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Rosenberg E, Andersen TI, Samajdar R, Petukhov A, Hoke JC, Abanin D, Bengtsson A, Drozdov IK, Erickson C, Klimov PV, Mi X, Morvan A, Neeley M, Neill C, Acharya R, Allen R, Anderson K, Ansmann M, Arute F, Arya K, Asfaw A, Atalaya J, Bardin JC, Bilmes A, Bortoli G, Bourassa A, Bovaird J, Brill L, Broughton M, Buckley BB, Buell DA, Burger T, Burkett B, Bushnell N, Campero J, Chang HS, Chen Z, Chiaro B, Chik D, Cogan J, Collins R, Conner P, Courtney W, Crook AL, Curtin B, Debroy DM, Barba ADT, Demura S, Di Paolo A, Dunsworth A, Earle C, Faoro L, Farhi E, Fatemi R, Ferreira VS, Burgos LF, Forati E, Fowler AG, Foxen B, Garcia G, Genois É, Giang W, Gidney C, Gilboa D, Giustina M, Gosula R, Dau AG, Gross JA, Habegger S, Hamilton MC, Hansen M, Harrigan MP, Harrington SD, Heu P, Hill G, Hoffmann MR, Hong S, Huang T, Huff A, Huggins WJ, Ioffe LB, Isakov SV, Iveland J, Jeffrey E, Jiang Z, Jones C, Juhas P, Kafri D, Khattar T, Khezri M, Kieferová M, Kim S, Kitaev A, Klots AR, Korotkov AN, Kostritsa F, Kreikebaum JM, Landhuis D, Laptev P, Lau KM, Laws L, Lee J, Lee KW, Lensky YD, Lester BJ, Lill AT, Liu W, Locharla A, Mandrà S, Martin O, Martin S, McClean JR, McEwen M, Meeks S, Miao KC, Mieszala A, Montazeri S, Movassagh R, Mruczkiewicz W, Nersisyan A, Newman M, Ng JH, Nguyen A, Nguyen M, Niu MY, O'Brien TE, Omonije S, Opremcak A, Potter R, Pryadko LP, Quintana C, Rhodes DM, Rocque C, Rubin NC, Saei N, Sank D, Sankaragomathi K, Satzinger KJ, Schurkus HF, Schuster C, Shearn MJ, Shorter A, Shutty N, Shvarts V, Sivak V, Skruzny J, Smith WC, Somma RD, Sterling G, Strain D, Szalay M, Thor D, Torres A, Vidal G, Villalonga B, Heidweiller CV, White T, Woo BWK, Xing C, Yao ZJ, Yeh P, Yoo J, Young G, Zalcman A, Zhang Y, Zhu N, Zobrist N, Neven H, Babbush R, Bacon D, Boixo S, Hilton J, Lucero E, Megrant A, Kelly J, Chen Y, Smelyanskiy V, Khemani V, Gopalakrishnan S, Prosen T, Roushan P. Dynamics of magnetization at infinite temperature in a Heisenberg spin chain. Science 2024; 384:48-53. [PMID: 38574139 DOI: 10.1126/science.adi7877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 03/01/2024] [Indexed: 04/06/2024]
Abstract
Understanding universal aspects of quantum dynamics is an unresolved problem in statistical mechanics. In particular, the spin dynamics of the one-dimensional Heisenberg model were conjectured as to belong to the Kardar-Parisi-Zhang (KPZ) universality class based on the scaling of the infinite-temperature spin-spin correlation function. In a chain of 46 superconducting qubits, we studied the probability distribution of the magnetization transferred across the chain's center, [Formula: see text]. The first two moments of [Formula: see text] show superdiffusive behavior, a hallmark of KPZ universality. However, the third and fourth moments ruled out the KPZ conjecture and allow for evaluating other theories. Our results highlight the importance of studying higher moments in determining dynamic universality classes and provide insights into universal behavior in quantum systems.
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Affiliation(s)
- E Rosenberg
- Google Research, Mountain View, CA, USA
- Department of Physics, Cornell University, Ithaca, NY, USA
| | | | - R Samajdar
- Department of Physics, Princeton University, Princeton, NJ, USA
- Princeton Center for Theoretical Science, Princeton University, Princeton, NJ, USA
| | | | - J C Hoke
- Department of Physics, Stanford University, Stanford, CA, USA
| | - D Abanin
- Google Research, Mountain View, CA, USA
| | | | - I K Drozdov
- Google Research, Mountain View, CA, USA
- Department of Physics, University of Connecticut, Storrs, CT, USA
| | | | | | - X Mi
- Google Research, Mountain View, CA, USA
| | - A Morvan
- Google Research, Mountain View, CA, USA
| | - M Neeley
- Google Research, Mountain View, CA, USA
| | - C Neill
- Google Research, Mountain View, CA, USA
| | - R Acharya
- Google Research, Mountain View, CA, USA
| | - R Allen
- Google Research, Mountain View, CA, USA
| | | | - M Ansmann
- Google Research, Mountain View, CA, USA
| | - F Arute
- Google Research, Mountain View, CA, USA
| | - K Arya
- Google Research, Mountain View, CA, USA
| | - A Asfaw
- Google Research, Mountain View, CA, USA
| | - J Atalaya
- Google Research, Mountain View, CA, USA
| | - J C Bardin
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of Massachusetts, Amherst, MA, USA
| | - A Bilmes
- Google Research, Mountain View, CA, USA
| | - G Bortoli
- Google Research, Mountain View, CA, USA
| | | | - J Bovaird
- Google Research, Mountain View, CA, USA
| | - L Brill
- Google Research, Mountain View, CA, USA
| | | | | | - D A Buell
- Google Research, Mountain View, CA, USA
| | - T Burger
- Google Research, Mountain View, CA, USA
| | - B Burkett
- Google Research, Mountain View, CA, USA
| | | | - J Campero
- Google Research, Mountain View, CA, USA
| | - H-S Chang
- Google Research, Mountain View, CA, USA
| | - Z Chen
- Google Research, Mountain View, CA, USA
| | - B Chiaro
- Google Research, Mountain View, CA, USA
| | - D Chik
- Google Research, Mountain View, CA, USA
| | - J Cogan
- Google Research, Mountain View, CA, USA
| | - R Collins
- Google Research, Mountain View, CA, USA
| | - P Conner
- Google Research, Mountain View, CA, USA
| | | | - A L Crook
- Google Research, Mountain View, CA, USA
| | - B Curtin
- Google Research, Mountain View, CA, USA
| | | | | | - S Demura
- Google Research, Mountain View, CA, USA
| | | | | | - C Earle
- Google Research, Mountain View, CA, USA
| | - L Faoro
- Google Research, Mountain View, CA, USA
| | - E Farhi
- Google Research, Mountain View, CA, USA
| | - R Fatemi
- Google Research, Mountain View, CA, USA
| | | | | | - E Forati
- Google Research, Mountain View, CA, USA
| | | | - B Foxen
- Google Research, Mountain View, CA, USA
| | - G Garcia
- Google Research, Mountain View, CA, USA
| | - É Genois
- Google Research, Mountain View, CA, USA
| | - W Giang
- Google Research, Mountain View, CA, USA
| | - C Gidney
- Google Research, Mountain View, CA, USA
| | - D Gilboa
- Google Research, Mountain View, CA, USA
| | | | - R Gosula
- Google Research, Mountain View, CA, USA
| | | | - J A Gross
- Google Research, Mountain View, CA, USA
| | | | - M C Hamilton
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA
| | - M Hansen
- Google Research, Mountain View, CA, USA
| | | | | | - P Heu
- Google Research, Mountain View, CA, USA
| | - G Hill
- Google Research, Mountain View, CA, USA
| | | | - S Hong
- Google Research, Mountain View, CA, USA
| | - T Huang
- Google Research, Mountain View, CA, USA
| | - A Huff
- Google Research, Mountain View, CA, USA
| | | | - L B Ioffe
- Google Research, Mountain View, CA, USA
| | | | - J Iveland
- Google Research, Mountain View, CA, USA
| | - E Jeffrey
- Google Research, Mountain View, CA, USA
| | - Z Jiang
- Google Research, Mountain View, CA, USA
| | - C Jones
- Google Research, Mountain View, CA, USA
| | - P Juhas
- Google Research, Mountain View, CA, USA
| | - D Kafri
- Google Research, Mountain View, CA, USA
| | - T Khattar
- Google Research, Mountain View, CA, USA
| | - M Khezri
- Google Research, Mountain View, CA, USA
| | - M Kieferová
- Google Research, Mountain View, CA, USA
- QSI, Faculty of Engineering & Information Technology, University of Technology Sydney, Ultimo, NSW, Australia
| | - S Kim
- Google Research, Mountain View, CA, USA
| | - A Kitaev
- Google Research, Mountain View, CA, USA
| | - A R Klots
- Google Research, Mountain View, CA, USA
| | - A N Korotkov
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of California, Riverside, CA, USA
| | | | | | | | - P Laptev
- Google Research, Mountain View, CA, USA
| | - K-M Lau
- Google Research, Mountain View, CA, USA
| | - L Laws
- Google Research, Mountain View, CA, USA
| | - J Lee
- Google Research, Mountain View, CA, USA
- Department of Chemistry, Columbia University, New York, NY, USA
| | - K W Lee
- Google Research, Mountain View, CA, USA
| | | | | | - A T Lill
- Google Research, Mountain View, CA, USA
| | - W Liu
- Google Research, Mountain View, CA, USA
| | | | - S Mandrà
- Google Research, Mountain View, CA, USA
| | - O Martin
- Google Research, Mountain View, CA, USA
| | - S Martin
- Google Research, Mountain View, CA, USA
| | | | - M McEwen
- Google Research, Mountain View, CA, USA
| | - S Meeks
- Google Research, Mountain View, CA, USA
| | - K C Miao
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - M Newman
- Google Research, Mountain View, CA, USA
| | - J H Ng
- Google Research, Mountain View, CA, USA
| | - A Nguyen
- Google Research, Mountain View, CA, USA
| | - M Nguyen
- Google Research, Mountain View, CA, USA
| | - M Y Niu
- Google Research, Mountain View, CA, USA
| | | | - S Omonije
- Google Research, Mountain View, CA, USA
| | | | - R Potter
- Google Research, Mountain View, CA, USA
| | - L P Pryadko
- Department of Physics and Astronomy, University of California, Riverside, CA, USA
| | | | | | - C Rocque
- Google Research, Mountain View, CA, USA
| | - N C Rubin
- Google Research, Mountain View, CA, USA
| | - N Saei
- Google Research, Mountain View, CA, USA
| | - D Sank
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - A Shorter
- Google Research, Mountain View, CA, USA
| | - N Shutty
- Google Research, Mountain View, CA, USA
| | - V Shvarts
- Google Research, Mountain View, CA, USA
| | - V Sivak
- Google Research, Mountain View, CA, USA
| | - J Skruzny
- Google Research, Mountain View, CA, USA
| | | | - R D Somma
- Google Research, Mountain View, CA, USA
| | | | - D Strain
- Google Research, Mountain View, CA, USA
| | - M Szalay
- Google Research, Mountain View, CA, USA
| | - D Thor
- Google Research, Mountain View, CA, USA
| | - A Torres
- Google Research, Mountain View, CA, USA
| | - G Vidal
- Google Research, Mountain View, CA, USA
| | | | | | - T White
- Google Research, Mountain View, CA, USA
| | - B W K Woo
- Google Research, Mountain View, CA, USA
| | - C Xing
- Google Research, Mountain View, CA, USA
| | | | - P Yeh
- Google Research, Mountain View, CA, USA
| | - J Yoo
- Google Research, Mountain View, CA, USA
| | - G Young
- Google Research, Mountain View, CA, USA
| | - A Zalcman
- Google Research, Mountain View, CA, USA
| | - Y Zhang
- Google Research, Mountain View, CA, USA
| | - N Zhu
- Google Research, Mountain View, CA, USA
| | - N Zobrist
- Google Research, Mountain View, CA, USA
| | - H Neven
- Google Research, Mountain View, CA, USA
| | - R Babbush
- Google Research, Mountain View, CA, USA
| | - D Bacon
- Google Research, Mountain View, CA, USA
| | - S Boixo
- Google Research, Mountain View, CA, USA
| | - J Hilton
- Google Research, Mountain View, CA, USA
| | - E Lucero
- Google Research, Mountain View, CA, USA
| | - A Megrant
- Google Research, Mountain View, CA, USA
| | - J Kelly
- Google Research, Mountain View, CA, USA
| | - Y Chen
- Google Research, Mountain View, CA, USA
| | | | - V Khemani
- Department of Physics, Stanford University, Stanford, CA, USA
| | | | - T Prosen
- Faculty of Mathematics and Physics, University of Ljubljana, Ljubljana, Slovenia
| | - P Roushan
- Google Research, Mountain View, CA, USA
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Hill G, Bulley C. Help me to come out gracefully! Working with lesbian, gay, and bisexual, people affected by cancer to develop a national practitioner guide supporting inclusive care. Radiography (Lond) 2023; 29 Suppl 1:S81-S86. [PMID: 36828748 DOI: 10.1016/j.radi.2023.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/18/2023] [Accepted: 01/30/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION The healthcare support needs of the lesbian, gay, bisexual (LGB) and transgender community are becoming an emerging area of healthcare research. Providing person-centred care is World Health Organisation policy and as such it is important that Radiography services can demonstrate areas in which they are working with people to design, develop and feedback on the services that they receive. This research aimed to establish how cancer treatment impacted on the identities of LGB people, their experiences of care, and their engagement with developing a practitioner guide. METHODS This cooperative inquiry is underpinned by person-centred philosophy and participatory research principles. Participants were nine lesbian, gay, and bisexual people affected by cancer. Each engaged in two facilitated, audio-recorded conversations to explore their experiences of cancer care. An analytical framework based on Mezirow's Transformational Theory was used to organise the data, followed by detailed content analysis to develop themes. RESULTS Participants included men and women, aged 45-68, who had experienced different cancers. They explored how cancer treatment had impacted on them, and worked with the researcher and stakeholders to establish a seven-recommendation practitioner guide aimed at improving LGB people's care experiences. Their accounts revealed a broad range of issues that both corroborate and build on existing evidence. Themes highlighted expectations and experiences of both assumptions and prejudice in healthcare interactions. These experiences, along with misinterpretation of relationships with significant others, led to feelings of discomfort and reserve about self-expression. Findings of the research are presented in the following key areas: Dilemmas of attending oncology appointments; Inclusive experiences of care; and Formulation of the practitioner guide. CONCLUSION The research findings enabled development of a national practitioner guide with the participants and key stakeholders to raise awareness of the needs of LGB persons affected by cancer and support better care. IMPLICATIONS FOR PRACTICE By providing real-life accounts this research adds to understanding of how LGB persons interact with services, developing evidence to support cultural competence within the profession of Radiography and oncology services more broadly.
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Affiliation(s)
- G Hill
- School of Health Sciences, Queen Margaret University (QMU), Edinburgh, Queen Margaret University Way, Musselburgh EH21 6UU, UK.
| | - C Bulley
- School of Health Sciences, Queen Margaret University (QMU), Edinburgh, Queen Margaret University Way, Musselburgh EH21 6UU, UK
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Hou J, Gao H, Fan Y, Wang Y, Qin M, Di Y, Wang L, Zhou X, Zhou Y, Qin D, Hill G. Pharmacokinetics and Safety Study of HN0037, a Novel Anti-Human Herpes Simplex Virus Inhibitor, in Healthy Volunteers. Clin Pharmacol Drug Dev 2022; 11:1467-1473. [PMID: 35794079 DOI: 10.1002/cpdd.1138] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/08/2022] [Indexed: 01/28/2023]
Abstract
HN0037 is a helicase-primase inhibitor developed to treat herpes simplex virus (HSV) infection. This study evaluated the safety, tolerability, and pharmacokinetics of HN0037, following oral administration in healthy volunteers. This double-blind, placebo-controlled, phase 1 study comprised two parts. In part 1, a single escalating dose of 10, 30, 60, 120, 200, 300, and 400 mg was assessed, and the food effect was evaluated in the 200-mg cohort. In part 2, a multiple dose evaluation involving 30 and 100 mg once a day was conducted for 14 days. Following single oral doses, the systemic exposure of HN0037 increased in a proportional manner over the lower dose range (10-120 mg) and in a subproportional manner over the higher dose range (200-400 mg). Following multiple oral doses, significant drug accumulation of systemic exposure was found at steady state, and the half-life ranged 50.4-61.0 h. The food effect study results indicated that a high-fat meal had a marginal impact on HN0037's pharmacokinetics. No differences were observed in the incidence of adverse events between HN0037 and placebo groups in either study. These results demonstrate that HN0037 is safe and well-tolerated, supporting further clinical development.
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Affiliation(s)
- Jie Hou
- PKU Care Luzhong Hospital, Shandong, China
| | - Hong Gao
- Phaeno Therapeutics Co. Ltd, Hangzhou, China
| | - Yingzhe Fan
- Phaeno Therapeutics Co. Ltd, Hangzhou, China
| | - Ying Wang
- Phaeno Therapeutics Co. Ltd, Hangzhou, China
| | - Meng Qin
- Phaeno Therapeutics Co. Ltd, Hangzhou, China
| | - Yujing Di
- PKU Care Luzhong Hospital, Shandong, China
| | - Lu Wang
- PKU Care Luzhong Hospital, Shandong, China
| | - Xin Zhou
- Phaeno Therapeutics Co. Ltd, Hangzhou, China
| | - Yi Zhou
- Phaeno Therapeutics Co. Ltd, Hangzhou, China
| | - Donghui Qin
- Phaeno Therapeutics Co. Ltd, Hangzhou, China
| | - George Hill
- Phaeno Therapeutics Co. Ltd, Hangzhou, China
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Hill G, Persad R, Bolomytis S. Reverse intermittent androgen deprivation therapy: Prostate cancer and hypopituitarism. Journal of Clinical Urology 2022. [DOI: 10.1177/2051415820923231] [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: 11/15/2022]
Abstract
Testosterone replacement in the context of untreated prostate cancer is a controversial topic, where the symptomatic benefits of testosterone therapy contrast with the risk of disease progression. We report the case of a 76-year-old gentleman, under watchful waiting for known prostate cancer, who underwent a transsphenoidal resection of a pituitary macroadenoma. The adenoma and subsequent surgical treatment resulted in secondary testosterone deficiency, effectively ‘self-commencing’ endogenous androgen deprivation therapy. After discussion with the endocrine team, careful intermittent testosterone supplementation was undertaken to address his symptoms, with the patient undergoing prostate-specific antigen surveillance. This was felt to be similar to intermittent androgen deprivation therapy in reverse. Here, we review current evidence regarding testosterone therapy in the context of prostate cancer. Level of Evidence: 5
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Affiliation(s)
| | - Raj Persad
- Bristol Urological Institute, Southmead Hospital, UK
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Ekwe A, Au R, McEnroe B, Tan M, Saldan A, Henden A, Zhang P, Hutchins C, Henderson A, Mudie K, Western R, Fuery M, Kennedy G, Hill G, Tey S. Clinical scale facs-sorting and expansion of regulatory t cells (TREGS) for phase i clinical trial. Cytotherapy 2021. [DOI: 10.1016/s1465324921006150] [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: 10/21/2022]
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Hill G, Sharman J, Campbell J, Murray T, Anderson N, Foale S, Ruigrok M, Singh R, Hayat U, Barthwal R, Burley M, Eberhardt E, Dare L, Black A. Tasmanian STEMI Network - A Whole of System Evaluation. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.334] [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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Reeves BC, Rooshenas L, Macefield RC, Woodward M, Welton NJ, Waterhouse BR, Torrance AD, Strong S, Siassakos D, Seligman W, Rogers CA, Rickard L, Pullyblank A, Pope C, Pinkney TD, Pathak S, Owais A, O'Callaghan J, O'Brien S, Nepogodiev D, Nadi K, Murkin CE, Munder T, Milne T, Messenger D, McMullan CM, Mathers JM, Mason M, Marshall M, Lovegrove R, Longman RJ, Lloyd J, Lim J, Lee K, Korwar V, Hughes D, Hill G, Harris R, Hamdan M, Brown HG, Gooberman-Hill R, Glasbey J, Fryer C, Ellis L, Elliott D, Dumville JC, Draycott T, Donovan JL, Cotton D, Coast J, Clout M, Calvert MJ, Byrne BE, Brown OD, Blencowe NS, Bera KD, Bennett J, Bamford R, Bakhbakhi D, Atif M, Ashton K, Armstrong E, Andronis L, Ananthavarathan P, Blazeby JM. Three wound-dressing strategies to reduce surgical site infection after abdominal surgery: the Bluebelle feasibility study and pilot RCT. Health Technol Assess 2020; 23:1-166. [PMID: 31392958 DOI: 10.3310/hta23390] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Surgical site infection (SSI) affects up to 20% of people with a primary closed wound after surgery. Wound dressings may reduce SSI. OBJECTIVE To assess the feasibility of a multicentre randomised controlled trial (RCT) to evaluate the effectiveness and cost-effectiveness of dressing types or no dressing to reduce SSI in primary surgical wounds. DESIGN Phase A - semistructured interviews, outcome measure development, practice survey, literature reviews and value-of-information analysis. Phase B - pilot RCT with qualitative research and questionnaire validation. Patients and the public were involved. SETTING Usual NHS care. PARTICIPANTS Patients undergoing elective/non-elective abdominal surgery, including caesarean section. INTERVENTIONS Phase A - none. Phase B - simple dressing, glue-as-a-dressing (tissue adhesive) or 'no dressing'. MAIN OUTCOME MEASURES Phase A - pilot RCT design; SSI, patient experience and wound management questionnaires; dressing practices; and value-of-information of a RCT. Phase B - participants screened, proportions consented/randomised; acceptability of interventions; adherence; retention; validity and reliability of SSI measure; and cost drivers. DATA SOURCES Phase A - interviews with patients and health-care professionals (HCPs), narrative data from published RCTs and data about dressing practices. Phase B - participants and HCPs in five hospitals. RESULTS Phase A - we interviewed 102 participants. HCPs interpreted 'dressing' variably and reported using available products. HCPs suggested practical/clinical reasons for dressing use, acknowledged the weak evidence base and felt that a RCT including a 'no dressing' group was acceptable. A survey showed that 68% of 1769 wounds (727 participants) had simple dressings and 27% had glue-as-a-dressing. Dressings were used similarly in elective and non-elective surgery. The SSI questionnaire was developed from a content analysis of existing SSI tools and interviews, yielding 19 domains and 16 items. A main RCT would be valuable to the NHS at a willingness to pay of £20,000 per quality-adjusted life-year. Phase B - from 4 March 2016 to 30 November 2016, we approached 862 patients for the pilot RCT; 81.1% were eligible, 59.4% consented and 394 were randomised (simple, n = 133; glue, n = 129; no dressing, n = 132); non-adherence was 3 out of 133, 8 out of 129 and 20 out of 132, respectively. SSI occurred in 51 out of 281 participants. We interviewed 55 participants. All dressing strategies were acceptable to stakeholders, with no indication that adherence was problematic. Adherence aids and patients' understanding of their allocated dressing appeared to be key. The SSI questionnaire response rate overall was 67.2%. Items in the SSI questionnaire fitted a single scale, which had good reliability (test-retest and Cronbach's alpha of > 0.7) and diagnostic accuracy (c-statistic = 0.906). The key cost drivers were hospital appointments, dressings and redressings, use of new medicines and primary care appointments. LIMITATIONS Multiple activities, often in parallel, were challenging to co-ordinate. An amendment took 4 months, restricting recruitment to the pilot RCT. Only 67% of participants completed the SSI questionnaire. We could not implement photography in theatres. CONCLUSIONS A main RCT of dressing strategies is feasible and would be valuable to the NHS. The SSI questionnaire is sufficiently accurate to be used as the primary outcome. A main trial with three groups (as in the pilot) would be valuable to the NHS, using a primary outcome of SSI at discharge and patient-reported SSI symptoms at 4-8 weeks. TRIAL REGISTRATION Phase A - Current Controlled Trials ISRCTN06792113; Phase B - Current Controlled Trials ISRCTN49328913. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 39. See the NIHR Journals Library website for further project information. Funding was also provided by the Medical Research Council ConDuCT-II Hub (reference number MR/K025643/1).
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Affiliation(s)
- Barnaby C Reeves
- Clinical Trials and Evaluation Unit, Department of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Leila Rooshenas
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rhiannon C Macefield
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mark Woodward
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Nicky J Welton
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Andrew D Torrance
- Department of Surgery, Sandwell and West Birmingham NHS Trust, West Bromwich, UK
| | - Sean Strong
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,North Bristol NHS Trust, Bristol, UK
| | - Dimitrios Siassakos
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,North Bristol NHS Trust, Bristol, UK
| | | | - Chris A Rogers
- Clinical Trials and Evaluation Unit, Department of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lloyd Rickard
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Caroline Pope
- Clinical Trials and Evaluation Unit, Department of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Thomas D Pinkney
- Academic Department of Surgery, Queen Elizabeth Hospital, University of Birmingham, Birmingham, UK
| | - Samir Pathak
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Anwar Owais
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | | | - Dmitri Nepogodiev
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Academic Department of Surgery, Queen Elizabeth Hospital, University of Birmingham, Birmingham, UK
| | | | - Charlotte E Murkin
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Tonia Munder
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Tom Milne
- North Bristol NHS Trust, Bristol, UK
| | - David Messenger
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Christel M McMullan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jonathan M Mathers
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Matthew Mason
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | | | | | | | - Jeffrey Lim
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Kathryn Lee
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | - Daniel Hughes
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | - Rosie Harris
- Clinical Trials and Evaluation Unit, Department of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mohammed Hamdan
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK.,North Bristol NHS Trust, Bristol, UK
| | | | - Rachael Gooberman-Hill
- Musculoskeletal Research Unit, Department of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - James Glasbey
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Caroline Fryer
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Lucy Ellis
- Clinical Trials and Evaluation Unit, Department of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Daisy Elliott
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jo C Dumville
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Jenny L Donovan
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - David Cotton
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Joanna Coast
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Madeleine Clout
- Clinical Trials and Evaluation Unit, Department of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Melanie J Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.,Centre for Patient Reported Outcomes Research, University of Birmingham, Birmingham, UK
| | - Benjamin E Byrne
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Oliver D Brown
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Natalie S Blencowe
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Katarzyna D Bera
- Clinical Academic Graduate School, University of Oxford, Oxford, UK
| | | | - Richard Bamford
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | - Muhammad Atif
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Kate Ashton
- Clinical Trials and Evaluation Unit, Department of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Lazaros Andronis
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Jane M Blazeby
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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Thakkar H, Targett O, Broadby G, Breslin M, Hill G, Hardikar A, Roberts-Thomson P. 137 Management Choices and Outcomes of Multi-Vessel Coronary Artery Disease in Diabetics With Left Ventricular Systolic Dysfunction. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hill G. Benjamin Collins Brodie 1783–1862. J R Soc Med 2018; 81:677-8. [PMID: 3062171 PMCID: PMC1291862 DOI: 10.1177/014107688808101131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Schauer S, Hill G, Arana A, April M. 279 Pediatric Out-of-Hospital Analgesia in Iraq and Afghanistan. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schauer S, April M, Naylor J, Hill G, Arana A, Oh J, Delorenzo R. 222 The Pediatric Blast Injury: Out-of-Hospital and Emergency Department Resuscitation and Resource Utilization in Iraq and Afghanistan. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.444] [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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Kao JH, Tung SY, Lee Y, Thongsawat S, Tanwandee T, Sheen IS, Wu JJ, Li H, Brennan BJ, Zhou J, Le Pogam S, Najera I, Thommes JA, Hill G. Ritonavir-boosted danoprevir plus peginterferon alfa-2a and ribavirin in Asian chronic hepatitis C patients with or without cirrhosis. J Gastroenterol Hepatol 2016; 31:1757-1765. [PMID: 26992248 DOI: 10.1111/jgh.13374] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 12/01/2015] [Revised: 03/04/2016] [Accepted: 03/07/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Chronic hepatitis C is an important public health problem in Asia. We evaluated the safety, efficacy, and pharmacokinetics of fixed-dose ritonavir-boosted danoprevir plus peginterferon alfa-2a/ribavirin in treatment-naive Asian patients with chronic hepatitis C virus (HCV) genotype (G)1 infection. METHODS Treatment-naive G1 patients in Taiwan, Thailand, and Korea with serum HCV-RNA level ≥ 105 IU/mL received ritonavir-boosted danoprevir 125/100 mg twice daily plus peginterferon alfa-2a/ribavirin for either 12 (noncirrhotic patients: Arm A, n = 34) or 24 weeks (cirrhotic patients: Arm B, n = 27) in this phase II open-label study. Sustained virologic response was defined as HCV-RNA < 25 IU/mL 12 weeks after end of treatment (SVR12). RESULTS Similar SVR12 rates were achieved in Arms A (88.2%; 95% confidence interval, 73.4-95.3%) and B (88.9%; 71.9-96.2%). Most patients had G1b infection, among whom SVR12 rates in Arms A and B were 96.7% and 91.7%, respectively. The overall SVR12 rate was 94.0% in noncirrhotic Taiwanese patients (100% in the subset of G1b patients). No patients withdrew for safety reasons. Three (11%) cirrhotic patients (Arm B) experienced serious adverse events, none of which was considered to be related to treatment. No Grade 3/4 alanine aminotransferase elevations were reported. The pharmacokinetic properties of danoprevir were broadly overlapping in noncirrhotic and cirrhotic patients both on Days 1 and 14. CONCLUSIONS Ritonavir-boosted danoprevir plus peginterferon alfa-2a/ribavirin produced sustained virologic response rates > 90% after 12 weeks' treatment in noncirrhotic and 24 weeks' treatment in cirrhotic Asian patients with G1b infection and was well tolerated. These regimens are well suited to countries where G1b predominates.
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Affiliation(s)
- Jia-Horng Kao
- Graduate Institute of Clinical Medicine and Hepatitis Research Center, National Taiwan University and Hospital, Taipei, Taiwan.
| | - Shui-Yi Tung
- Department of Gastroenterology, Chang Gung Memorial Hospital, Chia Yi, Taiwan.,Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Younjae Lee
- Pusan Paik Hospital, Inje University, Pusan, Korea
| | | | | | - I-Shyan Sheen
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | | | - Hui Li
- Roche Product Development, Shanghai, China
| | - Barbara J Brennan
- Roche Translational and Clinical Research Center, New York, New York, USA
| | | | | | - Isabel Najera
- Roche Pharma and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - George Hill
- Genentech, South San Francisco, California, USA
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Freeman M, Hinds M, Howard K, Howard J, Hill G. Elective single embryo transfer criteria should be applied to frozen embryo transfer cycles. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.598] [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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15
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Davenport C, Hill G, Bratcher C. Peracetic acid as an antimicrobial in beef. Meat Sci 2016. [DOI: 10.1016/j.meatsci.2015.08.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Hill G, Meikle D. The role of total body irradiation (TBI) as a conditioning regime for paediatric acute lymphoblastic leukaemia: A discussion of the evidence. Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2015.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Smith JE, Smith SRC, Hill G. The UK maritime Role 3 medical treatment facility: the Primary Casualty Receiving Facility, RFA ARGUS. ACTA ACUST UNITED AC 2015. [DOI: 10.1136/jrnms-101-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Smith JE, Smith SRC, Hill G. The UK maritime Role 3 medical treatment facility: the Primary Casualty Receiving Facility, RFA ARGUS. J R Nav Med Serv 2015; 101:3-5. [PMID: 26292383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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19
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Jukes C, Dawe E, Hill G. An audit of audit performance. Int J Surg 2014. [DOI: 10.1016/j.ijsu.2014.07.084] [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: 10/24/2022]
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Wu J, Ye J, Chen F, Hill G, Spiegel J, Mehta V. Duty Cycle Selection of Gating in Lung SBRT With Flatting Filter–Free Beams. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2559] [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: 10/24/2022]
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Zaidan M, Joly D, Karras A, Caudwell V, Bruneval P, Blanche P, Jacquot C, Pouchot J, Hill G, Hermine O, Thervet E, Nochy D. Atteinte rénale au cours des cryoglobulinémies de type 1. Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.172] [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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22
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Ye J, Wu J, Chen F, Hill G, Spiegel J, Mehta V. Does MLC With Finer Leaf Width Improve the Treatment Plan Quality in Stereotactic Body Radiation Therapy of Lung Cancers. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2558] [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: 11/30/2022]
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23
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Barhoum A, Ibrahim HM, Hassanein TF, Hill G, Reniers F, Dufour T, Delplancke MP, Van Assche G, Rahier H. Preparation and characterization of ultra-hydrophobic calcium carbonate nanoparticles. ACTA ACUST UNITED AC 2014. [DOI: 10.1088/1757-899x/64/1/012037] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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24
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Julien JS, Lang R, Brown TN, Aldrich MC, Deppen SA, Wu H, Feurer ID, Tarpley M, Hill G, Tarpley J, Beauchamp RD, Grogan EL. Minority Underrepresentation in Academia: Factors Impacting Careers of Surgery Residents. J Racial Ethn Health Disparities 2014; 1:238-246. [PMID: 25396113 DOI: 10.1007/s40615-014-0030-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Underrepresentation of minorities within academic surgery is an ever present problem with a profound impact on healthcare. The factors influencing surgery residents to pursue an academic career have yet to be formally investigated. We sought to elucidate these factors, with a focus on minority status. METHODS A web-based questionnaire was sent to all administered to all ACGME-accredited general surgery programs in the United States. The main outcome was the decision to pursue a fully academic versus non-academic career. Multivariable logistic regression was used to identify characteristics impacting career choice. RESULTS Of the 3,726 residents who received the survey, a total of 1,217 residents completed it - a response rate of 33%. Forty-seven percent planned to pursue non-academic careers, 35% academic careers, and 18% were undecided. There was no association between underrepresented minority status and academic career choice (Odds Ratio = 1.0, 95% Confidence Interval 0.6 - 1.6). Among all residents, research during training (OR=4.0, 95% CI 2.7-5.9), mentorship (OR=2.1, 95% CI 1.6-2.9), and attending a residency program requiring research (OR=2.3, 95% CI 1.5-3.4) were factors associated with choosing an academic career. When the analysis was performed among only senior residents (i.e., 4th and 5th year residents), a debt burden >$150,000 was associated with choosing a non-academic career (OR=0.4, 95% CI 0.1-0.9). CONCLUSIONS Underrepresented minority status is not associated with career choice. Intentional recruitment of minorities into research-oriented training programs, increased mentorship and research support among current minority residents, and improved financial options for minorities may increase the number choosing an academic surgical career.
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Affiliation(s)
- Jamii St Julien
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN ; Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Ryan Lang
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Tony N Brown
- Department of Sociology, Vanderbilt University Medical Center, Nashville, TN
| | - Melinda C Aldrich
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN ; Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN
| | - Steven A Deppen
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Huiyun Wu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Irene D Feurer
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN ; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Margaret Tarpley
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - George Hill
- Department of Multicultural Affairs, Vanderbilt University Medical Center, Nashville, TN
| | - John Tarpley
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN ; Veterans Affairs Medical Center, Nashville, TN
| | - R Daniel Beauchamp
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Eric L Grogan
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN ; Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN ; Veterans Affairs Medical Center, Nashville, TN
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Wu J, Ye J, Hill G, Spiegel J, Mehta V. SU-E-T-361: Clinical Benefit of Automatic Beam Gating Mixed with Breath Hold in Radiation Therapy of Left Breast. Med Phys 2014. [DOI: 10.1118/1.4888694] [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: 11/07/2022] Open
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Ball B, Gordon C, Hill G. EP-1887: Service user participation in radiotherapy education. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)32005-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Venot M, Nochy D, Piette J, Jacquot C, Caudwell V, Hill G, Daugas E. Évolution à long terme des patients lupiques présentant une néphropathie du syndrome des antiphospholipides. Nephrol Ther 2013. [DOI: 10.1016/j.nephro.2013.07.129] [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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Hill G, Boyle GJ, Geisheker JV. 'Circumcision of infant males' must warn doctors of possible criminal assault charges. Intern Med J 2013; 42:1280-1. [PMID: 23157536 DOI: 10.1111/j.1445-5994.2012.02960.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 08/21/2012] [Indexed: 11/30/2022]
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Schentag JJ, Hill G, Chu T, Rayner CR. Similarity in Pharmacokinetics of Oseltamivir and Oseltamivir Carboxylate in Japanese and Caucasian Subjects. J Clin Pharmacol 2013; 47:689-96. [PMID: 17456583 DOI: 10.1177/0091270007299761] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [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: 01/07/2023]
Abstract
The pharmacokinetics of oseltamivir and oseltamivir carboxylate in healthy Japanese (n = 14) and Caucasian (n = 14) males were compared. Subjects in each ethnic group were randomized to twice-daily oral oseltamivir 75 mg, 150 mg, or placebo for 13 doses. Oseltamivir was well tolerated across doses and ethnic groups. Oseltamivir was rapidly absorbed and hydrolyzed to oseltamivir carboxylate in all subjects. The mean plasma concentration-time profiles for oseltamivir and oseltamivir carboxylate were similar in Japanese and Caucasian subjects. At steady state, there was no evidence of any ethnic difference in the individual AUC(0-12) values for oseltamivir or oseltamivir carboxylate. Despite a significant difference in group mean body weight (approximately 20 kg) between the Japanese and Caucasian subjects, there was no evidence that dose-adjusted AUC(0-12) and C(max) for oseltamivir carboxylate were affected by body weight or ethnicity. Day 7 trough concentrations (C(min)) for oseltamivir carboxylate markedly exceeded the IC(50) (50% inhibitory concentration) against influenza A and B isolates. In conclusion, the results of this study support the use of the same dose regimens of oseltamivir in both Caucasian and Japanese subjects because of similarity in pharmacokinetics.
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Affiliation(s)
- Jerome J Schentag
- University at Buffalo School of Pharmacy, 517 Hochstetter Hall, Buffalo, NY 14260, USA.
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Huang Y, Ostrowitzki S, Hill G, Navarro M, Berger N, Kopeck P, Mau CI, Alfredson T, Lal R. Single- and Multiple-Dose Pharmacokinetics of Levovirin Valinate Hydrochloride (R1518) in Healthy Volunteers. J Clin Pharmacol 2013; 45:578-88. [PMID: 15831782 DOI: 10.1177/0091270005274861] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [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: 11/15/2022]
Abstract
R1518 is a valine ester prodrug of levovirin as an investigational new drug for the treatment of hepatitis C virus. Two phase 1, single- and multiple-dose studies were conducted to investigate the pharmacokinetics of R1518 in healthy volunteers. After oral dosing, R1518 was rapidly and exclusively converted to levovirin. Levovirin plasma concentrations peaked at 2 hours, with T(1/2) ranging from 6 to 8 hours. The T(1/2) of R1518 was less than 1 hour, with relative exposures (R1518/levovirin) less than 6%. A high-fat meal did not affect the pharmacokinetics. The female groups in both studies had higher plasma levels than males did due to age and renal function difference. An accumulation ratio of 1.3 to 1.5 was observed with the twice-daily regimen. About 75% to 90% of the levovirin equivalent dose was recovered in urine. Increase in exposure was slightly disproportionate to increase in dose. Significantly improved oral absorption of levovirin was achieved following administration of R1518.
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Affiliation(s)
- Yue Huang
- Clinical Pharmacology, Roche Palo Alto LLC, 3431 Hillview Avenue, Palo Alto, CA 94304, USA
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Calvo MS, Babu US, Garthoff LH, Woods TO, Dreher M, Hill G, Nagaraja S. Vitamin D2 from light-exposed edible mushrooms is safe, bioavailable and effectively supports bone growth in rats. Osteoporos Int 2013; 24:197-207. [PMID: 22358317 DOI: 10.1007/s00198-012-1934-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 01/13/2012] [Indexed: 10/28/2022]
Abstract
UNLABELLED Widespread poor vitamin D status, a health risk for bone disease, increases the need for new food sources of vitamin D. Light-exposed edible mushrooms synthesize vitamin D(2). Bioavailability, safety, and efficacy of high levels of vitamin D(2) from mushrooms to support bone health was established in chronically fed growing rats. INTRODUCTION Poor vitamin D status from reduced sun exposure is made worse by limited access to vitamin D-containing foods. Exposing white button mushrooms to ultraviolet B (UVB) light markedly increases their vitamin D(2) content, creating a new food source of vitamin D. We used a growing rat model to determine safety, bioavailability, and efficacy in support of bone growth by vitamin D(2) from UVB-exposed mushrooms. METHODS We fed 150 weanling female rats one of five diets for 10 weeks, all formulated on AIN-93 G. Control diets contained no mushrooms either with or without vitamin D(3). Other diets contained 2.5% and 5.0% of UVB-exposed or -unexposed mushrooms. Safety of the high levels of vitamin D(2) from mushrooms was assessed by animal growth and by Von Kossa staining for soft tissue calcification. Bioavailability was determined from changes in circulating levels of 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH). Efficacy in support of bone growth was determined from measures of femur bending properties, size, mineralization, and microarchitecture. RESULTS Diets containing 2.5% and 5.0% light-exposed mushrooms significantly raised 25(OH)D and suppressed PTH levels compared to control-fed rats or rats fed 5.0% mushroom unexposed to light. Microarchitecture and trabecular mineralization were only modestly higher in the light-treated mushroom-fed rats compared to the controls. Von Kossa staining revealed no soft tissue calcification despite very high plasma 25(OH)D. CONCLUSIONS Vitamin D(2) from UVB-exposed mushrooms is bioavailable, safe, and functional in supporting bone growth and mineralization in a growing rat model without evidence of toxicity.
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Affiliation(s)
- M S Calvo
- Office of Applied Research and Safety Assessment, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, 8301 Muirkirk Road, Laurel, MD 20708, USA.
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Hill G, Stradling JR. P258 Change in Sleep Study and CPAP Provision Following the NIHCE CPAP TA. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kofman T, Narjoz C, Raimbourg Q, Loriot MA, Karras A, Roland M, Hill G, Jacquot C, Nochy D, Thervet E. Collapsing glomerulopathy associated lupus in a black female with homozygous APOL1 mutation. Lupus 2012; 21:1459-62. [PMID: 22952321 DOI: 10.1177/0961203312460114] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Collapsing glomerulopathy (CG), characterized by collapse of the glomerular capillary loops onto the mesangial stalks is rarely associated to systemic lupus erythematosus (SLE). Recently a genetic predisposition to HIV associated nephropathy (HIVAN) has been shown in Afro-Americans: MYH9 polymorhism in 2008 and then APOL1 variants (G1 and G2 alleles) in 2010 were shown to be strongly associated with HIVAN. We describe here for the first time the association of CG in a young Afro-American female with SLE having a homozygous mutation of APOL1. The clinical history, laboratory findings and immunofluorescence all confirmed a diagnosis of SLE. However, studies for factors associated with collapsing glomerulopathy in other situations were consistently negative. As this Afro-American patient developed a CG, we performed genotyping of APOL1. It was found that she is homozygotic for the G2 allele of APOL1. Despite.
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Affiliation(s)
- T Kofman
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service d'anatomopathologie, Paris, France.
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Kofman T, Narjoz C, Raimbourg Q, Roland M, Loriot MA, Karras A, Hill G, Jacquot C, Nochy D, Thervet E. Une collapsing glomerulopathy lupique chez une patiente afro-américaine porteuse d’une mutation homozygote de APOL1. Nephrol Ther 2012. [DOI: 10.1016/j.nephro.2012.07.333] [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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Ripoll E, Ripoll E, Goma M, Bolanos N, Herrero I, Bestard O, Cruzado JM, Grinyo JM, Torras J, Venot M, Venot M, Nochy D, Caudwell V, Jacquot C, Hill G, Piette JC, Daugas E, Wilde B, Thewissen M, Van Paassen P, Hilhorst M, Damoiseaux J, Witzke O, Cohen Tervaert JW, Chen N, LI X, Zhang W, Shen P, Yu H, Chen Y, Ren H, Ni L, Lebas C, Guillevin L, Berezne A, Seror R, Teixeira L, Pourrat J, Mahr A, Hachulla E, Agard C, Cabane J, Vanhille P, Harle JR, Deleveaux I, Mouthon L. Autoimmune systemic diseases. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Affiliation(s)
- J E Risdall
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Department of Military Anaesthesia and Critical Care, Royal Centre of Defence Medicine, Birmingham.
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Hill G, Amesur N, Zajko A, Geller D, Tsung A, Marsh J. Abstract No. 160: Reconsidering the necessity for prophylactic embolization of the gastroduodenal artery and right gastric artery prior to radioembolization of the liver with Yttrium-90 microspheres. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.205] [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] Open
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Nelson DR, Zeuzem S, Andreone P, Ferenci P, Herring R, Jensen DM, Marcellin P, Pockros PJ, Rodríguez-Torres M, Rossaro L, Rustgi VK, Sepe T, Sulkowski M, Thomason IR, Yoshida EM, Chan A, Hill G. Balapiravir plus peginterferon alfa-2a (40KD)/ribavirin in a randomized trial of hepatitis C genotype 1 patients. Ann Hepatol 2012; 11:15-31. [PMID: 22166557 PMCID: PMC3739984] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Balapiravir (R1626, RG1626) is the prodrug of a nucleoside analogue inhibitor of the hepatitis C virus (HCV) RNA-dependent RNA polymerase (R1479, RG1479). This phase 2, double-blind international trial evaluated the optimal treatment regimen of balapiravir plus peginterferon alfa-2a (40KD)/ribavirin. MATERIAL AND METHODS Treatment-naive genotype 1 patients (N = 516) were randomized to one of seven treatment groups in which they received balapiravir 500, 1,000, or 1,500 mg twice daily, peginterferon alfa-2a (40KD) 180 or 90 µg/week and ribavirin 1,000/1,200 mg/day or peginterferon alfa-2a (40KD)/ribavirin. The planned treatment duration with balapiravir was reduced from 24 to 12 weeks due to safety concerns. RESULTS The percentage of patients with undetectable HCV RNA was consistently higher in all balapiravir groups from week 2 to 12. However, high rates of dose modifications and discontinuations of one/all study drugs compromised the efficacy assessment and resulted in similar sustained virological response rates in the balapiravir groups (range 32-50%) and the peginterferon alfa-2a (40KD)/ribavirin group (43%). Balapiravir was discontinued for safety reasons in 28-36% of patients (most often for lymphopenia) and the percentage of patients with serious adverse events (especially hematological, infection, ocular events) was dose related. Serious hematological adverse events (particularly neutropenia, lymphopenia) were more common in balapiravir recipients. Two deaths in the balapiravir/peginterferon alfa-2a/ribavirin combination groups were considered possibly related to study medication. CONCLUSION Further development of balapiravir for the treatment of chronic hepatitis C has been halted because of the unacceptable benefit to risk ratio revealed in this study (www.ClinicalTrials.gov NCT 00517439).
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Affiliation(s)
- David R. Nelson
- Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainsville, USA
| | - Stefan Zeuzem
- Department of Medicine, J.W. Goethe University Hospital, Frankfurt, Germany
| | - Pietro Andreone
- Dipartimento di Medicina Clinica, Università di Bologna, Bologna, Italy
| | - Peter Ferenci
- Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Robert Herring
- Nashville Gastrointestinal Specialists Inc, Nashville, USA
| | - Donald M. Jensen
- Center for Liver Diseases, Chicago, Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medical Center, USA
| | | | - Paul J. Pockros
- Division of Gastroenterology and Hepatology, The Scripps Clinic, Torrey Pines, USA
| | - Maribel Rodríguez-Torres
- Fundacion de Investigacion De Diego Santurce, Puerto Rico and Ponce School of Medicine, Puerto Rico, USA
| | - Lorenzo Rossaro
- Division of Gastroenterology and Hepatology, University of California, Davis Medical Center, Sacramento, USA
| | | | - Thomas Sepe
- University Gastroenterology, Providence, USA
| | - Mark Sulkowski
- Viral Hepatitis Center in the Divisions of Infectious Diseases and Gastroenterology/Hepatology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Isaac R. Thomason
- Mountain West Gastroenterology, Transplant Department, Intermountain Medical Center, Salt Lake City, USA
| | - Eric M. Yoshida
- Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada
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Boyle GJ, Hill G. Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: methodological, ethical and legal concerns. J Law Med 2011; 19:316-334. [PMID: 22320006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In 2007, WHO/UNAIDS recommended male circumcision as an HIV-preventive measure based on three sub-Saharan African randomised clinical trials (RCTs) into female-to-male sexual transmission. A related RCT investigated male-to-female transmission. However, the trials were compromised by inadequate equipoise; selection bias; inadequate blinding; problematic randomisation; trials stopped early with exaggerated treatment effects; and not investigating non-sexual transmission. Several questions remain unanswered. Why were the trials carried out in countries where more intact men were HIV-positive than in those where more circumcised men were HIV-positive? Why were men sampled from specific ethnic subgroups? Why were so many participants lost to follow-up? Why did men in the male circumcision groups receive additional counselling on safe sex practices? While the absolute reduction in HIV transmission associated with male circumcision across the three female-to-male trials was only about 1.3%, relative reduction was reported as 60%, but, after correction for lead-time bias, averaged 49%. In the Kenyan trial, male circumcision appears to have been associated with four new incident infections. In the Ugandan male-to-female trial, there appears to have been a 61% relative increase in HIV infection among female partners of HIV-positive circumcised men. Since male circumcision diverts resources from known preventive measures and increases risk-taking behaviours, any long-term benefit in reducing HIV transmission remains uncertain.
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Feng L, Mitra J, Dawson P, Hill G. High sensitivity (1 ppm) hydrogen detection using an unconventional Pd/n-InP Schottky device. J Phys Condens Matter 2011; 23:422201. [PMID: 21969103 DOI: 10.1088/0953-8984/23/42/422201] [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: 05/31/2023]
Abstract
Hydrogen is detected using a Pd/n-InP Schottky diode in which the elongated, very thin Pd electrode is of greater resistance than the underlying semiconductor substrate. Four-probe measurements of the device resistance, as a function of hydrogen concentration, are made by contacting only the Pd electrode, with a sensitivity of 1 ppm being achieved. On hydrogen exposure the device resistance drops from an initial high value, characteristic of the Pd electrode alone, to a lower value due to a hydrogen-induced lowering of the Schottky barrier that opens up the InP substrate as a parallel current carrying channel.
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Affiliation(s)
- Lei Feng
- Centre for Nanostructured Media, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, UK
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Paukku Y, Hill G. Correction to “Theoretical Determination of One-Electron Redox Potentials for DNA Bases, Base Pairs, and Stacks”. J Phys Chem A 2011. [DOI: 10.1021/jp204493j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Affiliation(s)
- Y. Paukku
- Interdisciplinary Center for Nanotoxicity, Department of Chemistry, Jackson State University, 1400 J. R. Lynch Street, P.O. Box 17910, Jackson, Mississippi, United States
| | - G. Hill
- Interdisciplinary Center for Nanotoxicity, Department of Chemistry, Jackson State University, 1400 J. R. Lynch Street, P.O. Box 17910, Jackson, Mississippi, United States
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Hill G. Career Development — Positive Impact on Patient Services. Clin Oncol (R Coll Radiol) 2011. [DOI: 10.1016/j.clon.2011.01.430] [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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Boyle GJ, Hill G. "The case for boosting infant male circumcision in the face of rising heterosexual transmission of HIV" ... and now the case against. Comment. Med J Aust 2011; 194:99-101. [PMID: 21302380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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van Rij A, Vincent J, Hill G, Jones G. Failure of Microvenous Valves in Small Superficial Veins: A Key to the Development of Venous Ulcers. J Vasc Surg 2011. [DOI: 10.1016/j.jvs.2010.11.017] [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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Denniston GC, Hill G. Gairdner was wrong. Can Fam Physician 2010; 56:986-987. [PMID: 20944034 PMCID: PMC2954072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Peterson CD, Scott DM, Rathke A, Killingsworth P, Hill G. Establishing a Central Order Entry System for Delivering Telepharmacy Services to Remote Rural Hospitals. J Pharm Technol 2010. [DOI: 10.1177/875512251002600402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Smaller, critical access hospitals continue to be challenged in finding sufficient pharmacist staffing to deliver quality pharmacy services. Innovative solutions are being explored, including use of technology, to address the problem of access to pharmacy services in remote rural areas. Objective: To describe a new telepharmacy model that is being developed in North Dakota; the model establishes a central order entry site (COE site) that provides 24-hour pharmacist staffing and telepharmacy services to rural critical access hospitals within the state. Methods: Nine rural hospitals in North Dakota established a contractual agreement with a pharmacist-staffed COE site in Fargo to obtain pharmacist staffing and pharmacy services via telepharmacy delivery. Results: All 9 rural hospitals receiving telepharmacy services from the Catholic Health Initiatives (CHI) COE site are critical access hospitals with 25 beds or less and an average of 6625 community population (range 470–16,010); 9986 doses filled per month (range <100–21,000); 1.8 full-time equivalent staff (FTE) pharmacists (range 0–4.6); 1.5 FTE technicians (range 0–3.0); and 0700 hours-1700 hours Monday through Friday service (range consultant pharmacist by phone 24/7 to 0700 hours-2000 hours Monday through Friday, and 0800 hours-1700 hours weekends and holidays). Six are CHI affiliates and 3 are non-CHI hospitals; 4 are Joint Commission accredited. The telepharmacy technology costs at each rural hospital were $25,300. Conclusions: A telepharmacy model that involves a COE site that provides 24-hour pharmacist staffing with pharmacists who are highly trained and skilled in use of telepharmacy technology and dedicate their full-time jobs to delivery of telepharmacy services to remote rural hospitals is an affordable means of delivering pharmacy services to these hospitals.
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Affiliation(s)
- Charles D Peterson
- CHARLES D PETERSON PharmD, Professor and Dean, College of Pharmacy, Nursing, and Allied Sciences, North Dakota State University, Fargo, ND
| | - David M Scott
- DAVID M SCOTT MPH PhD BSPharm, Professor, Department of Pharmacy Practice, College of Pharmacy, Nursing, and Allied Sciences, North Dakota State University
| | - Ann Rathke
- ANN RATHKE MS MEd, Telepharmacy Coordinator, College of Pharmacy, Nursing, and Allied Sciences, North Dakota State University
| | - Patricia Killingsworth
- PATRICIA KILLINGSWORTH BSPharm, National Pharmacy Director, Clinical Services, Catholic Health Initiatives, Denver, CO
| | - George Hill
- GEORGE HILL BSPharm MBA, National Pharmacy Director, Supply Chain, Catholic Health Initiatives
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Cawson JN, Nickson C, Amos A, Hill G, Whan AB, Kavanagh AM. Invasive breast cancers detected by screening mammography: a detailed comparison of computer-aided detection-assisted single reading and double reading. J Med Imaging Radiat Oncol 2010; 53:442-9. [PMID: 19788479 DOI: 10.1111/j.1754-9485.2009.02100.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To compare double reading plus arbitration for discordance, (currently best practice, (BP)) with computer-aided-detection (CAD)-assisted single reading (CAD-R) for detection of invasive cancers detected within BreastScreen Australia. Secondarily, to examine characteristics of cancers detected/rejected using each method. Mammograms of 157 randomly selected double-read invasive cancers were mixed 1:9 with normal cancers (total 1569), all detected in a BreastScreen service. Cancers were detected by two readers or one reader (C2 and C1 cancers, ratio 70:30%) in the program. The 1569 film-screen mammograms were read by two radiologists (reader A (RA) and reader B(RB)), with findings recorded before and after CAD. Discordant findings with BP were resolved by arbitration. We compared CAD-assisted reading (CAD-RA, CAD-RB) with BP, and CAD and arbitration contribution to findings. We correlated cancer size, sensitivity and mammographic density with detection methods. BP sensitivity 90.4% compared with CAD-RA sensitivity 86.6% (P = 0.12) and CAD-RB 94.3% (P = 0.14). CAD-RB specificity was less than BP (P = 0.01). CAD sensitivity was 93%, but readers rejected most positive CAD prompts. After CAD, reader's sensitivity increased 1.9% and specificity dropped 0.2% and 0.8%. Arbitration decreased specificity 4.7%. Receiving operator curves analysis demonstrated BP accuracy better than CAD-RA, borderline significance (P = 0.07), but not CAD-RB. Secondarily, cancer size was similar for BP and CAD-R. Cancers recalled after arbitration (P = 0.01) and CAD-R (P = 0.10) were smaller. No difference in cancer size or sensitivity between reading methods was found with increasing breast density. CAD-R and BP sensitivity and cancer detection size were not significantly different. CAD-R specificity was significantly lower for one reader.
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Affiliation(s)
- J N Cawson
- St Vincent's BreastScreen, St Vincent's Hospital, Fitzroy, Victoria, Australia.
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