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Herb CC, Custer L, Blemker S, Saliba S, Hart J, Hertel J. Gait kinematics and kinetics in patients with chronic ankle instability and healthy controls: A statistical parametric mapping analysis. Foot (Edinb) 2024; 59:102089. [PMID: 38593519 DOI: 10.1016/j.foot.2024.102089] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/27/2023] [Accepted: 03/10/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Chronic ankle instability (CAI) is associated with changes in gait biomechanics which may be related to chronic dysfunction. Traditional statistical models may be limited in their ability to assess the complex 3D movement of the lower extremity during gait. Multivariate analysis of the lower extremity kinematics may reveal unique biomechanical differences associated with CAI. RESEARCH QUESTION Do patients with CAI differ from healthy controls in their lower extremity biomechanics and GRF when comparing 3D biomechanics? METHODS Thirty-nine young, active adults participated in this study. Data was collected using a 3D motion analysis system while patients walked and jogged. Statistical parametric mapping (SPM) was used to explore 3D GRF, kinematics and kinetics of the of the lower extremity of CAI and healthy patients. RESULTS During walking, patients with CAI had greater inversion from 68-100% of gait cycle (p < 0.001, mean difference=3.2°). During jogging, patients with CAI had greater inversion from 20-92% (p < 0.001, mean difference=4.6°). Greater plantar flexion moments were found from 65-71% (p = 0.05, mean difference=347.4Nm/kg) and greater eversion moments were found from 95-100% (p = 0.03, mean difference=74.6Nm/kg) in the CAI group. No differences in GRF were found. SIGNIFICANCE Greater inversion may present a potentially injurious position. A faulty position of the rearfoot may require greater muscle function in order to correct the position of the joint resulting in greater eversion moments at the ankle. However, this kinetic change does not appear to correct the ankle position.
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Affiliation(s)
- C C Herb
- Northern Kentucky University, School of Kinesiology, Counseling and Rehabilitative Science, Highland Heights, KY, USA.
| | - L Custer
- Towson University, Department of Kinesiology, Towson, MD, USA
| | - S Blemker
- University of Virginia, School of Engineering and Applied Science, Charlottesville, VA, USA
| | - S Saliba
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hart
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hertel
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
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Lignou S, Hart J. Navigating climate responsibility: a critical examination of healthcare professionals' moral duties. J Med Ethics 2024:jme-2024-109883. [PMID: 38503482 DOI: 10.1136/jme-2024-109883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/25/2024] [Indexed: 03/21/2024]
Affiliation(s)
- Sapfo Lignou
- Ethox Centre, Nuffield Department for Population Health, Oxford University, Oxford, UK
| | - James Hart
- Ethox Centre, Nuffield Department for Population Health, Oxford University, Oxford, UK
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Green Z, Ashton JJ, Rodrigues A, Spray C, Howarth L, Mallikarjuna A, Chanchlani N, Hart J, Bakewell C, Lee KY, Wahid A, Beattie RM. Sustained Increase in Pediatric Inflammatory Bowel Disease Incidence Across the South West United Kingdom Over the Last 10 Years. Inflamm Bowel Dis 2024:izad302. [PMID: 38372691 DOI: 10.1093/ibd/izad302] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND Pediatric inflammatory bowel disease (pIBD) incidence has increased over the last 25 years. We aim to report contemporaneous trends across the South West United Kingdom. METHODS Data were provided from centers covering the South West United Kingdom (Bristol, Oxford, Cardiff, Exeter, and Southampton), with a total area at-risk population (<18 years of age) of 2 947 534. Cases were retrieved from 2013 to 2022. Incident rates were reported per 100 000 at-risk population, with temporal trends analyzed through correlation. Subgroup analysis was undertaken for age groups (0-6, 6-11, and 12-17 years of age), sex, and disease subtype. Choropleth maps were created for local districts. RESULTS In total, 2497 pIBD cases were diagnosed between 2013 and 2022, with a mean age of 12.6 years (38.7% female). Diagnosis numbers increased from 187 to 376, with corresponding incidence rates of 6.0 per 100 000 population per year (2013) to 12.4 per 100 000 population per year (2022) (b = 0.918, P < .01). Female rates increased from 5.1 per 100 000 population per year in 2013 to 11.0 per 100 000 population per year in 2022 (b = 0.865, P = .01). Male rates increased from 5.7 per 100 000 population per year to 14.4 per 100 000 population per year (b = 0.832, P = .03). Crohn's disease incidence increased from 3.1 per 100 000 population per year to 6.3 per 100 000 population per year (b = 0.897, P < .01). Ulcerative colitis increased from 2.3 per 100 000 population per year to 4.3 per 100 000 population per year (b = 0.813, P = .04). Inflammatory bowel disease unclassified also increased, from 0.6 per 100 000 population per year to 1.8 per 100 000 population per year (b = 0.851, P = .02). Statistically significant increases were seen in those ≥12 to 17 years of age, from 11.2 per 100 000 population per year to 24.6 per 100 000 population per year (b = 0.912, P < .01), and the 7- to 11-year-old age group, with incidence rising from 4.4 per 100 000 population per year to 7.6 per 100 000 population per year (b = 0.878, P = .01). There was no statistically significant increase in very early onset inflammatory bowel disease (≤6 years of age) (b = 0.417, P = .231). CONCLUSIONS We demonstrate significant increases in pIBD incidence across a large geographical area including multiple referral centers. Increasing incidence has implications for service provision for services managing pIBD.
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Affiliation(s)
- Zachary Green
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, United Kingdom
- Department of Paediatric Gastroenterology, Noah's Ark Children's Hospital for Wales, Cardiff, United Kingdom
| | - James J Ashton
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, United Kingdom
- Department of Human Genetics and Genomic Medicine, University of Southampton, Southampton, United Kingdom
| | - Astor Rodrigues
- Department of Paediatric Gastroenterology, Oxford University Hospitals, Oxford, United Kingdom
| | - Christine Spray
- Department of Paediatric Gastroenterology, Bristol Children's Hospital, Bristol, United Kingdom
| | - Lucy Howarth
- Department of Paediatric Gastroenterology, Oxford University Hospitals, Oxford, United Kingdom
| | - Akshatha Mallikarjuna
- Department of Paediatric Gastroenterology, Bristol Children's Hospital, Bristol, United Kingdom
| | - Neil Chanchlani
- Department of Paediatrics, Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom
| | - James Hart
- Department of Paediatrics, Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom
| | - Christopher Bakewell
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, United Kingdom
| | - Kwang Yang Lee
- Department of Paediatric Gastroenterology, Bristol Children's Hospital, Bristol, United Kingdom
| | - Amar Wahid
- Department of Paediatric Gastroenterology, Noah's Ark Children's Hospital for Wales, Cardiff, United Kingdom
| | - R Mark Beattie
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, United Kingdom
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Testard C, Shergold C, Acevedo-Ithier A, Hart J, Bernau A, Negron-Del Valle JE, Phillips D, Watowich MM, Sanguinetti-Scheck JI, Montague MJ, Snyder-Mackler N, Higham JP, Platt ML, Brent L. Natural disaster alters the adaptive benefits of sociality in a primate. bioRxiv 2024:2023.07.17.549328. [PMID: 37503170 PMCID: PMC10370068 DOI: 10.1101/2023.07.17.549328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Weather-related disasters can radically alter ecosystems. When disaster-driven ecological damage persists, the selective pressures exerted on individuals can change, eventually leading to phenotypic adjustments. For group-living animals, social relationships are believed to help individuals cope with environmental challenges and may be a critical mechanism enabling adaptation to ecosystems degraded by disasters. Yet, whether natural disasters alter selective pressures on patterns of social interactions and whether group-living animals can, as a result, adaptively change their social relationships remains untested. Here, we leveraged unique data collected on rhesus macaques from 5 years before to 5 years after a category 4 hurricane, leading to persistent deforestation which exacerbated monkeys' exposure to intense heat. In response, macaques increased tolerance for and decreased aggression toward other monkeys, facilitating access to scarce shade critical for thermoregulation. Social tolerance predicted individual survival for 5 years after the hurricane, but not before it, revealing a clear shift in the adaptive function of social relationships in this population. We demonstrate that an extreme climatic event altered selection on sociality and triggered substantial and persistent changes in the social structure of a primate species. Our findings unveil the function and adaptive flexibility of social relationships in degraded ecosystems and identify natural disasters as potential evolutionary drivers of sociality. One-Sentence Summary Testard et al. show that a natural disaster altered selection on sociality in group-living primates triggering persistent changes in their social structure.
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Graham M, Hanson I, Hart J, Young P, Lignou S, Parker MJ, Sheehan M. Getting rights right: implementing 'Martha's Rule'. J Med Ethics 2024:jme-2023-109650. [PMID: 38184371 DOI: 10.1136/jme-2023-109650] [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] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/12/2023] [Indexed: 01/08/2024]
Abstract
The UK government has recently committed to adopting a new policy-dubbed 'Martha's Rule'-which has been characterised as providing patients the right to rapidly access a second clinical opinion in urgent or contested cases. Support for the rule emerged following the death of Martha Mills in 2021, after doctors failed to admit her to intensive care despite concerns raised by her parents. We argue that framing this issue in terms of patient rights is not productive, and should be avoided. Insofar as the ultimate goal of Martha's Rule is the provision of a clinical service that protects patient safety, an approach that focuses on the obligations of the health system-rather than the individual rights of patients-will better serve this goal. We outline an alternative approach that situates rapid clinical review as part of a suite of services aimed at enhancing and protecting patient care. This approach would make greater progress towards addressing the difficult systemic issues that Martha's Rule does not, while also better engaging with the constraints of clinical practice.
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Affiliation(s)
- Mackenzie Graham
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Isabel Hanson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - James Hart
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Peter Young
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sapfo Lignou
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Michael J Parker
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mark Sheehan
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
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Gordon SF, Lam J, Vasquez JT, Cercone R, Tenneti N, Hart J, Chisholm M, Heland M, Hoq M, Kaufman J, Danchin M. A tailored COVID-19 vaccination pathway for children 5-11 years in Victoria, Australia. Vaccine 2023; 41:3436-3445. [PMID: 37120401 PMCID: PMC10106821 DOI: 10.1016/j.vaccine.2023.04.032] [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: 10/04/2022] [Revised: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Procedural anxiety was anticipated in children 5-11 years during the COVID-19 vaccine rollout in Victoria, Australia, as children in this age group receive few routine vaccines. Therefore, the Victorian state government designed a tailored, child-friendly vaccine program. This study aimed to assess parental satisfaction with elements of the bespoke vaccination pathway. METHODS The Victorian government and state-run vaccination hubs in Victoria facilitated an online immunisation plan to help parents identify their child's support needs, and utilised experienced paediatric staff and additional supports for children with severe needle distress and/or disability. All parents/guardians of children 5-11 years who received a COVID-19 vaccine in a vaccination hub were sent a 16-item feedback survey via text message. RESULTS Between 9 February and 31 May 2022 there were 9203 responses; 865 children (9.4%) had a first language other than English, 499 (5.4%) had a disability or special needs, and 142 (1.5%) were Aboriginal or Torres Strait Islander. Most parents (94.4%; 8687/9203) rated their satisfaction with the program as very good or excellent. The immunisation plan was used by 13.5% (1244/9203) of respondents, with usage more common for Aboriginal or Torres Strait Islander children (26.1%; 23/88) or families with a first language other than English (23.5%; 42/179). The child-friendly staff (88.5%, 255/288) and themed environment (66.3%, 191/288) were the most valued measures for vaccination. Additional support measures were required by 1.6% (150/9203) of children in the general population and 7.9%, (17/261) of children with a disability and/or special needs. CONCLUSION A tailored COVID-19 vaccination program for children 5-11 years, with additional support for children with severe needle distress and/or disability, had high parental satisfaction. This model could be utilised for COVID-19 vaccination in pre-school children and for routine childhood vaccination programs to provide optimal support to children and their families.
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Affiliation(s)
- S F Gordon
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia.
| | - J Lam
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J T Vasquez
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - R Cercone
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - N Tenneti
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - J Hart
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Chisholm
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Heland
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia
| | - M Hoq
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - J Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia
| | - M Danchin
- COVID-19 Vaccination Program, Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; Department of Paediatrics, The University of Melbourne, Grattan Street, Parkville, Melbourne, Victoria 3010, Australia; Department of General Medicine, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia
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Hart J, Okoro U, Mohr N, Ahmed A. 84 Bystander CPR Rates for Out-of-Hospital Cardiac Arrest Higher in Rural Areas Versus Urban Areas. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Conley M, Schaffert J, Cullum CM, Hart J, Didehbani N. A-10 Influence of Different Normative Reference Standards among Cognitively Normal Former NFL Players. Arch Clin Neuropsychol 2022. [DOI: 10.1093/arclin/acac32.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose: Demographic adjustments (e.g., age, sex, race/ethnicity) to neuropsychological tests can assist clinical interpretation and avoid false-positive diagnoses of cognitive impairment. The issue of “race” as a criterion for normative adjustment has been highlighted in recent cases among former NFL players. We examined the impact of different normative reference comparisons on neuropsychological scores among cognitively normal Black and White NFL retirees. Methods: Cognitively normal Black (n = 20) and White (n = 20) retirees were age- and education-matched. Measures of attention (Digit Span), processing speed (Coding, TMTA), memory (ROCFT, CVLT), language (FAS, Animals, BNT), and executive function (TMTB) were examined. Independent samples t-tests (using p < 0.01) were conducted between raw and normative scores of Black and White retirees that adjusted for 1) age/education (Mitrushina); 2) age/education/sex (NACC); and 3) age/education/sex/race (Heaton, MOANS/MOAANS). An additional ANCOVA evaluated group differences controlling for baseline estimated IQ. Results: Raw scores differed between groups on TMTB, Coding, and BNT. Mitrushina normative data showed differences on TMTB (p = 0.007) and BNT (p < 0.001). NACC normative data showed differences on the BNT (p < 0.001). ANCOVA (controlling for IQ) of raw scores between groups differed on the BNT (p = 0.002). Heaton and MOANS/MOAANS normative scores did not reveal differences between groups on any test. Conclusions: As expected, the use of different neuropsychological norms influences findings across different sociodemographic groups to various degrees, depending on the test. The underlying contributors to group differences using “race” as a proxy need to be disentangled and understood. Cautious use of demographically-adjusted norms as interpretive guidelines is warranted until these factors are identified.
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Doherty S, Knight JG, Backhouse T, Tran TST, Paterson R, Stahl F, Alharbi HY, Chamberlain TW, Bourne RA, Stones R, Griffiths A, White JP, Aslam Z, Hardare C, Daly H, Hart J, Temperton RH, O'Shea JN, Rees NH. Highly efficient and selective aqueous phase hydrogenation of aryl ketones, aldehydes, furfural and levulinic acid and its ethyl ester catalyzed by phosphine oxide-decorated polymer immobilized ionic liquid-stabilized ruthenium nanoparticles. Catal Sci Technol 2022. [DOI: 10.1039/d2cy00205a] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Phosphine oxide-decorated polymer immobilized ionic liquid stabilized RuNPs catalyse the hydrogenation of aryl ketones with remarkable selectivity for the CO bond, complete hydrogenation to the cyclohexylalcohol and hydrogenation of levulinic acid to γ-valerolactone.
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Affiliation(s)
- S. Doherty
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - J. G. Knight
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - T. Backhouse
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - T. S. T. Tran
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - R. Paterson
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - F. Stahl
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - H. Y. Alharbi
- Newcastle University Centre for Catalysis (NUCAT), School of Chemistry, Bedson Building, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - T. W. Chamberlain
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - R. A. Bourne
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - R. Stones
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - A. Griffiths
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - J. P. White
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - Z. Aslam
- Institute of Process Research & Development, School of Chemistry and School of Chemical and Process Engineering, University of Leeds, Woodhouse Land Leeds, LS2 9JT, UK
| | - C. Hardare
- School of Chemical Engineering and Analytical Sciences, The University of Manchester, The Mill, Sackville Street Campus, Manchester, M13 9PL, UK
| | - H. Daly
- School of Chemical Engineering and Analytical Sciences, The University of Manchester, The Mill, Sackville Street Campus, Manchester, M13 9PL, UK
| | - J. Hart
- School of Physics & Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - R. H. Temperton
- School of Physics & Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - J. N. O'Shea
- School of Physics & Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK
| | - N. H. Rees
- Inorganic Chemistry Laboratory, University of Oxford, South Parks Road, Oxford OX1 3QR, UK
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Drummond C, Drummond M, Fennell M, Hart J, Kamaludin M, Keith C, Lange B, Paparella L, Ramos J, Wallen M, Williams H. The relationship between cardiorespiratory fitness and chronic pelvic pain in women with endometriosis: a preliminary cross-sectional analysis. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Neipp MC, Martínez-González MC, Chisholm A, Peters S, Hart J. Translation and application of an obesity behavior change technique training in a Spanish nursing undergraduate setting. An Sist Sanit Navar 2021; 44:51-59. [PMID: 33853227 DOI: 10.23938/assn.0938] [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: 11/18/2022]
Abstract
BACKGROUND The TEnT PEGS framework is a behavior change communication toolkit which has been shown to be useful in increasing health professional trainees' skills and knowledge about obesity-related behavior change techniques. There is no version of the behavioral change intervention toolkit in Spanish. Therefore, the objectives of this study were 1) to translate the TEnT PEGS framework into Spanish and apply it to a Spanish nursing student population; 2) To analyze whether training with the Spanish toolkit (DEPREMIO) had a positive impact on students' skills in encouraging obesi-ty-related behavioral change. METHODS First year nursing students (n=95) attended two face-to-face (2 hours per session) obesity management training sessions. A specifically designed pre-post test was carried out. Data were collected using an ad-hoc questionnaire of fourteen items, ten of them evaluated the student's knowledge and attitude about behavior change techniques, and four evaluated the student's perception of their skills in developing different strategies. RESULTS Training significantly increased most students' knowledge and attitudes with a 0.05 level of significance and effect sizes were between 0.36 and 0.77. It also increased students' skills, although not to any significant extent. CONCLUSION The DEPREMIO toolkit helped nursing students to acquire more knowledge, attitudes and skills in obesity management. It therefore seems that this adaptation is an acceptable and feasible training tool for the Spanish nursing student population.
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Affiliation(s)
- M C Neipp
- Department of Health Psychology. University Miguel Hernández. Elche. Spain.
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Hart J, Cox CL, Kuhn I, Fritz Z. Communicating diagnostic uncertainty in the acute and emergency medical setting: A systematic review and ethical analysis of the empirical literature. Acute Med 2021; 20:204-218. [PMID: 34679138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND diagnostic uncertainty is ubiquitous. Its communication to patients requires further investigation. AIMS To determine: 1) What is known about how and why diagnostic uncertainty is communicated in acute care; 2) evidence of the effects of (not) communicating diagnostic uncertainty in the acute setting; 3) associated ethical issues. METHODS systematic review of Medline, Web of Science and SCOPUS for (acute or emergency care) AND (diagnostic uncertainty) AND (ethics OR behaviours). Critical interpretive synthesis and ethical analysis were conducted. RESULTS AND CONCLUSION Nine studies (primarily surveys and interviews) were identified. Doctors are not trained in communicating diagnostic uncertainty and perceive it to have negative effects on patients; however not communicating diagnostic uncertainty can disempower patients, resulting in delayed/missed diagnoses or inappropriate use of resource.
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Affiliation(s)
- J Hart
- MB BChir, MA (Cantab), North Middlesex University Hospital NHS Trust, The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
| | - C L Cox
- MB BChir, MA (Cantab), The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
| | - I Kuhn
- MA, MSc, The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
| | - Z Fritz
- MBBS, MA (Cantab), PhD, The Healthcare Improvement Studies (THIS) Institute, University of Cambridge
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Niculescu AB, Le-Niculescu H, Roseberry K, Wang S, Hart J, Kaur A, Robertson H, Jones T, Strasburger A, Williams A, Kurian SM, Lamb B, Shekhar A, Lahiri DK, Saykin AJ. Blood biomarkers for memory: toward early detection of risk for Alzheimer disease, pharmacogenomics, and repurposed drugs. Mol Psychiatry 2020; 25:1651-1672. [PMID: 31792364 PMCID: PMC7387316 DOI: 10.1038/s41380-019-0602-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/25/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022]
Abstract
Short-term memory dysfunction is a key early feature of Alzheimer's disease (AD). Psychiatric patients may be at higher risk for memory dysfunction and subsequent AD due to the negative effects of stress and depression on the brain. We carried out longitudinal within-subject studies in male and female psychiatric patients to discover blood gene expression biomarkers that track short term memory as measured by the retention measure in the Hopkins Verbal Learning Test. These biomarkers were subsequently prioritized with a convergent functional genomics approach using previous evidence in the field implicating them in AD. The top candidate biomarkers were then tested in an independent cohort for ability to predict state short-term memory, and trait future positive neuropsychological testing for cognitive impairment. The best overall evidence was for a series of new, as well as some previously known genes, which are now newly shown to have functional evidence in humans as blood biomarkers: RAB7A, NPC2, TGFB1, GAP43, ARSB, PER1, GUSB, and MAPT. Additional top blood biomarkers include GSK3B, PTGS2, APOE, BACE1, PSEN1, and TREM2, well known genes implicated in AD by previous brain and genetic studies, in humans and animal models, which serve as reassuring de facto positive controls for our whole-genome gene expression discovery approach. Biological pathway analyses implicate LXR/RXR activation, neuroinflammation, atherosclerosis signaling, and amyloid processing. Co-directionality of expression data provide new mechanistic insights that are consistent with a compensatory/scarring scenario for brain pathological changes. A majority of top biomarkers also have evidence for involvement in other psychiatric disorders, particularly stress, providing a molecular basis for clinical co-morbidity and for stress as an early precipitant/risk factor. Some of them are modulated by existing drugs, such as antidepressants, lithium and omega-3 fatty acids. Other drug and nutraceutical leads were identified through bioinformatic drug repurposing analyses (such as pioglitazone, levonorgestrel, salsolidine, ginkgolide A, and icariin). Our work contributes to the overall pathophysiological understanding of memory disorders and AD. It also opens new avenues for precision medicine- diagnostics (assement of risk) as well as early treatment (pharmacogenomically informed, personalized, and preventive).
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Affiliation(s)
- A B Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.
- Indianapolis VA Medical Center, Indianapolis, IN, USA.
| | - H Le-Niculescu
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - K Roseberry
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - S Wang
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Indianapolis VA Medical Center, Indianapolis, IN, USA
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - J Hart
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Kaur
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - H Robertson
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - T Jones
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - A Strasburger
- Indianapolis VA Medical Center, Indianapolis, IN, USA
| | - A Williams
- Indianapolis VA Medical Center, Indianapolis, IN, USA
- Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
| | - S M Kurian
- Department of Molecular Medicine, Scripps Research, La Jolla, CA, USA
| | - B Lamb
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Shekhar
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - D K Lahiri
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A J Saykin
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
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Schaffet J, Didehbani N, LoBue C, Hart J, Cullum CM. A-37 Neuropsychological Functioning In Cognitively Normal And Impaired Aging NFL Retirees. Arch Clin Neuropsychol 2020. [DOI: 10.1093/arclin/acaa036.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
Identify differences in neuropsychological (NP) functioning between older (≥ 50) National Football League (NFL) retirees and age-matched controls, and examine whether differences correlate to head-injury exposure.
Method
NFL retirees were diagnosed with normal cognition (n = 20), mild cognitive impairment (n = 19), or dementia (n = 5) using Jak and Bondi (2009) criteria and clinical consensus. Retirees were age-matched to either healthy controls (n = 18) or clinical controls with MCI (n = 21) or dementia (n = 5). MANCOVAs and partial correlations covarying for age and education compared retiree’s NP performances to controls, and examined whether differences in NP measures were correlated with number of concussions, or games and years played in the NFL.
Results
Cognitively normal (CN) retirees displayed lower processing speed, naming, and verbal memory (p’s < .05) than CN controls. Impaired retirees displayed worse processing speed and naming than impaired controls, but better verbal memory (p’s < .05). Only lower verbal memory performance in CN retirees significantly correlated with number of games (r = −.60) and years played (r = −.54).
Conclusions
Aging CN and impaired retirees performed worse on single measures of processing speed and naming, but their performances did not correlate to head-injury exposure. Verbal memory performance varied between CN (worse than controls) and impaired retirees (better than controls). Overall, results suggest some aging NFL players may be at risk for reduced verbal memory, but this relationship could diminish following onset of MCI. No clear dose-response relationship was observed between head-injury exposure and NP functioning. Future studies should examine longitudinal trajectories of NP performances in larger samples to elucidate these findings.
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15
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Hart J, Tracy R, Johnston M, Brown S, Stephenson C, Kegg J, Waymack J. Recommendations for Prehospital Airway Management in Patients with Suspected COVID-19 Infection. West J Emerg Med 2020; 21:809-812. [PMID: 32726247 PMCID: PMC7390580 DOI: 10.5811/westjem.2020.5.47540] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/25/2020] [Accepted: 05/20/2020] [Indexed: 12/14/2022] Open
Abstract
In light of the rapid spread of coronavirus disease 2019 (COVID-19) across the United States, the Centers for Disease Control and Prevention (CDC) and hospitals nationwide have developed new protocols to address infection control as well as the care of critical patients. Airway management has been particularly difficult; the challenge of quickly establishing an airway in patients must be balanced by the risk of aerosolizing respiratory secretions and putting the provider at risk of infection. Significant attention has been given to developing protocols for the emergency department and critical care units, but little guidance regarding establishing airway and respiratory support for patients in the prehospital setting has been made available. While some of the recommendations can be extrapolated from hospital guidelines, other factors such as environment and available resources make these protocols unfeasible. Through review of current literature the authors established recommendations regarding airway management and the provision of respiratory support to patients developing respiratory failure related to COVID-19.
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Affiliation(s)
- James Hart
- Southern Illinois University School of Medicine, Department of Emergency Medicine, Springfield, Illinois
| | - Rebecca Tracy
- Southern Illinois University School of Medicine, Department of Emergency Medicine, Springfield, Illinois
| | - Matthew Johnston
- Southern Illinois University School of Medicine, Department of Emergency Medicine, Springfield, Illinois
| | - Sara Brown
- Memorial Medical Center, Springfield, Illinois
| | - Connor Stephenson
- Southern Illinois University School of Medicine, Springfield, Illinois
| | - Jason Kegg
- Southern Illinois University School of Medicine, Department of Emergency Medicine, Springfield, Illinois
- State of Illinois EMS Medical Director, Department of Public Health, Springfield, Illinois
| | - James Waymack
- Southern Illinois University School of Medicine, Department of Emergency Medicine, Springfield, Illinois
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16
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Lilaonitkul M, Mishra S, Pritchard N, Andhoga J, Olang' P, Kibet EB, Walker IA, Hart J, Byrne-Davis L. Mixed methods analysis of factors influencing change in clinical behaviours of non-physician anaesthetists in Kenya following obstetric anaesthesia training. Anaesthesia 2020; 75:1331-1339. [PMID: 32436211 DOI: 10.1111/anae.15091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 11/30/2022]
Abstract
Maternal mortality rates in low-middle income countries remain high, with sub-Saharan Africa accounting for two-thirds of global maternal deaths. Inadequate staff training is one of the main contributors to anaesthesia-related deaths and the Association of Anaesthetists developed the Safe Anaesthesia from Education course in collaboration with the World Federation of Societies of Anaesthesiologists to address this training gap. We aimed to evaluate the impact of this course among Kenyan participants. Mixed methodologies and secondary analyses of anonymised data were used to study translation of learning into practice. In total, 103 participants from 66 facilities who attended courses between 2016 and 2017 were analysed. Ninety (87%) participants who were followed up completed knowledge tests. Baseline median (IQR [range]) knowledge test score was 41 (37-43 [21-46]). There was a significant improvement in median (IQR [range]) knowledge test score immediately post-course (43 (41-45 [33-48]); p < 0.001) which was sustained at 3-6 month follow-up (43 (41-45 [32-50]); p < 0.001 compared with baseline). Eighty-four of the 103 participants were observed in their workplace and capability, opportunity and motivation-behaviour framework was used to study the barriers and facilitators to practice change. Psychological capability and reflective motivation were the main factors enabling positive behaviour change such as team communication and pre-operative assessment, whereas physical and social opportunity accounted for the main barriers to behaviours such as performing the surgical safety checklist. Our study demonstrates that the Safe Anaesthesia from Education obstetric course is relevant in the low-resource setting and may lead to knowledge translation in clinical practice.
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Affiliation(s)
- M Lilaonitkul
- Department of Anesthesia and Peri-operative Care, University of California San Francisco, San Francisco, CA, USA
| | - S Mishra
- Department of Internal Medicine, Lincoln Medicine Center, New York, NY, USA
| | - N Pritchard
- Department of Anaesthesia, St George's University Hospitals NHS Foundation Trust, London, UK
| | - J Andhoga
- Department of Anaesthesia, Jomo Kenyatta University of Agriculture and Technology, Kiambu, Kenya
| | - P Olang'
- Department of Anaesthesia, University of Nairobi, Nairobi, Kenya
| | - E B Kibet
- Department of Anaesthesia, Kenyatta National Hospital, Nairobi, Kenya
| | - I A Walker
- University College London Institute of Child Health, London, UK
| | - J Hart
- Division of Medical Education, University of Manchester, Manchester, UK
| | - L Byrne-Davis
- Division of Medical Education, University of Manchester, UK
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Herb CC, Blemker S, Saliba S, Hart J, Hertel J. Chronic ankle instability patients exhibit higher variability in lower extremity joint-coupling variability during drop vertical jumps. J Biomech 2020; 99:109479. [PMID: 31744598 DOI: 10.1016/j.jbiomech.2019.109479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/27/2019] [Accepted: 10/30/2019] [Indexed: 12/26/2022]
Abstract
Chronic ankle instability (CAI) has been associated with biomechanical alterations during landing tasks. While joint coupling differences have been reported during gait in patients with CAI, there is no known research assessing joint coupling during a drop-vertical jumping (DVJ). Joint coupling variability measure may provide information on the sensorimotor health of these patients. The purpose of this study was to compare lower extremity joint coupling variability during a DVJ between patients with CAI and controls. Twenty-eight young, active individuals (CAI:n = 14, Control:n = 14) participated in the study. A 3D motion capture system was used to collect kinematics during 15 drop-vertical jump trials. A vector coding analysis was used to assess the variability in the following joint couples: knee sagittal-ankle frontal, knee sagittal-ankle sagittal, hip frontal-ankle frontal, and hip frontal-ankle sagittal. The CAI group had higher joint coupling variability in hip frontal-ankle sagittal, knee sagittal-ankle frontal and knee sagittal-ankle sagittal planes both prior to and following ground contact during the drop vertical jumps. These changes indicate potential adaptations to the constraint of CAI and the task of the DVJ. Higher variability may reflect an attempt by the subjects to explore alternate movement strategies or reflect poor sensorimotor control strategies. Clinicians should consider the challenges of DVJ during rehabilitation as they create a unique task constraint.
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Affiliation(s)
- C C Herb
- Northern Kentucky University, School of Kinesiology, Counseling and Rehabilitation Sciences, Highland Heights, KY, USA.
| | - S Blemker
- University of Virginia, School of Engineering and Applied Science, Charlottesville, VA, USA
| | - S Saliba
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hart
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
| | - J Hertel
- University of Virginia, Curry School of Education and Human Development, Charlottesville, VA, USA
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Atasoy D, Kandasamy N, Hart J, Lynch J, Yang SH, Walsh D, Tolias C, Booth TC. Outcome Study of the Pipeline Embolization Device with Shield Technology in Unruptured Aneurysms (PEDSU). AJNR Am J Neuroradiol 2019; 40:2094-2101. [PMID: 31727754 DOI: 10.3174/ajnr.a6314] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 09/20/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The recently introduced Pipeline Flex Embolization Device with Shield Technology (Pipeline Shield) is the third generation of Pipeline flow-diverter devices. It has a new stent-surface modification, which reduces thrombogenicity. We aimed to evaluate clinical and radiographic (safety and efficacy) outcomes of the Pipeline Shield. MATERIALS AND METHODS The 30-day and 1-year mortality and morbidity rates and the 6- and 18-month radiographic aneurysm occlusion outcomes for procedures performed between March 2016 and January 2018 were analyzed. 3D-TOF-MRA was used for follow-up. RESULTS Forty-four attempted Pipeline Shield procedures were performed for 41 patients with 44 target aneurysms (total of 52 aneurysms treated). A total of 88.5% of devices were inserted in the anterior circulation, and 11.5%, in the posterior circulation; 49/52 (94.2%) aneurysms were saccular; and 1/52 (1.9%) was fusiform. One (1.9%) aneurysm was an iatrogenic pseudoaneurysm, and 1 (1.9%) was a dissecting aneurysm. Seventy-one percent (35/49) of the saccular aneurysms were wide-neck (neck, >4 mm), 34.6% (18/52) were large (≥10 mm), and 3.8% (2/52) were giant (≥25 mm). The mean aneurysm sac maximal diameter was 9.0 mm, and the mean neck width was 5.0 mm. The cumulative mortality and morbidity rates were 2.3% and 6.8% at 1 year, respectively. The adequate occlusion rate was 78.8% at 6 months and 90.3% at 18 months. CONCLUSIONS In this pragmatic and non-industry-sponsored study, the occlusion rates and safety outcomes were similar to those seen in previously published studies with flow-diverter devices and earlier generation Pipeline Embolization Devices.
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Affiliation(s)
- D Atasoy
- From Karadeniz Technical University (D.A.), Farabi Hospital, Trabzon, Turkey
| | - N Kandasamy
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.)
| | - J Hart
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.)
| | - J Lynch
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.)
| | - S-H Yang
- Department of Radiology (S.-H.Y.), Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Radiology (S.-H.Y.), School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - D Walsh
- Neurosurgery (D.W., C.T.), King's College Hospital National Health Service Foundation Trust, London, UK
| | - C Tolias
- Neurosurgery (D.W., C.T.), King's College Hospital National Health Service Foundation Trust, London, UK
| | - T C Booth
- Departments of Neuroradiology (N.K., J.H., J.L., T.C.B.) .,School of Biomedical Engineering and Imaging Sciences (T.C.B.), King's College London, London, UK
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Li Y, Hart J, Profitt L, Intikhab S, Chatterjee S, Taheri M, Snyder J. Sequential Capacitive Deposition of Ionic Liquids for Conformal Thin Film Coatings on Oxygen Reduction Reaction Electrocatalysts. ACS Catal 2019. [DOI: 10.1021/acscatal.9b03157] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Yawei Li
- Department of Chemical and Biological Engineering, Drexel University, Philadelphia, Pennsylvania 19014, United States
| | - James Hart
- Department of Materials Science and Engineering, Drexel University, Philadelphia, Pennsylvania 19014, United States
| | - Lauren Profitt
- Department of Chemistry, Temple University, Philadelphia, Pennsylvania 19122, United States
| | - Saad Intikhab
- Department of Chemical and Biological Engineering, Drexel University, Philadelphia, Pennsylvania 19014, United States
| | - Swarnendu Chatterjee
- Department of Chemical and Biological Engineering, Drexel University, Philadelphia, Pennsylvania 19014, United States
| | - Mitra Taheri
- Department of Materials Science and Engineering, Drexel University, Philadelphia, Pennsylvania 19014, United States
| | - Joshua Snyder
- Department of Chemical and Biological Engineering, Drexel University, Philadelphia, Pennsylvania 19014, United States
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20
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Smith E, Schaffert J, LoBue C, Hart J, Rossetti H, Lacritz L. Annualized Decline in Instrumental Activities of Daily Living Is Slower in Hispanics Compared to Non-Hispanics in an Alzheimer’s Disease Sample. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Research examining the course of Alzheimer’s disease (AD) in Hispanics is lacking. This study examined demographic, psychiatric, cognitive, and genetic predictors of longitudinal functional change in Hispanics and non-Hispanics with AD.
Method
Longitudinal change in instrumental activities of daily living (IADL) was examined over 10 years (M = 4.15 years) in 292 subjects (Hispanic = 67, non-Hispanic = 225). All were part of the Texas Alzheimer’s Research & Care Consortium and included those with AD (n = 217) and those with mild cognitive impairment at baseline who progressed to AD at follow-up (n = 75). Baseline comparisons were conducted between ethnic groups for demographics, Geriatric Depression Scale (GDS-30) score, Mini Mental State Examination (MMSE) score, presence of apolipoprotein ɛ4 alleles (APOE4), and annualized IADL change scores and then entered into a multiple linear regression model as predictors of annualized IADL change.
Results
The Hispanic group had significantly more females (χ2 = 5.71, p = .017), lower education [MH = 9.96(4.39), MNH = 15.26(2.70)], higher depression scores [GDS-30; MH = 9.45(5.89), MNH = 5.51(4.29)], lower MMSE scores [MH = 23.31(4.33), MNH = 24.65(3.21)], and slower annualized IADL change [MH = 1.19(1.42), MNH = 2.02(1.60)]. Regression results were significant (F = 3.66, p = .001, R2 = .08 ), with higher baseline MMSE (p = .007) and Hispanic origin (p = .010) predicting slower annualized IADL change. Demographics, APOE4 status, and depression did not significantly predict IADL change.
Conclusions
Higher cognitive functioning at baseline and Hispanic origin was associated with slower functional decline over an average 4-year period of time. Despite having lower MMSE scores at baseline, greater depression, and less education, the Hispanic group had a slower decline in IADLs compared to non-Hispanics. Further research is needed to better understand how/why Hispanic origin is associated with slower functional decline.
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Schaffert J, LoBue C, Presley C, Hynan L, Wilmoth K, Lacritz L, Hart J, Cullum CM. Predictors of Life Expectancy After an Alzheimer’s Disease Diagnosis in a National Multi-Center Autopsy-Confirmed Sample. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Life expectancy varies between 3-12 years following the diagnosis of Alzheimer’s disease (AD) and is an important clinical question for patients and families. Current literature is limited by relatively small sample sizes and a reliance on clinical diagnoses. This study sought to evaluate predictors of AD life expectancy in a large autopsy-confirmed sample.
Methods
Baseline data from individuals 50 years and older clinically and neuropathologically diagnosed with AD (N=764) were obtained from the National Alzheimer’s Coordinating Center. Life expectancy was calculated in months from AD diagnosis to death. Nineteen variables (demographic, medical/health, disease severity, and psychiatric) obtained at dementia diagnosis were examined. Variables that showed significant differences in life expectancy using t-tests and Pearson correlations (14 of 19) were then entered into a forward multiple regression.
Results
Seven predictors in the model explained 27% of the variance in life expectancy (F= 40.7, R-squared= 0.267). Lower MMSE scores (β= 0.339, p < .001), male sex (β= -0.144, p < .001), older age (β= -0.130, p < .001), non-Hispanic Caucasian race/ethnicity (β= 0.115, p < .001), greater impairment on the Functional Activities Questionnaire (β= -0.091, p=.042), abnormal neurological/physical exam (β= -0.083, p=.011), and higher Neuropsychiatric Inventory Questionnaire total scores (β= -0.079, p=.016) predicted shorter life expectancy.
Conclusions
Global cognitive impairment, sex, age, race/ethnicity, functional impairment, abnormal neurological exam findings, and psychiatric symptoms explain a significant proportion of life expectancy following an AD diagnosis. Future studies should explore the relationship between life expectancy, specific neurological abnormalities, and psychiatric symptoms. These 7 predictors could potentially be used to predict life expectancy in individuals diagnosed with AD.
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Boyd N, Sharkey E, Nabukenya M, Tumukunde J, Sipuka N, Zyambo M, Walker I, Hart J, Byrne-Davis L. The Safer Anaesthesia from Education (SAFE) ® paediatric anaesthesia course: educational impact in five countries in East and Central Africa. Anaesthesia 2019; 74:1290-1297. [PMID: 31350856 DOI: 10.1111/anae.14778] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2019] [Indexed: 11/28/2022]
Abstract
There is an urgent need to improve access to safe surgical and anaesthetic care for children living in many low- and middle-income countries. Providing quality training for healthcare workers is a key component of achieving this. The 3-day Safer Anaesthesia from Education (SAFE)® paediatric anaesthesia course was developed to address the specific skills and knowledge required in this field. We undertook a project to expand this course across five East and Central African countries (Ethiopia, Kenya, Malawi, Uganda and Zambia) and train local faculty. This study reports the outcomes from course evaluation data, exploring the impact on knowledge, skills and behaviour change in participants. Eleven courses were conducted in a 15-month period, with 381 participants attending. Fifty-nine new faculty members were trained. Knowledge scores (0-50 scale) increased significantly from mean (SD) 37.5 (4.7) pre-course to 43.2 (3.5) post-course (p < 0.0001). Skills scores (0-10 scale) increased significantly from 5.7 (2.0) pre-course to 8.0 (1.5) post-course (p < 0.0001). One hundred and twenty-six participants in Malawi, Uganda and Zambia were visited in their workplace 3-6 months later. Knowledge and skills were maintained at follow-up, with scores of 41.5 (5.0) and 8.3 (1.4), respectively (p < 0.0001 compared with pre-course scores). Content analysis from interviews with these participants highlighted positive behaviour changes in the areas of preparation, peri-operative care, resuscitation, management of the sick child, communication and teaching. This study indicates that the SAFE paediatric anaesthesia course is an effective way to deliver training, and could be used to help strengthen emergency and essential surgical care for children as a component of universal health coverage.
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Affiliation(s)
- N Boyd
- Department of Anaesthesia, Bristol Royal Hospital for Children, Bristol, UK
| | - E Sharkey
- Department of Anaesthesia, University College Hospital, London, UK
| | - M Nabukenya
- Department of Anaesthesia, Makerere University College of Health Sciences, Kampala, Uganda
| | - J Tumukunde
- Department of Anaesthesia, Makerere University College of Health Sciences, Kampala, Uganda
| | - N Sipuka
- Department of Anaesthesia and Critical Care, University Teaching Hospital, Lusaka, Zambia
| | - M Zyambo
- Department of Anaesthesia and Critical Care, University Teaching Hospital, Lusaka, Zambia
| | - I Walker
- Department of Anaesthesia, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.,Department of Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - J Hart
- Department of Education, University of Manchester, Manchester, UK
| | - L Byrne-Davis
- Department of Education, University of Manchester, Manchester, UK
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Morris K, Wagner S, Reddy Y, Salerno C, Ravichandran A, Garcia-Cortes R, Patel A, Plotner S, Hart J, Neawedde K, Walsh M, Chaudhry S. SIPAT Scores Do Not Correlate with Outcomes in Patients with Ventricular Assist Devices. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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24
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Keyworth C, Hart J, Armitage CJ, Tully MP. What maximizes the effectiveness and implementation of technology-based interventions to support healthcare professional practice? A systematic literature review. BMC Med Inform Decis Mak 2018; 18:93. [PMID: 30404638 PMCID: PMC6223001 DOI: 10.1186/s12911-018-0661-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 09/27/2018] [Indexed: 02/02/2023] Open
Abstract
Background Technological support may be crucial in optimizing healthcare professional practice and improving patient outcomes. A focus on electronic health records has left other technological supports relatively neglected. Additionally, there has been no comparison between different types of technology-based interventions, and the importance of delivery setting on the implementation of technology-based interventions to change professional practice. Consequently, there is a need to synthesise and examine intervention characteristics using a methodology suited to identifying important features of effective interventions, and the barriers and facilitators to implementation. Three aims were addressed: to identify interventions with a technological component that are successful at changing professional practice, to determine if and how such interventions are theory-based, and to examine barriers and facilitators to successful implementation. Methods A literature review informed by realist review methods was conducted involving a systematic search of studies reporting either: (1) behavior change interventions that included technology to support professional practice change; or (2) barriers and facilitators to implementation of technological interventions. Extracted data was quantitative and qualitative, and included setting, target professionals, and use of Behaviour Change Techniques (BCTs). The primary outcome was a change in professional practice. A thematic analysis was conducted on studies reporting barriers and facilitators of implementation. Results Sixty-nine studies met the inclusion criteria; 48 (27 randomized controlled trials) reported behavior change interventions and 21 reported practicalities of implementation. The most successful technological intervention was decision support providing healthcare professionals with knowledge and/or person-specific information to assist with patient management. Successful technologies were more likely to operationalise BCTs, particularly “instruction on how to perform the behavior”. Facilitators of implementation included aligning studies with organisational initiatives, ensuring senior peer endorsement, and integration into clinical workload. Barriers included organisational challenges, and design, content and technical issues of technology-based interventions. Conclusions Technological interventions must focus on providing decision support for clinical practice using recognized behavior change techniques. Interventions must consider organizational context, clinical workload, and have clearly defined benefits for improving practice and patient outcomes. Electronic supplementary material The online version of this article (10.1186/s12911-018-0661-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C Keyworth
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK.
| | - J Hart
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK.,Division of Medical Education, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9PL, UK
| | - C J Armitage
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland 1 Building, Oxford Road, Manchester, M13 9PL, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9PL, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
| | - M P Tully
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester, M13 9PL, UK
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Abstract
Recent trends suggest that young people in Britain are refraining from engaging in formal political processes. At the same time, they are increasingly expressing support for, and turning toward, a new and diverse range of non-institutionalized forms of political action in order to actualize their interests. Using Inglehart's ideas on postmaterialism, we consider whether this apparent rejection of mainstream politics in favour of less conventional - and sometimes radical - forms of political action is changing over time in Britain, reflecting fluctuating economic conditions witnessed over the last two decades. We do this by comparing results from surveys of British 18 year olds conducted in 2002 during an era of relative global prosperity, and then in 2011 at the height of the current global crisis. The findings suggest that British young postmaterialists are considerably more likely than materialists to participate in and support both institutionalized and non-institutionalized forms of political action.
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Welsh IC, Hart J, Brown JM, Hansen K, Rocha Marques M, Aho RJ, Grishina I, Hurtado R, Herzlinger D, Ferretti E, Garcia-Garcia MJ, Selleri L. Pbx loss in cranial neural crest, unlike in epithelium, results in cleft palate only and a broader midface. J Anat 2018; 233:222-242. [PMID: 29797482 PMCID: PMC6036936 DOI: 10.1111/joa.12821] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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] [Accepted: 04/11/2018] [Indexed: 01/21/2023] Open
Abstract
Orofacial clefting represents the most common craniofacial birth defect. Cleft lip with or without cleft palate (CL/P) is genetically distinct from cleft palate only (CPO). Numerous transcription factors (TFs) regulate normal development of the midface, comprising the premaxilla, maxilla and palatine bones, through control of basic cellular behaviors. Within the Pbx family of genes encoding Three Amino-acid Loop Extension (TALE) homeodomain-containing TFs, we previously established that in the mouse, Pbx1 plays a preeminent role in midfacial morphogenesis, and Pbx2 and Pbx3 execute collaborative functions in domains of coexpression. We also reported that Pbx1 loss from cephalic epithelial domains, on a Pbx2- or Pbx3-deficient background, results in CL/P via disruption of a regulatory network that controls apoptosis at the seam of frontonasal and maxillary process fusion. Conversely, Pbx1 loss in cranial neural crest cell (CNCC)-derived mesenchyme on a Pbx2-deficient background results in CPO, a phenotype not yet characterized. In this study, we provide in-depth analysis of PBX1 and PBX2 protein localization from early stages of midfacial morphogenesis throughout development of the secondary palate. We further establish CNCC-specific roles of PBX TFs and describe the developmental abnormalities resulting from their loss in the murine embryonic secondary palate. Additionally, we compare and contrast the phenotypes arising from PBX1 loss in CNCC with those caused by its loss in the epithelium and show that CNCC-specific Pbx1 deletion affects only later secondary palate morphogenesis. Moreover, CNCC mutants exhibit perturbed rostro-caudal organization and broadening of the midfacial complex. Proliferation defects are pronounced in CNCC mutants at gestational day (E)12.5, suggesting altered proliferation of mutant palatal progenitor cells, consistent with roles of PBX factors in maintaining progenitor cell state. Although the craniofacial skeletal abnormalities in CNCC mutants do not result from overt patterning defects, osteogenesis is delayed, underscoring a critical role of PBX factors in CNCC morphogenesis and differentiation. Overall, the characterization of tissue-specific Pbx loss-of-function mouse models with orofacial clefting establishes these strains as unique tools to further dissect the complexities of this congenital craniofacial malformation. This study closely links PBX TALE homeodomain proteins to the variation in maxillary shape and size that occurs in pathological settings and during evolution of midfacial morphology.
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Affiliation(s)
- Ian C Welsh
- Program in Craniofacial Biology, Departments of Orofacial Sciences and Anatomy, Institute of Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - James Hart
- Department of Cell and Developmental Biology, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | - Joel M Brown
- Department of Molecular Biology and Genetics, Cornell University, Ithaca, NY, USA
| | - Karissa Hansen
- Program in Craniofacial Biology, Departments of Orofacial Sciences and Anatomy, Institute of Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - Marcelo Rocha Marques
- Program in Craniofacial Biology, Departments of Orofacial Sciences and Anatomy, Institute of Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - Robert J Aho
- Program in Craniofacial Biology, Departments of Orofacial Sciences and Anatomy, Institute of Human Genetics, University of California San Francisco, San Francisco, CA, USA
| | - Irina Grishina
- Department of Cell and Developmental Biology, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | - Romulo Hurtado
- Department of Physiology and Biophysics, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | - Doris Herzlinger
- Department of Physiology and Biophysics, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | - Elisabetta Ferretti
- Department of Cell and Developmental Biology, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | | | - Licia Selleri
- Program in Craniofacial Biology, Departments of Orofacial Sciences and Anatomy, Institute of Human Genetics, University of California San Francisco, San Francisco, CA, USA
- Department of Cell and Developmental Biology, Weill Cornell Medical College of Cornell University, New York, NY, USA
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Pakpoor J, Seminatore B, Graves J, Schreiner T, Waldman A, Lotze T, Belman A, Greenberg B, Weinstock-Guttman B, Aaen G, Tillema J, McDonald J, Hart J, Ness J, Harris Y, Rubin J, Candee M, Krupp L, Gorman M, Benson L, Rodriguez M, Chitnis T, Mar S, Kahn I, Rose J, Carmichael S, Roalstad S, Waltz M, Casper T, Waubant E. Dietary factors and pediatric multiple sclerosis: A case-control study. Mult Scler 2018; 24:1067-1076. [PMID: 28608728 PMCID: PMC5711616 DOI: 10.1177/1352458517713343] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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] [Indexed: 12/13/2022]
Abstract
BACKGROUND The role of diet in multiple sclerosis (MS) is largely uncharacterized, particularly as it pertains to pediatric-onset disease. OBJECTIVE To determine the association between dietary factors and MS in children. METHODS Pediatric MS patients and controls were recruited from 16 US centers (MS or clinically isolated syndrome onset before age 18, <4 years from symptom onset and at least 2 silent lesions on magnetic resonance imaging). The validated Block Kids Food Screener questionnaire was administered 2011-2016. Chi-squared test compared categorical variables, Kruskal-Wallis test compared continuous variables, and multivariable logistic regression analysis was performed. RESULTS In total, 312 cases and 456 controls were included (mean ages 15.1 and 14.4 years). In unadjusted analyses, there was no difference in intake of fats, proteins, carbohydrates, sugars, fruits, or vegetables. Dietary iron was lower in cases ( p = 0.04), and cases were more likely to consume below recommended guidelines of iron (77.2% of cases vs 62.9% of controls, p < 0.001). In multivariable analysis, iron consumption below recommended guidelines was associated with MS (odds ratio = 1.80, p < 0.01). CONCLUSION Pediatric MS cases may be less likely to consume sufficient iron compared to controls, and this warrants broader study to characterize a temporal relationship. No other significant difference in intake of most dietary factors was found.
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Affiliation(s)
- J. Pakpoor
- Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - B. Seminatore
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - J. Graves
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - T. Schreiner
- University of Colorado School of Medicine, Neurology
| | - A. Waldman
- Children’s Hospital of Philadelphia, Neurology
| | - T. Lotze
- Texas Children’s Hospital, Child Neurology
| | - A. Belman
- Stony Brook University Medical Center, Department of Neurology, Neurology
| | | | | | - G. Aaen
- Loma Linda University, Neurology
| | | | - J. McDonald
- Multiple Sclerosis Center, University of California, San Francisco, CA
| | - J. Hart
- University of California, San Francisco, Regional Pediatric MS Center, Neurology
| | - J. Ness
- University of Alabama at Birmingham, Pediatrics
| | - Y. Harris
- University of Alabama at Birmingham, Pediatrics
| | - J. Rubin
- Ann & Robert Lurie Children's Hospital of Chicago, Neurology
| | | | - L. Krupp
- Stony Brook University Medical Center, Department of Neurology, Neurology
| | - M. Gorman
- Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center
| | - L. Benson
- Massachusetts General Hospital, Partners Pediatric Multiple Sclerosis Center
| | | | | | - S. Mar
- Washington University St. Louis, Neurology
| | - I. Kahn
- Children’s National Medical Center, Washington, D.C
| | - J. Rose
- University of Utah, Neurology
| | - S.L. Carmichael
- Department of Pediatrics Division of Neonatal and Developmental Medicine, Stanford University, California, USA
| | | | | | | | - E. Waubant
- Multiple Sclerosis Center, University of California, San Francisco, CA
- University of California, San Francisco, Regional Pediatric MS Center, Neurology
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28
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Chisholm A, Ang-Chen P, Peters S, Hart J, Beenstock J. Public health practitioners’ views of the ‘Making Every Contact Count’ initiative and standards for its evaluation. J Public Health (Oxf) 2018; 41:e70-e77. [DOI: 10.1093/pubmed/fdy094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/04/2018] [Accepted: 05/10/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Chisholm
- Department of Psychological Sciences, Institute of Psychology, Health and Society University of Liverpool, L69 7ZA, UK
| | - P Ang-Chen
- Department of Psychological Sciences, Institute of Psychology, Health and Society University of Liverpool, L69 7ZA, UK
| | - S Peters
- Division of Psychology and Mental Health, University of Manchester, UK
| | - J Hart
- Division of Medical Education, University of Manchester, UK
| | - J Beenstock
- Medical Directorate, Lancashire Care NHS Foundation Trust, UK
- Faculty of Health & Medicine, Lancaster University, UK
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Abstract
Background Research findings indicate that working as a prison officer can be highly stressful, but the aspects of work that predict their mental health status are largely unknown. Aims To examine, using elements of the demands-resources model, the extent to which work pressure and several potential resources (i.e. control, support from managers and co-workers, role clarity, effective working relationships and positive change management) predict mental health in a sample of UK prison officers. Methods The Health and Safety Executive Management Standards Indicator Tool was used to measure job demands and resources. Mental health was assessed by the General Health Questionnaire-28. The effects of demands and resources on mental health were examined via linear regression analysis with GHQ score as the outcome. Results The study sample comprised 1267 prison officers (86% male). Seventy-four per cent met 'caseness' criteria for mental health problems. Job demands, poor interpersonal relationships, role ambiguity and, to a lesser extent, low job control and poor management of change were key predictors of mental health status. Conclusions The findings of this study can help occupational health practitioners and psychologists develop structured interventions to improve well-being among prison officers.
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Affiliation(s)
- G Kinman
- Department of Psychology, University of Bedfordshire, Luton LU1 3JU, UK
| | - A J Clements
- Department of Psychology, University of Bedfordshire, Luton LU1 3JU, UK
| | - J Hart
- Department of Psychology, University of Bedfordshire, Luton LU1 3JU, UK
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Lee S, Van Ha T, Yassan L, Hart J, Ostdiek A, Zhu Y, Yi S, Scott E, Ameer G. 3:45 PM Abstract No. 317 Thermoresponsive Nanonet as a carrier for transarterial immunomodulatory chemoembolization: an experimental study for rabbit liver cancer model. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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31
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Losa M, Risolino M, Li B, Hart J, Quintana L, Grishina I, Yang H, Choi IF, Lewicki P, Khan S, Aho R, Feenstra J, Vincent CT, Brown AMC, Ferretti E, Williams T, Selleri L. Face morphogenesis is promoted by Pbx-dependent EMT via regulation of Snail1 during frontonasal prominence fusion. Development 2018; 145:dev157628. [PMID: 29437830 PMCID: PMC5868993 DOI: 10.1242/dev.157628] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 07/29/2017] [Accepted: 01/24/2018] [Indexed: 12/17/2022]
Abstract
Human cleft lip with or without cleft palate (CL/P) is a common craniofacial abnormality caused by impaired fusion of the facial prominences. We have previously reported that, in the mouse embryo, epithelial apoptosis mediates fusion at the seam where the prominences coalesce. Here, we show that apoptosis alone is not sufficient to remove the epithelial layers. We observed morphological changes in the seam epithelia, intermingling of cells of epithelial descent into the mesenchyme and molecular signatures of epithelial-mesenchymal transition (EMT). Utilizing mouse lines with cephalic epithelium-specific Pbx loss exhibiting CL/P, we demonstrate that these cellular behaviors are Pbx dependent, as is the transcriptional regulation of the EMT driver Snail1. Furthermore, in the embryo, the majority of epithelial cells expressing high levels of Snail1 do not undergo apoptosis. Pbx1 loss- and gain-of-function in a tractable epithelial culture system revealed that Pbx1 is both necessary and sufficient for EMT induction. This study establishes that Pbx-dependent EMT programs mediate murine upper lip/primary palate morphogenesis and fusion via regulation of Snail1. Of note, the EMT signatures observed in the embryo are mirrored in the epithelial culture system.
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Affiliation(s)
- Marta Losa
- Program in Craniofacial Biology, Institute of Human Genetics, Eli and Edyth Broad Center of Regeneration Medicine & Stem Cell Research, Departments of Orofacial Sciences and Anatomy, University of California, San Francisco, 513 Parnassus Avenue, HSW 710, San Francisco, CA 94143, USA
| | - Maurizio Risolino
- Program in Craniofacial Biology, Institute of Human Genetics, Eli and Edyth Broad Center of Regeneration Medicine & Stem Cell Research, Departments of Orofacial Sciences and Anatomy, University of California, San Francisco, 513 Parnassus Avenue, HSW 710, San Francisco, CA 94143, USA
| | - Bingsi Li
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - James Hart
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Laura Quintana
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Irina Grishina
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Hui Yang
- Departments of Craniofacial Biology and Cell and Developmental Biology, University of Colorado at Denver, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Irene F Choi
- Departments of Craniofacial Biology and Cell and Developmental Biology, University of Colorado at Denver, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Patrick Lewicki
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Sameer Khan
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Robert Aho
- Program in Craniofacial Biology, Institute of Human Genetics, Eli and Edyth Broad Center of Regeneration Medicine & Stem Cell Research, Departments of Orofacial Sciences and Anatomy, University of California, San Francisco, 513 Parnassus Avenue, HSW 710, San Francisco, CA 94143, USA
| | - Jennifer Feenstra
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
- Karolinska Institute, Department of Physiology and Pharmacology, Nanna svartz väg 2, 17177 Stockholm, Sweden
| | - C Theresa Vincent
- Karolinska Institute, Department of Physiology and Pharmacology, Nanna svartz väg 2, 17177 Stockholm, Sweden
- Department of Physiology and Biophysics, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA
| | - Anthony M C Brown
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Elisabetta Ferretti
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
| | - Trevor Williams
- Departments of Craniofacial Biology and Cell and Developmental Biology, University of Colorado at Denver, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Licia Selleri
- Program in Craniofacial Biology, Institute of Human Genetics, Eli and Edyth Broad Center of Regeneration Medicine & Stem Cell Research, Departments of Orofacial Sciences and Anatomy, University of California, San Francisco, 513 Parnassus Avenue, HSW 710, San Francisco, CA 94143, USA
- Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, W-512, New York, NY 10065, USA
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Chang MC, Souter LH, Kamel-Reid S, Rutherford M, Bedard P, Trudeau M, Hart J, Eisen A. Clinical utility of multigene profiling assays in early-stage breast cancer. ACTA ACUST UNITED AC 2017; 24:e403-e422. [PMID: 29089811 DOI: 10.3747/co.24.3595] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND This clinical practice guideline was developed to determine the level of evidence supporting the clinical utility of commercially available multigene profiling assays and to provide guidance about whether certain breast cancer patient populations in Ontario would benefit from alternative tests in addition to Oncotype dx (Genomic Health, Redwood City, CA, U.S.A.). METHODS A systematic electronic Ovid search of the medline and embase databases sought out systematic reviews and primary literature. A systematic review and practice guideline was written by a working group and was then reviewed and approved by Cancer Care Ontario's Molecular Oncology Advisory Committee. RESULTS Twenty-four studies assessing the clinical utility of Oncotype dx, Prosigna (NanoString Technologies, Seattle, WA, U.S.A.), EndoPredict (Myriad Genetics, Salt Lake City, U.S.A.), and MammaPrint (Agendia, Irvine, CA, U.S.A.) were included in the evidence base. CONCLUSIONS The clinical utility of multigene profiling assays is currently established for an appropriate subset of patients with estrogen receptor-positive, her2-negative, node-negative breast cancer for whom a decision to give chemotherapy is difficult to make. For patients with estrogen receptor-positive tumours who receive tamoxifen alone, Oncotype dx, Prosigna, and EndoPredict validly identify a low-risk population with favourable outcomes, indicating that a low-risk assay result is actionable and the decision to withhold chemotherapy is supported. Clinical evidence indicates that a high Oncotype dx recurrence score can predict for chemotherapy benefit, but a high Prosigna or EndoPredict score, although prognostic, is not, based on clinical trial evidence, directly actionable. Prosigna and EndoPredict are statistically more likely to identify a population at risk for recurrence beyond 5 years, but that information is currently not actionable because of a lack of interventional studies.
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Affiliation(s)
- M C Chang
- Department of Laboratory Medicine and Pathobiology, Mount Sinai Hospital, Toronto
| | - L H Souter
- Juravinski Hospital, Hamilton.,Department of Oncology, McMaster University, Hamilton
| | - S Kamel-Reid
- Department of Pathology, University Health Network, Toronto
| | - M Rutherford
- Department of Molecular Diagnostics, Health Sciences North, Sudbury
| | - P Bedard
- Princess Margaret Cancer Centre, Toronto
| | | | - J Hart
- Cancer Care Ontario, Toronto, ON
| | - A Eisen
- Odette Cancer Centre, Toronto; and
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Foster C, Lee A, Hart J, Alpert L, Furtado L, Xiao S, Liauw S. Long-Term Outcomes and HPV Characteristics for an Institutional Cohort of Patients With Anal Cancer Receiving Concurrent Chemotherapy and Intensity-Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schaffert J, LoBue C, Nguyen T, Lacritz L, Womack K, Hart J, Cullum C. A-40Risk Factors for Earlier Age at Onset of Dementia with Lewy Bodies. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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Schaffert J, Lobue C, White C, Chiang H, Dieppa M, Lacritz L, Didehbani N, Hart J, Cullum C. Aging and Dementia-4Traumatic Brain Injury History is Associated with an Earlier Age of Dementia Onset in Autopsy-confirmed Alzheimer Disease. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx075.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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McIngvale E, Rufino K, Ehlers M, Hart J. An In-Depth Look at the Scrupulosity Dimension of Obsessive-Compulsive Disorder. Journal of Spirituality in Mental Health 2017. [DOI: 10.1080/19349637.2017.1288075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- E. McIngvale
- Diana R. Garland School of Social Work, Baylor University, Waco, Texas, USA
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, Houston, Texas, USA
| | - K. Rufino
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, Houston, Texas, USA
- Department of Social Sciences, University of Houston–Downtown, Houston, Texas, USA
- The Menninger Clinic, Department of Psychology, Houston, Texas, USA
| | - M. Ehlers
- Diana R. Garland School of Social Work, Baylor University, Waco, Texas, USA
| | - J. Hart
- The Menninger Clinic, Department of Psychology, Houston, Texas, USA
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Abstract
INTRODUCTION Across the US, vape shops have emerged to provide e-cigarette users access to products not usually available at gas stations or retail stores. As vape shop sales have steadily increased, so have questions about the impact of marketing and price on e-cigarette use behaviors. In this exploratory analysis, we aim to characterize spending on e-cigarettes and evaluate the association with customer perceptions and use behaviors. METHODS In a cross-sectional survey of vape shop customers (n=78), perceptions and use of e-cigarettes and tobacco products were assessed. Descriptive statistics and multivariate logistic regression were used to evaluate the association between spending and socioeconomic factors, demographics, and use behaviors. RESULTS Overall, spending amounts ranged from less than $10/month to more than $250/month, with a median around $50-75/month. Males spent more than females (p=0.003), but spending did not significantly differ by age (p=0.13). Customers who spent more than $50/month used lower levels of nicotine (mg/ml) (p=0.003) but a greater quantity of e-liquid (ml/month) (p<0.0001) compared to customers who spent under that amount. Mod use and intention to use e-cigarettes as a cessation device were significantly associated with vape shop spending in the regression model (OR= 17.5; 95% CI= (4.3, 70.2) and OR=0.22; 95% CI= (0.06, 0.75), respectively). CONCLUSIONS Spending appears to be significantly associated with e-cigarette use behaviors. Making "sense" of the potential relationships between the dollars spent at vape shops and consumer use behaviors is important as regulations for e-cigarette sales are proposed.
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Affiliation(s)
- C Sears
- University of Louisville, Kentucky, USA
| | - J Hart
- University of Louisville, Kentucky, USA
| | - K Walker
- University of Louisville, Kentucky, USA
| | - A Lee
- University of Louisville, Kentucky, USA
| | - R Keith
- University of Louisville, Kentucky, USA
| | - S Ridner
- University of Louisville, Kentucky, USA
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Wan Y, Lim S, Gao X, Danker WA, Kocharian R, Gangoli G, DeAnglis AP, Hart J. Bleeding-Related Complications and Readmission Rates Associated With Fibrin Sealant Use in Patients Undergoing Coronary Artery Bypass Graft Surgery in the United States. J Cardiothorac Vasc Anesth 2016; 31:876-882. [PMID: 28320573 DOI: 10.1053/j.jvca.2016.11.015] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To compare the clinical and economic outcomes of EVICEL (Ethicon, Inc., Somerville, NJ) and TISSEEL (Baxter Healthcare Corporation, Westlake Village, CA) use in patients undergoing primary coronary artery bypass graft (CABG) surgery. DESIGN Retrospective database analysis. SETTING Premier prospective hospital database (June 2009 through March 2014) covering approximately 20% of hospital discharges in the United States. PARTICIPANTS Adults undergoing primary CABG surgery who received either EVICEL or TISSEEL on the day of surgery (index date). INTERVENTIONS Two intervention groups were formed, EVICEL and TISSEEL. Clinical outcomes compared included postoperative bleeding complications (International Classification of Diseases, Ninth Revision, Clinical Modification code: 998.1) and number of blood transfusions received on the index day. Economic outcomes compared included hospital length of stay, hospital costs, and 30-day readmission rates. Propensity-score matching was used to control for patient and hospital characteristics. MEASUREMENTS AND MAIN RESULTS A total of 129,014 primary CABG surgery patients were identified; 986 patients (mean age: 64 years, 73% male) received EVICEL and 6,340 patients (mean age: 65 years, 75% male) received TISSEEL on the index day. After propensity-score matching, patients who received EVICEL compared with TISSEEL had significantly fewer postoperative bleeding complications (3.0% v 5.0%, p = 0.0197), index-day blood transfusion rates (19% v 34%, p<0.0001), readmission rates (18% v 32%, p<0.0001), and costs ($40,736 [standard deviation $19,465] v $46,005 [standard deviation $24,049], p<0.0001). Results from a sensitivity analysis using a generalized linear model to control for other hemostatic agent use also favored EVICEL over TISSEEL. CONCLUSION Results from this real-world retrospective database analysis showed fewer bleeding complications and lower costs in patients undergoing primary CABG surgery who received EVICEL compared with TISSEEL.
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Affiliation(s)
- Yin Wan
- Pharmerit International, Bethesda, MD
| | | | - Xin Gao
- Pharmerit International, Bethesda, MD
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Demetris AJ, Bellamy C, Hübscher SG, O'Leary J, Randhawa PS, Feng S, Neil D, Colvin RB, McCaughan G, Fung JJ, Del Bello A, Reinholt FP, Haga H, Adeyi O, Czaja AJ, Schiano T, Fiel MI, Smith ML, Sebagh M, Tanigawa RY, Yilmaz F, Alexander G, Baiocchi L, Balasubramanian M, Batal I, Bhan AK, Bucuvalas J, Cerski CTS, Charlotte F, de Vera ME, ElMonayeri M, Fontes P, Furth EE, Gouw ASH, Hafezi-Bakhtiari S, Hart J, Honsova E, Ismail W, Itoh T, Jhala NC, Khettry U, Klintmalm GB, Knechtle S, Koshiba T, Kozlowski T, Lassman CR, Lerut J, Levitsky J, Licini L, Liotta R, Mazariegos G, Minervini MI, Misdraji J, Mohanakumar T, Mölne J, Nasser I, Neuberger J, O'Neil M, Pappo O, Petrovic L, Ruiz P, Sağol Ö, Sanchez Fueyo A, Sasatomi E, Shaked A, Shiller M, Shimizu T, Sis B, Sonzogni A, Stevenson HL, Thung SN, Tisone G, Tsamandas AC, Wernerson A, Wu T, Zeevi A, Zen Y. 2016 Comprehensive Update of the Banff Working Group on Liver Allograft Pathology: Introduction of Antibody-Mediated Rejection. Am J Transplant 2016; 16:2816-2835. [PMID: 27273869 DOI: 10.1111/ajt.13909] [Citation(s) in RCA: 361] [Impact Index Per Article: 45.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 06/01/2016] [Accepted: 05/25/2016] [Indexed: 02/06/2023]
Abstract
The Banff Working Group on Liver Allograft Pathology reviewed and discussed literature evidence regarding antibody-mediated liver allograft rejection at the 11th (Paris, France, June 5-10, 2011), 12th (Comandatuba, Brazil, August 19-23, 2013), and 13th (Vancouver, British Columbia, Canada, October 5-10, 2015) meetings of the Banff Conference on Allograft Pathology. Discussion continued online. The primary goal was to introduce guidelines and consensus criteria for the diagnosis of liver allograft antibody-mediated rejection and provide a comprehensive update of all Banff Schema recommendations. Included are new recommendations for complement component 4d tissue staining and interpretation, staging liver allograft fibrosis, and findings related to immunosuppression minimization. In an effort to create a single reference document, previous unchanged criteria are also included.
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Affiliation(s)
- A J Demetris
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - C Bellamy
- The University of Edinburgh, Edinburgh, Scotland
| | | | - J O'Leary
- Baylor University Medical Center, Dallas, TX
| | - P S Randhawa
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - S Feng
- University of California San Francisco Medical Center, San Francisco, CA
| | - D Neil
- Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - R B Colvin
- Massachusetts General Hospital, Boston, MA
| | - G McCaughan
- Royal Prince Alfred Hospital, Sydney, Australia
| | | | | | - F P Reinholt
- Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - H Haga
- Kyoto University Hospital, Kyoto, Japan
| | - O Adeyi
- University Health Network and University of Toronto, Toronto, Canada
| | - A J Czaja
- Mayo Clinic College of Medicine, Rochester, MN
| | - T Schiano
- Mount Sinai Medical Center, New York, NY
| | - M I Fiel
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - M L Smith
- Mayo Clinic Health System, Scottsdale, AZ
| | - M Sebagh
- AP-HP Hôpital Paul-Brousse, Paris, France
| | - R Y Tanigawa
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - F Yilmaz
- University of Ege, Faculty of Medicine, Izmir, Turkey
| | | | - L Baiocchi
- Policlinico Universitario Tor Vergata, Rome, Italy
| | | | - I Batal
- Columbia University College of Physicians and Surgeons, New York, NY
| | - A K Bhan
- Massachusetts General Hospital, Boston, MA
| | - J Bucuvalas
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - C T S Cerski
- Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | - M ElMonayeri
- Ain Shams University, Wady El-Neel Hospital, Cairo, Egypt
| | - P Fontes
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - E E Furth
- Hospital of the University of Pennsylvania, Philadelphia, PA
| | - A S H Gouw
- University Medical Center Groningen, Groningen, the Netherlands
| | | | - J Hart
- University of Chicago Hospitals, Chicago, IL
| | - E Honsova
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - W Ismail
- Beni-Suef University, Beni-Suef, Egypt
| | - T Itoh
- Kobe University Hospital, Kobe, Japan
| | | | - U Khettry
- Lahey Hospital and Medical Center, Burlington, MA
| | | | - S Knechtle
- Duke University Health System, Durham, NC
| | - T Koshiba
- Soma Central Hospital, Soma, Fukushima, Japan
| | - T Kozlowski
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - C R Lassman
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - J Lerut
- Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - J Levitsky
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - L Licini
- Pope John XXIII Hospital, Bergamo, Italy
| | - R Liotta
- Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center, Palermo, Italy
| | - G Mazariegos
- Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA
| | - M I Minervini
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - J Misdraji
- Massachusetts General Hospital, Boston, MA
| | - T Mohanakumar
- St. Joseph's Hospital and Medical Center, Norton Thoracic Institute, Phoenix, AZ
| | - J Mölne
- University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - I Nasser
- Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA
| | - J Neuberger
- Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - M O'Neil
- University of Kansas Medical Center, Kansas City, KS
| | - O Pappo
- Hadassah Medical Center, Jerusalem, Israel
| | - L Petrovic
- University of Southern California, Los Angeles, CA
| | - P Ruiz
- University of Miami, Miami, FL
| | - Ö Sağol
- School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | | | - E Sasatomi
- University of North Carolina School of Medicine, Chapel Hill, NC
| | - A Shaked
- University of Pennsylvania Health System, Philadelphia, PA
| | - M Shiller
- Baylor University Medical Center, Dallas, TX
| | - T Shimizu
- Toda Chuo General Hospital, Saitama, Japan
| | - B Sis
- University of Alberta Hospital, Edmonton, Canada
| | - A Sonzogni
- Pope John XXIII Hospital, Bergamo, Italy
| | | | - S N Thung
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - G Tisone
- University of Rome-Tor Vergata, Rome, Italy
| | | | - A Wernerson
- Karolinska University Hospital, Stockholm, Sweden
| | - T Wu
- Tulane University School of Medicine, New Orleans, LA
| | - A Zeevi
- University of Pittsburgh, Pittsburgh, PA
| | - Y Zen
- Kobe University Hospital, Kobe, Japan
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Wilmoth K, LoBue C, Clem M, Didehbani N, Hart J, Womack K, Bell K, Batjer H, Cullum C. B-72Reliability of Self-Reported Concussion History in Older Adults with and Without Cognitive Impairment. Arch Clin Neuropsychol 2016. [DOI: 10.1093/arclin/acw043.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hart J, Woodruff M, Joy E, Dalto J, Snow G, Srivastava R, Isaacson B, Allen T. Association of Age, Systolic Blood Pressure, and Heart Rate with Adult Morbidity and Mortality after Urgent Care Visits. West J Emerg Med 2016; 17:591-9. [PMID: 27625724 PMCID: PMC5017844 DOI: 10.5811/westjem.2016.6.30353] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 03/16/2016] [Accepted: 06/30/2016] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Little data exists to help urgent care (UC) clinicians predict morbidity and mortality risk. Age, systolic blood pressure (SBP), and heart rate (HR) are easily obtainable and have been used in other settings to predict short-term risk of deterioration. We hypothesized that there is a relationship between advancing age, SBP, HR, and short-term health outcomes in the UC setting. METHODS We collected retrospective data from 28 UC clinics and 22 hospitals in the Intermountain Healthcare system between years 2008-2013. Adult patients (≥18 years) were included if they had a unique UC visit and HR or SBP data. Three endpoints following UC visit were assessed: emergency department (ED) visit within three days, hospitalization within three days, and death within seven days. We analyzed associations between age, SBP, HR and endpoints using local regression with a binomial likelihood. Five age groups were chosen from previously published national surveys. Vital sign (VS) distributions were determined for each age group, and the central tendency was compared against previously published norms (90-120mmHg for SBP and 60-100bpm for HR.). RESULTS A total of 1,720,207 encounters (714,339 unique patients) met the inclusion criteria; 51,446 encounters (2.99%) had ED visit within three days; 12,397 (0.72%) experienced hospitalization within three days; 302 (0.02%) died within seven days of UC visit. Heart rate and SBP combined with advanced age predicted the probability of ED visit (p<0.0001) and hospitalization (p<0.0001) following UC visit. Significant associations between advancing age and death (p<0.0001), and VS and death (p<0.0001) were observed. Odds ratios of risk were highest for elderly patients with lower SBP or higher HR. Observed distributions of SBP were higher than published normal ranges for all age groups. CONCLUSION Among adults seeking care in the UC, associations between HR and SBP and likelihood of ED visits and hospitalization were more pronounced with advancing age. Death following UC visit had a more limited association with advancing age or the VS evaluated. Rapidly increasing risk below SBP of 100-110 mmHg in older patients suggests that accepted normal ranges for SBP may need to be redefined for patients treated in the UC clinic.
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Affiliation(s)
- James Hart
- Intermountain Healthcare, Intermountain Instacare, Salt Lake City, Utah
| | - Michael Woodruff
- Intermountain Healthcare, Intermountain Medical Center, Department of Emergency Medicine, Salt Lake City, Utah
- Intermountain Healthcare, Quality and Patient Safety, Salt Lake City, Utah
| | - Elizabeth Joy
- Intermountain Healthcare, Community Benefit, Salt Lake City, Utah
| | - Joseph Dalto
- Intermountain Healthcare, Quality and Patient Safety, Salt Lake City, Utah
| | - Gregory Snow
- Intermountain Healthcare, Office of Research, Salt Lake City, Utah
| | - Rajendu Srivastava
- Intermountain Healthcare, Office of Research, Salt Lake City, Utah
- Intermountain Healthcare, Institute for Healthcare Leadership, Salt Lake City, Utah
- Intermountain Healthcare, Intermountain Medical Center, Department of Medicine, Salt Lake City, Utah
- University of Utah School of Medicine, Department of Pediatrics, Salt Lake City, Utah
| | - Brad Isaacson
- Intermountain Healthcare, Office of Research, Salt Lake City, Utah
| | - Todd Allen
- Intermountain Healthcare, Intermountain Medical Center, Department of Emergency Medicine, Salt Lake City, Utah
- Intermountain Healthcare, Institute for Healthcare Leadership, Salt Lake City, Utah
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Clem M, LoBue C, Wilmoth K, Hart J, Cullum M. A-73History of Depression Is Associated with Earlier Age of Diagnosis in Alzheimer's Disease. Arch Clin Neuropsychol 2016. [DOI: 10.1093/arclin/acw043.73] [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: 11/14/2022] Open
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Wilmoth K, LoBue C, Clem M, Didehbani N, Hart J, Womack K, Bell K, Batjer H, Cullum C. Traumatic Brain Injury -4Reliability of Self-Reported Concussion History in Older Adults with and Without Cognitive Impairment. Arch Clin Neuropsychol 2016. [DOI: 10.1093/arclin/acw042.16] [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
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Keskintepe L, Beyhan Z, Dayal M, Hart J, Keskintepe M. Intracytoplasmic morphologically selected sperm injection (IMSI) does not improve clinical outcomes and embryo ploidy in assisted reproductive cycles. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gondal B, Patel P, Gallan A, Hart J, Bissonnette M. Immune--Mediated Colitis with Novel Immunotherapy : PD-1 Inhibitor Associated Gastrointestinal Toxicity. Acta Gastroenterol Belg 2016; 79:379-381. [PMID: 27821037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Gnann JW, Sköldenberg B, Hart J. Gnann JW et al (Clin Infect Dis 2015; 61:683-91). Herpes Simplex Encephalitis: Lack of Clinical Benefit of Long-term Valacyclovir Therapy. Clin Infect Dis 2016; 62:530. [PMID: 26703861 DOI: 10.1093/cid/civ1011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Herb CC, Patacky T, Hart J, Saliba S, Blemker S, Hertel J. 38 Gait kinematics and kinetics in patients with and without chronic ankle instability: a statistical parametric mapping analysis. Br J Sports Med 2015. [DOI: 10.1136/bjsports-2015-095573.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wilmoth K, LoBue C, Strain J, Hart J, Cullum C, Dieppa M, Didehbani N. A-74Reliability of Self-Reported Concussion History in Retired Professional Football Players with and without Cognitive Impairment. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.74] [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: 11/14/2022] Open
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Didehbani N, Aslan S, Strain J, Hart J, Cullum M. A-75Functional and Structural Brain Changes of High School Football Athletes after One Season. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Koea J, Baldwin P, Shen J, Patel B, Batiller J, Arnaud A, Hart J, Hammond J, Fischer C, James Garden O. Erratum to: Safety and Hemostatic Effectiveness of the Fibrin Pad for Severe Soft-Tissue Bleeding During Abdominal, Retroperitoneal, Pelvic, and Thoracic (Non-cardiac) Surgery: A Randomized, Controlled, Superiority Trial. World J Surg 2015. [PMID: 26216641 DOI: 10.1007/s00268-015-3163-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jonathan Koea
- Department of Surgery, Auckland City Hospital, Grafton, New Zealand,
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