosis factor alone or combination with immunomodulators. An additional dose of COVID-19 vaccine elicited serological response in most nonresponders to complete vaccination. CONCLUSIONS Complete COVID-19 vaccination is associated with seroconversion in most patients with IBD. The decay in titers over time necessitates consideration of additional doses in these patients.
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Affiliation(s)
- Anuraag Jena
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepak James
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anupam K Singh
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Usha Dutta
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shaji Sebastian
- IBD Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - Vishal Sharma
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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Man L, Lustgarten Guahmich N, Kallinos E, Bodine R, Zaninovic N, Schattman G, Rosenwaks Z, James D. P-478 Deleterious influence of cyclophosphamide on primordial follicles derives from increased DNA damage and reduced proliferation in xenotransplanted human ovarian tissue. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
What are the acute effects of cyclophosphamide (Cp) on primordial follicles (PrFs) in human ovarian tissue?
Summary answer
Administration of Cp damages PrFs via DNA fragmentation and results in reduced proliferation with no increase in PrF activation markers.
What is known already
Alkylating agents are highly gonadotoxic, and in cases where freezing oocytes, embryos, or ovarian tissue is impractical, a better understanding of the underlying damage mechanism could enable development of fertoprotective approaches (1). Studies from different groups suggest conflicting mechanisms of ovarian damage, with either PrF activation (2) or cell damage and apoptosis (3-4) proposed as drivers of PrF depletion. Few studies have examined this question using human tissue. We performed xenografts using ovarian tissue from a 17-month-old girl to ensure a graft with plentiful PrFs to test the acute effect of Cp.
Study design, size, duration
Cross-sectional study.
We utilized a xenotransplantation model in which human ovarian tissue is co-transplanted with endothelial cells (ECs) into immunocompromised mice (NSG) (5). Three weeks after xenotransplantation, time 0, intraperitoneal (IP) injection of (saline/Cp) was followed by an IP injection of ethynyl-deoxyuridine (Edu), at 0 and 24 hours, followed by 5-chloro-2′-deoxyuridine (CldU), at 48 and 72 hours. Grafts were harvested at 96 hours.
Participants/materials, setting, methods
We co-xenotransplanted human ovarian cortical tissue from a 17-month-old girl, cryopreserved for fertility preservation, into immunocompromised mice. After 3 weeks, Cp (75mg/Kg)/saline was administered IP. Mice were then sequentially injected with EdU, followed by CldU (both at 100mg/kg for 2 days) 24 hours apart. Twenty-four hours later, mice were sacrificed and xenografts were harvested and sectioned. Slides were stained for EdU, CldU, VASA, γ-H2AX, FOXO3a, and 4',6-Diamidino-2-Phenylindole-Dilactate (DAPI) and imaged using a confocal microscope.
Main results and the role of chance
We used anti-VASA staining to evaluate oocyte morphology, confirming that chemotherapy was not sterilizing; we counted 76.5% of morphologically normal PrF in the control group (Ctrl) (130/170) and 35.1% (13/37) in the Cp group. In the Ctrl group, 11% stained positively for DNA fragmentation using anti-γ-H2AX, whereas 43% were positive in the Cp group (p = 0.0073). To evaluate activation, we stained for FOXO3a in the oocyte nucleus. No difference was found between the groups: 52.4% (74/144) versus 44.6% (37/83) in Ctrl versus Cp, respectively. Interestingly, when comparing EdU incorporation, the Ctrl group had higher incorporation at 72%, versus the Cp group with 40% of incorporation (p = 0.0485), and no difference was found with CldU incorporation: Ctrl 22% versus 27% in the Cp group, respectively (P = 0.6960).
Limitations, reasons for caution
We measured acute effects, DNA fragmentation, and proliferation, at five days post-Cp administration; however, this falls short of evaluating processes that appear later (fibrosis and neovascularization). Also, the results may partly stem from the patient’s young age. Repeating the experiment using adult-derived tissue might yield different results.
Wider implications of the findings
A better understanding of both the timeline and underlying mechanisms that contribute to chemotherapy-related gonadotoxicity could diminish the damage and depletion of the ovarian reserve (PrF). These results provide evidence that direct damage to PrFs, and not increased activation, contributes to gonadotoxicity in the acute phase following administration of Cp.
Trial registration number
NA
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Affiliation(s)
- L Man
- Weill Cornell medicine, Center for Reproductive Medicine , New York City, U.S.A
| | | | - E Kallinos
- Weill Cornell medicine, Center for Reproductive Medicine , New York City, U.S.A
| | - R Bodine
- Weill Cornell medicine, Center for Reproductive Medicine , New York City, U.S.A
| | - N Zaninovic
- Weill Cornell medicine, Center for Reproductive Medicine , New York City, U.S.A
| | - G Schattman
- Weill Cornell medicine, Center for Reproductive Medicine , New York City, U.S.A
| | - Z Rosenwaks
- Weill Cornell medicine, Center for Reproductive Medicine , New York City, U.S.A
| | - D James
- Weill Cornell medicine, Center for Reproductive Medicine , New York City, U.S.A
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11
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James D, Jena A, Bharath PN, Choudhury A, Singh AK, Sebastian S, Sharma V. Safety of SARS-CoV-2 vaccination in patients with inflammatory bowel disease: A systematic review and meta-analysis. Dig Liver Dis 2022; 54:713-721. [PMID: 35382972 PMCID: PMC8938236 DOI: 10.1016/j.dld.2022.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Risk of adverse effects and flare of inflammatory bowel disease (IBD) are frequently cited reasons for COVID-19 vaccine hesitancy. METHODS Electronic databases were searched to identify studies reporting the use of COVID-19 vaccine in IBD. We selected studies reporting the incidence of various adverse effects (local or systemic) and flares of IBD after COVID-19 vaccination. The pooled incidence rates for various adverse effects, stratified for the dose and the type of vaccine (adenoviral or mRNA) were estimated. RESULTS Nine studies (16 vaccination cohorts) were included. The pooled incidence rate of overall adverse events was 0.55 (95%CI, 0.45-0.64, I2= 95%). The pooled incidence rate of local adverse events was 0.64 (0.47-0.78, I2= 100%). The pooled incidence rates of fatigue, headache, myalgia, fever and chills were 0.30 (0.21-0.40, I2= 99%), 0.23 (0.17-0.30, I2= 99%), 0.18 (0.13-0.24, I2= 99%), 0.10 (0.06-0.17, I2= 98%) and 0.15 (0.06-0.3, I2= 86%), respectively. The pooled incidence rates of severe adverse events, adverse events requiring hospitalization and flares of IBD following COVID-19 vaccination were 0.02 (0.00-0.12, I2= 97%), 0.00 (0.00-0.01, I2= 27%) and 0.01 (0.01-0.03, I2= 45%), respectively. CONCLUSION COVID-19 vaccination in patients with IBD appears to be safe with only mild adverse events. Flares of IBD and severe adverse events requiring hospitalization were infrequent.
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Affiliation(s)
- Deepak James
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuraag Jena
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pardhu Neelam Bharath
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arup Choudhury
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anupam K. Singh
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Vishal Sharma
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,Corresponding author
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12
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Muktesh G, Samanta J, Dhar J, Agarwala R, Bellam BL, James D, Gupta P, Chauhan R, Yadav TD, Gupta V, Sinha SK, Kochhar R. Endoscopic Ultrasound-guided Drainage of Patients With Infected Walled-off Necrosis: Which Stent to Choose? Surg Laparosc Endosc Percutan Tech 2022; 32:335-341. [PMID: 35258015 DOI: 10.1097/sle.0000000000001046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/25/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Endoscopic ultrasound (EUS)-guided drainage is the preferred treatment of pancreatic fluid collections (PFC). However, the choice of the stent for EUS-guided drainage in critically ill PFC cases with infected walled-off necrosis (WON) and/or organ failure (OF) remains unknown. MATERIALS AND METHODS Between January 2018 and December 2019, consecutive patients with symptomatic PFC subjected to EUS-guided drainage using biflanged metal stents (BFMS) or double-pigtail plastic stents (DPPS) were compared for technical success, clinical success, duration of the procedure, need for intensive care unit stay, duration of intensive care unit stay, ventilator need, resolution of OF, the duration for resolution of OF, complications, need for salvage percutaneous drainage or surgery and mortality. A subgroup of patients having infected WON with/without OF were analyzed separately. RESULTS Among 120 patients (84.6% males) with PFC (108 WON, 22 pseudocyst) who underwent EUS-guided drainage, there was no difference in outcome parameters in BFMS and DPPS groups. Among patients with WON, clinical success was significantly higher (96.2% vs. 81.8%, P=0.04), with significantly shorter hospital stay (6 vs. 10 d) and procedure duration (17.18±4.6 vs. 43.6±9.7 min, P<0.0001) in the BFMS group. Among patients with infected WON with/without OF, the clinical success was significantly higher (100% vs. 73.9%, P=0.02), and the duration of the procedure was significantly lower (16.28±4.4 vs. 44.39±10.7, P<0.0001) in BFMS compared with DPPS group. CONCLUSION EUS-guided drainage of WON using BFMS scores over DPPS. In patients having infected WON with/without OF, BFMS may be preferred over DPPS.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Thakur D Yadav
- Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Vikas Gupta
- Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
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Roth N, Khalil N, Moore-Gillon C, James D, Gilby L, Morgan C. 737 STOOLS FOR STOOLS - COMBINING MEDICAL AND CONSERVATIVE TREATMENTS TO REDUCE CONSTIPATION IN THE ELDERLY INPATIENT POPULATION. Age Ageing 2022. [DOI: 10.1093/ageing/afac034.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Constipation is a common cause of morbidity in the elderly. Its management is particularly challenging in the inpatient population, where many factors exacerbate constipation. We describe a Quality Improvement Project to reduce the rates of constipation on a female Medicine for the Elderly ward.
Aims
Our aim was to increase bowel chart documentation (nursing and doctor entries) and increase patient frequency of bowel motions to at least once every two days. In particular we focused on conservative measures such as the use of footstools to optimise posture when using commodes and toilets [R Hari Krishnan, Proc Inst Mech Eng H, 2019, 233(4):464–475].
Method
• Weekly monitoring of ward inpatients. • Measurements taken were: days since last bowel motion, laxatives prescribed, bowel chart and ward round documentation, and episodes of diarrhoea over the past week. • One episode of diarrhoea was defined as 3 motions of type 6 or type 7 stool in 24 hours. • A new intervention was introduced every two weeks, over a total of 2 months. Interventions: 1. Recording bowel motions at the daily ‘Board Round’ Multi-Disciplinary Meeting. 2. Ward staff education sessions. 3. Footstools for use with commodes and toilets. 4. High-fibre foods to patients with constipation.
Results
Level of constipation was successfully reduced, with 100% patients moving bowels every 2 days from a baseline of 68%. Ward round and bowel chart documentation improved to 100% and 93.3% respectively (from 41.3% and 33.3%). However, incidence of diarrhoea increased from 0 episodes/week to 8 episodes/week, with laxative prescriptions similarly increased from 50% to 86%.
Conclusion
Constipation improved with our interventions, but at the unintended cost of laxative-associated diarrhoea. Our next steps will be to reduce laxative prescriptions in favour of conservative measures, in order to reduce episodes of loose stool while maintaining our improved constipation rates.
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Affiliation(s)
- N Roth
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - N Khalil
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - C Moore-Gillon
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - D James
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - L Gilby
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
| | - C Morgan
- Department for Medicine for the Elderly, St. Mary’s Hospital, Imperial College Healthcare NHS Trust
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Warford L, Mason C, Lonsdale J, Bersuder P, Blake S, Evans N, Thomas B, James D. A reassessment of TBT action levels for determining the fate of dredged sediments in the United Kingdom. Mar Pollut Bull 2022; 176:113439. [PMID: 35183026 DOI: 10.1016/j.marpolbul.2022.113439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 06/14/2023]
Abstract
As part of reviewing the United Kingdom (UK) action levels (ALs) of contaminants for managing the disposal of dredged marine sediment material, tributyl tin (TBT) has been reassessed. TBT is a banned biocide capable of causing severe harm to the marine environment. Its presence is routinely screened for prior to marine disposal of dredged sediment material. Dredged sediment TBT concentrations have been studied using UK monitoring data obtained between 2000 and 2018. The changes in these TBT concentrations have guided the reassessment of ALs. Recent toxicity studies have also guided the reassessment of TBT ALs. This study, which itself forms part of a larger review by the Department for Environment, Food and Rural Affairs, has concluded that current UK TBT ALs may no longer be fit for purpose. A more environmentally protective approach for controlling release of TBT into the marine environment is recommended.
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Affiliation(s)
- L Warford
- Cefas, Lowestoft, Suffolk NR33 0HT, UK.
| | - C Mason
- Cefas, Lowestoft, Suffolk NR33 0HT, UK
| | | | | | - S Blake
- Cefas, Lowestoft, Suffolk NR33 0HT, UK
| | - N Evans
- Nottingham Trent University, Nottingham NG11 8NS, UK
| | - B Thomas
- Cefas, Lowestoft, Suffolk NR33 0HT, UK
| | - D James
- Cefas, Lowestoft, Suffolk NR33 0HT, UK
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Bell SF, Roberts TCD, Freyer Martins Pereira J, De Lloyd L, Amir Z, James D, Jenkins PV, Collis RE, Collins PW. The sensitivity and specificity of rotational thromboelastometry (ROTEM) to detect coagulopathy during moderate and severe postpartum haemorrhage: a prospective observational study. Int J Obstet Anesth 2021; 49:103238. [PMID: 34840018 DOI: 10.1016/j.ijoa.2021.103238] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 10/23/2021] [Accepted: 10/31/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Point-of-care viscoelastic haemostatic assays such as rotational thromboelastometry (including ROTEM and TEG) have been used in the management of postpartum haemorrhage (PPH). This study compared results obtained from the automated ROTEM Sigma with laboratory tests of coagulation and platelet count during PPH. METHODS A prospective observational cohort study recruited women with PPH ≥1000 mL (or clinical concern of bleeding). The Fibtem A5, Extem CT and Pltem (Extem A5 - Fibtem A5) results were compared with laboratory tests of fibrinogen, prothrombin time (PT), activated partial thromboplastin time (APTT) and platelet count. RESULTS 521 women were recruited, including 274/277 (98.9%) of women with PPH ≥1500 mL. Fibtem A5 results were matched with laboratory fibrinogen in 552/644 (85.7%) samples. The incidence of abnormal laboratory results was low: fibrinogen ≤2 g/L 23/464 (5.0%), PT or APTT >1.5 × midpoint of reference range 4/464 (0.9%), and platelet count <75 × 109/L 11/477 (2.3%). Area-under- the-receiver operator characteristic curve for Fibtem A5 to detect fibrinogen ≤2 g/L was 0.96 (95% Confidence Intervals (CI) 0.94 to 0.98, P<0.001), with sensitivity and specificity of Fibtem A5 ≤11 mm to detect fibrinogen ≤2 g/L of 0.76 and 0.96. Prolonged Extem CT results improved after treatment of hypofibrinogenaemia alone. Intervention points for platelet and fresh frozen plasma (FFP) transfusion based on ROTEM Sigma parameters could not be established. CONCLUSION During PPH (≥1000 mL or cases of clinical concern about bleeding), ROTEM Sigma Fibtem A5 can detect fibrinogen ≤2 g/L and guide targeted fibrinogen replacement. Laboratory results should continue to be used to guide platelet and FFP transfusion.
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Affiliation(s)
- S F Bell
- Department of Anaesthetics, Cardiff and Vale University Health Board, Cardiff, UK.
| | - T C D Roberts
- Department of Anaesthetics, Cardiff and Vale University Health Board, Cardiff, UK
| | | | - L De Lloyd
- Department of Anaesthetics, Cardiff and Vale University Health Board, Cardiff, UK
| | - Z Amir
- Department of Anaesthetics, Cardiff and Vale University Health Board, Cardiff, UK
| | - D James
- Department of Maternity, Cardiff and Vale University Health Board, Cardiff, UK
| | - P V Jenkins
- Haemostasis and Thrombosis, Cardiff and Vale University Health Board, Cardiff, UK
| | - R E Collis
- Department of Anaesthetics, Cardiff and Vale University Health Board, Cardiff, UK
| | - P W Collins
- School of Medicine, Cardiff University, Cardiff, UK
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James D, Kang P, Facey J, Toro M, Walker N, Higgins S, Cineus B. Barriers and Motivators to Participating in Online Weight Management Communities among African American Women. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Roberts TCD, De Lloyd L, Bell SF, Cohen L, James D, Ridgway A, Jenkins V, Field V, Collis RE, Collins PW. Utility of viscoelastography with TEG 6s to direct management of haemostasis during obstetric haemorrhage: a prospective observational study. Int J Obstet Anesth 2021; 47:103192. [PMID: 34144351 DOI: 10.1016/j.ijoa.2021.103192] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/29/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The TEG 6s is an automated cartridge-based device with limited description of use in obstetric haemorrhage. The aim of this analysis was to describe the utility of TEG 6s in identifying abnormal laboratory results of coagulation and platelet count, and inform an interventional treatment algorithm for postpartum haemorrhage. METHODS A prospective observational cohort study of 521 women with moderate to severe obstetric haemorrhage (>1000 mL blood loss), including 372 women with at least one TEG 6s test. A non-pregnant control group was used for reference. TEG 6s test parameters Citrated Functional Fibrinogen (CFF), Citrated Kaolin TEG (CK) and Citrated Rapid TEG (CRT) were compared with paired laboratory tests of fibrinogen, PT/aPTT and platelet count, obtained during haemorrhage. RESULTS Among 456 TEG 6s tests, 389 were matched with laboratory coagulation results. The receiver operator characteristic area-under-the-curve (95% CI) for CFF amplitude by 10 min to detect Clauss fibrinogen ≤2 g/L was 0.95 (0.91 to 0.99) (P<0.0001, sensitivity 0.74 and specificity 0.97 at ≤17 mm). False positives had median (IQR) Clauss fibrinogen of 2.4 (2.3-2.7) g/L. The CK-R time had some utility for detecting prolonged PT/aPTT, however a threshold for fresh frozen plasma transfusion was not established. A CRT maximum amplitude <57 mm, when CFF was ≥15 mm, identified four of eight samples with platelet count <75 × 109/L. CONCLUSION The TEG 6s CFF can be used to identify low fibrinogen during obstetric haemorrhage. A value to identify transfusion thresholds for PT/aPTT and platelets was not established, and laboratory results should continue to be used.
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Affiliation(s)
- T C D Roberts
- Department of Anaesthetics, Cardiff & Vale University Health Board, UK
| | - L De Lloyd
- Department of Anaesthetics, Cardiff & Vale University Health Board, UK
| | - S F Bell
- Department of Anaesthetics, Cardiff & Vale University Health Board, UK
| | - L Cohen
- Department of Anaesthetics, Cardiff & Vale University Health Board, UK
| | - D James
- Midwifery, Cardiff & Vale University Health Board, UK
| | - A Ridgway
- Midwifery, Cardiff & Vale University Health Board, UK
| | - V Jenkins
- Haemostasis and Thrombosis, Cardiff & Vale University Health Board, UK
| | - V Field
- Department of Anaesthetics, Cardiff & Vale University Health Board, UK
| | - R E Collis
- Department of Anaesthetics, Cardiff & Vale University Health Board, UK
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Mughal A, Subramanian T, Jones R, James D, Ogboli M, Soccorso G. 469 Evaluating the Use of Laparoscopic-Assisted Gastrostomy Tube Insertion in Children with Epidermolysis Bullosa: A Retrospective Observational Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Nutritional management of children with epidermolysis bullosa (EB) presents multiple challenges including reduced oral intake and mucosal fragility. Laparoscopic-assisted gastrostomy (LAG) tube feeding is effective in improving nutritional status. We aim to review the effectiveness and morbidity of our minimally invasive laparoscopic-assisted approach in EB patients.
Method
A retrospective, observational cohort study was conducted on all EB patients who underwent LAG tube insertion between 2009 and 2019. Patient demographics, admission details and 12-month clinical outcomes were reported.
Results
31 EB patients underwent LAG placement. Median age at insertion was 7.2 (IQR ± 6.5) years, with 8 (25.8%) and 3 (9.7%) of patients requiring oesophageal dilatation and fundoplication, respectively. 71.4% patients experienced minor complications including: overgranulation (35.7%), gastrostomy infection (32.1%), pain (21.4%), mild gastrostomy leakage (17.9%), blockage (10.7%) and late displacement (3.6%). 6 patients (21.4%) developed major complications with extensive gastrostomy site leakage. Only one patient required laparoscopic refashioning for stoma prolapse six years post-insertion. No cases of gastrostomy-related mortality were recorded and an improvement in both mean weight and height Z-scores was observed.
Conclusions
LAG is well-tolerated in EB patients with improvements in growth and minimal morbidity 12-months post-gastrostomy insertion. An extended follow-up period is required to ascertain long-term impacts of gastrostomy feeding.
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Affiliation(s)
- A Mughal
- University of Birmingham, Birmingham, United Kingdom
| | - T Subramanian
- Birmingham Children’s Hospital, Birmingham, United Kingdom
| | - R Jones
- Birmingham Children’s Hospital, Birmingham, United Kingdom
| | - D James
- Birmingham Children’s Hospital, Birmingham, United Kingdom
| | - M Ogboli
- Birmingham Children’s Hospital, Birmingham, United Kingdom
| | - G Soccorso
- Birmingham Children’s Hospital, Birmingham, United Kingdom
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Li A, Barabadi M, Kusuma G, James D, Lim R. Improving cell viability using counterflow centrifugation elutriation. Cytotherapy 2021. [DOI: 10.1016/s1465324921005879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Epro G, König M, James D, Lambrianides Y, Werth J, Hunter S, Karamanidis K. Evidence that ageing does not influence the uniformity of the muscle-tendon unit adaptation in master sprinters. J Biomech 2021; 120:110364. [PMID: 33743395 DOI: 10.1016/j.jbiomech.2021.110364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 01/18/2021] [Accepted: 02/22/2021] [Indexed: 10/22/2022]
Abstract
Differences in the adaptation processes between muscle and tendon in response to mechanical loading can lead to non-uniform mechanical properties within the muscle-tendon unit (MTU), potentially increasing injury risk. The current study analysed the mechanical properties of the triceps surae (TS) MTU in 10 young (YS; 22 ± 3 yrs) and 10 older (OS; age 65 ± 8 yrs; i.e. master) (inter)national level sprinters and 11 young recreationally active adults (YC; 23 ± 3 yrs) to detect possible non-uniformities in muscle and tendon adaptation due to habitual mechanical loading and ageing. Triceps surae muscle strength, tendon stiffness and maximal tendon strain were assessed in both legs during maximal voluntary isometric plantarflexion contractions via dynamometry and ultrasonography. Irrespective of the leg, OS and YC in comparison to YS demonstrated significantly (P < 0.05) lower TS muscle strength and tendon stiffness, with no differences between OS and YC. Furthermore, no group differences were detected in the maximal tendon strain (average of both legs: OS 3.7 ± 0.8%, YC 4.4 ± 0.8% and YS 4.3 ± 0.9%) as well as in the inter-limb symmetry indexes in muscle strength, tendon stiffness and maximal tendon strain (range across groups: -5.8 to 4.9%; negative value reflects higher value for the non-preferred leg). Thus, the findings provide no clear evidence for a disruption in the TS MTU uniformity in master sprinters, demonstrating that ageing tendons can maintain their integrity to meet the increased functional demand due to elite sports.
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Affiliation(s)
- G Epro
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, United Kingdom.
| | - M König
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, United Kingdom
| | - D James
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, United Kingdom
| | - Y Lambrianides
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, United Kingdom
| | - J Werth
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, United Kingdom
| | - S Hunter
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, United Kingdom
| | - K Karamanidis
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, United Kingdom
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Tempero M, Oh DY, Tabernero J, Reni M, Van Cutsem E, Hendifar A, Waldschmidt DT, Starling N, Bachet JB, Chang HM, Maurel J, Garcia-Carbonero R, Lonardi S, Coussens LM, Fong L, Tsao LC, Cole G, James D, Macarulla T. Ibrutinib in combination with nab-paclitaxel and gemcitabine for first-line treatment of patients with metastatic pancreatic adenocarcinoma: phase III RESOLVE study. Ann Oncol 2021; 32:600-608. [PMID: 33539945 DOI: 10.1016/j.annonc.2021.01.070] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [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: 07/14/2020] [Revised: 01/16/2021] [Accepted: 01/20/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND First-line treatment of metastatic pancreatic ductal adenocarcinoma (PDAC) includes nab-paclitaxel/gemcitabine. Ibrutinib, a Bruton's tyrosine kinase inhibitor, exhibits antitumor activity through tumor microenvironment modulation. The safety and efficacy of first-line ibrutinib plus nab-paclitaxel/gemcitabine treatment in patients with PDAC were evaluated. PATIENTS AND METHODS RESOLVE (NCT02436668) was a phase III, randomized, double-blind, placebo-controlled study. Patients (histologically-confirmed PDAC; stage IV diagnosis ≥6 weeks of randomization; Karnofsky performance score ≥70) were randomized to once-daily oral ibrutinib (560 mg) or placebo plus nab-paclitaxel (125 mg/m2) and gemcitabine (1000 mg/m2). Primary endpoints were overall survival (OS) and investigator-assessed progression-free survival (PFS); overall response rate and safety were assessed. RESULTS In total, 424 patients were randomized (ibrutinib arm, n = 211; placebo arm, n = 213). Baseline characteristics were balanced across arms. After a median follow-up of 25 months, there was no significant difference in OS between ibrutinib plus nab-paclitaxel/gemcitabine versus placebo plus nab-paclitaxel/gemcitabine (median of 9.7 versus 10.8 months; P = 0.3225). PFS was shorter for ibrutinib plus nab-paclitaxel/gemcitabine compared with placebo plus nab-paclitaxel/gemcitabine (median 5.3 versus 6.0 months; P < 0.0001). Overall response rates were 29% and 42%, respectively (P = 0.0058). Patients in the ibrutinib arm had less time on treatment and received lower cumulative doses for all agents compared with the placebo arm. The most common grade ≥3 adverse events for ibrutinib versus placebo arms included neutropenia (24% versus 35%), peripheral sensory neuropathy (17% versus 8%), and anemia (16% versus 17%). Primary reasons for any treatment discontinuation were disease progression and adverse events. CONCLUSIONS Ibrutinib plus nab-paclitaxel/gemcitabine did not improve OS or PFS for patients with PDAC. Safety was consistent with known profiles for these agents.
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Affiliation(s)
- M Tempero
- Department of Medicine, University of California San Francisco, San Francisco, USA.
| | - D-Y Oh
- Department of Internal Medicine, Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - J Tabernero
- Department of Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UICC, CIBERONC, Barcelona, Spain
| | - M Reni
- Department of Radiochemotherapy, San Raffaele Hospital Scientific Institute, Milan, Italy
| | - E Van Cutsem
- Department of Digestive Oncology, University Hospitals Gasthuisberg/Leuven & KU Leuven, Leuven, Belgium
| | - A Hendifar
- Department of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, USA
| | - D-T Waldschmidt
- Department of General, Visceral and Cancer Surgery, University of Cologne, Köln, Germany
| | - N Starling
- Section of GI and Lymphoma Units, Department of Medicine, The Royal Marsden, London, UK
| | - J-B Bachet
- Department of Hepatogastroenterology, UPMC, Sorbonne University, Pitié Salpêtrière Hospital, APHP, Paris, France
| | - H-M Chang
- Division of Oncology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, South Korea
| | - J Maurel
- Department of Medical Oncology, Translational Genomics and Targeted Therapeutics in Solid Tumors Group, IDIBAPS, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
| | - R Garcia-Carbonero
- Department of Medical Oncology, Hospital Universitario Doce de Octubre, Imas12, UCM, CNIO, CIBERONC, Madrid, Spain
| | - S Lonardi
- Dipartimento di Oncologia Clinical e Sperimentale, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - L M Coussens
- Department of Cell, Developmental & Cancer Biology, Knight Cancer Institute, Oregon Health & Science University, Portland, USA
| | - L Fong
- Department of Medicine, University of California San Francisco, San Francisco, USA
| | - L C Tsao
- Department of Statistics, Pharmacyclics LLC, an AbbVie Company, Sunnyvale, USA
| | - G Cole
- Department of Oncology Development, Pharmacyclics LLC, an AbbVie Company, Sunnyvale, USA
| | - D James
- Department of Clinical Science, Pharmacyclics LLC, an AbbVie Company, Sunnyvale, USA
| | - T Macarulla
- Department of Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), IOB-Quiron, UVic-UICC, CIBERONC, Barcelona, Spain
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Freynhagen R, Elling C, Radic T, Sohns M, Liedgens H, James D, McCool R, Edwards M. Safety of tapentadol compared with other opioids in chronic pain treatment: network meta-analysis of randomized controlled and withdrawal trials. Curr Med Res Opin 2021; 37:89-100. [PMID: 33032466 DOI: 10.1080/03007995.2020.1832977] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the relative safety of oral tapentadol PR and other opioid analgesics for moderate or severe chronic pain in adults, we conducted a systematic review and network meta-analysis (NMA). METHODS A systematic review was conducted to identify randomized controlled trials (RCTs) and randomized withdrawal trials of tapentadol with other WHO stage II and III opioid analgesics in patients with moderate or severe chronic pain. Searches were conducted in MEDLINE, EMBASE, PubMed, Cochrane databases and trial registries. Feasibility assessment evaluated the trials' suitability for NMA. Outcomes assessed were overall AEs, overall serious adverse events, constipation, nausea, dizziness, somnolence, headache, and discontinuation due to AEs. Randomized withdrawal trials were analyzed separately to other RCTs. RESULTS Searches conducted in April 2019 identified 16,604 records. Following screening and feasibility assessment, 29 RCTs and 19 randomized withdrawal trials were identified and included in the NMA. Consistent with existing research, evidence from RCTs suggested that tapentadol is associated with relatively lower odds of adverse events occurring than most active comparators. The withdrawal trial data were less clear, with higher uncertainty around the results, and results that appear to contradict the RCT evidence. There are a number of trial design factors that may be affecting these results. CONCLUSIONS RCT evidence suggests that tapentadol can be a useful treatment option for patients suffering from chronic pain and in need of an opioid analgesic. Opioids should be prescribed by a qualified physician only after other analgesics have been considered, taking side effects and misuse risk into account.
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Affiliation(s)
- R Freynhagen
- Department of Anaesthesiology, Critical Care Medicine, Pain Medicine & Palliative Care, Benedictus Krankenhaus Tutzing, Pain Center Lake Starnberg, Academic Teaching Hospital Technische Universität München, Munich, Germany
- Department of Anaesthesiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - C Elling
- Grünenthal GmbH, Aachen, Germany
| | - T Radic
- Grünenthal GmbH, Aachen, Germany
| | - M Sohns
- Grünenthal GmbH, Aachen, Germany
| | | | - D James
- Quantics Biostatistics, Edinburgh, UK
| | - R McCool
- York Health Economics Consortium, York, UK
| | - M Edwards
- York Health Economics Consortium, York, UK
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James D, Sharma V. A Cutaneous Clue to a Tropical Cause of Acute Pancreatitis: Scrub Typhus. Clin Gastroenterol Hepatol 2021; 19:A19. [PMID: 31927109 DOI: 10.1016/j.cgh.2019.12.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 12/23/2019] [Accepted: 12/29/2019] [Indexed: 02/07/2023]
Affiliation(s)
- Deepak James
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vishal Sharma
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Sheikh S, Brailsford J, James D, Holden D, Anton S, Hendry P, Fillingim R, Fernandez R, Cavallari L. 156 Use of a Risk Index to Predict Falls and Opioid Adverse Events in Opioid Naive Older Adults. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Dunn R, Greenhouse J, James D, Ohlssen D, Mesenbrink P. Risk scoring for time to end-stage knee osteoarthritis: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2020; 28:1020-1029. [PMID: 32416218 PMCID: PMC7575033 DOI: 10.1016/j.joca.2019.12.013] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 11/06/2019] [Accepted: 01/01/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study constructs a risk score for patients' progression to end-stage knee osteoarthritis (OA) within 4 years. DESIGN The Osteoarthritis Initiative (OAI) was a longitudinal study of the onset and progression of knee OA. Using a recent definition of end-stage knee OA, we implement interval-censored survival forests to select predictors of this endpoint. We fit an interval-censored Cox model for time to end-stage knee OA, using the selected predictors. The risk score is the Cox model's fitted linear combination of the nine selected baseline structural and symptomatic knee OA variables. RESULTS We fit our models on a training set of 2,701 patients, and we evaluate on an independent test set of 1,436 patients. On the test sample, we observe a concordance index of 0.86 between risk score and time to end-stage, AUC of 0.87 for predicting end-stage within 24, 36, and 48 months, and positive predictive values that increase with the risk score. This risk stratification algorithm could enrich clinical trial patient enrollment. By enrolling test sample patients with scores above a threshold, a trial could have included 91% of test set patients who reach end-stage within 4 years while only enrolling 45% of the test sample. CONCLUSION Using statistical methods, we construct and validate an interpretable risk score for time to end-stage knee OA. This score can help disease-modifying OA treatment developers to select candidates with the highest risk of fast-progressing knee OA.
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Affiliation(s)
- R Dunn
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA, 15213, USA.
| | - J Greenhouse
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA, 15213, USA.
| | - D James
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, 07936, USA.
| | - D Ohlssen
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, 07936, USA.
| | - P Mesenbrink
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, 07936, USA.
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Powell E, James D, Collis R, Collins PW, Pallmann P, Bell S. Introduction of standardized, cumulative quantitative measurement of blood loss into routine maternity care. J Matern Fetal Neonatal Med 2020; 35:1491-1497. [PMID: 32366138 DOI: 10.1080/14767058.2020.1759534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity in the UK. Visual estimation of blood loss is unreliable yet remains common practice. As part of a national quality improvement project to improve care during PPH, standardized, quantitative measurement of blood loss (QBL) for all deliveries was introduced into a tertiary obstetric unit in Cardiff, Wales.Methods: Retrospective analysis of 875 consecutive maternities between December 2017 and February 2018 was undertaken. Of these, 372 mothers had both pre- and post-partum hemoglobin (Hb) were recorded. Regression analyses were performed to investigate the relationship between change in Hb adjusted for red cell transfusion and QBL.Results: The correlation coefficient between QBL and adjusted change in Hb for all deliveries (n = 372) was 0.57. This corresponded to an estimated fall of adjusted change in Hb of 15.3 g/L (95% CI: 13.1, 17.6) per 1000 mL blood loss.Discussion: QBL has been shown to be reliable across all maternity settings, with reproducible results in theater and delivery rooms (on the obstetric unit and alongside midwifery-led unit). QBL is moderately correlated with adjusted change in Hb for all volumes of bleeding and gives clinicians more accurate knowledge of blood loss than visual estimation. This low-cost, low-fidelity intervention can influence the timely escalation of clinical care and therefore patient outcome.
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Affiliation(s)
- E Powell
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff and Vale University Health Board, Cardiff, UK
| | - D James
- Department of Obstetrics and Gynaecology, Cardiff and Vale University Health Board, Cardiff, UK
| | - R Collis
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff and Vale University Health Board, Cardiff, UK
| | - P W Collins
- Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - P Pallmann
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - S Bell
- Department of Anaesthetics, Intensive Care and Pain Medicine, Cardiff and Vale University Health Board, Cardiff, UK
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Piquette M, James D, Horányi M. Calibration of polyvinylidene fluoride based dust detectors in response to varying grain density and incidence angle. Rev Sci Instrum 2020; 91:023307. [PMID: 32113461 DOI: 10.1063/1.5125448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 01/09/2020] [Indexed: 06/10/2023]
Abstract
Permanently polarized Polyvinylidene Fluoride (PVDF) films have been used on a variety of spacecraft as in situ dust detectors to measure the size and spatial distributions of micron and sub-micron dust particles. The detectors produce a short electric pulse when impacted by a hypervelocity dust particle. The pulse amplitude depends on the mass and relative speed of the dust grain. This relationship has been studied both empirically and numerically to better understand the film's principle of operation, as well as the effects of film thickness, film temperature, and particle penetration depth. However, little work has been done to constrain the effects of varying particle density and incidence angle despite the frequent occurrence of such configurations in most space-based applications. We present calibrations of non-penetrating impacts on 28 μm thick films at varying incidence angles ranging from 0° to 75° for iron and aluminum particles in the mass and speed range of 10-12 ≤ m ≤ 10-8 g and 0.5 ≤ v ≤ 7 km/s, respectively. The study was carried out at the 3 MV dust accelerator laboratory at the University of Colorado at Boulder. The results show that PVDF signals are largely independent of particle density and incidence angle up to 75° for non-penetrating impacts.
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Affiliation(s)
- M Piquette
- Department of Astrophysical and Planetary Sciences, University of Colorado, Boulder, Colorado 80309, USA
| | - D James
- Institute for Modeling Plasma, Atmospheres, and Cosmic Dust, Boulder, Colorado 80303, USA
| | - M Horányi
- Institute for Modeling Plasma, Atmospheres, and Cosmic Dust, Boulder, Colorado 80303, USA
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Salazar M, James D, Welch C, Viles J, Karnad A, Arora S. IMPLEMENTATION OF A GERIATRIC ONCOLOGY ASSESSMENT TOOL (G8) IN AN ACADEMIC ONCOLOGY PRACTICE SERVING A HISPANIC-RICH POPULATION. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31288-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Tempero M, Oh D, Macarulla T, Reni M, Van Cutsem E, Hendifar A, Waldschmidt D, Starling N, Bachet J, Chang H, Maurel J, Lonardi S, Coussens L, Fong L, Tsao L, Cole G, James D, Tabernero J. Ibrutinib in combination with nab-paclitaxel and gemcitabine as first-line treatment for patients with metastatic pancreatic adenocarcinoma: results from the phase 3 RESOLVE study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Taylor J, Cain K, Ramirez P, Earles T, Harris M, James D, Dottino J, Hubbs C, Stewart K, McGrew L, Siebel C, Enbaya A, Iniesta-Donate M, Vachhani S, Lasala J, Best C, Thosani S, Sahai S, Schmeler K, Meyer L. Integration of a standardized diabetic management protocol into an ERAS program. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2019.03.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Lim R, Li A, Kusuma G, Chan S, McPhee G, Fitzpatrick I, Wilson S, James D. Enabling clinical trials in an academic GMP setting through use of closed, semi-automated manufacturing of allogeneic amniotic epithelial cells. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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32
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de Mollerat du Jeu X, Fitzpatrick I, James D, de Mollerat du Jeu X. Closed and automated cell processing using roteaTM to advance cell therapy. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Alam A, Mukherjee A, Xu J, Pagan E, Hiltner E, Rios E, Pollack S, Iyer D, Mody K, Kassotis J, James D, Jermyn R, Almendral J. Validating the Newly Reported ASA Score. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Affiliation(s)
- D James
- Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, UK
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35
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Spiegal S, Nyamuryekung’e S, Estell R, Cibils A, James D, Gonzalez A, McIntosh M. PSXI-34 Diet selection by Raramuri Criollo and Angus crossbreds in the Chihuahuan Desert. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Spiegal
- USDA/ARS/Jornada Experimental Range, Las Cruces, NM, United States
| | | | - R Estell
- USDA/ARS/Jornada Experimental Range, Las Cruces, NM, United States
| | - A Cibils
- USDA/ARS/Jornada Experimental Range, Las Cruces, NM, United States
| | - D James
- USDA/ARS/Jornada Experimental Range, Las Cruces, NM, United States
| | - A Gonzalez
- USDA/ARS/Jornada Experimental Range, Las Cruces, NM, United States
| | - M McIntosh
- New Mexico State University, Las Cruces, NM, United States
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36
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James D. A Framework Analysis of the #BlackWomenDoBreastfeed Social Media Campaign. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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37
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James D, Wilson J. Weight Loss Strategies used by Army ROTC Cadets. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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38
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Burns T, Gargan L, Walker L, Heatherington S, Topping-Morris B, Vellonoweth C, Deahl M, James D, McDougall N, Richards J. Not Just Bricks and Mortar. Psychiatr bull 2018. [DOI: 10.1192/pb.22.8.465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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James D, Lavanya J, Verma S, Rawat A, S V, Aggarwal N. Cord Blood Antibody Seroprevalance Against Diphtheria, Pertussis, Measles, Mumps and Rubella among Term Healthy Indian Newborns. Open Forum Infect Dis 2017. [PMCID: PMC5631470 DOI: 10.1093/ofid/ofx163.762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The resurgence of vaccine preventable diseases in young infants is a matter of concern worldwide. The aim of our study was to determine the seroprevalance of protective antibodies against diphtheria, pertussis, measles, mumps and rubella antigens in cord blood among term Indian newborns, at birth. Methods Apparently healthy term newborns, delivered at a tertiary care hospital in Northern India, over two year period (Apr 15-March 17) were enrolled after taking informed written consent from their parents; and their cord blood sample was collected. Ethical clearance was obtained from Institute Ethics committee, before enrolling subjects. Cord blood samples were tested for antibodies using commercial ELISA kits IMMUNOLAB IgG. Results A total of 160 newborns (M:F = 86:74) were enrolled. In our study, antibodies (IgG) against diphtheria toxin (DT) were > 0.1 IU/mL in 44.4% (71/160), 0.01 to 0.1 IU/mL in 53.1% (85/160) and < 0.01 IU/mL in 2.5% (4/160). None of their mothers received Tdap vaccine in past. Antibodies (IgG) against pertussis toxin (PT) > 40 U/mL were seen in 41.2% (66/160). Out of these 66 children, 23 had titres > 100 U/mL. Total of 58.8% (94/160) children had antibodies < 40 U/mL. Out of these 94 children, 48 had titers < 20 U/mL. Antibodies (IgG) against measles antigen were > 12 IU/mL in 88.8% (142/160). A total of 11.2 (18/160) had titers below 12 IU/mL. Out of these 18 children, 5 had titers < 6 IU/mL. Antibodies (IgG) against mumps antigen were > 12 IU/mL in 83.1% (133/160). A total of 16.9% (27/160) had titers below 12 IU/mL. Out of these 27 children, 12 had titers < 6 IU/mL. Antibodies (IgG) against rubella antigen were > 12 IU/mL in 83.7% (134/160). A total of 16.3% (26/160) had titers below 12 IU/mL. Out of these 26 children, 22 had titers < 6 IU/mL. Conclusion Only 44.4% of studied newborns were fully protected (> 0.1 IU/mL) against diphtheria, because of maternal antibodies. As correlates of protection for pertussis are not yet defined; those having anti-PT titers >100 IU/mL i.e., 14.3% (23/160) were most protected; while those having titers < 20 U/mL i.e., 30% (48/160) were least protected. Out of studied newborns, fully protected (>12 IU/mL) against measles, mumps and rubella were 88.8%, 83.1% and 83.7% respectively. Acknowledgement. PGI Intramural research grant Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Deepak James
- Pediatrics, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Jula Lavanya
- Pediatrics, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Sanjay Verma
- Pediatrics, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Amit Rawat
- Pediatrics, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Venkataseshan S
- Pediatrics, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Neelam Aggarwal
- Obs & Gyn, Post Graduate Institute of Medical Education & Research, Chandigarh, India
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Lekovich J, Man L, Canon C, Pereira N, James D. Cycle day 2 IGF-1 levels are predictive of negative pregnancy outcome in poor responders. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Irani M, Elder S, Kreines F, Gunnala V, James D, Reichman D, Rosenwaks Z. Should we measure progesterone level on the day of trigger before fresh embryo transfer? Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lekovich J, Man L, Pereira N, Rosenwaks Z, James D. Co-transplantation of human ovarian tissue with IGF-1 producing endothelial cells improves survival of early stage follicles and is associated with accelerated follicular growth in vivo. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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James D, Harville C. Exploring African American Women’s Concept of Body Weight: Implications for Tailoring Weight Loss Messages and Programs. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Spiegal S, Nyamurekung'e S, Estell R, Cibils A, McIntosh M, Gonzalez A, James D. 287 Comparison of diet selection by Raramuri Criollo and Angus crossbreeds in the Chihuahuan Desert. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.287] [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: 11/13/2022] Open
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Fischetti RF, Martin-Garcia J, Zatsepin N, Stander N, Zhu L, Subramanian G, Nelson G, Coe J, Nagaratnam N, Roy-Chowdury S, Kissick D, Ishchenko A, Conrad C, Ketawala G, James D, Zook J, Ogata C, Venugopalan N, Xu S, Meents A, Srajer V, Henning R, Chapman H, Spence J, Weierstall U, Cherezov V, Fromme P, Liu W. Monochromatic and polychromatic serial crystallography at the Advanced Photon Source. Acta Crystallogr A Found Adv 2017. [DOI: 10.1107/s0108767317096404] [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: 11/11/2022] Open
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Perram A, Hills C, Johnston C, MacDonald-Wicks L, Surjan Y, James D, Warren-Forward H. Characteristics of an ideal practice educator: Perspectives from undergraduate students in diagnostic radiography, nuclear medicine, nutrition and dietetics, occupational therapy, physiotherapy and radiation therapy. Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2016.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Francis A, Hills C, MacDonald-Wicks L, Johnston C, James D, Surjan Y, Warren-Forward H. Characteristics of an ideal practice educator: Perspectives from practice educators in diagnostic radiography, nuclear medicine, nutrition and dietetics, occupational therapy and physiotherapy and radiation therapy. Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2016.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wang Z, Liu Q, Waganaar W, Fontanese J, James D, Munsat T. Four-dimensional (4D) tracking of high-temperature microparticles. Rev Sci Instrum 2016; 87:11D601. [PMID: 27910396 DOI: 10.1063/1.4955280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
High-speed tracking of hot and molten microparticles in motion provides rich information about burning plasmas in magnetic fusion. An exploding-wire apparatus is used to produce moving high-temperature metallic microparticles and to develop four-dimensional (4D) or time-resolved 3D particle tracking techniques. The pinhole camera model and algorithms developed for computer vision are used for scene calibration and 4D reconstructions. 3D positions and velocities are then derived for different microparticles. Velocity resolution approaches 0.1 m/s by using the local constant velocity approximation.
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Affiliation(s)
- Zhehui Wang
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Q Liu
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - W Waganaar
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Fontanese
- University of Colorado, Boulder, Colorado 80309, USA
| | - D James
- University of Colorado, Boulder, Colorado 80309, USA
| | - T Munsat
- University of Colorado, Boulder, Colorado 80309, USA
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Trichet AAP, Dolan PR, James D, Hughes GM, Vallance C, Smith JM. Nanoparticle Trapping and Characterization Using Open Microcavities. Nano Lett 2016; 16:6172-6177. [PMID: 27652604 DOI: 10.1021/acs.nanolett.6b02433] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Characterization and trapping of nanoparticles in solution is of great importance for lab-on-a-chip applications in biomedical, environmental, and materials sciences. Devices are now starting to emerge allowing such manipulations and investigations in real-time. Better insights into the interaction between the nanoparticle and the optical trap is therefore necessary in order to move forward in this field. In this work, we present a new kind of nanotweezers based on open microcavities. We show that by monitoring the cavity mode wavelength shift as the particle diffuses through the cavity, it is possible to establish both the nanoparticle polarizability and its coefficient of friction. Additionally, our experiment provides a deep insight in the interaction between the nanoparticle and the cavity mode. The technique has built-in calibration of the trap strength and spring constant, making it attractive for practical applications. This work illustrates the potential of such optical microcavities for future developments in nanoparticle sensors and lab-on-a-chip devices.
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Affiliation(s)
- A A P Trichet
- Department of Materials, University of Oxford , Oxford OX1 3PH, United Kingdom
| | - P R Dolan
- Department of Materials, University of Oxford , Oxford OX1 3PH, United Kingdom
| | - D James
- Department of Chemistry, University of Oxford , Oxford OX1 3RQ, United Kingdom
| | - G M Hughes
- Department of Materials, University of Oxford , Oxford OX1 3PH, United Kingdom
| | - C Vallance
- Department of Chemistry, University of Oxford , Oxford OX1 3RQ, United Kingdom
| | - J M Smith
- Department of Materials, University of Oxford , Oxford OX1 3PH, United Kingdom
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Man L, Bodine R, Park L, Zaninovic N, Rosenwaks Z, Schattman G, James D. Co-transplantation of human ovarian tissue with AMH-producing endothelial cells inhibits recruitment of primordial follicles. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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