1
|
Manara JR, Goonatillake M, Marley M, Pretty W, Collopy D, Clark G. Virtual assessment of coronal balance prior to bone resection with the MAKO robotic-assisted system accurately predicts final balance in TKA. J Robot Surg 2023; 17:2849-2854. [PMID: 37776492 DOI: 10.1007/s11701-023-01705-9] [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: 06/09/2023] [Accepted: 08/19/2023] [Indexed: 10/02/2023]
Abstract
Total knee arthroplasty (TKA) has traditionally relied on the surgeon's judgement and manual instruments to determine balance. The MAKO robotic system (Stryker Ltd, Kalamazoo, MI, USA) allows assessment of virtual compartmental gaps from CT-derived bone models intra-operatively as a predictor of soft tissue balance that will be achieved, prior to any bony resection. This study aims to assess the accuracy of this pre-resection balancing technique in determining the resultant final soft tissue balance of the TKA. A consecutive prospective cohort of 2027 Robotic-Assisted TKAs (RATKA) were performed between January'17 and March'22. Osteophytes were removed; initial virtual gaps on the virtual bone model were measured at 10° and 90° of flexion prior to bone resections. Optimization of the virtual component positions was then made and final pre-resection gaps were measured. The gaps were then re-assessed post-implantation and compared to the final pre-resection values. Virtual balancing in extension within 1 mm was achieved in 95% of cases. Of those, 98% maintained coronal balance within 1 mm after implantation, with 1.5% requiring a coronal plane soft tissue release. Inability to virtually balance a TKA within 2 mm prior to bone resection resulted in a soft tissue release in 44.4% of cases. The absolute values of the final gaps achieved were a mean of 1.3 mm greater than virtual gaps. The ability to balance a knee on the virtual bone model prior to bone resection, in conjunction with robotic-assisted execution of TKA, consistently achieves a balanced knee after component implantation.
Collapse
Affiliation(s)
- J R Manara
- SJOG Healthcare, Perth, WA, Australia
- Aneurin Bevan University Health Board, Caerleon, Wales
| | | | - M Marley
- SJOG Healthcare, Perth, WA, Australia
| | - W Pretty
- Perth Hip & Knee Clinic, 1/1Wexford St, Subiaco, Perth, WA, 6008, Australia
| | - D Collopy
- SJOG Healthcare, Perth, WA, Australia
- Perth Hip & Knee Clinic, 1/1Wexford St, Subiaco, Perth, WA, 6008, Australia
| | - G Clark
- SJOG Healthcare, Perth, WA, Australia.
- Perth Hip & Knee Clinic, 1/1Wexford St, Subiaco, Perth, WA, 6008, Australia.
| |
Collapse
|
2
|
Hopkins B, Wang A, McKendy K, Deckelbaum D, Fata P, Khwaja K, Jastaniah A, Razek T, Wong E, Clark G, Grushka JR. A Retrospective Analysis of the Clinical Use and Utility of Advanced Imaging in the Evaluation of Near-Hanging and Strangulation Injuries at a Canadian Level One Trauma Centre. Injury 2023; 54:110978. [PMID: 37599191 DOI: 10.1016/j.injury.2023.110978] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/03/2023] [Accepted: 08/05/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION Computed tomography (CT) of the neck is highly sensitive and may effectively rule-out cervical spine, cerebrovascular, and aerodigestive injuries after blunt and penetrating trauma. However, CT may be overutilized in the evaluation of hanging or strangulation injuries. The objective of this study was to determine the diagnostic yield of CT imaging among patients evaluated for hanging or strangulation mechanisms at a Canadian level-1 trauma center. METHODS All adult patients evaluated for hanging or strangulation injuries over an eight-year period were reviewed. The primary outcome was the diagnostic yield of CT imaging for major aerodigestive, cervical spine, cerebrovascular, or neurological injuries. Multiple logistic regression were performed to determine predictive factors for the use of CT imaging and the identification of injury on imaging. RESULTS Among 124 patients evaluated for hanging or strangulation injuries during the study period, 101 (80%) were evaluated with CT of the head or neck. A total of 26 injuries were identified in 21 patients (18 anoxic brain injuries, 4 aerodigestive, 3 cerebrovascular, and 1 of cervical spine injury). The overall diagnostic yield of neck CT for cervical injuries was 7.8%, 4.7% for laryngeal-tracheal injuries, 3.5% for carotid and vertebral artery injuries, and 1.1% for cervical spine injury. The diagnostic yield of CT head for anoxic brain injury was 22.8%. Factors predicting the use of CT imaging were abnormal physical exam findings (RR 1.7 95% CI [1.2, 2.3]) and transfer accepted by the trauma team leader (RR 1.3 95% CI [1.1, 1.5]). CONCLUSION CT imaging is often used in the evaluation of patients presenting with hanging or strangulation mechanisms. Seven cerebrovascular, aerodigestive, or cervical spine injuries were identified on imaging during the study period, representing a diagnostic yield of 7%. No injuries were identified among patient with a normal GCS or physical exam. Factors predicting the use of CT imaging included transfer accepted by the trauma team leader and abnormal physical exam findings. The variable clinical presentation of near-hanging and strangulation injuries and the relatively low diagnostic yield of CT imaging should prompt the development of tools and institutional protocols to guide the evaluation of hanging and strangulation injuries.
Collapse
Affiliation(s)
- Brent Hopkins
- Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada.
| | - Anna Wang
- Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Katherine McKendy
- Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Division of Trauma and Critical Care Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Dan Deckelbaum
- Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Division of Trauma and Critical Care Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Paola Fata
- Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Division of Trauma and Critical Care Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Kozar Khwaja
- Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Division of Trauma and Critical Care Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Atif Jastaniah
- Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Division of Trauma and Critical Care Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Tarek Razek
- Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Division of Trauma and Critical Care Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Evan Wong
- Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Division of Trauma and Critical Care Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Gregory Clark
- Department of Emergency Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Jeremy Richard Grushka
- Division of General Surgery, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada; Division of Trauma and Critical Care Medicine, McGill University Health Centre, Montreal, QC, Canada
| |
Collapse
|
3
|
Clark G. The inheritance of social status: England, 1600 to 2022. Proc Natl Acad Sci U S A 2023; 120:e2300926120. [PMID: 37364122 DOI: 10.1073/pnas.2300926120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/17/2023] [Indexed: 06/28/2023] Open
Abstract
A lineage of 422,374 English people (1600 to 2022) contains correlations in social outcomes among relatives as distant as 4th cousins. These correlations show striking patterns. The first is the strong persistence of social status across family trees. Correlations decline by a factor of only 0.79 across each generation. Even fourth cousins, with a common ancestor only five generations earlier, show significant status correlations. The second remarkable feature is that the decline in correlation with genetic distance in the lineage is unchanged from 1600 to 2022. Vast social changes in England between 1600 and 2022 would have been expected to increase social mobility. Yet people in 2022 remain correlated in outcomes with their lineage relatives in exactly the same way as in preindustrial England. The third surprising feature is that the correlations parallel those of a simple model of additive genetic determination of status, with a genetic correlation in marriage of 0.57.
Collapse
Affiliation(s)
- Gregory Clark
- Department of Economics, University of Southern Denmark, Odense DK-5230, Denmark
- Department of Economics, University of California, Davis, CA 95616
- Department of Economic History, London School of Economics, London WC2A 2AE, United Kingdom
| |
Collapse
|
4
|
Kavsak PA, Clark L, Arnoldo S, Lou A, Shea JL, Eintracht S, Lyon AW, Bhayana V, Thorlacius L, Raizman JE, Tsui AKY, Djiana R, Chen M, Huang Y, Booth RA, McCudden C, Lavoie J, Beriault DR, Blank DW, Fung AWS, Hoffman B, Taher J, St-Cyr J, Yip PM, Belley-Cote EP, Abramson BL, Borgundvaag B, Friedman SM, Mak S, McLaren J, Steinhart B, Udell JA, Wijeysundera HC, Atkinson P, Campbell SG, Chandra K, Cox JL, Mulvagh S, Quraishi AUR, Chen-Tournoux A, Clark G, Segal E, Suskin N, Johri AM, Sivilotti MLA, Garuba H, Thiruganasambandamoorthy V, Robinson S, Scheuermeyer F, Humphries KH, Than M, Pickering JW, Worster A, Mills NL, Devereaux PJ, Jaffe AS. Analytic Result Variation for High-Sensitivity Cardiac Troponin: Interpretation and Consequences. Can J Cardiol 2023; 39:947-951. [PMID: 37094710 DOI: 10.1016/j.cjca.2023.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/06/2023] [Accepted: 04/18/2023] [Indexed: 04/26/2023] Open
Affiliation(s)
| | - Lorna Clark
- McMaster University, Hamilton, Ontario, Canada
| | | | - Amy Lou
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jennifer L Shea
- Department of Laboratory Medicine, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | | | - Andrew W Lyon
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | | | - Joshua E Raizman
- Department of Laboratory Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Albert K Y Tsui
- Department of Laboratory Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | | | - Michael Chen
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Yun Huang
- Queen's University, Kingston, Ontario, Canada
| | | | | | - Joël Lavoie
- Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | | | | | - Angela W S Fung
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | - Paul M Yip
- University of Toronto, Toronto, Ontario, Canada
| | - Emilie P Belley-Cote
- McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada
| | | | | | | | - Susanna Mak
- University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | | - Jafna L Cox
- Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | | | - Eli Segal
- McGill University, Montréal, Québec, Canada
| | | | | | | | | | | | - Simon Robinson
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Martin Than
- Department of Emergency Medicine, Christchurch Hospital, Christchurch, New Zealand
| | - John W Pickering
- Department of Emergency Medicine, Christchurch Hospital, Christchurch, New Zealand; Department of Medicine, University of Otago, Christchurch, New Zealand
| | | | - Nicholas L Mills
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - P J Devereaux
- McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada
| | - Allan S Jaffe
- Mayo Clinic and Medical Center, Rochester, Minnesota, United States
| |
Collapse
|
5
|
Archambault PM, Rosychuk RJ, Audet M, Bola R, Vatanpour S, Brooks SC, Daoust R, Clark G, Grant L, Vaillancourt S, Welsford M, Morrison LJ, Hohl CM. Accuracy of Self-Reported COVID-19 Vaccination Status Compared With a Public Health Vaccination Registry in Québec: Observational Diagnostic Study. JMIR Public Health Surveill 2023; 9:e44465. [PMID: 37327046 DOI: 10.2196/44465] [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: 11/24/2022] [Revised: 04/11/2023] [Accepted: 05/03/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND The accuracy of self-reported vaccination status is important to guide real-world vaccine effectiveness studies and policy making in jurisdictions where access to electronic vaccine registries is restricted. OBJECTIVE This study aimed to determine the accuracy of self-reported vaccination status and reliability of the self-reported number of doses, brand, and time of vaccine administration. METHODS This diagnostic accuracy study was completed by the Canadian COVID-19 Emergency Department Rapid Response Network. We enrolled consecutive patients presenting to 4 emergency departments (EDs) in Québec between March 24, 2020, and December 25, 2021. We included adult patients who were able to consent, could speak English or French, and had a proven COVID-19 infection. We compared the self-reported vaccination status of the patients with their vaccination status in the electronic Québec Vaccination Registry. Our primary outcome was the accuracy of the self-reported vaccination status (index test) ascertained during telephone follow-up compared with the Québec Vaccination Registry (reference standard). The accuracy was calculated by dividing all correctly self-reported vaccinated and unvaccinated participants by the sum of all correctly and incorrectly self-reported vaccinated and unvaccinated participants. We also reported interrater agreement with the reference standard as measured by unweighted Cohen κ for self-reported vaccination status at telephone follow-up and at the time of their index ED visit, number of vaccine doses, and brand. RESULTS During the study period, we included 1361 participants. At the time of the follow-up interview, 932 participants reported at least 1 dose of a COVID-19 vaccine. The accuracy of the self-reported vaccination status was 96% (95% CI 95%-97%). Cohen κ for self-reported vaccination status at phone follow-up was 0.91 (95% CI 0.89-0.93) and 0.85 (95% CI 0.77-0.92) at the time of their index ED visit. Cohen κ was 0.89 (95% CI 0.87-0.91) for the number of doses, 0.80 (95% CI 0.75-0.84) for the brand of the first dose, 0.76 (95% CI 0.70-0.83) for the brand of the second dose, and 0.59 (95% CI 0.34-0.83) for the brand of the third dose. CONCLUSIONS We reported a high accuracy of self-reported vaccination status for adult patients without cognitive disorders who can express themselves in English or French. Researchers can use self-reported COVID-19 vaccination data on the number of doses received, vaccine brand name, and timing of vaccination to guide future research with patients who are capable of self-reporting their vaccination data. However, access to official electronic vaccine registries is still needed to determine the vaccination status in certain susceptible populations where self-reported vaccination data remain missing or impossible to obtain. TRIAL REGISTRATION Clinicaltrials.gov NCT04702945; https://clinicaltrials.gov/ct2/show/NCT04702945.
Collapse
Affiliation(s)
- Patrick M Archambault
- Department of Family Medicine and Emergency Medicine, Université Laval, Québec, QC, Canada
- Centre de recherche intégrée pour un système de santé apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-Appalaches, Lévis, QC, Canada
- VITAM - Centre de recherche en santé durable, Québec, QC, Canada
- Department of Anesthesiology and Intensive Care, Université Laval, Québec, QC, Canada
| | - Rhonda J Rosychuk
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Martyne Audet
- Centre de recherche intégrée pour un système de santé apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-Appalaches, Lévis, QC, Canada
| | - Rajan Bola
- Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shabnam Vatanpour
- Center for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Steven C Brooks
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
| | - Raoul Daoust
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montréal, QC, Canada
| | - Gregory Clark
- Department of Emergency Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Lars Grant
- Department of Emergency Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Samuel Vaillancourt
- Department of Emergency Medicine, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michelle Welsford
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Laurie J Morrison
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Corinne M Hohl
- Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
6
|
Ross CT, Hooper PL, Smith JE, Jaeggi AV, Smith EA, Gavrilets S, Zohora FT, Ziker J, Xygalatas D, Wroblewski EE, Wood B, Winterhalder B, Willführ KP, Willard AK, Walker K, von Rueden C, Voland E, Valeggia C, Vaitla B, Urlacher S, Towner M, Sum CY, Sugiyama LS, Strier KB, Starkweather K, Major-Smith D, Shenk M, Sear R, Seabright E, Schacht R, Scelza B, Scaggs S, Salerno J, Revilla-Minaya C, Redhead D, Pusey A, Purzycki BG, Power EA, Pisor A, Pettay J, Perry S, Page AE, Pacheco-Cobos L, Oths K, Oh SY, Nolin D, Nettle D, Moya C, Migliano AB, Mertens KJ, McNamara RA, McElreath R, Mattison S, Massengill E, Marlowe F, Madimenos F, Macfarlan S, Lummaa V, Lizarralde R, Liu R, Liebert MA, Lew-Levy S, Leslie P, Lanning J, Kramer K, Koster J, Kaplan HS, Jamsranjav B, Hurtado AM, Hill K, Hewlett B, Helle S, Headland T, Headland J, Gurven M, Grimalda G, Greaves R, Golden CD, Godoy I, Gibson M, Mouden CE, Dyble M, Draper P, Downey S, DeMarco AL, Davis HE, Crabtree S, Cortez C, Colleran H, Cohen E, Clark G, Clark J, Caudell MA, Carminito CE, Bunce J, Boyette A, Bowles S, Blumenfield T, Beheim B, Beckerman S, Atkinson Q, Apicella C, Alam N, Mulder MB. Reproductive inequality in humans and other mammals. Proc Natl Acad Sci U S A 2023; 120:e2220124120. [PMID: 37216525 PMCID: PMC10235947 DOI: 10.1073/pnas.2220124120] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/16/2023] [Indexed: 05/24/2023] Open
Abstract
To address claims of human exceptionalism, we determine where humans fit within the greater mammalian distribution of reproductive inequality. We show that humans exhibit lower reproductive skew (i.e., inequality in the number of surviving offspring) among males and smaller sex differences in reproductive skew than most other mammals, while nevertheless falling within the mammalian range. Additionally, female reproductive skew is higher in polygynous human populations than in polygynous nonhumans mammals on average. This patterning of skew can be attributed in part to the prevalence of monogamy in humans compared to the predominance of polygyny in nonhuman mammals, to the limited degree of polygyny in the human societies that practice it, and to the importance of unequally held rival resources to women's fitness. The muted reproductive inequality observed in humans appears to be linked to several unusual characteristics of our species-including high levels of cooperation among males, high dependence on unequally held rival resources, complementarities between maternal and paternal investment, as well as social and legal institutions that enforce monogamous norms.
Collapse
Affiliation(s)
- Cody T. Ross
- Santa Fe Institute, Santa Fe, NM87501
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
| | - Paul L. Hooper
- Santa Fe Institute, Santa Fe, NM87501
- Department of Anthropology, University of New Mexico, Albuquerque, NM87131
| | | | - Adrian V. Jaeggi
- Institut für Anthropologie und Anthropologisches Museum, University of Zürich, Zürich8006, Switzerland
| | - Eric Alden Smith
- Department of Anthropology, University of Washington, Seattle, WA98195
| | - Sergey Gavrilets
- Departments of Ecology and Evolutionary Biology and Mathematics, University of Tennessee, Knoxville, TN37996
| | - Fatema tuz Zohora
- International Centre for Diarrheal Disease Research, Dhaka1000, Bangladesh
| | - John Ziker
- Department of Anthropology, Boise State University, Boise, ID83725
| | | | | | - Brian Wood
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
- Department of Anthropology, University of California, Los Angeles, CA90095
| | | | - Kai P. Willführ
- Institute for Social Science, University of Oldenburg, Oldenburg26129, Germany
| | - Aiyana K. Willard
- Centre for Culture and Evolution, Brunel University, LondonUB8 3PH, United Kingdom
| | - Kara Walker
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC27695
| | | | - Eckart Voland
- Institute for Philosophy, Justus-Liebig University, Giessen35390, Germany
| | | | - Bapu Vaitla
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA02115
| | - Samuel Urlacher
- Department of Anthropology, Baylor University, Waco, TX76706
- Canadian Institute for Advanced Research, Toronto, CAM5G 1M1
| | - Mary Towner
- Department of Integrative Biology, Oklahoma State University, Stillwater, OK74078
| | - Chun-Yi Sum
- College of General Studies, Boston University, Boston, MA02215
| | | | - Karen B. Strier
- Department of Zoology, University of Wisconsin, Madison, WI53706
| | | | - Daniel Major-Smith
- Department of Anthropology and Archaeology, University of Bristol, BristolBS8 1QU, United Kingdom
| | - Mary Shenk
- Department of Anthropology, Pennsylvania State University, University Park, PA16802
| | - Rebecca Sear
- Department of Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, United Kingdom
| | - Edmond Seabright
- Department of Anthropology, University of New Mexico, Albuquerque, NM87131
| | - Ryan Schacht
- Department of Anthropology, East Carolina University, Greenville, NC27858
| | - Brooke Scelza
- Department of Anthropology, University of California, Los Angeles, CA90095
| | - Shane Scaggs
- Department of Anthropology, Ohio State University, Columbus, OH43210
| | - Jonathan Salerno
- Department of Human Dimensions of Natural Resources, Colorado State University, Fort Collins, CO80523
| | - Caissa Revilla-Minaya
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
| | - Daniel Redhead
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
| | - Anne Pusey
- Department of Evolutionary Anthropology, Duke University, Durham, NC27708
| | - Benjamin Grant Purzycki
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
- Department of the Study of Religion, Aarhus University, Aarhus8000, Denmark
| | - Eleanor A. Power
- Santa Fe Institute, Santa Fe, NM87501
- Department of Methodology, London School of Economics and Political Science, LondonWC2A 2AE, United Kingdom
| | - Anne Pisor
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
- Department of Anthropology, Washington State University, Pullman, WA99164
| | - Jenni Pettay
- Department of Biology, University of Turku, Turku20014, Finland
| | - Susan Perry
- Department of Anthropology, University of California, Los Angeles, CA90095
| | - Abigail E. Page
- Department of Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, United Kingdom
| | - Luis Pacheco-Cobos
- Facultad de Ciencias Biológicas y Agropecuarias, Universidad Veracruzana, Veracruz94294, Mexico
| | - Kathryn Oths
- Department of Anthropology, University of Alabama, Tuscaloosa, AL35487
| | - Seung-Yun Oh
- Korea Insurance Research Institute, Seoul150-606, Korea
| | - David Nolin
- Department of Sociology, University of Massachusetts, Amherst, MA01003
| | - Daniel Nettle
- Département d’Etudes Cognitives, Ecole Normale Supérieure, Université PSL, Paris75230, France
| | - Cristina Moya
- Department of Anthropology, University of California, Davis, CA95616
| | - Andrea Bamberg Migliano
- Institut für Anthropologie und Anthropologisches Museum, University of Zürich, Zürich8006, Switzerland
| | - Karl J. Mertens
- Department of Anthropology, Boise State University, Boise, ID83725
| | - Rita A. McNamara
- School of Psychology, Victoria University of Wellington, Wellington6012, New Zealand
| | - Richard McElreath
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
| | - Siobhan Mattison
- Department of Anthropology, University of New Mexico, Albuquerque, NM87131
| | - Eric Massengill
- Department of Anthropology, University of New Mexico, Albuquerque, NM87131
| | - Frank Marlowe
- Department of Biological Anthropology, University of Cambridge, CambridgeCB2 1TN, United Kingdom
| | - Felicia Madimenos
- Department of Anthropology, Queens College (CUNY), New York, NY11367
| | - Shane Macfarlan
- Department of Anthropology, University of Utah, Salt Lake City, UT84112
| | - Virpi Lummaa
- Department of Biology, University of Turku, Turku20014, Finland
| | - Roberto Lizarralde
- Facultad de Ciencias Económicas y Sociales, Universidad Central de Venezuela, Caracas1010A, Venezuela
| | - Ruizhe Liu
- Department of Anthropology, University of New Mexico, Albuquerque, NM87131
| | - Melissa A. Liebert
- Department of Anthropology, Northern Arizona University, Flagstaff, AZ86011
| | - Sheina Lew-Levy
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
- Department of Psychology, Durham University, DurhamDH1 3LE, United Kingdom
| | - Paul Leslie
- Department of Anthropology, University of North Carolina, Chapel Hill, NC27599
| | | | - Karen Kramer
- Department of Anthropology, University of Utah, Salt Lake City, UT84112
| | - Jeremy Koster
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
- Department of Biological Sciences, University of Cincinnati, Cincinnati, OH45221
| | | | | | - A. Magdalena Hurtado
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ85287
| | - Kim Hill
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ85287
| | - Barry Hewlett
- Department of Anthropology, Washington State University, Pullman, WA99164
| | - Samuli Helle
- Department of Biology, University of Turku, Turku20014, Finland
| | | | | | - Michael Gurven
- Department of Anthropology, University of California, Santa Barbara, CA93106
| | | | - Russell Greaves
- Department of Anthropology, University of Utah, Salt Lake City, UT84112
| | - Christopher D. Golden
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA02115
| | - Irene Godoy
- Department of Animal Behaviour, Bielefeld University, Bielefeld33615, Germany
| | - Mhairi Gibson
- Department of Anthropology and Archaeology, University of Bristol, BristolBS8 1QU, United Kingdom
| | - Claire El Mouden
- School of Anthropology and Museum Ethnography, University of Oxford, OxfordOX1 2JD, United Kingdom
| | - Mark Dyble
- Department of Anthropology, University College London, LondonWC1E 6BT, United Kingdom
| | - Patricia Draper
- School of Global Integrative Studies, University of Nebraska, Lincoln, NE68588
| | - Sean Downey
- Department of Anthropology, Ohio State University, Columbus, OH43210
| | | | | | - Stefani Crabtree
- Santa Fe Institute, Santa Fe, NM87501
- Department of Environment and Society, Utah State University, Logan, UT84322
| | - Carmen Cortez
- Department of Anthropology, University of California, Davis, CA95616
| | - Heidi Colleran
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
| | - Emma Cohen
- School of Anthropology and Museum Ethnography, University of Oxford, OxfordOX1 2JD, United Kingdom
| | - Gregory Clark
- Department of Economics, University of California, Davis, CA95616
| | | | - Mark A. Caudell
- Department of Anthropology, Washington State University, Pullman, WA99164
| | - Chelsea E. Carminito
- Department of Biological Sciences, University of Cincinnati, Cincinnati, OH45221
| | - John Bunce
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
| | - Adam Boyette
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
| | | | - Tami Blumenfield
- Department of Anthropology, University of New Mexico, Albuquerque, NM87131
- School of Ethnology and Sociology, Yunnan University, Yunnan650106, China
| | - Bret Beheim
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
| | - Stephen Beckerman
- Department of Anthropology, Pennsylvania State University, University Park, PA16802
| | - Quentin Atkinson
- School of Psychology, University of Auckland, Auckland1010, New Zealand
| | - Coren Apicella
- Department of Psychology, University of Pennsylvania, Philadelphia, PA19104
| | - Nurul Alam
- International Centre for Diarrheal Disease Research, Dhaka1000, Bangladesh
| | - Monique Borgerhoff Mulder
- Santa Fe Institute, Santa Fe, NM87501
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig04103, Germany
- Department of Anthropology, University of California, Davis, CA95616
| |
Collapse
|
7
|
Hansen CJ, Bolton S, Sulaiman AH, Duling S, Bagenal F, Brennan M, Connerney J, Clark G, Lunine J, Levin S, Kurth W, Mura A, Paranicas C, Tosi F, Withers P. Juno's Close Encounter With Ganymede-An Overview. Geophys Res Lett 2022; 49:e2022GL099285. [PMID: 37034391 PMCID: PMC10078441 DOI: 10.1029/2022gl099285] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/20/2022] [Accepted: 05/28/2022] [Indexed: 06/19/2023]
Abstract
The Juno spacecraft has been in orbit around Jupiter since 2016. Two flybys of Ganymede were executed in 2021, opportunities realized by evolution of Juno's polar orbit over the intervening 5 years. The geometry of the close flyby just prior to the 34th perijove pass by Jupiter brought the spacecraft inside Ganymede's unique magnetosphere. Juno's payload, designed to study Jupiter's magnetosphere, had ample dynamic range to study Ganymede's magnetosphere. The Juno radio system was used both for gravity measurements and for study of Ganymede's ionosphere. Remote sensing of Ganymede returned new results on geology, surface composition, and thermal properties of the surface and subsurface.
Collapse
Affiliation(s)
| | - S. Bolton
- Southwest Research InstituteSan AntonioTXUSA
| | - A. H. Sulaiman
- Department of Physics and AstronomyUniversity of IowaIowa CityIAUSA
| | | | - F. Bagenal
- Laboratory for Atmospheric and Space PhysicsUniversity of ColoradoBoulderCOUSA
| | | | | | - G. Clark
- Johns Hopkins Applied Physics LaboratoryLaurelMDUSA
| | | | - S. Levin
- Jet Propulsion LaboratoryPasadenaCAUSA
| | - W. Kurth
- Department of Physics and AstronomyUniversity of IowaIowa CityIAUSA
| | - A. Mura
- Istituto Nazionale di AstroFisica – Istituto di Astrofisica e Planetologia Spaziali (INAF‐IAPS)RomeItaly
| | - C. Paranicas
- Johns Hopkins Applied Physics LaboratoryLaurelMDUSA
| | - F. Tosi
- Istituto Nazionale di AstroFisica – Istituto di Astrofisica e Planetologia Spaziali (INAF‐IAPS)RomeItaly
| | | |
Collapse
|
8
|
Kurth WS, Sulaiman AH, Hospodarsky GB, Menietti JD, Mauk BH, Clark G, Allegrini F, Valek P, Connerney JEP, Waite JH, Bolton SJ, Imai M, Santolik O, Li W, Duling S, Saur J, Louis C. Juno Plasma Wave Observations at Ganymede. Geophys Res Lett 2022; 49:e2022GL098591. [PMID: 37034392 PMCID: PMC10078157 DOI: 10.1029/2022gl098591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/22/2022] [Accepted: 04/27/2022] [Indexed: 06/19/2023]
Abstract
The Juno Waves instrument measured plasma waves associated with Ganymede's magnetosphere during its flyby on 7 June, day 158, 2021. Three distinct regions were identified including a wake, and nightside and dayside regions in the magnetosphere distinguished by their electron densities and associated variability. The magnetosphere includes electron cyclotron harmonic emissions including a band at the upper hybrid frequency, as well as whistler-mode chorus and hiss. These waves likely interact with energetic electrons in Ganymede's magnetosphere by pitch angle scattering and/or accelerating the electrons. The wake is accentuated by low-frequency turbulence and electrostatic solitary waves. Radio emissions observed before and after the flyby likely have their source in Ganymede's magnetosphere.
Collapse
Affiliation(s)
- W. S. Kurth
- Department of Physics and AstronomyUniversity of IowaIowa CityIAUSA
| | - A. H. Sulaiman
- Department of Physics and AstronomyUniversity of IowaIowa CityIAUSA
| | | | - J. D. Menietti
- Department of Physics and AstronomyUniversity of IowaIowa CityIAUSA
| | - B. H. Mauk
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - G. Clark
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - F. Allegrini
- Southwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | - P. Valek
- Southwest Research InstituteSan AntonioTXUSA
| | | | - J. H. Waite
- Southwest Research InstituteSan AntonioTXUSA
| | | | - M. Imai
- Department of Electrical Engineering and Information ScienceNational Institute of Technology (KOSEN), Niihama CollegeNiihamaJapan
| | - O. Santolik
- Department of Space PhysicsInstitute of Atmospheric Physics of the Czech Academy of SciencesPragueCzechia
- Faculty of Mathematics and PhysicsCharles UniversityPragueCzechia
| | - W. Li
- Center for Space PhysicsBoston UniversityBostonMAUSA
| | - S. Duling
- Institute of Geophysics and MeteorologyUniversity of CologneCologneGermany
| | - J. Saur
- Institute of Geophysics and MeteorologyUniversity of CologneCologneGermany
| | - C. Louis
- School of Cosmic Physics, DIAS Dunsink ObservatoryDublin Institute for Advanced StudiesDublinIreland
| |
Collapse
|
9
|
Al Saati S, Clément N, Louis C, Blanc M, Wang Y, André N, Lamy L, Bonfond B, Collet B, Allegrini F, Bolton S, Clark G, Connerney JEP, Gérard J, Gladstone GR, Kotsiaros S, Kurth WS, Mauk B. Magnetosphere-Ionosphere-Thermosphere Coupling Study at Jupiter Based on Juno's First 30 Orbits and Modeling Tools. J Geophys Res Space Phys 2022; 127:e2022JA030586. [PMID: 36591321 PMCID: PMC9787687 DOI: 10.1029/2022ja030586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/26/2022] [Accepted: 09/15/2022] [Indexed: 06/17/2023]
Abstract
The dynamics of the Jovian magnetosphere is controlled by the interplay of the planet's fast rotation, its solar-wind interaction and its main plasma source at the Io torus, mediated by coupling processes involving its magnetosphere, ionosphere, and thermosphere. At the ionospheric level, these processes can be characterized by a set of parameters including conductances, field-aligned currents, horizontal currents, electric fields, transport of charged particles along field lines including the fluxes of electrons precipitating into the upper atmosphere which trigger auroral emissions, and the particle and Joule heating power dissipation rates into the upper atmosphere. Determination of these key parameters makes it possible to estimate the net transfer of momentum and energy between Jovian upper atmosphere and equatorial magnetosphere. A method based on a combined use of Juno multi-instrument data and three modeling tools was developed by Wang et al. (2021, https://doi.org/10.1029/2021ja029469) and applied to an analysis of the first nine orbits to retrieve these parameters along Juno's magnetic footprint. We extend this method to the first 30 Juno science orbits and to both hemispheres. Our results reveal a large variability of these parameters from orbit to orbit and between the two hemispheres. They also show dominant trends. Southern current systems are consistent with the generation of a region of sub-corotating ionospheric plasma flows, while both super-corotating and sub-corotating plasma flows are found in the north. These results are discussed in light of the previous space and ground-based observations and currently available models of plasma convection and current systems, and their implications are assessed.
Collapse
Affiliation(s)
- S. Al Saati
- IRAPCNRSUniversité Toulouse III‐Paul SabatierCNESToulouseFrance
- CPHTCNRSInstitut Polytechnique de ParisPalaiseauFrance
| | - N. Clément
- IRAPCNRSUniversité Toulouse III‐Paul SabatierCNESToulouseFrance
- Laboratoire d’Astrophysique de BordeauxUniversité de BordeauxBordeauxFrance
| | - C. Louis
- IRAPCNRSUniversité Toulouse III‐Paul SabatierCNESToulouseFrance
- School of Cosmic PhysicsDIAS Dunsink ObservatoryDublin Institute for Advanced StudiesDublinIreland
| | - M. Blanc
- IRAPCNRSUniversité Toulouse III‐Paul SabatierCNESToulouseFrance
- LAMPythéasAix Marseille UniversitéCNRSCNESMarseilleFrance
| | - Y. Wang
- State Key Laboratory of Space WeatherNational Space Science CenterChinese Academy of SciencesBeijingChina
| | - N. André
- IRAPCNRSUniversité Toulouse III‐Paul SabatierCNESToulouseFrance
| | - L. Lamy
- LAMPythéasAix Marseille UniversitéCNRSCNESMarseilleFrance
- LESIAObservatoire de ParisUniversité PSLCNRSSorbonne UniversitéUniversité de ParisMeudonFrance
| | | | - B. Collet
- LAMPythéasAix Marseille UniversitéCNRSCNESMarseilleFrance
| | | | | | | | | | | | | | - S. Kotsiaros
- Technical University of DenmarkKongens LyngbyDenmark
| | | | | |
Collapse
|
10
|
Sulaiman AH, Mauk BH, Szalay JR, Allegrini F, Clark G, Gladstone GR, Kotsiaros S, Kurth WS, Bagenal F, Bonfond B, Connerney JEP, Ebert RW, Elliott SS, Gershman DJ, Hospodarsky GB, Hue V, Lysak RL, Masters A, Santolík O, Saur J, Bolton SJ. Jupiter's Low-Altitude Auroral Zones: Fields, Particles, Plasma Waves, and Density Depletions. J Geophys Res Space Phys 2022; 127:e2022JA030334. [PMID: 36247326 PMCID: PMC9539694 DOI: 10.1029/2022ja030334] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/15/2022] [Accepted: 07/21/2022] [Indexed: 06/16/2023]
Abstract
The Juno spacecraft's polar orbits have enabled direct sampling of Jupiter's low-altitude auroral field lines. While various data sets have identified unique features over Jupiter's main aurora, they are yet to be analyzed altogether to determine how they can be reconciled and fit into the bigger picture of Jupiter's auroral generation mechanisms. Jupiter's main aurora has been classified into distinct "zones", based on repeatable signatures found in energetic electron and proton spectra. We combine fields, particles, and plasma wave data sets to analyze Zone-I and Zone-II, which are suggested to carry upward and downward field-aligned currents, respectively. We find Zone-I to have well-defined boundaries across all data sets. H+ and/or H3 + cyclotron waves are commonly observed in Zone-I in the presence of energetic upward H+ beams and downward energetic electron beams. Zone-II, on the other hand, does not have a clear poleward boundary with the polar cap, and its signatures are more sporadic. Large-amplitude solitary waves, which are reminiscent of those ubiquitous in Earth's downward current region, are a key feature of Zone-II. Alfvénic fluctuations are most prominent in the diffuse aurora and are repeatedly found to diminish in Zone-I and Zone-II, likely due to dissipation, at higher altitudes, to energize auroral electrons. Finally, we identify significant electron density depletions, by up to 2 orders of magnitude, in Zone-I, and discuss their important implications for the development of parallel potentials, Alfvénic dissipation, and radio wave generation.
Collapse
Affiliation(s)
- A. H. Sulaiman
- Department of Physics and AstronomyUniversity of IowaIowa CityIAUSA
| | - B. H. Mauk
- Applied Physics LaboratoryJohns Hopkins UniversityLaurelMDUSA
| | - J. R. Szalay
- Department of Astrophysical SciencesPrinceton UniversityPrincetonNJUSA
| | - F. Allegrini
- Southwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | - G. Clark
- Applied Physics LaboratoryJohns Hopkins UniversityLaurelMDUSA
| | - G. R. Gladstone
- Southwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | - S. Kotsiaros
- DTU‐SpaceTechnical University of DenmarkKongens LyngbyDenmark
| | - W. S. Kurth
- Department of Physics and AstronomyUniversity of IowaIowa CityIAUSA
| | - F. Bagenal
- Laboratory for Atmospheric and Space PhysicsUniversity of Colorado BoulderBoulderCOUSA
| | - B. Bonfond
- Space SciencesTechnologies and Astrophysics Research InstituteLPAPUniversité de LiègeLiègeBelgium
| | - J. E. P. Connerney
- Space Research CorporationAnnapolisMDUSA
- NASA/Goddard Space Flight CenterGreenbeltMDUSA
| | - R. W. Ebert
- Southwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | - S. S. Elliott
- Minnetota Institute for AstrophysicsSchool of Physics and AstronomyUniversity of MinnesotaMinneapolisMNUSA
| | | | | | - V. Hue
- Southwest Research InstituteSan AntonioTXUSA
| | - R. L. Lysak
- Minnetota Institute for AstrophysicsSchool of Physics and AstronomyUniversity of MinnesotaMinneapolisMNUSA
| | - A. Masters
- Blackett LaboratoryImperial College LondonLondonUK
| | - O. Santolík
- Department of Space PhysicsInstitute of Atmospheric Physics of the Czech Academy of SciencesPragueCzechia
- Faculty of Mathematics and PhysicsCharles UniversityPragueCzechia
| | - J. Saur
- Institute of Geophysics and MeteorologyUniversity of CologneCologneGermany
| | | |
Collapse
|
11
|
Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, Low Z, May C, Musto L, Nagi S, Nur S, Salau E, Shabbir S, Thomas MC, Uthayanan L, Vig S, Zaheer M, Zeng G, Ashcroft-Quinn S, Brown R, Hayes J, McConville R, French R, Gilliam A, Sheetal S, Shehzad MU, Bani W, Christie I, Franklyn J, Khan M, Russell J, Smolarek S, Varadarassou R, Ahmed SK, Narayanaswamy S, Sealy J, Shah M, Dodhia V, Manukyan A, O'Hare R, Orbell J, Chung I, Forenc K, Gupta A, Agarwal A, Al Dabbagh A, Bennewith R, Bottomley J, Chu TSM, Chu YYA, Doherty W, Evans B, Hainsworth P, Hosfield T, Li CH, McCullagh I, Mehta A, Thaker A, Thompson B, Virdi A, Walker H, Wilkins E, Dixon C, Hassan MR, Lotca N, Tong KS, Batchelor-Parry H, Chaudhari S, Harris T, Hooper J, Johnson C, Mulvihill C, Nayler J, Olutobi O, Piramanayagam B, Stones K, Sussman M, Weaver C, Alam F, Al Rawi M, Andrew F, Arrayeh A, Azizan N, Hassan A, Iqbal Z, John I, Jones M, Kalake O, Keast M, Nicholas J, Patil A, Powell K, Roberts P, Sabri A, Segue AK, Shah A, Shaik Mohamed SA, Shehadeh A, Shenoy S, Tong A, Upcott M, Vijayasingam D, Anarfi S, Dauncey J, Devindaran A, Havalda P, Komninos G, Mwendwa E, Norman C, Richards J, Urquhart A, Allan J, Cahya E, Hunt H, McWhirter C, Norton R, Roxburgh C, Tan JY, Ali Butt S, Hansdot S, Haq I, Mootien A, Sanchez I, Vainas T, Deliyannis E, Tan M, Vipond M, Chittoor Satish NN, Dattani A, De Carvalho L, Gaston-Grubb M, Karunanithy L, Lowe B, Pace C, Raju K, Roope J, Taylor C, Youssef H, Munro T, Thorn C, Wong KHF, Yunus A, Chawla S, Datta A, Dinesh AA, Field D, Georgi T, Gwozdz A, Hamstead E, Howard N, Isleyen N, Jackson N, Kingdon J, Sagoo KS, Schizas A, Yin L, Aung E, Aung YY, Franklin S, Han SM, Kim WC, Martin Segura A, Rossi M, Ross T, Tirimanna R, Wang B, Zakieh O, Ben-Arzi H, Flach A, Jackson E, Magers S, Olu abara C, Rogers E, Sugden K, Tan H, Veliah S, Walton U, Asif A, Bharwada Y, Bowley D, Broekhuizen A, Cooper L, Evans N, Girdlestone H, Ling C, Mann H, Mehmood N, Mulvenna CL, Rainer N, Trout I, Gujjuri R, Jeyaraman D, Leong E, Singh D, Smith E, Anderton J, Barabas M, Goyal S, Howard D, Joshi A, Mitchell D, Weatherby T, Badminton R, Bird R, Burtle D, Choi NY, Devalia K, Farr E, Fischer F, Fish J, Gunn F, Jacobs D, Johnston P, Kalakoutas A, Lau E, Loo YNAF, Louden H, Makariou N, Mohammadi K, Nayab Y, Ruhomaun S, Ryliskyte R, Saeed M, Shinde P, Sudul M, Theodoropoulou K, Valadao-Spoorenberg J, Vlachou F, Arshad SR, Janmohamed AM, Noor M, Oyerinde O, Saha A, Syed Y, Watkinson W, Ahmadi H, Akintunde A, Alsaady A, Bradley J, Brothwood D, Burton M, Higgs M, Hoyle C, Katsura C, Lathan R, Louani A, Mandalia R, Prihartadi AS, Qaddoura B, Sandland-Taylor L, Thadani S, Thompson A, Walshaw J, Teo S, Ali S, Bawa JH, Fox S, Gargan K, Haider SA, Hanna N, Hatoum A, Khan Z, Krzak AM, Li T, Pitt J, Tan GJS, Ullah Z, Wilson E, Cleaver J, Colman J, Copeland L, Coulson A, Davis P, Faisal H, Hassan F, Hughes JT, Jabr Y, Mahmoud Ali F, Nahaboo Solim ZN, Sangheli A, Shaya S, Thompson R, Cornwall H, De Andres Crespo M, Fay E, Findlay J, Groves E, Jones O, Killen A, Millo J, Thomas S, Ward J, Wilkins M, Zaki F, Zilber E, Bhavra K, Bilolikar A, Charalambous M, Elawad A, Eleni A, Fawdon R, Gibbins A, Livingstone D, Mala D, Oke SE, Padmakumar D, Patsalides MA, Payne D, Ralphs C, Roney A, Sardar N, Stefanova K, Surti F, Timms R, Tosney G, Bannister J, Clement NS, Cullimore V, Kamal F, Lendor J, McKay J, Mcswiggan J, Minhas N, Seneviratne K, Simeen S, Valverde J, Watson N, Bloom I, Dinh TH, Hirniak J, Joseph R, Kansagra M, Lai CKN, Melamed N, Patel J, Randev J, Sedighi T, Shurovi B, Sodhi J, Vadgama N, Abdulla S, Adabavazeh B, Champion A, Chennupati R, Chu K, Devi S, Haji A, Schulz J, Testa F, Davies P, Gurung B, Howell S, Modi P, Pervaiz A, Zahid M, Abdolrazaghi S, Abi Aoun R, Anjum Z, Bawa G, Bhardwaj R, Brown S, Enver M, Gill D, Gopikrishna D, Gurung D, Kanwal A, Kaushal P, Khanna A, Lovell E, McEvoy C, Mirza M, Nabeel S, Naseem S, Pandya K, Perkins R, Pulakal R, Ray M, Reay C, Reilly S, Round A, Seehra J, Shakeel NM, Singh B, Vijay Sukhnani M, Brown L, Desai B, Elzanati H, Godhaniya J, Kavanagh E, Kent J, Kishor A, Liu A, Norwood M, Shaari N, Wood C, Wood M, Brown A, Chellapuri A, Ferriman A, Ghosh I, Kulkarni N, Noton T, Pinto A, Rajesh S, Varghese B, Wenban C, Aly R, Barciela C, Brookes T, Corrin E, Goldsworthy M, Mohamed Azhar MS, Moore J, Nakhuda S, Ng D, Pillay S, Port S, Abdullah M, Akinyemi J, Islam S, Kale A, Lewis A, Manjunath T, McCabe H, Misra S, Stubley T, Tam JP, Waraich N, Chaora T, Ford C, Osinkolu I, Pong G, Rai J, Risquet R, Ainsworth J, Ayandokun P, Barham E, Barrett G, Barry J, Bisson E, Bridges I, Burke D, Cann J, Cloney M, Coates S, Cripps P, Davies C, Francis N, Green S, Handley G, Hathaway D, Hurt L, Jenkins S, Johnston C, Khadka A, McGee U, Morris D, Murray R, Norbury C, Pierrepont Z, Richards C, Ross O, Ruddy A, Salmon C, Shield M, Soanes K, Spencer N, Taverner S, Williams C, Wills-Wood W, Woodward S, Chow J, Fan J, Guest O, Hunter I, Moon WY, Arthur-Quarm S, Edwards P, Hamlyn V, McEneaney L, N D G, Pranoy S, Ting M, Abada S, Alawattegama LH, Ashok A, Carey C, Gogna A, Haglund C, Hurley P, Leelo N, Liu B, Mannan F, Paramjothy K, Ramlogan K, Raymond-Hayling O, Shanmugarajah A, Solichan D, Wilkinson B, Ahmad NA, Allan D, Amin A, Bakina C, Burns F, Cameron F, Campbell A, Cavanagh S, Chan SMZ, Chapman S, Chong V, Edelsten E, Ekpete O, El Sheikh M, Ghose R, Hassane A, Henderson C, Hilton-Christie S, Husain M, Hussain H, Javid Z, Johnson-Ogbuneke J, Johnston A, Khalil M, Leung TCC, Makin I, Muralidharan V, Naeem M, Patil P, Ravichandran S, Saraeva D, Shankey-Smith W, Sharma N, Swan R, Waudby-West R, Wilkinson A, Wright K, Balasubramanian A, Bhatti S, Chalkley M, Chou WK, Dixon M, Evans L, Fisher K, Gandhi P, Ho S, Lau YB, Lowe S, Meechan C, Murali N, Musonda C, Njoku P, Ochieng L, Pervez MU, Seebah K, Shaikh I, Sikder MA, Vanker R, Alom J, Bajaj V, Coleman O, Finch G, Goss J, Jenkins C, Kontothanassis A, Liew MS, Ng K, Outram M, Shakeel MM, Tawn J, Zuhairy S, Chapple K, Cinnamond A, Coleman S, George HA, Goulder L, Hare N, Hawksley J, Kret A, Luesley A, Mecia L, Porter H, Puddy E, Richardson G, Sohail B, Srikaran V, Tadross D, Tobin J, Tokidis E, Young L, Ashdown T, Bratsos S, Koomson A, Kufuor A, Lim MQ, Shah S, Thorne EPC, Warusavitarne J, Xu S, Abigail S, Ahmed A, Ahmed J, Akmal A, Al-Khafaji M, Amini B, Arshad M, Bogie E, Brazkiewicz M, Carroll M, Chandegra A, Cirelli C, Deng A, Fairclough S, Fung YJ, Gornell C, Green RL, Green SV, Gulamhussein AHM, Isaac AG, Jan R, Jegatheeswaran L, Knee M, Kotecha J, Kotecha S, Maxwell-Armstrong C, McIntyre C, Mendis N, Naing TKP, Oberman J, Ong ZX, Ramalingam A, Saeed Adam A, Tan LL, Towell S, Yadav J, Anandampillai R, Chung S, Hounat A, Ibrahim B, Jeyakumar G, Khalil A, Khan UA, Nair G, Owusu-Ayim M, Wilson M, Kanani A, Kilkelly B, Ogunmwonyi I, Ong L, Samra B, Schomerus L, Shea J, Turner O, Yang Y, Amin M, Blott N, Clark A, Feather A, Forrest M, Hague S, Hamilton K, Higginbotham G, Hope E, Karimian S, Loveday K, Malik H, McKenna O, Noor A, Onsiong C, Patel B, Radcliffe N, Shah P, Tye L, Verma K, Walford R, Yusufi U, Zachariah M, Casey A, Doré C, Fludder V, Fortescue L, Kalapu SS, Karel E, Khera G, Smith C, Appleton B, Ashaye A, Boggon E, Evans A, Faris Mahmood H, Hinchcliffe Z, Marei O, Silva I, Spooner C, Thomas G, Timlin M, Wellington J, Yao SL, Abdelrazek M, Abdelrazik Y, Bee F, Joseph A, Mounce A, Parry G, Vignarajah N, Biddles D, Creissen A, Kolhe S, K T, Lea A, Ledda V, O'Loughlin P, Scanlon J, Shetty N, Weller C, Abdalla M, Adeoye A, Bhatti M, Chadda KR, Chu J, Elhakim H, Foster-Davies H, Rabie M, Tailor B, Webb S, Abdelrahim ASA, Choo SY, Jiwa A, Mangam S, Murray S, Shandramohan A, Aghanenu O, Budd W, Hayre J, Khanom S, Liew ZY, McKinney R, Moody N, Muhammad-Kamal H, Odogwu J, Patel D, Roy C, Sattar Z, Shahrokhi N, Sinha I, Thomson E, Wonga L, Bain J, Khan J, Ricardo D, Bevis R, Cherry C, Darkwa S, Drew W, Griffiths E, Konda N, Madani D, Mak JKC, Meda B, Odunukwe U, Preest G, Raheel F, Rajaseharan A, Ramgopal A, Risbrooke C, Selvaratnam K, Sethunath G, Tabassum R, Taylor J, Thakker A, Wijesingha N, Wybrew R, Yasin T, Ahmed Osman A, Alfadhel S, Carberry E, Chen JY, Drake I, Glen P, Jayasuriya N, Kawar L, Myatt R, Sinan LOH, Siu SSY, Tjen V, Adeboyejo O, Bacon H, Barnes R, Birnie C, D'Cunha Kamath A, Hughes E, Middleton S, Owen R, Schofield E, Short C, Smith R, Wang H, Willett M, Zimmerman M, Balfour J, Chadwick T, Coombe-Jones M, Do Le HP, Faulkner G, Hobson K, Shehata Z, Beattie M, Chmielewski G, Chong C, Donnelly B, Drusch B, Ellis J, Farrelly C, Feyi-Waboso J, Hibell I, Hoade L, Ho C, Jones H, Kodiatt B, Lidder P, Ni Cheallaigh L, Norman R, Patabendi I, Penfold H, Playfair M, Pomeroy S, Ralph C, Rottenburg H, Sebastian J, Sheehan M, Stanley V, Welchman J, Ajdarpasic D, Antypas A, Azouaghe O, Basi S, Bettoli G, Bhattarai S, Bommireddy L, Bourne K, Budding J, Cookey-Bresi R, Cummins T, Davies G, Fabelurin C, Gwilliam R, Hanley J, Hird A, Kruczynska A, Langhorne B, Lund J, Lutchman I, McGuinness R, Neary M, Pampapathi S, Pang E, Podbicanin S, Rai N, Redhouse White G, Sujith J, Thomas P, Walker I, Winterton R, Anderson P, Barrington M, Bhadra K, Clark G, Fowler G, Gibson C, Hudson S, Kaminskaite V, Lawday S, Longshaw A, MacKrill E, McLachlan F, Murdeshwar A, Nieuwoudt R, Parker P, Randall R, Rawlins E, Reeves SA, Rye D, Sirkis T, Sykes B, Ventress N, Wosinska N, Akram B, Burton L, Coombs A, Long R, Magowan D, Ong C, Sethi M, Williams G, Chan C, Chan LH, Fernando D, Gaba F, Khor Z, Les JW, Mak R, Moin S, Ng Kee Kwong KC, Paterson-Brown S, Tew YY, Bardon A, Burrell K, Coldwell C, Costa I, Dexter E, Hardy A, Khojani M, Mazurek J, Raymond T, Reddy V, Reynolds J, Soma A, Agiotakis S, Alsusa H, Desai N, Peristerakis I, Adcock A, Ayub H, Bennett T, Bibi F, Brenac S, Chapman T, Clarke G, Clark F, Galvin C, Gwyn-Jones A, Henry-Blake C, Kerner S, Kiandee M, Lovett A, Pilecka A, Ravindran R, Siddique H, Sikand T, Treadwell K, Akmal K, Apata A, Barton O, Broad G, Darling H, Dhuga Y, Emms L, Habib S, Jain R, Jeater J, Kan CYP, Kathiravelupillai A, Khatkar H, Kirmani S, Kulasabanathan K, Lacey H, Lal K, Manafa C, Mansoor M, McDonald S, Mittal A, Mustoe S, Nottrodt L, Oliver P, Papapetrou I, Pattinson F, Raja M, Reyhani H, Shahmiri A, Small O, Soni U, Aguirrezabala Armbruster B, Bunni J, Hakim MA, Hawkins-Hooker L, Howell KA, Hullait R, Jaskowska A, Ottewell L, Thomas-Jones I, Vasudev A, Clements B, Fenton J, Gill M, Haider S, Lim AJM, Maguire H, McMullan J, Nicoletti J, Samuel S, Unais MA, White N, Yao PC, Yow L, Boyle C, Brady R, Cheekoty P, Cheong J, Chew SJHL, Chow R, Ganewatta Kankanamge D, Mamer L, Mohammed B, Ng Chieng Hin J, Renji Chungath R, Royston A, Sharrad E, Sinclair R, Tingle S, Treherne K, Wyatt F, Maniarasu VS, Moug S, Appanna T, Bucknall T, Hussain F, Owen A, Parry M, Parry R, Sagua N, Spofforth K, Yuen ECT, Bosley N, Hardie W, Moore T, Regas C, Abdel-Khaleq S, Ali N, Bashiti H, Buxton-Hopley R, Constantinides M, D'Afflitto M, Deshpande A, Duque Golding J, Frisira E, Germani Batacchi M, Gomaa A, Hay D, Hutchison R, Iakovou A, Iakovou D, Ismail E, Jefferson S, Jones L, Khouli Y, Knowles C, Mason J, McCaughan R, Moffatt J, Morawala A, Nadir H, Neyroud F, Nikookam Y, Parmar A, Pinto L, Ramamoorthy R, Richards E, Thomson S, Trainer C, Valetopoulou A, Vassiliou A, Wantman A, Wilde S, Dickinson M, Rockall T, Senn D, Wcislo K, Zalmay P, Adelekan K, Allen K, Bajaj M, Gatumbu P, Hang S, Hashmi Y, Kaur T, Kawesha A, Kisiel A, Woodmass M, Adelowo T, Ahari D, Alhwaishel K, Atherton R, Clayton B, Cockroft A, Curtis Lopez C, Hilton M, Ismail N, Kouadria M, Lee L, MacConnachie A, Monks F, Mungroo S, Nikoletopoulou C, Pearce L, Sara X, Shahid A, Suresh G, Wilcha R, Atiyah A, Davies E, Dermanis A, Gibbons H, Hyde A, Lawson A, Lee C, Leung-Tack M, Li Saw Hee J, Mostafa O, Nair D, Pattani N, Plumbley-Jones J, Pufal K, Ramesh P, Sanghera J, Saram S, Scadding S, See S, Stringer H, Torrance A, Vardon H, Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
Collapse
|
12
|
Szalay JR, Clark G, Livadiotis G, McComas DJ, Mitchell DG, Rankin JS, Sulaiman AH, Allegrini F, Bagenal F, Ebert RW, Gladstone GR, Kurth WS, Mauk BH, Valek PW, Wilson RJ, Bolton SJ. Closed Fluxtubes and Dispersive Proton Conics at Jupiter's Polar Cap. Geophys Res Lett 2022; 49:e2022GL098741. [PMID: 35859815 PMCID: PMC9285739 DOI: 10.1029/2022gl098741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/14/2022] [Accepted: 04/16/2022] [Indexed: 05/08/2023]
Abstract
Two distinct proton populations are observed over Jupiter's southern polar cap: a ∼1 keV core population and ∼1-300 keV dispersive conic population at 6-7 RJ planetocentric distance. We find the 1 keV core protons are likely the seed population for the higher-energy dispersive conics, which are accelerated from a distance of ∼3-5 RJ. Transient wave-particle heating in a "pressure-cooker" process is likely responsible for this proton acceleration. The plasma characteristics and composition during this period show Jupiter's polar-most field lines can be topologically closed, with conjugate magnetic footpoints connected to both hemispheres. Finally, these observations demonstrate energetic protons can be accelerated into Jupiter's magnetotail via wave-particle coupling.
Collapse
Affiliation(s)
- J. R. Szalay
- Department of Astrophysical SciencesPrinceton UniversityPrincetonNJUSA
| | - G. Clark
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - G. Livadiotis
- Department of Astrophysical SciencesPrinceton UniversityPrincetonNJUSA
| | - D. J. McComas
- Department of Astrophysical SciencesPrinceton UniversityPrincetonNJUSA
| | - D. G. Mitchell
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - J. S. Rankin
- Department of Astrophysical SciencesPrinceton UniversityPrincetonNJUSA
| | | | - F. Allegrini
- Southwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | - F. Bagenal
- Laboratory for Atmospheric and Space PhysicsUniversity of Colorado BoulderBoulderCOUSA
| | - R. W. Ebert
- Southwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | | | | | - B. H. Mauk
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - P. W. Valek
- Southwest Research InstituteSan AntonioTXUSA
| | - R. J. Wilson
- Laboratory for Atmospheric and Space PhysicsUniversity of Colorado BoulderBoulderCOUSA
| | | |
Collapse
|
13
|
Hoareau GL, Peters A, Hilgart D, Iversen M, Clark G, Zabriskie M, Rieke V, Floyd C, Shah L. Feasibility of non-invasive recording of somatosensory evoked potential in pigs. Lab Anim Res 2022; 38:9. [PMID: 35331342 PMCID: PMC8943992 DOI: 10.1186/s42826-022-00118-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/12/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Non-invasive measurement of somatosensory-evoked potentials (SEP) in a large animal model is important to translational cognitive research. We sought to develop a methodology for neurophysiological recording via a transcranial electroencephalography (EEG) cap under an effective sedative regimen with dexmedetomidine, midazolam, and butorphanol that will produce sedation instead of anesthesia while not compromising data quality. RESULTS Pigs received intramuscular dexmedetomidine, midazolam, and butorphanol for SEP assessment with peroneal nerve stimulation. Semi-quantitative sedation assessment was performed after the animal was sufficiently sedated and 30 min later, during the transcranial SEP recording. SEP data were analyzed with commercial software. Binary qualitative analysis of the recording was categorized by an experienced neurophysiologist. All four animals had adequate surface SEP recordings. Animals received 43 [21-47] mcg/kg of dexmedetomidine, 0.3 [0.2-0.3] mg/kg of midazolam, and 0.3 [0.3-0.3] mg/kg of butorphanol IM. All treatments resulted in moderate to deep sedation (Baseline median sedation score 11.5 [11-12]; median score at 30 min: 11.5 [10.5-12]). Heart rate (median [range]) (55 [49-71] beats per minute), respiratory rate (24 [21-30] breaths per minute), and hemoglobin oxygen saturation (99 [98-100]%) and body temperature (37.7 [37.4-37.9] °C) remained within clinically acceptable ranges. There were no undesirable recovery incidents. CONCLUSIONS In this pilot study, we demonstrate the feasibility of SEP recording via a transcranial EEG cap under an effective sedative regimen in pigs. Our approach will expand the use of a large animal model in neurotranslational research.
Collapse
Affiliation(s)
- Guillaume L Hoareau
- Emergency Medicine, Department of Surgery, University of Utah, Salt Lake City, UT, USA.
| | - Angela Peters
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - David Hilgart
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
| | - Marta Iversen
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Gregory Clark
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
| | - Matthew Zabriskie
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Viola Rieke
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Candace Floyd
- Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, USA
| | - Lubdha Shah
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
14
|
Gibson B, Clark G. 348 Continuity of care - impact of continuity of obstetrician on unplanned attendances in high-risk pregnancies; A qualitative cohort study in a uk tertiary hospital. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.317] [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]
|
15
|
Tourigny JN, Boucher V, Paquet V, Fortier É, Malo C, Mercier É, Chauny JM, Clark G, Blanchard PG, Carmichael PH, Gariépy JL, D'Astous M, Émond M. External validation of the updated Brain Injury Guidelines for complicated mild traumatic brain injuries: a retrospective cohort study. J Neurosurg 2022; 137:1-7. [PMID: 35078154 DOI: 10.3171/2021.10.jns211794] [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: 07/22/2021] [Accepted: 10/16/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Approximately 10% of patients with mild traumatic brain injury (mTBI) have intracranial bleeding (complicated mTBI) and 3.5% eventually require neurosurgical intervention, which is mostly available at centers with a higher level of trauma care designation and often requires interhospital transfer. In 2018, the Brain Injury Guidelines (BIG) were updated in the United States to guide emergency department care and patient disposition for complicated mild to moderate TBI. The aim of this study was to validate the sensitivity and specificity of the updated BIG (uBIG) for predicting the need for interhospital transfer in Canadian patients with complicated mTBI. METHODS This study took place at three level I trauma centers. Consecutive medical records of patients with complicated mTBI (Glasgow Coma Scale score 13-15) who were aged ≥ 16 years and presented between September 2016 and December 2017 were retrospectively reviewed. Patients with a penetrating trauma and those who had a documented cerebral tumor or aneurysm were excluded. The primary outcome was a combination of neurosurgical intervention and/or mTBI-related death. Sensitivity and specificity analyses were performed. RESULTS A total of 477 patients were included, of whom 8.4% received neurosurgical intervention and 3% died as a result of their mTBI. Forty patients (8%) were classified as uBIG-1, 168 (35%) as uBIG-2, and 269 (56%) as uBIG-3. No patients in uBIG-1 underwent neurosurgical intervention or died as a result of their injury. This translates into a sensitivity for predicting the need for a transfer of 100% (95% CI 93.2%-100%) and a specificity of 9.4% (95% CI 6.8%-12.6%). Using the uBIG could potentially reduce the number of transfers by 6% to 25%. CONCLUSIONS The patients in uBIG-1 could be safely managed at their initial center without the need for transfer to a center with a higher level of neurotrauma care. Although the uBIG could decrease the number of transfers, further refinement of the criteria could improve its specificity.
Collapse
Affiliation(s)
- Jean-Nicolas Tourigny
- 1Département de médecine familiale et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Valérie Boucher
- 2Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
- 3VITAM-Centre de recherche en santé durable de l'Université Laval, Québec, Québec, Canada
- 6Centre d'excellence sur le vieillissement de Québec, Québec, Canada
| | - Véronique Paquet
- 1Département de médecine familiale et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Émile Fortier
- 1Département de médecine familiale et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Christian Malo
- 1Département de médecine familiale et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, Québec, Canada
- 2Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Éric Mercier
- 1Département de médecine familiale et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, Québec, Canada
- 3VITAM-Centre de recherche en santé durable de l'Université Laval, Québec, Québec, Canada
| | | | | | - Pierre-Gilles Blanchard
- 1Département de médecine familiale et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, Québec, Canada
- 2Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
- 3VITAM-Centre de recherche en santé durable de l'Université Laval, Québec, Québec, Canada
| | | | - Jean-Luc Gariépy
- 2Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Myreille D'Astous
- 2Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Marcel Émond
- 1Département de médecine familiale et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, Québec, Canada
- 2Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
- 3VITAM-Centre de recherche en santé durable de l'Université Laval, Québec, Québec, Canada
- 6Centre d'excellence sur le vieillissement de Québec, Québec, Canada
| |
Collapse
|
16
|
Hohl CM, Rosychuk RJ, Archambault PM, O'Sullivan F, Leeies M, Mercier É, Clark G, Innes GD, Brooks SC, Hayward J, Ho V, Jelic T, Welsford M, Sivilotti MLA, Morrison LJ, Perry JJ. The CCEDRRN COVID-19 Mortality Score to predict death among nonpalliative patients with COVID-19 presenting to emergency departments: a derivation and validation study. CMAJ Open 2022; 10:E90-E99. [PMID: 35135824 PMCID: PMC9259439 DOI: 10.9778/cmajo.20210243] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Predicting mortality from COVID-19 using information available when patients present to the emergency department can inform goals-of-care decisions and assist with ethical allocation of critical care resources. The study objective was to develop and validate a clinical score to predict emergency department and in-hospital mortality among consecutive nonpalliative patients with COVID-19; in this study, we define palliative patients as those who do not want resuscitative measures, such as intubation, intensive care unit care or cardiopulmonary resuscitation. METHODS This derivation and validation study used observational cohort data recruited from 46 hospitals in 8 Canadian provinces participating in the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN). We included adult (age ≥ 18 yr) nonpalliative patients with confirmed COVID-19 who presented to the emergency department of a participating site between Mar. 1, 2020, and Jan. 31, 2021. We randomly assigned hospitals to derivation or validation, and prespecified clinical variables as candidate predictors. We used logistic regression to develop the score in a derivation cohort and examined its performance in predicting emergency department and in-hospital mortality in a validation cohort. RESULTS Of 8761 eligible patients, 618 (7.0%) died. The CCEDRRN COVID-19 Mortality Score included age, sex, type of residence, arrival mode, chest pain, severe liver disease, respiratory rate and level of respiratory support. The area under the curve was 0.92 (95% confidence interval [CI] 0.90-0.93) in derivation and 0.92 (95% CI 0.90-0.93) in validation. The score had excellent calibration. These results suggest that scores of 6 or less would categorize patients as being at low risk for in-hospital death, with a negative predictive value of 99.9%. Patients in the low-risk group had an in-hospital mortality rate of 0.1%. Patients with a score of 15 or higher had an observed mortality rate of 81.0%. INTERPRETATION The CCEDRRN COVID-19 Mortality Score is a simple score that can be used for level-of-care discussions with patients and in situations of critical care resource constraints to accurately predict death using variables available on emergency department arrival. The score was derived and validated mostly in unvaccinated patients, and before variants of concern were circulating widely and newer treatment regimens implemented in Canada. STUDY REGISTRATION ClinicalTrials.gov, no. NCT04702945.
Collapse
Affiliation(s)
- Corinne M Hohl
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont.
| | - Rhonda J Rosychuk
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Patrick M Archambault
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Fiona O'Sullivan
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Murdoch Leeies
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Éric Mercier
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Gregory Clark
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Grant D Innes
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Steven C Brooks
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Jake Hayward
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Vi Ho
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Tomislav Jelic
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Michelle Welsford
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Marco L A Sivilotti
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Laurie J Morrison
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| | - Jeffrey J Perry
- Department of Emergency Medicine (Hohl, O'Sullivan, Ho), University of British Columbia; Centre for Clinical Epidemiology and Evaluation (Hohl, O'Sullivan, Ho), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Pediatrics (Rosychuk), University of Alberta, Edmonton, Alta.; Department of Family Medicine and Emergency Medicine (Archambault), Université Laval, Québec, Que.; Centre de recherche du Centre intégré de santé et de services sociaux de Chaudière-Appalaches (Archambault), Lévis, Que.; Department of Emergency Medicine (Leeies, Jelic) and Section of Critical Care Medicine (Leeies), Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Centre de recherche (Mercier), CHU de Québec, Université Laval; VITAM (Centre de recherche en santé durable) (Mercier), Québec, Que.; Department of Emergency Medicine (Clark), McGill University, Montréal, Que.; Department of Emergency Medicine and Community Health Sciences (Innes), University of Calgary, Calgary, Alta.; Department of Emergency Medicine (Brooks, Sivilotti), Queen's University, Kingston, Ont.; Department of Emergency Medicine (Hayward), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Welsford), McMaster University; Hamilton Health Sciences (Welsford), Hamilton, Ont.; Kingston Health Sciences Centre (Sivilotti), Kingston, Ont.; Emergency Services (Morrison), Sunnybrook Health Sciences Centre; Division of Emergency Medicine (Morrison), Department of Medicine, University of Toronto, Toronto, Ont.; Department of Emergency Medicine (Perry), University of Ottawa; Ottawa Hospital Research Institute (Perry), Ottawa, Ont
| |
Collapse
|
17
|
Clark G, Johnson NA, Saluja SS, Correa JA, Delaney JS. Do Mountain Bikers Know When They Have Had a Concussion and, Do They Know to Stop Riding? Clin J Sport Med 2021; 31:e414-e419. [PMID: 31895715 DOI: 10.1097/jsm.0000000000000819] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 11/15/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To establish the prevalence of concussions in mountain bikers and to determine factors that increase their risk of concussion. Secondary objectives include determination of whether mountain bikers have undiagnosed concussions, continue to ride after experiencing concussion symptoms, and if they knowingly ride with a broken helmet. DESIGN Retrospective survey. SETTING Seven-day mountain bike stage race. PARTICIPANTS Two hundred nineteen mountain bikers. MAIN OUTCOME MEASURES Number of rider concussions diagnosed, number of riders experiencing concussion symptoms without diagnosed concussions, number of riders who continue to ride after experiencing a concussion symptom, and number of riders who rode with a broken helmet. INDEPENDENT VARIABLES The independent variables studied included age, gender, nationality, number of times riding in past year, style of riding (cross-country, downhill, or freeride), years mountain biking, years mountain bike racing, whether they are a sponsored cyclist, and whether they also ride a road bike. RESULTS Fifteen of 219 mountain bikers (6.9%) had a diagnosed concussion after being hit in the head while mountain biking within the past year, with older riders having a decreased risk [odds ratio (OR), 0.91; P = 0.04], and sponsored riders having a 5-fold increased risk compared with nonsponsored riders (OR, 4.20; P = 0.05). Twenty-eight riders (12.8%) experienced a concussion symptom without being diagnosed with a concussion and 67.5% of the riders who experienced a concussion symptom continued to ride afterward. Overall, 29.2% of riders reported riding with a broken helmet. CONCLUSIONS The yearly prevalence of diagnosed concussions in mountain bikers is 6.9%. More than one-third of mountain bikers do not recognize when they have had a concussion and continue riding after experiencing concussion symptoms or with a broken helmet. These behaviors increase their risk of worsening concussion symptoms and acquiring a second injury.
Collapse
Affiliation(s)
- Gregory Clark
- Department of Emergency Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Nathalie A Johnson
- Department of Medicine, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Sanjeet S Saluja
- Department of Emergency Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - José A Correa
- Department of Mathematics and Statistics, McGill University, Montreal, Quebec, Canada; and
| | - J Scott Delaney
- Department of Emergency Medicine, McGill University Health Centre, Montreal, Quebec, Canada
- McGill Sport Medicine Clinic, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
18
|
Bukowski P, Clark G, Gáspár A, Pető R. Social Mobility and Political Regimes: Intergenerational Mobility in Hungary, 1949-2017. J Popul Econ 2021; 35:1551-1588. [PMID: 34642546 PMCID: PMC8497688 DOI: 10.1007/s00148-021-00875-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
This paper measures social mobility rates in Hungary during the period 1949 to 2017, using surnames to measure social status. In those years, there were two very different social regimes. The first was the Hungarian People's Republic (1949-1989), which was a communist regime with an avowed aim of favouring the working class. The second is the modern liberal democracy (1989-2017), which is a free-market economy. We find five surprising things. First, social mobility rates were low for both upper- and lower-class families during 1949-2017, with an underlying intergenerational status correlation of 0.6-0.8. Second, social mobility rates under communism were the same as in the subsequent capitalist regime. Third, the Romani minority throughout both periods showed even lower social mobility rates. Fourth, the descendants of the eighteenth-century noble class in Hungary were still significantly privileged in 1949 and later. And fifth, although social mobility rates did not change measurably during the transition, the composition of the political elite changed rapidly and sharply.
Collapse
Affiliation(s)
- Paweł Bukowski
- Centre for Economic Performance, London School of Economics and Political Science (LSE), London, UK
- Institute of Economics, Polish Academy of Sciences, Warsaw, Poland
| | - Gregory Clark
- Department of Economics, University of California, Davis, CA 95616 USA
- Department of Economic History, LSE, London, UK
| | - Attila Gáspár
- Department of Economics and Management, University of Padua, Padua, Italy
- Institute of Economics (KRTK KTI), Centre for Economic and Regional Studies, Budapest, Hungary
| | - Rita Pető
- Institute of Economics (KRTK KTI), Centre for Economic and Regional Studies, Budapest, Hungary
| |
Collapse
|
19
|
Stiell IG, Eagles D, Nemnom MJ, Brown E, Taljaard M, Archambault PM, Birnie D, Borgundvaag B, Clark G, Davis P, Godin D, Hohl C, Mathieu B, McRae AD, Mercier E, Morris J, Parkash R, Perry JJ, Rowe BH, Thiruganasambandamoorthy V, Scheuermeyer F, Sivilotti MLA, Vadeboncoeur A. Adverse Events Associated With Electrical Cardioversion in Patients With Acute Atrial Fibrillation and Atrial Flutter. Can J Cardiol 2021; 37:1775-1782. [PMID: 34474123 DOI: 10.1016/j.cjca.2021.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND We sought to evaluate safety of electrical cardioversion (ECV) for patients with acute atrial fibrillation (AF) or atrial flutter (AFL) in the emergency department (ED). METHODS This was an analysis of data from 4 multicentre AF/AFL studies conducted from 2008 to 2019 at 23 large EDs. We included adult patients who received attempts at ECV and who had presented acutely after symptom onset. Staff manually reviewed study and clinical records to abstract data. RESULTS We evaluated 1736 ECV cases with a mean age of 60.1 years and 67.1% male. The overall success of ECV was 90.2% (95% confidence interval 88.7%-91.6%), with 4.9% of patients admitted. ED physicians performed the ECV in 95.2% and provided sedation in 96.5%; 13.9% (12.3%-15.7%) of cases experienced important adverse events that required treatment, and 0.4% were classified as life threatening. Another 5.6% had adverse events that did not require treatment. Logistic regression found that the RAFF-3 study cohort (odds ratio [OR] 2.0), age ≥ 85 years (OR 2.1), coronary artery disease (OR 1.5), midazolam (OR 1.9), and fentanyl (OR 1.5) were associated with important adverse events. CONCLUSIONS This large evaluation of the safety of ECV for acute AF/AFL in the ED found that while serious adverse events were rare, there were a concerning number of events following sedation that required intervention. Physicians should be aware that older age, coronary artery disease, and fentanyl are associated with higher risks of important adverse events. This study provides more information for shared decision making discussions with patients when choosing between drug-shock and shock-only cardioversion strategies.
Collapse
Affiliation(s)
- Ian G Stiell
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
| | - Debra Eagles
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Marie-Joe Nemnom
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Erica Brown
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Patrick M Archambault
- Département de Médecine Familiale et de Médicine d'Urgence, Centre de Recherche du Centre Intégré de Santé et de Services Sociaux de Chaudière-Appalaches, Université Laval, Québec City, Québec, Canada; Département d'Anesthésiologie et de Soins Intensifs, Centre de Recherche du Centre Intégré de Santé et de Services Sociaux de Chaudière-Appalaches, Université Laval, Québec City, Québec, Canada
| | - David Birnie
- Division of Cardiology, University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Bjug Borgundvaag
- Division of Emergency Medicine, University of Toronto, Schwartz/Reisman Emergency Medicine Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Gregory Clark
- Department of Emergency Medicine, McGill University Health Centre, Montréal, Québec, Canada
| | - Philip Davis
- Department of Emergency Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Corinne Hohl
- Department of Emergency Medicine, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bernard Mathieu
- Département de Médecine de Famille et de Médecine d'Urgence, Université de Montréal, Montréal, Québec, Canada
| | - Andrew D McRae
- Department of Emergency Medicine, and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Eric Mercier
- Department of Emergency Medicine, Centre for Clinical Epidemiology and Evaluation, Université Laval, Québec City, Québec, Canada; Département de Médecine Familiale et de Médecine d'Urgence, Centre de Recherche du CHU de Québec, Université Laval, Québec City, Québec, Canada
| | - Judy Morris
- Département de Médecine de Famille et de Médecine d'Urgence, Université de Montréal, Montréal, Québec, Canada
| | - Ratika Parkash
- Division of Cardiology, Department of Medicine, Dalhousie University, Dartmouth, Nova Scotia, Canada
| | - Jeffrey J Perry
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Brian H Rowe
- Department of Emergency Medicine, and School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | | | - Frank Scheuermeyer
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marco L A Sivilotti
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
| | - Alain Vadeboncoeur
- Institut de Cardiologie de Montréal, Université de Montréal, Montréal, Québec, Canada
| |
Collapse
|
20
|
Tourigny JN, Paquet V, Fortier É, Malo C, Mercier É, Chauny JM, Clark G, Blanchard PG, Boucher V, Carmichael PH, Gariépy JL, Émond M. Predictors of neurosurgical intervention in complicated mild traumatic brain injury patients: a retrospective cohort study. Brain Inj 2021; 35:1267-1274. [PMID: 34488497 DOI: 10.1080/02699052.2021.1972147] [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] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To determine the predicting demographic, clinical and radiological factors for neurosurgical intervention in complicated mild traumatic brain injury (mTBI) patients. METHODS Design: retrospective multicenter cohort study. Participants: patients aged ≥16 presenting to all level-I trauma centers in Quebec between 09/2016 and 12/2017 with mTBI(GCS 13-15) and complication on initial head CT (intracranial hemorrhage/skull fracture). Procedure: Consecutive medical records were reviewed and separated into two groups: no neurosurgical intervention and neurosurgical intervention (NSI). Main outcome: neurosurgical intervention. Analysis: multiple logistic regression model. RESULTS Four hundred and seventy-eight patients were included and 40 underwent NSI. One patient had radiological deterioration but no clinical deterioration prior to surgery. Subdural hemorrhage ≥4 mm width (OR:3.755 [95% CI:1.290-10.928]) and midline shift (OR:7.507 [95% CI: 3.317-16.989]) increased the risk of NSI. Subarachnoid hemorrhage was associated with a lower risk of NSI (OR:0.312 [95% CI: 0.136-0.713]). All other intracranial hemorrhages were not associated with NSI. CONCLUSION Radiological deterioration was not associated with the incidence of NSI. Subdural hemorrhage and midline shift should be predicting factors for neurosurgery. Some patients with isolated findings such as subarachnoid hemorrhage could be safely managed in their original center without being transferred to a level-I trauma center.
Collapse
Affiliation(s)
- Jean-Nicolas Tourigny
- Département de Médicine Familiale et de Médicine d'urgence, Faculté de Médecine, Université Laval, Québec, Canada
| | - Véronique Paquet
- Département de Médicine Familiale et de Médicine d'urgence, Faculté de Médecine, Université Laval, Québec, Canada
| | - Émile Fortier
- Département de Médicine Familiale et de Médicine d'urgence, Faculté de Médecine, Université Laval, Québec, Canada
| | - Christian Malo
- Département de Médicine Familiale et de Médicine d'urgence, Faculté de Médecine, Université Laval, Québec, Canada.,Chu de Québec - Université Laval, Québec, Canada
| | - Éric Mercier
- Département de Médicine Familiale et de Médicine d'urgence, Faculté de Médecine, Université Laval, Québec, Canada.,Chu de Québec - Université Laval, Québec, Canada.,Vitam - Centre de Recherche en Santé Durable, Québec, Canada
| | | | | | - Pierre-Gilles Blanchard
- Département de Médicine Familiale et de Médicine d'urgence, Faculté de Médecine, Université Laval, Québec, Canada.,Chu de Québec - Université Laval, Québec, Canada.,Vitam - Centre de Recherche en Santé Durable, Québec, Canada
| | - Valérie Boucher
- Chu de Québec - Université Laval, Québec, Canada.,Vitam - Centre de Recherche en Santé Durable, Québec, Canada.,Centre d'excellence Sur le Vieillissement de Québec, Québec, Canada
| | | | | | - Marcel Émond
- Département de Médicine Familiale et de Médicine d'urgence, Faculté de Médecine, Université Laval, Québec, Canada.,Chu de Québec - Université Laval, Québec, Canada.,Vitam - Centre de Recherche en Santé Durable, Québec, Canada.,Centre d'excellence Sur le Vieillissement de Québec, Québec, Canada
| |
Collapse
|
21
|
Watson JW, Clark G, Williams DT. The value of virtual biobanks for transparency purposes with respect to reagents and samples used during test development and validation. REV SCI TECH OIE 2021; 40:253-259. [PMID: 34140726 DOI: 10.20506/rst.40.1.3222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Biobanks represent a valuable resource in many areas of biomedical research and development. They function as repositories for well-documented and well-characterised biological material that can be used as the basis for this work. Virtual biobanks amplify the availability of this resource by linking multiple biobanks via a single interface. Test development and validation is an essential process that helps to provide confidence in diagnostic test results and, by extension, the disease and health status of animal populations demonstrated by such results. The quality of the development and validation pathway can be enhanced by the use of well-characterised material for standards and validation panels. Virtual biobanks represent a powerful mechanism for enhancing access to such material, and allow other parties to both have greater confidence in the work done, and to be able to repeat it themselves, as required.
Collapse
|
22
|
Waugh C, Clark G. Factors affecting test reproducibility among laboratories. REV SCI TECH OIE 2021; 40:131-143. [PMID: 34140735 DOI: 10.20506/rst.40.1.3213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Reproducibility is the ability of an assay to provide consistent results (when testing the same samples) in different laboratories. The validation of a new diagnostic assay should include specific assessment of assay reproducibility to determine the degree to which results are unaffected by minor changes in experimental conditions. Ideally, assessment of reproducibility involves the testing of identical samples in multiple laboratories by multiple analysts using the same method, reagents and controls, albeit with different equipment. Such an assessment will provide estimates of the precision and accuracy of an assay across laboratories. In reality, although the reproducibility of an assay is often assessed by multiple laboratories testing identical samples, the reagents, controls and testing platforms used, while similar, are usually not the same. Thus, reproducibility testing permits the assessment of variability resulting from different testing platforms, reagent supplies and operators. The determination of minor versus major variations in test conditions that may be anticipated in multi-laboratory use is part of the assessment at this stage of validation. Once validated, there are ongoing monitoring requirements to assess the performance characteristics and ensure they are consistently maintained. The use of quality assurance programmes is required, as this offers continued monitoring of assay performance by measuring the precision and accuracy of results for well-characterised samples and controls. Tests recommended by the World Organisation for Animal Health as fit for purpose are widely used internationally and need to have satisfactory reproducibility.
Collapse
|
23
|
Lewis A, Beresford A, Chambers MS, Clark G, Hartley DC, Hirst KL, Higashino M, Kawahadara S, Nakanishi M, Saito T, Imagawa A, Habashita H, Maidment S, Macleod AM, Owens AP, Rae A, Rouse C, Wishart G. Discovery of ONO-8590580: A novel, potent and selective GABA A α 5 negative allosteric modulator for the treatment of cognitive disorders. Bioorg Med Chem Lett 2020; 30:127536. [PMID: 32898695 DOI: 10.1016/j.bmcl.2020.127536] [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: 05/11/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 10/23/2022]
Abstract
The identification and SAR development of a series of negative allosteric modulators of the GABAA α5 receptor is described. This novel series of compounds was optimised to provide analogues with high GABAA α5 binding affinity, high α5 negative allosteric modulatory activity, good functional subtype selectivity and low microsomal turnover, culminating in identification of ONO-8590580.
Collapse
Affiliation(s)
- A Lewis
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - A Beresford
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - M S Chambers
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - G Clark
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - D C Hartley
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - K L Hirst
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - M Higashino
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - S Kawahadara
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - M Nakanishi
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - T Saito
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - A Imagawa
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - H Habashita
- Ono Pharmaceutical Co. Ltd., Minase Research Institute, Shimamoto-cho, Mishima-gun, Osaka 618-8585, Japan
| | - S Maidment
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - A M Macleod
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - A P Owens
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - A Rae
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom.
| | - C Rouse
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| | - G Wishart
- Charles River Discovery Research Services, Chesterford Research Park, Little Chesterford, Essex CB10 1XL, United Kingdom
| |
Collapse
|
24
|
Abstract
A conclusion of the European Fertility Project in 1986 was that pretransition populations mostly displayed natural fertility, where parity-dependent birth control was absent. This conclusion has recently been challenged for England by new empirical results and has also been widely rejected by theorists of long-run economic growth, where pre-industrial fertility control is integral to most models. In this study, we use the accident of twin births to show that for three Western European-derived pre-industrial populations-namely, England (1730-1879), France (1670-1788), and Québec (1621-1835)-we find no evidence for parity-dependent control of marital fertility. If a twin was born in any of these populations, family size increased by 1 compared with families with a singleton birth at the same parity and mother age, with no reduction of subsequent fertility. Numbers of children surviving to age 14 also increased. Twin births also show no differential effect on fertility when they occurred at high parities; this finding is in contrast to populations where fertility is known to have been controlled by at least some families, such as in England, 1900-1949, where a twin birth increased average births per family by significantly less than 1.
Collapse
Affiliation(s)
- Gregory Clark
- Department of Economics, University of California, Davis, Davis, CA USA
- Department of Economic History, London School of Economics, and Center for Economic Policy Research, London, UK
| | - Neil Cummins
- Department of Economic History, London School of Economics, and Center for Economic Policy Research, London, UK
| | - Matthew Curtis
- Department of Economics, University of California, Davis, Davis, CA USA
| |
Collapse
|
25
|
Artemyev AV, Clark G, Mauk B, Vogt MF, Zhang XJ. Juno Observations of Heavy Ion Energization During Transient Dipolarizations in Jupiter Magnetotail. J Geophys Res Space Phys 2020; 125:e2020JA027933. [PMID: 32874822 PMCID: PMC7458100 DOI: 10.1029/2020ja027933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/24/2020] [Indexed: 06/11/2023]
Abstract
Transient magnetic reconnection and associated fast plasma flows led by dipolarization fronts play a crucial role in energetic particle acceleration in planetary magnetospheres. Despite large statistical observations on this phenomenon in the Earth's magnetotail, many important characteristics (e.g., mass or charge dependence of acceleration efficiency and acceleration scaling with the spatial scale of the system) of transient reconnection cannot be fully investigated with the limited parameter range of the Earth's magnetotail. The much larger Jovian magnetodisk, filled by a mixture of various heavy ions and protons, provides a unique opportunity for such investigations. In this study, we use recent Juno observations in Jupiter's magnetosphere to examine the properties of reconnection associated dipolarization fronts and charged particle acceleration. High-energy fluxes of sulfur, oxygen, and hydrogen ions show clear mass-dependent acceleration with energy ~ m 1/3. We compare Juno observations with similar observations in the Earth's magnetotail and discuss possible mechanism for the observed ion acceleration.
Collapse
Affiliation(s)
- A. V. Artemyev
- Institute of Geophysics and Planetary Physics, University of California, Los Angeles, CA, USA
- Space Research Institute of Russian Academy of Sciences, Moscow, Russia
| | - G. Clark
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - B. Mauk
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - M. F. Vogt
- Center for Space Physics, Boston University, Boston, MA, USA
| | - X.-J. Zhang
- Institute of Geophysics and Planetary Physics, University of California, Los Angeles, CA, USA
| |
Collapse
|
26
|
Allen RC, Paranicas CP, Bagenal F, Vines SK, Hamilton DC, Allegrini F, Clark G, Delamere PA, Kim TK, Krimigis SM, Mitchell DG, Smith TH, Wilson RJ. Energetic Oxygen and Sulfur Charge States in the Outer Jovian Magnetosphere: Insights From the Cassini Jupiter Flyby. Geophys Res Lett 2019; 46:11709-11717. [PMID: 31894172 PMCID: PMC6919296 DOI: 10.1029/2019gl085185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Abstract
On 10 January 2001, Cassini briefly entered into the magnetosphere of Jupiter, en route to Saturn. During this excursion into the Jovian magnetosphere, the Cassini Magnetosphere Imaging Instrument/Charge-Energy-Mass Spectrometer detected oxygen and sulfur ions. While Charge-Energy-Mass Spectrometer can distinguish between oxygen and sulfur charge states directly, only 95.9 ± 2.9 keV/e ions were sampled during this interval, allowing for a long time integration of the tenuous outer magnetospheric (~200 RJ) plasma at one energy. For this brief interval for the 95.9 keV/e ions, 96% of oxygen ions were O+, with the other 4% as O2+, while 25% of the energetic sulfur ions were S+, 42% S2+, and 33% S3+. The S2+/O+ flux ratio was observed to be 0.35 (±0.06 Poisson error).
Collapse
Affiliation(s)
- R. C. Allen
- Applied Physics LaboratoryJohns Hopkins UniversityLaurelMDUSA
| | - C. P. Paranicas
- Applied Physics LaboratoryJohns Hopkins UniversityLaurelMDUSA
| | - F. Bagenal
- Laboratory for Atmospheric and Space PhysicsUniversity of Colorado BoulderBoulderCOUSA
| | - S. K. Vines
- Applied Physics LaboratoryJohns Hopkins UniversityLaurelMDUSA
| | - D. C. Hamilton
- Department of PhysicsUniversity of MarylandCollege ParkMDUSA
| | - F. Allegrini
- Space Science and Engineering DivisionSouthwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | - G. Clark
- Applied Physics LaboratoryJohns Hopkins UniversityLaurelMDUSA
| | - P. A. Delamere
- Geophysical InstituteUniversity of Alaska FairbanksFairbanksAKUSA
| | - T. K. Kim
- Space Science and Engineering DivisionSouthwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | - S. M. Krimigis
- Applied Physics LaboratoryJohns Hopkins UniversityLaurelMDUSA
| | - D. G. Mitchell
- Applied Physics LaboratoryJohns Hopkins UniversityLaurelMDUSA
| | - T. H. Smith
- Applied Physics LaboratoryJohns Hopkins UniversityLaurelMDUSA
| | - R. J. Wilson
- Laboratory for Atmospheric and Space PhysicsUniversity of Colorado BoulderBoulderCOUSA
| |
Collapse
|
27
|
Westlake JH, Clark G, Haggerty DK, Jaskulek SE, Kollmann P, Mauk BH, Mitchell DG, Nelson KS, Paranicas CP, Rymer AM. High-Energy (>10 MeV) Oxygen and Sulfur Ions Observed at Jupiter From Pulse Width Measurements of the JEDI Sensors. Geophys Res Lett 2019; 46:10959-10966. [PMID: 31894168 PMCID: PMC6919389 DOI: 10.1029/2019gl083842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/03/2019] [Accepted: 09/06/2019] [Indexed: 06/10/2023]
Abstract
The Jovian polar regions produce X-rays that are characteristic of very energetic oxygen and sulfur that become highly charged on precipitating into Jupiter's upper atmosphere. Juno has traversed the polar regions above where these energetic ions are expected to be precipitating revealing a complex composition and energy structure. Energetic ions are likely to drive the characteristic X-rays observed at Jupiter (Haggerty et al., 2017, https://doi.org/10.1002/2017GL072866; Houston et al., 2018, https://doi.org/10.1002/2017JA024872; Kharchenko et al., 2006, https://doi.org/10.1029/2006GL026039). Motivated by the science of X-ray generation, we describe here Juno Jupiter Energetic Particle Detector Instrument (JEDI) measurements of ions above 1 MeV and demonstrate the capability of measuring oxygen and sulfur ions with energies up to 100 MeV. We detail the process of retrieving ion fluxes from pulse width data on instruments like JEDI (called "puck's"; Clark, Cohen, et al., 2016, https://doi.org/10.1002/2017GL074366; Clark, Mauk, et al., 2016, https://doi.org/10.1002/2015JA022257; Mauk et al., 2013, https://doi.org/10.1007/s11214-013-0025-3) as well as details on retrieving very energetic particles (>20 MeV) above which the pulse width also saturates.
Collapse
Affiliation(s)
- J. H. Westlake
- Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - G. Clark
- Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - D. K. Haggerty
- Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - S. E. Jaskulek
- Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - P. Kollmann
- Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - B. H. Mauk
- Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - D. G. Mitchell
- Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - K. S. Nelson
- Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - C. P. Paranicas
- Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - A. M. Rymer
- Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| |
Collapse
|
28
|
Kollmann P, Hill ME, Allen RC, McNutt RL, Brown LE, Barnes NP, Delamere P, Clark G, Andrews GB, Salazar N, Westlake J, Romeo G, Vandegriff J, Kusterer M, Smith D, Nelson K, Jaskulek S, Decker RB, Cheng AF, Krimigis SM, Lisse CM, Mitchell DG, Weaver HA, Elliott HA, Fattig E, Gladstone GR, Valek PW, Weidner S, Kammer J, Bagenal F, Horanyi M, Kaufmann D, Harch A, Olkin CB, Piquette MR, Spencer JR, Young LA, Ennico K, Summers ME, Stern SA. Pluto's Interaction With Energetic Heliospheric Ions. J Geophys Res Space Phys 2019; 124:7413-7424. [PMID: 35860291 PMCID: PMC9285724 DOI: 10.1029/2019ja026830] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/08/2019] [Accepted: 07/10/2019] [Indexed: 06/15/2023]
Abstract
Pluto energies of a few kiloelectron volts and suprathermal ions with tens of kiloelectron volts and above. We measure this population using the Pluto Energetic Particle Spectrometer Science Investigation (PEPSSI) instrument on board the New Horizons spacecraft that flew by Pluto in 2015. Even though the measured ions have gyroradii larger than the size of Pluto and the cross section of its magnetosphere, we find that the boundary of the magnetosphere is depleting the energetic ion intensities by about an order of magnitude close to Pluto. The intensity is increasing exponentially with distance to Pluto and reaches nominal levels of the interplanetary medium at about 190R P distance. Inside the wake of Pluto, we observe oscillations of the ion intensities with a periodicity of about 0.2 hr. We show that these can be quantitatively explained by the electric field of an ultralow-frequency wave and discuss possible physical drivers for such a field. We find no evidence for the presence of plutogenic ions in the considered energy range.
Collapse
|
29
|
Haggerty DK, Mauk BH, Paranicas CP, Clark G, Kollmann P, Rymer AM, Gladstone GR, Greathouse TK, Bolton SJ, Levin SM. Jovian Injections Observed at High Latitude. Geophys Res Lett 2019; 46:9397-9404. [PMID: 31762519 PMCID: PMC6853255 DOI: 10.1029/2019gl083442] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/30/2019] [Accepted: 08/05/2019] [Indexed: 06/10/2023]
Abstract
The polar orbit of Juno at Jupiter provides a unique opportunity to observe high-latitude energetic particle injections. We measure energy-dispersed impulsive injections of protons and electrons. Ion injection signatures are just as prevalent as electron signatures, contrary to previous equatorial observations. Included are previously unreported observations of high-energy banded structures believed to be remnants of much earlier injections, where the particles have had time to disperse around Jupiter. A model fit of the injections used to estimate timing fits the shape of the proton signatures better than it does the electron shapes, suggesting that electrons and protons are different in their abilities to escape the injection region. We present ultaviolet observations of Jupiter's aurora and discuss the relationship between auroral injection features and in situ injection events. We find, unexpectedly, that the presence of in situ particle injections does not necessarily result in auroral injection signatures.
Collapse
Affiliation(s)
- D. K. Haggerty
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - B. H. Mauk
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - C. P. Paranicas
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - G. Clark
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - P. Kollmann
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | - A. M. Rymer
- The Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
| | | | | | | | | |
Collapse
|
30
|
Clark G, Corey K, Hutchison T, Lalonde T, Dunn J. Assessing Lift-Off Times for a Hospital-Based Helicopter Transport Program. Air Med J 2019; 38:183-187. [PMID: 31122584 DOI: 10.1016/j.amj.2018.12.001] [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: 09/12/2018] [Accepted: 12/02/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Hospital-based helicopter transport programs must define and track their own lift-off times (LOTs). The goal of this quality improvement study was to evaluate LOTs, identify factors influencing LOTs, and implement changes to improve LOTs without compromising safety. METHODS A retrospective evaluation of 248 flights during 2016 was completed using recorded times from our dispatch center. Actual LOTs were compared with policy LOT goals. Tasks for flight departure were identified, timed, and sorted into those that should not be pressured and those amenable to process change. RESULTS Five tasks were identified as being amenable to process change. The average LOT for scene calls was 10.56 minutes (range, 1-22 minutes) and met our 10-minute policy goal 59% of the time. The average LOT for interfacility flights was 13.2 minutes (range, 4-76 minutes) and met the policy goal of 15 minutes 76.5% of the time. CONCLUSION We identified tasks amenable to safe process change to decrease LOTs. The data supported LOT policy change to a single LOT goal of 13 minutes for all flights. This change represents an acceptable goal for all LOTs without compromising safety to our patients and teams.
Collapse
Affiliation(s)
| | | | | | | | - Julie Dunn
- UCHealth Trauma Research/Acute Care Surgery
| |
Collapse
|
31
|
Kluger D, Duncan C, Davis T, Warren DJ, Hutchinson D, Clark G. Abstract #35: Using High-Electrode-Count Intrafascicular Peripheral Nerve Interfaces for Selective Mitigation of Chronic Pain. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.042] [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] Open
|
32
|
Ebert RW, Greathouse TK, Clark G, Allegrini F, Bagenal F, Bolton SJ, Connerney JEP, Gladstone GR, Imai M, Hue V, Kurth WS, Levin S, Louarn P, Mauk BH, McComas DJ, Paranicas C, Szalay JR, Thomsen MF, Valek PW, Wilson RJ. Comparing Electron Energetics and UV Brightness in Jupiter's Northern Polar Region During Juno Perijove 5. Geophys Res Lett 2019; 46:19-27. [PMID: 30828110 PMCID: PMC6378591 DOI: 10.1029/2018gl081129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/14/2018] [Accepted: 12/20/2018] [Indexed: 05/24/2023]
Abstract
We compare electron and UV observations mapping to the same location in Jupiter's northern polar region, poleward of the main aurora, during Juno perijove 5. Simultaneous peaks in UV brightness and electron energy flux are identified when observations map to the same location at the same time. The downward energy flux during these simultaneous observations was not sufficient to generate the observed UV brightness; the upward energy flux was. We propose that the primary acceleration region is below Juno's altitude, from which the more intense upward electrons originate. For the complete interval, the UV brightness peaked at ~240 kilorayleigh (kR); the downward and upward energy fluxes peaked at 60 and 700 mW/m2, respectively. Increased downward energy fluxes are associated with increased contributions from tens of keV electrons. These observations provide evidence that bidirectional electron beams with broad energy distributions can produce tens to hundreds of kilorayleigh polar UV emissions.
Collapse
Affiliation(s)
- R. W. Ebert
- Southwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | | | - G. Clark
- Johns Hopkins University Applied Physics LabLaurelMDUSA
| | - F. Allegrini
- Southwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | - F. Bagenal
- Laboratory for Atmospheric and Space PhysicsUniversity of Colorado BoulderBoulderCOUSA
| | | | | | - G. R. Gladstone
- Southwest Research InstituteSan AntonioTXUSA
- Department of Physics and AstronomyUniversity of Texas at San AntonioSan AntonioTXUSA
| | - M. Imai
- Department of Physics and AstronomyUniversity of IowaIowa CityIAUSA
| | - V. Hue
- Southwest Research InstituteSan AntonioTXUSA
| | - W. S. Kurth
- Department of Physics and AstronomyUniversity of IowaIowa CityIAUSA
| | - S. Levin
- Jet Propulsion LaboratoryPasadenaCAUSA
| | - P. Louarn
- Institut de Recherche en Astrophysique et PlanétologieToulouseFrance
| | - B. H. Mauk
- Johns Hopkins University Applied Physics LabLaurelMDUSA
| | - D. J. McComas
- Southwest Research InstituteSan AntonioTXUSA
- Department of Astrophysical SciencesPrinceton UniversityPrincetonNJUSA
| | - C. Paranicas
- Johns Hopkins University Applied Physics LabLaurelMDUSA
| | - J. R. Szalay
- Department of Astrophysical SciencesPrinceton UniversityPrincetonNJUSA
| | | | - P. W. Valek
- Southwest Research InstituteSan AntonioTXUSA
| | - R. J. Wilson
- Laboratory for Atmospheric and Space PhysicsUniversity of Colorado BoulderBoulderCOUSA
| |
Collapse
|
33
|
Ebert RW, Greathouse TK, Clark G, Allegrini F, Bagenal F, Bolton SJ, Connerney JEP, Gladstone GR, Imai M, Hue V, Kurth WS, Levin S, Louarn P, Mauk BH, McComas DJ, Paranicas C, Szalay JR, Thomsen MF, Valek PW, Wilson RJ. Comparing Electron Energetics and UV Brightness in Jupiter's Northern Polar Region During Juno Perijove 5. Geophys Res Lett 2019; 46:19-27. [PMID: 30828110 DOI: 10.1029/2019gl084146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/14/2018] [Accepted: 12/20/2018] [Indexed: 05/24/2023]
Abstract
We compare electron and UV observations mapping to the same location in Jupiter's northern polar region, poleward of the main aurora, during Juno perijove 5. Simultaneous peaks in UV brightness and electron energy flux are identified when observations map to the same location at the same time. The downward energy flux during these simultaneous observations was not sufficient to generate the observed UV brightness; the upward energy flux was. We propose that the primary acceleration region is below Juno's altitude, from which the more intense upward electrons originate. For the complete interval, the UV brightness peaked at ~240 kilorayleigh (kR); the downward and upward energy fluxes peaked at 60 and 700 mW/m2, respectively. Increased downward energy fluxes are associated with increased contributions from tens of keV electrons. These observations provide evidence that bidirectional electron beams with broad energy distributions can produce tens to hundreds of kilorayleigh polar UV emissions.
Collapse
Affiliation(s)
- R W Ebert
- Southwest Research Institute San Antonio TX USA
- Department of Physics and Astronomy University of Texas at San Antonio San Antonio TX USA
| | | | - G Clark
- Johns Hopkins University Applied Physics Lab Laurel MD USA
| | - F Allegrini
- Southwest Research Institute San Antonio TX USA
- Department of Physics and Astronomy University of Texas at San Antonio San Antonio TX USA
| | - F Bagenal
- Laboratory for Atmospheric and Space Physics University of Colorado Boulder Boulder CO USA
| | - S J Bolton
- Southwest Research Institute San Antonio TX USA
| | | | - G R Gladstone
- Southwest Research Institute San Antonio TX USA
- Department of Physics and Astronomy University of Texas at San Antonio San Antonio TX USA
| | - M Imai
- Department of Physics and Astronomy University of Iowa Iowa City IA USA
| | - V Hue
- Southwest Research Institute San Antonio TX USA
| | - W S Kurth
- Department of Physics and Astronomy University of Iowa Iowa City IA USA
| | - S Levin
- Jet Propulsion Laboratory Pasadena CA USA
| | - P Louarn
- Institut de Recherche en Astrophysique et Planétologie Toulouse France
| | - B H Mauk
- Johns Hopkins University Applied Physics Lab Laurel MD USA
| | - D J McComas
- Southwest Research Institute San Antonio TX USA
- Department of Astrophysical Sciences Princeton University Princeton NJ USA
| | - C Paranicas
- Johns Hopkins University Applied Physics Lab Laurel MD USA
| | - J R Szalay
- Department of Astrophysical Sciences Princeton University Princeton NJ USA
| | | | - P W Valek
- Southwest Research Institute San Antonio TX USA
| | - R J Wilson
- Laboratory for Atmospheric and Space Physics University of Colorado Boulder Boulder CO USA
| |
Collapse
|
34
|
Kollmann P, Roussos E, Paranicas C, Woodfield EE, Mauk BH, Clark G, Smith DC, Vandegriff J. Electron Acceleration to MeV Energies at Jupiter and Saturn. J Geophys Res Space Phys 2018; 123:9110-9129. [PMID: 30775196 PMCID: PMC6360449 DOI: 10.1029/2018ja025665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/16/2018] [Accepted: 09/24/2018] [Indexed: 06/09/2023]
Abstract
The radiation belts and magnetospheres of Jupiter and Saturn show significant intensities of relativistic electrons with energies up to tens of megaelectronvolts (MeV). To date, the question on how the electrons reach such high energies is not fully answered. This is largely due to the lack of high-quality electron spectra in the MeV energy range that models could be fit to. We reprocess data throughout the Galileo orbiter mission in order to derive Jupiter's electron spectra up to tens of MeV. In the case of Saturn, the spectra from the Cassini orbiter are readily available and we provide a systematic analysis aiming to study their acceleration mechanisms. Our analysis focuses on the magnetospheres of these planets, at distances of L > 20 and L > 4 for Jupiter and Saturn, respectively, where electron intensities are not yet at radiation belt levels. We find no support that MeV electrons are dominantly accelerated by wave-particle interactions in the magnetospheres of both planets at these distances. Instead, electron acceleration is consistent with adiabatic transport. While this is a common assumption, confirmation of this fact is important since many studies on sources, losses, and transport of energetic particles rely on it. Adiabatic heating can be driven through various radial transport mechanisms, for example, injections driven by the interchange instability or radial diffusion. We cannot distinguish these processes at Saturn with our technique. For Jupiter, we suggest that the dominating acceleration process is radial diffusion because injections are never observed at MeV energies.
Collapse
Affiliation(s)
- P. Kollmann
- The Johns Hopkins University, Applied Physics LaboratoryLaurelMDUSA
| | - E. Roussos
- Max Planck Institute for Solar System ResearchGóttingenGermany
| | - C. Paranicas
- The Johns Hopkins University, Applied Physics LaboratoryLaurelMDUSA
| | | | - B. H. Mauk
- The Johns Hopkins University, Applied Physics LaboratoryLaurelMDUSA
| | - G. Clark
- The Johns Hopkins University, Applied Physics LaboratoryLaurelMDUSA
| | - D. C. Smith
- The Johns Hopkins University, Applied Physics LaboratoryLaurelMDUSA
| | - J. Vandegriff
- The Johns Hopkins University, Applied Physics LaboratoryLaurelMDUSA
| |
Collapse
|
35
|
Ross CT, Mulder MB, Oh SY, Bowles S, Beheim B, Bunce J, Caudell M, Clark G, Colleran H, Cortez C, Draper P, Greaves RD, Gurven M, Headland T, Headland J, Hill K, Hewlett B, Kaplan HS, Koster J, Kramer K, Marlowe F, McElreath R, Nolin D, Quinlan M, Quinlan R, Revilla-Minaya C, Scelza B, Schacht R, Shenk M, Uehara R, Voland E, Willführ K, Winterhalder B, Ziker J. Correction to: ‘Greater wealth inequality, less polygyny: rethinking the polygyny threshold model’. J R Soc Interface 2018; 15:rsif.2018.0752. [PMID: 30381348 PMCID: PMC6228491 DOI: 10.1098/rsif.2018.0752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
|
36
|
Higgins L, Haines C, MacLeod A, Chatham L, Clark G, Princivalle M. In vitro approaches to risk assess chemical mediated changes in thyroid function. Toxicol Lett 2018. [DOI: 10.1016/j.toxlet.2018.07.039] [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]
|
37
|
Clark G, Marechal M, Monnin D. Late Breaking Abstract - COPD knowledge in a swiss frail selected population. Epidemiology 2018. [DOI: 10.1183/13993003.congress-2018.pa4474] [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: 11/05/2022]
|
38
|
Ross CT, Borgerhoff Mulder M, Oh SY, Bowles S, Beheim B, Bunce J, Caudell M, Clark G, Colleran H, Cortez C, Draper P, Greaves RD, Gurven M, Headland T, Headland J, Hill K, Hewlett B, Kaplan HS, Koster J, Kramer K, Marlowe F, McElreath R, Nolin D, Quinlan M, Quinlan R, Revilla-Minaya C, Scelza B, Schacht R, Shenk M, Uehara R, Voland E, Willführ K, Winterhalder B, Ziker J. Greater wealth inequality, less polygyny: rethinking the polygyny threshold model. J R Soc Interface 2018; 15:20180035. [PMID: 30021924 PMCID: PMC6073648 DOI: 10.1098/rsif.2018.0035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 06/25/2018] [Indexed: 11/12/2022] Open
Abstract
Monogamy appears to have become the predominant human mating system with the emergence of highly unequal agricultural populations that replaced relatively egalitarian horticultural populations, challenging the conventional idea-based on the polygyny threshold model-that polygyny should be positively associated with wealth inequality. To address this polygyny paradox, we generalize the standard polygyny threshold model to a mutual mate choice model predicting the fraction of women married polygynously. We then demonstrate two conditions that are jointly sufficient to make monogamy the predominant marriage form, even in highly unequal societies. We assess if these conditions are satisfied using individual-level data from 29 human populations. Our analysis shows that with the shift to stratified agricultural economies: (i) the population frequency of relatively poor individuals increased, increasing wealth inequality, but decreasing the frequency of individuals with sufficient wealth to secure polygynous marriage, and (ii) diminishing marginal fitness returns to additional wives prevent extremely wealthy men from obtaining as many wives as their relative wealth would otherwise predict. These conditions jointly lead to a high population-level frequency of monogamy.
Collapse
Affiliation(s)
- Cody T Ross
- Behavioral Sciences Program, Santa Fe Institute, Santa Fe, NM, USA
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | | | - Seung-Yun Oh
- Korea Insurance Research Institute, Yeongdeungpo-gu, Republic of Korea
| | - Samuel Bowles
- Behavioral Sciences Program, Santa Fe Institute, Santa Fe, NM, USA
| | - Bret Beheim
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - John Bunce
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Mark Caudell
- Allen School for Global Animal Health, Washington State University, Pullman, WA, USA
| | - Gregory Clark
- Department of Anthropology, University of California, Davis, CA, USA
| | - Heidi Colleran
- Dept. of Linguistic and Cultural Evolution, Max Planck Institute for the Science of Human History, Leipzig, Germany
| | - Carmen Cortez
- Department of Anthropology, University of California, Davis, CA, USA
| | - Patricia Draper
- Department of Anthropology, University of Nebraska, Lincoln, NE, USA
| | | | - Michael Gurven
- Department of Anthropology, University of California, Santa Barbara, CA, USA
| | | | | | - Kim Hill
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Barry Hewlett
- Department of Anthropology, Washington State University, Vancouver, WA, USA
| | - Hillard S Kaplan
- Department of Anthropology, University of New Mexico, Albuquerque, NM, USA
| | - Jeremy Koster
- Department of Anthropology, University of Cincinnati, Cincinnati, OH, USA
| | - Karen Kramer
- Department of Anthropology, University of Utah, Logan, UT, USA
| | - Frank Marlowe
- Department of Biological Anthropology, University of Cambridge, UK
| | - Richard McElreath
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - David Nolin
- Department of Anthropology, Pennsylvania State University, Philadelphia, PA, USA
| | - Marsha Quinlan
- Department of Anthropology, Washington State University, Vancouver, WA, USA
| | - Robert Quinlan
- Department of Anthropology, Washington State University, Vancouver, WA, USA
| | | | - Brooke Scelza
- Department of Anthropology, University of California, Los Angeles, CA, USA
| | - Ryan Schacht
- Department of Anthropology, University of Utah, Logan, UT, USA
| | - Mary Shenk
- Department of Anthropology, Pennsylvania State University, Philadelphia, PA, USA
| | | | - Eckart Voland
- Institut für Philosophie der Universität Giessen, Giessen, Germany
| | - Kai Willführ
- Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | | | - John Ziker
- Department of Anthropology, Boise State University, Boise, ID, USA
| |
Collapse
|
39
|
Abstract
An increase in fibroblast growth factor-1 (FGF-1) is established as part of the cause of several important cancers including breast cancer, but the mechanisms by which it induces malignant behavior are not known. We now report that the protein 80K-H, a substrate for PKC, appears to be part of this mechanism and that it is increased in breast cancer and localizes to the nucleus as part of the mechanism. Our conclusion is based on an examination of a total of 58 biopsy specimens from human breast cancer patients for the presence of relationships between the 80K-H protein and the following: fibroblast growth factor receptor-1 (FGFR-1), tumor grade, microvessel counts (MVC), estrogen receptor (ER) and progesterone receptor (PgR) status. Based on histological grading and immunohistochemical (IHC) assays, we found strong direct relationships between 80K-H and FGFR-1 (r=0.49, p=0.003) and tumor grade (r=0.42, p=0.006). A trend for a direct relationship was observed with PgR (r=0.27, p=0.087). Notably, 80K-H immunostaining was largely limited to the epithelial cells of the mammary ducts. Subsequently, we studied the effects of FGF-1 on 80K-H in cultured human mammary carcinoma epithelial cells in order to establish a more direct relationship between these two molecules. We observed that FGF-1 treatment of MCF-7 cells stimulated translocation of 80K-H protein to the cell nucleus, as demonstrated by subcellular fractionation studies. Maximal intranuclear 80K-H was observed approximately 30 minutes following FGF-1 treatment. In addition, FGF-1 treatment of MCF-7 cells increased growth and invasion of MCF-7 cells, as demonstrated by cell proliferation and a modified Boyden chamber assay, respectively. Further support for 80K-H nuclearization was provided by the immunostaining of human breast cancer specimens and computer-assisted identification of a putative nuclear localization signal (NLS) near the amino terminus of 80K-H protein structure. These data support the existence of a previously unrecognized FGF-1/80K-H nuclear pathway in progression of human breast cancer and suggest that 80K-H may be useful for the assessment of breast tumor progression.
Collapse
Affiliation(s)
- R Forough
- Department of Medical Physiology, College of Medicine, Texas A&M University, HSC, College Station, Texas 77843, USA.
| | | | | | | | | | | |
Collapse
|
40
|
Clark G. [Not Available]. Rev Med Suisse 2018; 14:185-186. [PMID: 29380971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Gregory Clark
- Pneumologie et Médecine interne FMH, Av. Léopold-Robert 12, 2300 La Chaux-de-Fonds
| |
Collapse
|
41
|
Daien V, Nguyen V, Essex RW, Morlet N, Barthelmes D, Gillies MC, Gillies M, Hunt A, Essex R, Dayajeewa C, Hunyor A, Fraser-Bell S, Younan C, Fung A, Guymer R, Louis D, Arnold J, Chan D, Cass H, Harper A, O’Day J, Daniell M, Field A, Chow L, Barthelmes D, Cohn A, Young S, Lal S, Ferrier R, Barnes R, Thompson A, Vincent A, Manning L, Lake S, Phillips R, Perks M, Chen J, Landers J, Niladri, Banerjee G, Swamy B, Windle P, Dunlop A, Tang K, McLean I, Amini A, Hunt A, Clark G, McAllister I, Chen F, Squirrell D, Ng C, Hinchcliffe P, Barry R, Ah-Chan J, Steiner H, Morgan M, Thompson C, Game J, Murray N. Incidence and Outcomes of Infectious and Noninfectious Endophthalmitis after Intravitreal Injections for Age-Related Macular Degeneration. Ophthalmology 2018; 125:66-74. [DOI: 10.1016/j.ophtha.2017.07.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/19/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022] Open
|
42
|
Isaacson S, Eggert K, Kumar R, Stocchi F, Mori A, Ohta E, Toyama K, Spence G, Clark G, Cantillon M. Efficacy and safety of istradefylline in moderate to severe Parkinson’s disease: A phase 3, multinational, randomized, double-blind, placebo-controlled trial (i-step study). J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.999] [Citation(s) in RCA: 2] [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: 10/18/2022]
|
43
|
Sherwood J, Rettino A, Brown H, Schreieck A, Claes B, Clark G, Agrawal B, Chaston R, Choppa P, Nygren A, Kohlman A. Implications of key differences across 12 KRAS mutation detection technologies and their relevance in clinical practice. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.39] [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: 11/12/2022] Open
|
44
|
Westlake JH, Mitchell DG, Brandt PC, Andrews BG, Clark G. The Low-Energy Neutral Imager (LENI). J Geophys Res Space Phys 2016; 121:8228-8236. [PMID: 27867800 PMCID: PMC5101854 DOI: 10.1002/2016ja022547] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/27/2016] [Accepted: 07/05/2016] [Indexed: 06/01/2023]
Abstract
To achieve breakthroughs in the areas of heliospheric and magnetospheric energetic neutral atom (ENA) imaging, a new class of instruments is required. We present a high angular resolution ENA imager concept aimed at the suprathermal plasma populations with energies between 0.5 and 20 keV. This instrument is intended for understanding the spatial and temporal structure of the heliospheric boundary recently revealed by Interstellar Boundary Explorer instrumentation and the Cassini Ion and Neutral Camera. The instrument is also well suited to characterize magnetospheric ENA emissions from low-altitude ENA emissions produced by precipitation of magnetospheric ions into the terrestrial upper atmosphere, or from the magnetosheath where solar wind protons are neutralized by charge exchange, or from portions of the ring current region. We present a new technique utilizing ultrathin carbon foils, 2-D collimation, and a novel electron optical design to produce high angular resolution (≤2°) and high-sensitivity (≥10-3 cm2 sr/pixel) ENA imaging in the 0.5-20 keV energy range.
Collapse
Affiliation(s)
- J. H. Westlake
- Applied Physics LaboratoryThe Johns Hopkins UniversityLaurelMarylandUSA
| | - D. G. Mitchell
- Applied Physics LaboratoryThe Johns Hopkins UniversityLaurelMarylandUSA
| | - P. C.‐son. Brandt
- Applied Physics LaboratoryThe Johns Hopkins UniversityLaurelMarylandUSA
| | - B. G. Andrews
- Applied Physics LaboratoryThe Johns Hopkins UniversityLaurelMarylandUSA
| | - G. Clark
- Applied Physics LaboratoryThe Johns Hopkins UniversityLaurelMarylandUSA
| |
Collapse
|
45
|
Clark G, Cohen I, Westlake JH, Andrews GB, Brandt P, Gold RE, Gkioulidou MA, Hacala R, Haggerty D, Hill ME, Ho GC, Jaskulek SE, Kollmann P, Mauk BH, McNutt RL, Mitchell DG, Nelson KS, Paranicas C, Paschalidis N, Schlemm CE. The "Puck" energetic charged particle detector: Design, heritage, and advancements. J Geophys Res Space Phys 2016; 121:7900-7913. [PMID: 27867799 PMCID: PMC5101846 DOI: 10.1002/2016ja022579] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 06/10/2016] [Accepted: 07/27/2016] [Indexed: 06/06/2023]
Abstract
Energetic charged particle detectors characterize a portion of the plasma distribution function that plays critical roles in some physical processes, from carrying the currents in planetary ring currents to weathering the surfaces of planetary objects. For several low-resource missions in the past, the need was recognized for a low-resource but highly capable, mass-species-discriminating energetic particle sensor that could also obtain angular distributions without motors or mechanical articulation. This need led to the development of a compact Energetic Particle Detector (EPD), known as the "Puck" EPD (short for hockey puck), that is capable of determining the flux, angular distribution, and composition of incident ions between an energy range of ~10 keV to several MeV. This sensor makes simultaneous angular measurements of electron fluxes from the tens of keV to about 1 MeV. The same measurements can be extended down to approximately 1 keV/nucleon, with some composition ambiguity. These sensors have a proven flight heritage record that includes missions such as MErcury Surface, Space ENvironment, GEochemistry, and Ranging and New Horizons, with multiple sensors on each of Juno, Van Allen Probes, and Magnetospheric Multiscale. In this review paper we discuss the Puck EPD design, its heritage, unexpected results from these past missions and future advancements. We also discuss high-voltage anomalies that are thought to be associated with the use of curved foils, which is a new foil manufacturing processes utilized on recent Puck EPD designs. Finally, we discuss the important role Puck EPDs can potentially play in upcoming missions.
Collapse
Affiliation(s)
- G. Clark
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - I. Cohen
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - J. H. Westlake
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - G. B. Andrews
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - P. Brandt
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - R. E. Gold
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - M. A. Gkioulidou
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - R. Hacala
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - D. Haggerty
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - M. E. Hill
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - G. C. Ho
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - S. E. Jaskulek
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - P. Kollmann
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - B. H. Mauk
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - R. L. McNutt
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - D. G. Mitchell
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - K. S. Nelson
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | - C. Paranicas
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| | | | - C. E. Schlemm
- The Johns Hopkins University Applied Physics LaboratoryLaurelMarylandUSA
| |
Collapse
|
46
|
Diab N, Clark G, Hamlington B, Brzeskiewicz L, Langer L, Diab S. Abstract P1-09-02: Higher incidence of second cancers in African American (AA) patients compared to Caucasian patients with a primary breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-09-02] [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: 11/16/2022]
Abstract
Abstract
Background: AA women with breast cancer have lower survival rates compared to Caucasian women. Since this lower survival rate may be related to genetic mutations, and environmental/socioeconomically factors, we hypothesize that the same factors may lead to a higher risk of secondary cancers after an initial diagnosis of breast cancer.
Method: Analysis of the Surveillance, Epidemiology, and End Results (SEER) Program data using Multiple Primary - Standardized Incidence Ratio parameters. The incidence of second cancer diagnoses in AA and Caucasian women previously diagnosed with breast was compared to the incidence of cancer in the general population matched by age, race, and year of diagnosis. Results are reported as the observed risk divided by the expected risk (O/E).
Results: For the 43,688 AA pts, the overall O/E and excess risks were 1.48 and 51.2 compared to 1.11 and 14.7 for the 428,103 Caucasian patients. The mean ages of diagnoses of initial breast cancer diagnosis and second cancer were 57.2 and 65 years for AA patients compared to 61.8 and 70.2 years for Caucasian patients. The following is a summary of statically significant (p <0.05) selected O/E by the site of second cancer :
O/E for AA and white by site of second cancerSiteAAWhiteOral Cavity and Pharynx1.651.41Digestive System1.181Respiratory System1.271.13Skin excluding Basal and Squamous1.931.33Breast1.671.18Female Genital System1.110.95Urinary System1.561.18Endocrine System1.521.38All Lymphatic and Hematopoietic Diseases1.261.05
This higher risk of second cancers occurred despite the lower relative survival rate for AA compared to Caucasian patients with a 5-year relative survival rate of 68.6% for AA and 78.3% for Caucasian patients.
Conclusions: To our knowledge, this is the first report of the incidence of second cancers in AA patients with breast cancer compared to caucasian. More research to understand the biological, genetic, therapeutic, and environmental factors leading to this higher risk of second cancers is warranted.
Citation Format: Diab N, Clark G, Hamlington B, Brzeskiewicz L, Langer L, Diab S. Higher incidence of second cancers in African American (AA) patients compared to Caucasian patients with a primary breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-09-02.
Collapse
Affiliation(s)
- N Diab
- Vanderbilt University, Nashville, TN; Arry BioPharma, Boulder, CO; Rocky Mountain Cancer Centers, Aurora and Denver, CO; Compass Oncology, Portland, OR
| | - G Clark
- Vanderbilt University, Nashville, TN; Arry BioPharma, Boulder, CO; Rocky Mountain Cancer Centers, Aurora and Denver, CO; Compass Oncology, Portland, OR
| | - B Hamlington
- Vanderbilt University, Nashville, TN; Arry BioPharma, Boulder, CO; Rocky Mountain Cancer Centers, Aurora and Denver, CO; Compass Oncology, Portland, OR
| | - L Brzeskiewicz
- Vanderbilt University, Nashville, TN; Arry BioPharma, Boulder, CO; Rocky Mountain Cancer Centers, Aurora and Denver, CO; Compass Oncology, Portland, OR
| | - L Langer
- Vanderbilt University, Nashville, TN; Arry BioPharma, Boulder, CO; Rocky Mountain Cancer Centers, Aurora and Denver, CO; Compass Oncology, Portland, OR
| | - S Diab
- Vanderbilt University, Nashville, TN; Arry BioPharma, Boulder, CO; Rocky Mountain Cancer Centers, Aurora and Denver, CO; Compass Oncology, Portland, OR
| |
Collapse
|
47
|
Arnold JJ, Campain A, Barthelmes D, Simpson JM, Guymer RH, Hunyor AP, McAllister IL, Essex RW, Morlet N, Gillies MC, Gillies M, Hunt A, Hunyor A, Arnold J, Young S, Clark G, Banerjee G, Phillips R, Perks M, Essex R, McAllister I, Constable I, Guymer R, Guymer R, Lim L, Harper A, Chow L, Wickremansinghe S, Wickremasinghe S, Wickremasinghe S. Two-year outcomes of "treat and extend" intravitreal therapy for neovascular age-related macular degeneration. Ophthalmology 2015; 122:1212-9. [PMID: 25846847 DOI: 10.1016/j.ophtha.2015.02.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To report 24-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice. DESIGN Database observational study. PARTICIPANTS We included treatment-naïve eyes receiving predominantly ranibizumab for nAMD in routine clinical practice treated using a treat and extend regimen that were tracked in the Fight Retinal Blindness observational registry. METHODS A cohort of eyes treated by practitioners using exclusively a treat and extend regimen was extracted from the Fight Retinal Blindness observational registry. MAIN OUTCOME MEASURES Change in visual acuity (VA) over 2 years and number of injections and visits. RESULTS Data from 1198 eyes from 1011 patients receiving anti-VEGF therapy using a treat and extend regimen for treatment-naïve nAMD between January 2007 and December 2012 and with 24-month follow-up were included in the analysis. Mean VA increased by +5.3 logarithm of the minimum angle of resolution letters from 56.5 letters (20/80+1) at initial visit to 61.8 (20/60+2) letters at 24 months. Mean VA gains improved and number of injections increased with successive years from +2.7 letters for eyes commencing in 2007 after a mean of 9.7 injections in 2 years, to +7.8 letters for eyes commencing in 2012 after a mean of 14.2 injections over 2 years. The proportion of eyes with VA >20/40 increased from 27% when starting treatment to 45% after 24 months; the proportion with vision of <20/200 remained unchanged (13% initial, 11% at 24 months). Of the included eyes, 90.5% avoided a vision loss of ≥15 letters. There was an overall mean of 13.0 injections over the 24 months, 7.5 injections in the first year and 5.5 in the second year, with a mean of 14.8 clinic visits. CONCLUSIONS These data indicate that eyes managed in routine clinical practice with a treat and extend regimen can achieve good visual outcomes while decreasing the burden of treatments and clinic visits.
Collapse
Affiliation(s)
| | - Anna Campain
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Barthelmes
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Judy M Simpson
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Robyn H Guymer
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia
| | - Alex P Hunyor
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Retina Associates, Chatswood, New South Wales, Australia
| | - Ian L McAllister
- Lions Eye Institute, Centre for Ophthalmology and Vision Science, University of Western Australia, Western Australia
| | - Rohan W Essex
- Academic Unit of Ophthalmology, Australian National University, Acton, Canberra, Australia
| | - Nigel Morlet
- University of Western Australia Department of Population Health, Perth, Western Australia
| | - Mark C Gillies
- Marsden Eye Specialists, Parramatta, New South Wales, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Clark G, Cummins N. Clarification: surnames and social mobility in England. Hum Nat 2015; 26:122. [PMID: 25814472 DOI: 10.1007/s12110-015-9226-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Gregory Clark
- Department of Economics, University of California, Davis, CA, 95616, USA,
| | | |
Collapse
|
49
|
Rosenzweig N, Hanson LE, Clark G, Franc GD, Stump WL, Jiang QW, Stewart J, Kirk WW. Use of PCR-RFLP Analysis to Monitor Fungicide Resistance in Cercospora beticola Populations from Sugarbeet (Beta vulgaris) in Michigan, United States. Plant Dis 2015; 99:355-362. [PMID: 30699698 DOI: 10.1094/pdis-03-14-0241-re] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Genetic resistance to Quinone outside inhibitor (QoI) and benzimidazole fungicides may be responsible for a recent decline in efficacy of chemical control management strategies for Cercospora leaf spot (CLS) caused by Cercospora beticola in Michigan sugarbeet (Beta vulgaris) fields. The target genes and fungicide resistance mutations are known for these two fungicides. Based on this, two standard polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assays were developed to detect the G143A and E198A point mutations in the fungal mitochondrial cytochrome b and the β-tubulin genes, respectively. These mutations confer a high level of resistance to either QoI or benzimidazole fungicides. The presence of the G143A and E198A mutations was monitored within C. beticola populations recovered from Michigan sugarbeet production fields collected in 2012. Both the QoI-resistant cytochrome b allele and the benzimidazole-resistant β-tubulin allele were detected directly from leaf tissue following a PCR-RFLP assay. Using either detection assay, the G143A and E198A mutations were detected in over 90% of the 118 field samples originating from Michigan sugarbeet production under fungicide management programs for CLS control. Monitoring of the G143A and E198A mutations in fields located in 9 counties and 58 townships indicated that the mutations were widespread in Michigan sugarbeet production areas. The PCR-based assays used and developed in this study were effective in detecting the presence of the G143A and E198A mutations in C. beticola field populations from Michigan.
Collapse
Affiliation(s)
- N Rosenzweig
- Department of Plant, Soil and Microbial Sciences, Michigan State University, 612, Wilson Road, 35 Plant Biology Building, East Lansing, MI 48824, USA
| | - L E Hanson
- Department of Plant, Soil and Microbial Science, and United States Department of Agriculture Agricultural Research Service, 1066 Bogue Street, Room 494, East Lansing, MI 48824, USA
| | - G Clark
- Michigan Sugar Company, Euclid Road, Bay City, MI 48706, USA
| | - G D Franc
- Department of Plant Sciences, University of Wyoming, Laramie, WY 82071
| | - W L Stump
- Department of Plant Sciences, University of Wyoming, Laramie, WY 82071
| | - Q W Jiang
- Department of Plant, Soil and Microbial Sciences, Michigan State University
| | | | - W W Kirk
- Department of Plant, Soil and Microbial Sciences, Michigan State University
| |
Collapse
|
50
|
Bushart TJ, Cannon A, Clark G, Roux SJ. Structure and function of CrACA1, the major PM-type Ca2+-ATPase, expressed at the peak of the gravity-directed trans-cell calcium current in spores of the fern Ceratopteris richardii. Plant Biol (Stuttg) 2014; 16 Suppl 1:151-7. [PMID: 24373013 DOI: 10.1111/plb.12107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 01/04/2013] [Accepted: 08/16/2013] [Indexed: 05/15/2023]
Abstract
Spores of the fern Ceratopteris richardii have proven to be a valuable single-cell system for studying gravity responses. The earliest cellular change directed by gravity in these cells is a trans-cell calcium current, which peaks near 10 h after the spores are induced to germinate. This current is needed for gravity-directed axis alignment, and its peak is coincident with the time period when gravity polarises the direction of subsequent nuclear migration and rhizoid growth. Transcriptomic analysis of genes expressed at the 10-h time point revealed several that encode proteins likely to be key components that either drive the current or regulate it. Notable among these is a plasma membrane (PM)-type Ca(2+) ATPase, CrACA1, whose activity pumping Ca(2+) out of cells is regulated by gravity. This report provides an initial characterisation of the structure and expression of this protein, and demonstrates its heterologous function complementing the K616 mutant of yeast, which is deficient in PM-type Ca(2+) pump activity. Gravity-induced changes in the trans-cell Ca(2+) current occur within seconds, a result consistent with the hypothesis that the force of gravity can rapidly alter the post-translational state of the channels and pumps that drive this current across spore cells. This report identifies a transporter likely to be a key driver of the current, CrACA1, and characterises the role of this protein in early germination and gravity-driven polarity fixation through analysis of expression levels, functional complementation and pharmacological treatments. These data, along with newly available transcriptomic data obtained at the 10-h time point, indicate that CrACA1 is present, functional and likely a major contributing component of the trans-cell Ca(2+) efflux. CrACA1 is not necessary for polar axis alignment, but pharmacological perturbations of it disrupt rhizoid development. These data support and help refine the post-translational modification model for gravity responses.
Collapse
Affiliation(s)
- T J Bushart
- Section of Molecular Cell & Developmental Biology, The University of Texas at Austin, Austin, TX, USA
| | | | | | | |
Collapse
|