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Miller C, Ettridge K, Pettigrew S, Wittert G, Coveney J, Wakefield M, Roder D, Durkin S, Martin J, Kay E, Dono J. Warning labels for sugar-sweetened beverages and fruit juice: evaluation of 27 different labels on health effects, sugar content, energy and exercise equivalency. Public Health 2024; 230:138-148. [PMID: 38547760 DOI: 10.1016/j.puhe.2024.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/19/2023] [Accepted: 01/26/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVES Front-of-pack warning labels may reduce consumption of sugar-sweetened beverages, potentially mitigating negative health outcomes. Comparisons between different warning label types to inform future research and policy directions are lacking. This study compared 27 warning labels across six message types for their potential to reduce sugar-sweetened beverage consumption. DESIGN AND METHODS A national sample of regular soda (n = 2578) and juice (n = 1048) consumers aged 14-60 years participated in an online survey. Participants evaluated randomly allocated labels; one from each of six warning label sets (health-graphic, sugar-pictogram, sugar-text, exercise equivalents, health-text, energy information) on four measures of perceived effectiveness (PE: overall effectiveness, discourage from drinking, emotional response, persuasive potential). Participants could also provide open comments. A general linear model compared differences in mean scores across label sets for each measure of PE. RESULTS PE ratings differed significantly between label sets. Labels clearly quantifying sugar content (sugar-teaspoons) received consistently high PE ratings, whereas 'high in sugar' labels did not. Health-graphic labels were rated highly across all PE measures except persuasive potential. Exercise labels only rated highly on persuasive potential. Health-text results were mixed, and energy labels were consistently low. CONCLUSIONS Simple, factual labels were easily interpreted and perceived as most effective. Labels quantifying sugar content were consistently high performers and should be advanced into policy to help decrease overconsumption of sugar-sweetened beverages.
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Affiliation(s)
- C Miller
- School of Public Health, The University of Adelaide, Adelaide, Australia; Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia.
| | - K Ettridge
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia; School of Psychology, The University of Adelaide, Adelaide, Australia
| | - S Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - G Wittert
- Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and Faculty of Health Sciences, University of Adelaide, Adelaide, Australia
| | - J Coveney
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - M Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia; School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - D Roder
- Cancer Epidemiology and Population Health, University of South Australia, Australia
| | - S Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia; School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - J Martin
- Food for Health Alliance, Cancer Council Victoria, Melbourne, Australia
| | - E Kay
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia; College of Education Psychology and Social Work, Flinders University, Adelaide, Australia
| | - J Dono
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia; School of Psychology, The University of Adelaide, Adelaide, Australia
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Jenkins DR, Auckland C, Chadwick C, Dodgson AR, Enoch DA, Goldenberg SD, Hussain A, Martin J, Spooner E, Whalley T. A practical approach to screening for carbapenemase-producing Enterobacterales- views of a group of multidisciplinary experts from English hospitals. BMC Infect Dis 2024; 24:444. [PMID: 38671365 PMCID: PMC11046869 DOI: 10.1186/s12879-024-09307-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Carbapenemase-producing Enterobacterales (CPE) are an important public health threat, with costly operational and economic consequences for NHS Integrated Care Systems and NHS Trusts. UK Health Security Agency guidelines recommend that Trusts use locally developed risk assessments to accurately identify high-risk individuals for screening, and implement the most appropriate method of testing, but this presents many challenges. METHODS A convenience sample of cross-specialty experts from across England met to discuss the barriers and practical solutions to implementing UK Health Security Agency framework into operational and clinical workflows. The group derived responses to six key questions that are frequently asked about screening for CPE. KEY FINDINGS Four patient groups were identified for CPE screening: high-risk unplanned admissions, high-risk elective admissions, patients in high-risk units, and known positive contacts. Rapid molecular testing is a preferred screening method for some of these settings, offering faster turnaround times and more accurate results than culture-based testing. It is important to stimulate action now, as several lessons can be learnt from screening during the COVID-19 pandemic, as well as from CPE outbreaks. CONCLUSION Further decisive and instructive information is needed to establish CPE screening protocols based on local epidemiology and risk factors. Local management should continually evaluate local epidemiology, analysing data and undertaking frequent prevalence studies to understand risks, and prepare resources- such as upscaled screening- to prevent increasing prevalence, clusters or outbreaks. Rapid molecular-based methods will be a crucial part of these considerations, as they can reduce unnecessary isolation and opportunity costs.
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Affiliation(s)
- D R Jenkins
- University Hospitals of Leicester NHS Trust, Leicester, UK.
| | - C Auckland
- Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
| | - C Chadwick
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - A R Dodgson
- Manchester University NHS FT, Manchester, UK
| | - D A Enoch
- Cambridge University NHS Foundation Trust, Cambridge, UK
| | - S D Goldenberg
- Centre for Clinical Infection and Diagnostics Research, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK
| | - A Hussain
- University Hospitals Birmingham NHS Foundation Trust, West Midlands, UK
| | - J Martin
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - E Spooner
- Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - T Whalley
- Lancashire & South Cumbria ICB, Preston, UK
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Álvarez-León F, Rosado-Aguilar JA, Gamboa-Angulo M, Flota-Burgos GJ, Martin J, Reyes F. Anthelmintic activity and chemical profile of native plant extracts from the Yucatan Peninsula against Toxocara canis. Acta Trop 2024; 255:107214. [PMID: 38663537 DOI: 10.1016/j.actatropica.2024.107214] [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: 12/12/2023] [Revised: 03/26/2024] [Accepted: 04/09/2024] [Indexed: 05/12/2024]
Abstract
Toxocara canis can produce the "larva migrans" syndrome in humans, and in puppies, it can cause severe digestive disorders. The most used treatments are based on anthelmintics, although there are reports of anthelmintic (AH) resistance. The Yucatan Peninsula has a great variety of plant species whose AH properties are still unknown. The objective of this study was to evaluate the in vitro AH activity of ethanolic (EE), methanolic (ME) and aqueous (AE) extracts from the leaves of five native plant species of the Yucatan Peninsula on T. canis eggs of dogs from Merida, Yucatan. As part of a screening, the EE of the plants Alseis yucatanensis, Calea jamaicensis, Cameraria latifolia, Macrocepis diademata, and Parathesis cubana were evaluated at doses of 2400 and 3600 μg/ml. The EE and AE of A. yucatanensis and M. diademata presented high percentages (≥ 91.3%) of inhibition of the larval development of T. canis after six days of exposure. The lowest LC50 and LC99 was presented by the ME from A. yucatanensis (255.5 and 629.06 µg/ml, respectively) and the ME from M. diademata (222.4 and 636.5 µg/ml, respectively), and the AE from A. yucatanenesis (LC50 of 535.9 µg/ml). Chemical profiling of the most potent AH extract (Alseis yucatanensis) was carried out by LC-UV-HRMS. Data from the ME and AE from this plant indicated the presence of the known glucosylngoumiensine, kaempferol 3,7-diglucosyde, uvaol, linoleic acid and linolenic acid together with unknown alkaloids. The EE, ME and AE from leaves of M. diademata and A. yucatanensis could be developed as natural alternatives to control T. canis.
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Affiliation(s)
- F Álvarez-León
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Yucatan, Km 15.5, Merida- Xmatkuil highway, CP 97000 Merida, Yucatan, Mexico
| | - J A Rosado-Aguilar
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Yucatan, Km 15.5, Merida- Xmatkuil highway, CP 97000 Merida, Yucatan, Mexico.
| | - M Gamboa-Angulo
- Biotechnology Unit, Scientific Research Center of Yucatan, Street 43 number 130 × 32 and 34, CP 97205 Merida, Yucatan, Mexico
| | - G J Flota-Burgos
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Yucatan, Km 15.5, Merida- Xmatkuil highway, CP 97000 Merida, Yucatan, Mexico
| | - J Martin
- Fundación MEDINA, Avenida del conocimiento, 34 Parque Tecnológico de Ciencias de la Salud, Granada 18016, España
| | - F Reyes
- Fundación MEDINA, Avenida del conocimiento, 34 Parque Tecnológico de Ciencias de la Salud, Granada 18016, España
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Baudouin R, Hans S, Lisan Q, Morin B, Adimi Y, Martin J, Lechien JR, Tartour E, Badoual C. Prognostic Significance of the Microenvironment in Human Papillomavirus Oropharyngeal Carcinoma: A Systematic Review. Laryngoscope 2024; 134:1507-1516. [PMID: 37642393 DOI: 10.1002/lary.31010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/01/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE The immune microenvironment of HPV-associated (HPV+) oropharyngeal squamous cell carcinomas (OPSCCs) (HPV+OPSCCs) differs from that of HPV-independent oropharyngeal cancers (HPV-independent OPSCCs). The literature on the subject is very abundant, demanding an organized synthesis of this wealth of information to evaluate the hypothesis associating the favorable prognosis of HPV+OPSCC patients with a different immune microenvironment. A systematic review of the literature was conducted regarding the microenvironment of HPV+OPSCCs. DATA SOURCE MEDLINE/PubMed, Embase, and Cochrane Library databases. REVIEW METHODS A literature search was performed following PRISMA guidelines (Moher D. PLoS Med. 2009). The PEO (Population, Exposure, and Outcome) framework is detailed as follows: P: patients with oropharyngeal squamous cell carcinomas, E: human papillomavirus (HPV), and O: histological and immunological composition of the tumoral microenvironment (TME). No meta-analysis was performed. RESULTS From 1,202 studies that were screened, 58 studies were included (n = 6,474 patients; n = 3,581 (55%) HPV+OPSCCs and n = 2,861(45%) HPV-independent OPSCCs). The presence of tumor-infiltrating lymphocytes (TIL), CD3+ in 1,733 patients, CD4+ in 520 patients, and CD8+ (cytotoxic T lymphocytes (CTL)) in 3,104 patients, and high levels of PD-L1 expression in 1,222 patients is strongly correlated with an improved clinical outcome in HPV+OPSCCs. CONCLUSION This systematic review provides the most comprehensive information on the immune microenvironment of HPV+OPSCCs to date. Tumor-infiltrating lymphocytes and PD-L1 expression are associated with a favorable prognosis. B, CD8+ and resident memory cells densities are higher in HPV+OPSCCs. The importance of myeloid lineages is still a matter of debate and research. LEVEL OF EVIDENCE NA Laryngoscope, 134:1507-1516, 2024.
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Affiliation(s)
- R Baudouin
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France
- School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France
| | - S Hans
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France
- School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France
| | - Q Lisan
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France
- School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France
| | - B Morin
- Department of Pathology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
- Department of Biological Immunology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
| | - Y Adimi
- Department of Pathology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
- Department of Biological Immunology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
| | - J Martin
- Department of Pathology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
- Department of Biological Immunology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
| | - J R Lechien
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France
- School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France
| | - E Tartour
- Department of Biological Immunology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
| | - C Badoual
- Department of Pathology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
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Ademuyiwa AO, Bhangu A, Chakrabortee S, Glasbey J, Kamarajah SK, Ledda V, Li E, Morton D, Nepogodiev D, Picciochi M, Simoes JFF, Lapitan MC, Cheetham M, Forkman E, El-Boghdadly E, Ghosh D, Harrison EM, Hutchinson P, Lawani I, Aguilera ML, Martin J, Meara JG, Ntirenganya F, Medina ARDL, Tabiri S. Strategies to strengthen elective surgery systems during the SARS-CoV-2 pandemic: systematic review and framework development. Br J Surg 2024; 111:znad405. [PMID: 38300731 PMCID: PMC10833142 DOI: 10.1093/bjs/znad405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/12/2023] [Accepted: 10/27/2023] [Indexed: 02/03/2024]
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Johnson JT, Irfanoglu MO, Manninen E, Ross TJ, Yang Y, Laun FB, Martin J, Topgaard D, Benjamini D. In vivo disentanglement of diffusion frequency-dependence, tensor shape, and relaxation using multidimensional MRI. bioRxiv 2023:2023.10.10.561702. [PMID: 37987005 PMCID: PMC10659440 DOI: 10.1101/2023.10.10.561702] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Diffusion MRI with free gradient waveforms, combined with simultaneous relaxation encoding, referred to as multidimensional MRI (MD-MRI), offers microstructural specificity in complex biological tissue. This approach delivers intravoxel information about the microstructure, local chemical composition, and importantly, how these properties are coupled within heterogeneous tissue containing multiple microenvironments. Recent theoretical advances incorporated diffusion time dependency and integrated MD-MRI with concepts from oscillating gradients. This framework probes the diffusion frequency, ω , in addition to the diffusion tensor, D , and relaxation, R 1 , R 2 , correlations. A D ( ω ) - R 1 - R 2 clinical imaging protocol was then introduced, with limited brain coverage and 3 mm3 voxel size, which hinder brain segmentation and future cohort studies. In this study, we introduce an efficient, sparse in vivo MD-MRI acquisition protocol providing whole brain coverage at 2 mm3 voxel size. We demonstrate its feasibility and robustness using a well-defined phantom and repeated scans of five healthy individuals. Additionally, we test different denoising strategies to address the sparse nature of this protocol, and show that efficient MD-MRI encoding design demands a nuanced denoising approach. The MD-MRI framework provides rich information that allows resolving the diffusion frequency dependence into intravoxel components based on their D ( ω ) - R 1 - R 2 distribution, enabling the creation of microstructure-specific maps in the human brain. Our results encourage the broader adoption and use of this new imaging approach for characterizing healthy and pathological tissues.
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Affiliation(s)
- Jessica T.E. Johnson
- Multiscale Imaging and Integrative Biophysics Unit, National Institute on Aging, NIH, Baltimore, MD, USA
| | - M. Okan Irfanoglu
- Quantitative Medical Imaging Section, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD, USA
| | - Eppu Manninen
- Multiscale Imaging and Integrative Biophysics Unit, National Institute on Aging, NIH, Baltimore, MD, USA
| | - Thomas J. Ross
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Frederik B. Laun
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Jan Martin
- Department of Chemistry, Lund University, Lund, Sweden
| | | | - Dan Benjamini
- Multiscale Imaging and Integrative Biophysics Unit, National Institute on Aging, NIH, Baltimore, MD, USA
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Harz D, Catalán Gamonal B, Matute García S, Jeremias F, Martin J, Fresno MC. Prevalence and severity of molar-incisor hypomineralization, is there an association with socioeconomic status? A cross-sectional study in Chilean schoolchildren. Eur Arch Paediatr Dent 2023; 24:577-584. [PMID: 37432610 DOI: 10.1007/s40368-023-00820-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 06/24/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE Data about molar-incisor hypomineralization (MIH) prevalence and its severity remains limited for some Latin American countries. Furthermore, its association with socioeconomic status (SES) is still unclear. Thus, this study aims to determine the prevalence and severity of MIH in Santiago, Chile and explore its association with SES. METHODS A cross-sectional study with schoolchildren between 6 and 12 years was conducted. Children were evaluated using the European Academy of Paediatric Dentistry to diagnose MIH, and the Mathu-Muju and Wright criteria to determine its severity. RESULTS A total of 1,270 children were included. The MIH prevalence was 12.8% without association with gender (p = 0.609). Prevalence was higher among schoolchildren ages 8 and 9 (p = 0.002), and in lower SES (p = 0.007). MIH mild cases were the most prevalent (63%), and severity was not related to gender (p = 0.656), age (p = 0.060), or SES (p = 0.174). CONCLUSIONS The prevalence of MIH in the province of Santiago, Chile is 12.8% and was found to have a higher incidence in 8-9-year-old students and among those categorized by low SES. Furthermore, MIH prevalence was associated with low SES. IMPLICATIONS Public health policies to address MIH in Chile should start with schoolchildren aged 8 to 9, and with low SES.
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Affiliation(s)
- D Harz
- Dental School, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | - F Jeremias
- Graduate Program in Dental Science Araraquara School of Dentistry, UNESP Univ Estadual Paulista São Paulo, Araraquara, São Paulo, Brazil
| | - J Martin
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Olivos 943, Independencia, Santiago, Chile
| | - M C Fresno
- Faculty of Dentistry, University of Chile, Santiago, Chile.
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Rosenthal S, Mazzio E, Wellman Gilbert H, Guistolisi S, Marks J, Jewell J, Straley M, Silveira L, Messer R, Martin J, Mistry R, Yonker ME, Press CA. Efficacy of IV Valproic Acid and Oral Valproic Acid Tapers for the Treatment of Pediatric Headaches in the Emergency Department. Neurol Clin Pract 2023; 13:e200170. [PMID: 37292258 PMCID: PMC10245683 DOI: 10.1212/cpj.0000000000200170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/28/2023] [Indexed: 06/10/2023]
Abstract
Background and Objectives Pediatric headaches, including migraine, are a common reason for emergency department (ED) presentation. IV valproic acid (VPA) followed by oral VPA tapers are often used to abort pediatric headache and reduce recurrence, though limited data exist regarding this approach. This study evaluated the effectiveness of IV VPA and oral VPA tapers for the treatment of acute pediatric headaches in the ED in preventing return encounters. Methods This is a retrospective cohort study of patients aged 5-21 years presenting to a tertiary-care pediatric ED from 2010 to 2016 who received IV VPA for headache or migraine. Primary outcomes were ED disposition, percent pain reduction (initial vs 2-hour patient-reported pain score [10-point scale]), and return for acute headache treatment within 1 month. Results A total of 486 ED encounters were included with a median patient age of 15 years; most of them were females (76%, 369/486). Of available pain scores within 2 hours of IV VPA administration, 41% (173/425) had ≥50% pain reduction. Fifty-two percent (254/486) were discharged without additional treatment, 14% (69/486) were discharged after additional treatment, and 33% (163/486) were admitted to the hospital. Initial pain score, number of preceding home treatments, and number of preceding ED treatments were not associated with ED disposition. Oral VPA tapers were prescribed in 39% (94/253) of encounters when the patient was discharged after IV VPA. Oral VPA tapers produced a transient decrease in recurrence at 72 hours, which was no longer present at 1 week nor 1 month. There was no difference in the time to recurrence or total number of return visits within 1 month. Discussion IV VPA was efficacious in treating pediatric headaches evaluated in the ED, with nearly two-thirds of patients discharged home after administration. Oral VPA tapers did not reduce total headache recurrence nor time to recurrence. Given the limited benefit of oral VPA tapers, this practice should be re-examined. Classification of Evidence This study provides Class IV evidence that for children with headache seen in the ED, IV VPA reduces head pain and Class III evidence that following this with an oral VPA taper is of no benefit.
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Affiliation(s)
- Scott Rosenthal
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Emma Mazzio
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Hannah Wellman Gilbert
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Sarah Guistolisi
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Jill Marks
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Jerry Jewell
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Megan Straley
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Lori Silveira
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Ricka Messer
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Jan Martin
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Rakesh Mistry
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Marcy E Yonker
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
| | - Craig A Press
- Department of Pediatrics Section of Neurology (SR, EM, HWG, SG, J. Marks, JJ, R. Messer, J. Martin, MEY), Department of Pediatrics (MS, LS), and Department of Pediatrics Section of Emergency Medicine (R. Mistry), University of Colorado Anschutz School of Medicine; and Department of Pediatrics and Neurology (CAP), University of Pennsylvania Perelman School of Medicine
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Cullington HE, Jiang D, Broomfield SJ, Chung M, Craddock LC, Driver S, Edwards D, Gallacher JM, Jones LL, Koleva T, Martin J, Meakin H, Nash R, Rocca C, Schramm DR, Willmott NS, Vanat ZH. Cochlear implant services for children, young people and adults. Quality standard. Cochlear Implants Int 2023:1-13. [PMID: 37114384 DOI: 10.1080/14670100.2023.2197344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- H E Cullington
- University of Southampton Auditory Implant Service, SO17 1BJ, UK
| | - D Jiang
- Hearing Implant Centre, Guy's and St. Thomas NHS Foundation Trust, London, UK
- Centre for Craniofacial and Regenerative Biology, King's College London, London, UK
| | - S J Broomfield
- West of England Hearing Implant Programme, University Hospitals Bristol and Weston NHS Foundation Trust, UK
| | - M Chung
- Auditory Implant Department, Royal National ENT & Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, UK
| | - L C Craddock
- Midlands Hearing Implant Programme (Adult service), University Hospitals Birmingham NHS Foundation Trust, UK
| | - S Driver
- Hearing Implant Centre, Guy's and St. Thomas NHS Foundation Trust, London, UK
| | - D Edwards
- Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Trust, UK
| | - J M Gallacher
- Scottish Cochlear Implant Program, Crosshouse Hospital, Kilmarnock, UK
| | - L Ll Jones
- North Wales Auditory Implant Service, Betsi Cadwaladr University Health Board, Bodelwyddan, UK
| | - T Koleva
- Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Trust, UK
| | - J Martin
- Cochlear Implant Programme, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - H Meakin
- Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Trust, UK
| | - R Nash
- Cochlear Implant Programme, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - C Rocca
- Hearing Implant Centre, Guy's and St. Thomas NHS Foundation Trust, London, UK
| | - D R Schramm
- University of Ottawa Auditory Implant Centre, Ottawa, Canada
| | - N S Willmott
- Auditory Implant Centre, Belfast Health and Social Care Trust, UK
| | - Z H Vanat
- Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Trust, UK
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Hulo S, Jacques J, Sihrener F, Wasielewski E, Jourdan L, Poslednik G, Poulet C, Turlotte A, Gey T, Douadi Y, Thiberville L, Dewolf M, Lecerf JM, Estevié I, Ricard V, Martin J, Romain AC, Locoge N, Matran R, Scherpereel A. 160P Non-invasive analysis of VOCs in exhaled air can distinguish healthy controls from lung cancer patients and may improve the effectiveness of lung cancer screening. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00414-8] [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: 04/03/2023]
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11
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Barral E, Martin J. Abstract No. 70 Safety and Clinical Outcomes of Aspiration Thrombectomy in Patients with Massive PE: A Single-Center Retrospective Review. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.115] [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: 02/27/2023] Open
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12
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Ajrawat H, Buchholz J, Triana B, Pabon-Ramos W, Martin J, Kim C, Cline B, Ronald J. Abstract No. 583 Financial Analysis of Intravascular Ultrasound-Guided Transvenous Biopsy in an Outpatient Medicare Population. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.441] [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: 02/27/2023] Open
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13
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Gallo C, Cline B, Befera N, Ronald J, Martin J, Sag A, Pabon-Ramos W, Suhocki P, Smith T, Kim C. Abstract No. 97 Safety and Patency of Dedicated Venous Stents for Treatment of Thoracic Central Vein Stenosis Compared with Non-Venous Stents. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.145] [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: 02/27/2023] Open
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14
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Sailer S, Mundszinger M, Martin J, Mancini M, Wohlfahrt-Mehrens M, Kaiser U. Quantitative FIB/SEM tomogram analysis of closed and open porosity of spheroidized graphite anode materials for LiBs applications. Micron 2023; 166:103398. [PMID: 36682294 DOI: 10.1016/j.micron.2022.103398] [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: 10/24/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
The electrochemical behaviour of rounded graphite particles as anode material in a lithium-ion battery strongly depends on the particle properties. The spheroidization process directly affects these properties, including the open porosity that determines the extent of direct contact between liquid electrolyte and carbon surface. Therefore, the quantification of the proportion between open and closed pores is of great interest. Here, we quantify the open and closed porosity of spheroidized porous graphite particles from FIB-SEM tomograms. Quantification is achieved based on two developments: (1) a new sample preparation strategy and (2) a newly developed image evaluation scheme based on neural networks. The sample preparation strategy involves embedding of many graphite powder particles in indium enabling the investigation of several graphite particles in one FIB/SEM tomogram with high stability and with high contrast between the conductive embedding material and porous graphite. A quantitative evaluation of closed and open porosity is achieved by machine learning in form of convolutional neural networks. The convolutional neural network is used to detect the bulk graphite and by further morphological operations, closed and open pores are identified. An error is determined by comparing automatically created quantifications with manual reference values. Our porosity data for two differently spheroidized graphite samples agree qualitatively well with corresponding results from nitrogen physisorption measurements. This approach may allow quantitative data evaluation from porous powders and support understanding of the correlation to the electrochemical behaviour in the lithium-ion battery.
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Affiliation(s)
- Stefan Sailer
- Central Facility for Electron Microscopy, Electron Microscopy Group of Materials Science, Albert-Einstein-Allee 11, Universität Ulm, 89081 Ulm, Germany.
| | - Manuel Mundszinger
- Central Facility for Electron Microscopy, Electron Microscopy Group of Materials Science, Albert-Einstein-Allee 11, Universität Ulm, 89081 Ulm, Germany
| | - Jan Martin
- Center for Solar Energy and Hydrogen Research Baden-Württemberg (ZSW), Helmholtzstraße 8, 89081 Ulm, Germany
| | - Marilena Mancini
- Center for Solar Energy and Hydrogen Research Baden-Württemberg (ZSW), Helmholtzstraße 8, 89081 Ulm, Germany
| | - Margret Wohlfahrt-Mehrens
- Center for Solar Energy and Hydrogen Research Baden-Württemberg (ZSW), Helmholtzstraße 8, 89081 Ulm, Germany
| | - Ute Kaiser
- Central Facility for Electron Microscopy, Electron Microscopy Group of Materials Science, Albert-Einstein-Allee 11, Universität Ulm, 89081 Ulm, Germany.
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15
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Barral E, Martin J. Abstract No. 501 Safety and Clinical Outcomes of Aspiration Thrombectomy in Patients with Intermediate-High Risk PE: A Single-Center Retrospective Review. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.359] [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: 02/27/2023] Open
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16
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Buchholz J, Ajrawat H, Cline B, Martin J, Kim C, Ronald J. Abstract No. 223 Intravascular Ultrasound-Guided Transvenous Biopsy of Retroperitoneal Lymph Nodes: Efficacy and Safety Compared with Percutaneous CT-Guided Biopsy. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.284] [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: 02/27/2023] Open
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17
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Kasivisvanathan V, Murphy D, Link E, Lawrentschuk N, O’Brien J, Buteau J, Roberts M, Francis R, Tang C, Vela I, Thomas P, Rutherford N, Martin J, Frydenberg M, Shakher R, Wong LM, Taubman K, Lee S, Hsiao E, Nottage M, Kirkwood I, Iravani A, Williams S, Hofman M. Baseline PSMA PET-CT is prognostic for treatment failure in men with intermediate-to-high risk prostate cancer: 54 months follow-up of the proPSMA randomised trial. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01275-7] [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: 02/12/2023]
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18
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Rice W, Martin J, Hodgkin M, Carter J, Barrasa A, Sweeting K, Johnson R, Best E, Nahl J, Denton M, Hughes GJ. A protracted outbreak of difficult-to-treat resistant Pseudomonas aeruginosa in a haematology unit: a matched case-control study demonstrating increased risk with use of fluoroquinolone. J Hosp Infect 2023; 132:52-61. [PMID: 36563938 DOI: 10.1016/j.jhin.2022.11.013] [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: 09/09/2022] [Revised: 11/11/2022] [Accepted: 11/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Between September 2016 and November 2020, 17 cases of difficult-to-treat resistant Pseudomonas aeruginosa (DTR-PA) were reported in haematology patients at a tertiary referral hospital in the North of England. AIM A retrospective case-control study was conducted to investigate the association between DTR-PA infection and clinical interventions, patient movement, antimicrobial use and comorbidities. METHODS Cases were patients colonized or infected with the outbreak strain of DTR-PA who had been admitted to hospital prior to their positive specimen. Exposures were extracted from medical records, and cases were compared with controls using conditional logistic regression. Environmental and microbiological investigations were also conducted. FINDINGS Seventeen cases and 51 controls were included. The final model included age [>65 years, adjusted OR (aOR) 6.85, P=0.232], sex (aOR 0.60, P=0.688), admission under the transplant team (aOR 14.27, P=0.43) and use of ciprofloxacin (aOR 102.13, P=0.030). Investigations did not indicate case-to-case transmission or a point source, although a common environmental source was highly likely. CONCLUSION This study found that the use of fluoroquinolones is an independent risk factor for DTR-PA in haematology patients. Antimicrobial stewardship and review of fluoroquinolone prophylaxis should be considered as part of PA outbreak investigations in addition to standard infection control interventions.
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Affiliation(s)
- W Rice
- Field Epidemiology Training Programme, United Kingdom Heath Security Agency, London, UK; Field Service, United Kingdom Health Security Agency, Leeds, UK
| | - J Martin
- Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | - M Hodgkin
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J Carter
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Barrasa
- Field Epidemiology Training Programme, United Kingdom Heath Security Agency, London, UK
| | - K Sweeting
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - R Johnson
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - E Best
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J Nahl
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - M Denton
- Field Service, United Kingdom Health Security Agency, Leeds, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - G J Hughes
- Field Service, United Kingdom Health Security Agency, Leeds, UK.
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19
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Badoual C, Adimi Y, Martin J, Morin B, Baudouin R. Les cancers des voies aérodigestives supérieures induits par une infection par Papillomavirus humain : spécificités épidémiologiques, diagnostiques, pronostiques et thérapeutiques. Bulletin de l'Académie Nationale de Médecine 2023. [DOI: 10.1016/j.banm.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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20
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Ward DD, Martin J, Gordon EH. Is There a Sex-Frailty Paradox in Dementia? J Nutr Health Aging 2023; 27:1281-1283. [PMID: 38151880 DOI: 10.1007/s12603-023-2040-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 12/29/2023]
Affiliation(s)
- D D Ward
- David D. Ward, Centre for Health Services Research, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4121, Australia.
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21
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Fuest KE, Lorenz M, Grunow JJ, Weiss B, Mörgeli R, Finkenzeller S, Bogdanski R, Heim M, Kapfer B, Kriescher S, Lingg C, Martin J, Ulm B, Jungwirth B, Blobner M, Schaller SJ. Corrigendum: The functional trajectory in frail compared with non-frail critically ill patients during the hospital stay. Front Med (Lausanne) 2023; 10:1163166. [PMID: 37122324 PMCID: PMC10142559 DOI: 10.3389/fmed.2023.1163166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/24/2023] [Indexed: 05/02/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fmed.2021.748812.].
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Affiliation(s)
- K. E. Fuest
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Marco Lorenz
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Julius J. Grunow
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Björn Weiss
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rudolf Mörgeli
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sebastian Finkenzeller
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Ralph Bogdanski
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Markus Heim
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Barbara Kapfer
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Silja Kriescher
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Charlotte Lingg
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan Martin
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Bernhard Ulm
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Bettina Jungwirth
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Anesthesiology, Universitätsklinikum Ulm, Ulm, Germany
| | - Manfred Blobner
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Anesthesiology, Universitätsklinikum Ulm, Ulm, Germany
| | - Stefan J. Schaller
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- *Correspondence: Stefan J. Schaller
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22
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Takousis P, Devonshire AS, Redshaw N, von Baumgarten L, Whale AS, Jones GM, Fernandez-Gonzalez A, Martin J, Foy CA, Alexopoulos P, Huggett JF, Perneczky R. A standardised methodology for the extraction and quantification of cell-free DNA in cerebrospinal fluid and application to evaluation of Alzheimer's disease and brain cancers. N Biotechnol 2022; 72:97-106. [PMID: 36202346 DOI: 10.1016/j.nbt.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 09/23/2022] [Accepted: 10/01/2022] [Indexed: 11/27/2022]
Abstract
Cerebrospinal fluid (CSF) is a source of diagnostic biomarkers for a range of neurological conditions. Cell-free DNA (cfDNA) is detected in CSF and differences in the concentration of cell-free mitochondrial DNA have been reported in studies of neurodegenerative disorders including Alzheimer's disease (AD). However, the influence of pre-analytical steps has not been investigated for cfDNA in CSF and there is no standardised approach for quantification of total cfDNA (copies of nuclear genome or mitochondria-derived gene targets). In this study, the suitability of four extraction methods was evaluated: QIAamp Circulating Nucleic Acid (Qiagen), Quick-cfDNA Serum & Plasma (Zymo), NucleoSnap® DNA Plasma (Macherey-Nagel) and Plasma/Serum Circulating DNA Purification Mini (Norgen) kits, for cfDNA extraction from CSF of controls and AD dementia patients, utilising a spike-in control for extraction efficiency and fragment size. One of the optimal extraction methods was applied to a comparison of cfDNA concentrations in CSF from control subjects, AD dementia and primary and secondary brain tumour patients. Extraction efficiency based on spike-in recovery was similar in all three groups whilst both endogenous mitochondrial and nucleus-derived cfDNA was significantly higher in CSF from cancer patients compared to control and AD groups, which typically contained < 100 genome copies/mL. This study shows that it is feasible to measure low concentration nuclear and mitochondrial gene targets in CSF and that normalisation of extraction yield can help control pre-analytical variability influencing biomarker measurements.
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Affiliation(s)
- Petros Takousis
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
| | - Alison S Devonshire
- Molecular and Cell Biology Team, National Measurement Laboratory, LGC, Teddington, Middlesex, UK.
| | - Nicholas Redshaw
- Molecular and Cell Biology Team, National Measurement Laboratory, LGC, Teddington, Middlesex, UK
| | - Louisa von Baumgarten
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany; Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
| | - Alexandra S Whale
- Molecular and Cell Biology Team, National Measurement Laboratory, LGC, Teddington, Middlesex, UK
| | - Gerwyn M Jones
- Molecular and Cell Biology Team, National Measurement Laboratory, LGC, Teddington, Middlesex, UK
| | - Ana Fernandez-Gonzalez
- Molecular and Cell Biology Team, National Measurement Laboratory, LGC, Teddington, Middlesex, UK
| | - Jan Martin
- Department of Anaesthesiology and Intensive Care Medicine, Technical University Munich, Munich, Germany
| | - Carole A Foy
- Molecular and Cell Biology Team, National Measurement Laboratory, LGC, Teddington, Middlesex, UK
| | - Panagiotis Alexopoulos
- Department of Psychiatry, University of Patras, Rion Patras, Greece; Department of Psychiatry and Psychotherapy, Technical University Munich, Munich, Germany
| | - Jim F Huggett
- Molecular and Cell Biology Team, National Measurement Laboratory, LGC, Teddington, Middlesex, UK; School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Robert Perneczky
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
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23
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Podtschaske AH, Martin J, Ulm B, Jungwirth B, Kagerbauer SM. Sex-specific issues of central and peripheral arginine-vasopressin concentrations in neurocritical care patients. BMC Neurosci 2022; 23:69. [PMID: 36434506 PMCID: PMC9700878 DOI: 10.1186/s12868-022-00757-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/17/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Arginine-Vasopressin (AVP) is a nonapeptide that exerts multiple functions within the central nervous system and in the blood circulation that might contribute to outcome in critically ill patients. Sex differences have been found for mental and physical effects of AVP. For example, stress response and response due to hemorrhage differ between males and females, at least in animal studies. Data on humans -especially on AVP within the central nervous system (CNS)-are scarce, as cerebrospinal fluid (CSF) which is said to represent central AVP activity, has to be collected by means of invasive procedures. Here we present data on 30 neurocritical care patients where we simultaneously collected blood, CSF and saliva to analyze concentrations in the central and peripheral compartments. PATIENTS AND METHODS 30 neurocritical care patients were included (13 male, 13 postmenopausal female, 4 premenopausal female) with a median age of 60 years. CSF, plasma and saliva were obtained simultaneously once in each patient and analyzed for AVP concentrations. Correlations between the central compartment represented by CSF, and the peripheral compartment represented by plasma and saliva, were identified. Relations between AVP concentrations and serum sodium and hematocrit were also determined. RESULTS In the whole patient collective, only very weak to weak correlations could be detected between AVP plasma/CSF, plasma/saliva and CSF/saliva as well as between AVP concentrations in each of the compartments and serum sodium/hematocrit. Regarding the subgroup of postmenopausal females, a significant moderate correlation could be detected for AVP in plasma and CSF and AVP CSF and serum sodium. CONCLUSION Absolute concentrations of AVP in central and peripheral compartments did not show sex differences. However, correlations between AVP plasma and CSF and AVP CSF and serum sodium in postmenopausal females indicate differences in AVP secretion and AVP response to triggers that deserve further examination.
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Affiliation(s)
- A. H. Podtschaske
- grid.6936.a0000000123222966Department of Anaesthesiology and Intensive Care Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - J. Martin
- grid.6936.a0000000123222966Department of Anaesthesiology and Intensive Care Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - B. Ulm
- grid.6936.a0000000123222966Department of Anaesthesiology and Intensive Care Medicine, School of Medicine, Technical University of Munich, Munich, Germany ,grid.6582.90000 0004 1936 9748Department of Anaesthesiology and Intensive Care Medicine, School of Medicine, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - B. Jungwirth
- grid.6582.90000 0004 1936 9748Department of Anaesthesiology and Intensive Care Medicine, School of Medicine, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - S. M. Kagerbauer
- grid.6936.a0000000123222966Department of Anaesthesiology and Intensive Care Medicine, School of Medicine, Technical University of Munich, Munich, Germany ,grid.6582.90000 0004 1936 9748Department of Anaesthesiology and Intensive Care Medicine, School of Medicine, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
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24
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Martin J, Elster C. Aleatoric Uncertainty for Errors-in-Variables Models in Deep Regression. Neural Process Lett 2022. [DOI: 10.1007/s11063-022-11066-3] [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: 11/06/2022]
Abstract
AbstractA Bayesian treatment of deep learning allows for the computation of uncertainties associated with the predictions of deep neural networks. We show how the concept of Errors-in-Variables can be used in Bayesian deep regression to also account for the uncertainty associated with the input of the employed neural network. The presented approach thereby exploits a relevant, but generally overlooked, source of uncertainty and yields a decomposition of the predictive uncertainty into an aleatoric and epistemic part that is more complete and, in many cases, more consistent from a statistical perspective. We discuss the approach along various simulated and real examples and observe that using an Errors-in-Variables model leads to an increase in the uncertainty while preserving the prediction performance of models without Errors-in-Variables. For examples with known regression function we observe that this ground truth is substantially better covered by the Errors-in-Variables model, indicating that the presented approach leads to a more reliable uncertainty estimation.
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25
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Sandler H, Shore N, Dearnaley D, Freedland S, Smith M, Rosales R, Brookman-May S, Dicker A, McKenzie M, Bossi A, Widmark A, Wiegel T, Martin J, Miladinovic B, Lefresne F, Ciprotti M, McCarthy S, Mundle S, Tombal B, Feng F. Challenges and Solutions during the COVID Pandemic for Patient Retention and Physician Engagement in the Phase 3 ATLAS Study of Apalutamide Added to Androgen Deprivation Therapy (ADT) in High-Risk Localized or Locally Advanced Prostate Cancer (HRLPC). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1217] [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: 10/31/2022]
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Martin J, Perraton L, Gupta A, Garofolini A, Malliaras P. The use of physical function capacity measures in the management of lower limb tendinopathy: A scoping review of expert recommendations. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gonzalez A, Anchor T, Hevia A, Posadas A, Wade J, Ansag R, Benko K, Bottoni B, Kazakova V, Alvarez M, Wong J, Martin J, Knauf R, Jantke K, Wu A. The evolution of the fAIble system to automatically compose and narrate stories for children. J EXP THEOR ARTIF IN 2022. [DOI: 10.1080/0952813x.2022.2104382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- A.J. Gonzalez
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
| | - T. Anchor
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
| | - A. Hevia
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
| | - A. Posadas
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
| | - J. Wade
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
| | - R.A. Ansag
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
| | - K. Benko
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
| | - B. Bottoni
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
| | - V. Kazakova
- Computer Science Dept, Knox College, Galesburg, IL, USA
| | - M.J. Alvarez
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
| | - J.M Wong
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
| | - J. Martin
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
| | - R. Knauf
- Computer Science Faculty, Technical University Ilmenau, Ilmenau, Germany
| | | | - A.S. Wu
- Intelligent Systems Laboratory, Computer Science Department, University of Central Florida, Orlando, FL, USA
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Otten LS, Heine RT, Chiong J, Martin J, van den Heuvel M, Piet B, Burger D. EP08.02-090 Sotorasib Drug-Drug Interactions: Essential Guidance Requested by Physicians Worldwide. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.773] [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: 10/14/2022]
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Giraud E, Chiong J, Martin J, Burger D, Erp N, Smolders E. 1595P QTc-prolonging drug-drug interactions related to CDK4/6 inhibitors. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Amanova N, Martin J, Elster C. Explainability for deep learning in mammography image quality assessment. Mach Learn : Sci Technol 2022. [DOI: 10.1088/2632-2153/ac7a03] [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
The application of deep learning has recently been proposed for the assessment of image quality in mammography. It was demonstrated in a proof-of-principle study that the proposed approach can be more efficient than currently applied automated conventional methods. However, in contrast to conventional methods, the deep learning approach has a black-box nature and, before it can be recommended for the routine use, it must be understood more thoroughly. For this purpose, we propose and apply a new explainability method: the oriented, modified integrated gradients (OMIG) method. The design of this method is inspired by the integrated gradientsmethod but adapted considerably to the use case at hand. To further enhance this method, an upsampling technique is developed that produces high-resolution explainability maps for the downsampled data used by the deep learning approach. Comparison with established explainability methods demonstrates that the proposed approach yields substantially more expressive and informative results for our specific use case. Application of the proposed explainability approach generally confirms the validity of the considered deep learning-based mammography image quality assessment (IQA) method. Specifically, it is demonstrated that the predicted image quality is based on a meaningful mapping that makes successful use of certain geometric structures of the images. In addition, the novel explainability method helps us to identify the parts of the employed phantom that have the largest impact on the predicted image quality, and to shed some light on cases in which the trained neural networks fail to work as expected. While tailored to assess a specific approach from deep learning for mammography IQA, the proposed explainability method could also become relevant in other, similar deep learning applications based on high-dimensional images.
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, 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Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Miller C, Wright K, Dono J, Pettigrew S, Wakefield M, Coveney J, Wittert G, Roder D, Durkin S, Martin J, Ettridge K. "You can't just eat 16 teaspoons of sugar so why would you drink 16 teaspoons' worth of sugar?": a qualitative study of young adults' reactions to sugary drink warning labels. BMC Public Health 2022; 22:1241. [PMID: 35733102 PMCID: PMC9219237 DOI: 10.1186/s12889-022-13648-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Several jurisdictions have introduced nutrient warning front of pack (FoP) labels in an effort to curb consumption of ultra-processed foods and beverages high in free sugars (sugars added to foods and beverages, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates). This study aimed to explore consumer understanding and perceptions of FoP warning labels that convey different nutritional and health information messages regarding the consumption of sugary drinks. Methods Sixteen focus groups were held with 4–8 young adults per group (aged 18–24; n = 105 participants in total) stratified by education level, location (rural centres, large cities) and gender (males, females) to ensure diversity. Labels shown to participants during group discussions included text warning labels of health effects, exercise equivalents, calorie/kilojoule information and sugar content as a “high in” label and as teaspoons (text and pictograms). Thematic analysis was undertaken. Results Four themes were identified related to participants’ perceived effectiveness of labels: the extent to which labels were perceived to be useful, relevant and credible; the extent to which a label elicited shock or disgust (perceived aversiveness); the extent to which the label message was resistant to self-exemption; and participants’ perceived potential of the label to reduce purchasing and consumption behaviour. Across all four themes, labels communicating the number of teaspoons of sugar in a sugary drink (whether by text or pictogram) were perceived as the most impactful, resistant to self-exemption and to have the greatest potential to reduce consumption, with enhanced reactions to the pictogram label. Labels depicting health effects, exercise equivalents, calorie/kilojoule information or a general ‘high in sugar’ warning were perceived by consumers to be less effective in one or more themes. Conclusions Labels conveying the amount of sugar in a beverage in teaspoons were perceived as highly factual, relatable and interpretable, and as having the greatest potential to impact consumption attitudes and intentions. Further quantitative studies are required to compare the potential effectiveness of the teaspoons of sugar labels in reducing purchasing and consumption behaviour than other alternative warning labels, such as health effects or “high in” sugar labels. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13648-1.
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Affiliation(s)
- C Miller
- The University of Adelaide's School of Public Health, Adelaide, Australia. .,Health Policy Centre, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia.
| | - K Wright
- Health Policy Centre, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia.,The University of Adelaide's School of Psychology, Adelaide, Australia
| | - J Dono
- Health Policy Centre, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia.,The University of Adelaide's School of Psychology, Adelaide, Australia
| | - S Pettigrew
- Food Policy, The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - M Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia.,School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - J Coveney
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - G Wittert
- Freemasons Foundation Centre for Men's Health, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia.,Centre for Nutrition and GI Diseases, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - D Roder
- Cancer Epidemiology and Population Health, University of South Australia, Adelaide, Australia
| | - S Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia.,School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - J Martin
- Obesity Policy Coalition and Alcohol and Obesity Policy, Cancer Council Victoria, Melbourne, Australia
| | - K Ettridge
- Health Policy Centre, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000, Australia.,The University of Adelaide's School of Psychology, Adelaide, Australia
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Mazzio E, Mistry RD, Rosenthal S, Ser E, Jewell J, Martin J, Messer R, Straley M, Leonard J, Press CA. Neuroimaging for Pediatric Non-First-Time Seizures in the Emergency Department. Neurol Clin Pract 2022; 12:e7-e13. [DOI: 10.1212/cpj.0000000000001165] [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] [Received: 12/08/2021] [Accepted: 02/28/2022] [Indexed: 11/15/2022]
Abstract
AbstractBackground& Objectives: Neuroimaging is often part of the workup for a pediatric patient presenting with a seizure to an emergency department (ED). We aim to evaluate when neuroimaging in the emergency department for children with a non-first-time seizure, or non-index seizure (NIS), is associated with an acute change in management (ACM).Methods:Retrospective cohort study of all pediatric patients presenting to an ED from 2008-2018 with a NIS, excluding repeat febrile seizures, who underwent neuroimaging. Clinical characteristics were extracted from the electronic medical record. The primary outcome was new abnormal neuroimaging resulting in an ACM, defined as admission to the hospital, neurosurgical intervention, or new non-seizure medication administration.Results:We identified 492 encounters. Neuroimaging revealed new findings in 21% of encounters and led to ACMs in 5% of encounters. ACMs included admissions, neurosurgical interventions, and non-seizure medication changes. Factors associated with ACM included new seizure type (OR 3.3, 95% CI 1.3-8.0), new focal exam finding (OR 3.0, 95% CI 1.3-7.1), altered mental status (OR 2.9, 95% CI 1.2-7.0), and a history of only provoked seizures (OR 2.8, 95% CI 1.0-7.5). Patients with 2 risk factors had an OR 6.9 (95% CI 1.8 – 26.5) for an ACM, those with 3-4 risk factors had an OR of 45.8 (95% CI 9.8-213.2). The negative predictive value for ACM in a patient with no risk factors was 98.6% (95% CI 95.9 - 99.5).Discussion:Patients with a NIS who have abnormal neuroimaging associated with an ACM present with unique risk factors. Prospectively validating these factors may allow for a prediction tool for NIS in EDs where reduced exposure to ionizing radiation, sedation, and resource utilization is critically important.
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Duffy FJR, Papadopolou C, Barrie J, Hendry A, Andrew M, Martin J. 799 FRAILTY MATTERS PROJECT. Age Ageing 2022. [DOI: 10.1093/ageing/afac036.799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Preventing and managing frailty is a new area for many community practitioners yet frailty specific education remains limited. We aimed to understand and strengthen the capability of District Nurses (DNs) in leading personalised care for older people with frailty.
Methods
We conducted a participatory action research (PAR) study with DNs in one Scottish NHS Board area. Phase 1 involved three focus groups (n = 17); one one-to-one interviews; and collection of baseline team dynamics questionnaires (n = 10). Evidence from phase 1 informed co-design of an educational framework, delivered in Phase 2 as a combined coaching and educational programme through small group learning, web based coaching and bite sized online education. Interactive sessions were supported by a person-centred coach and 2 older citizen ‘co-coaches’ to bring the experience of people affected by frailty. In Phase 3 we analysed participant feedback and assessed transferability to other disciplines and to health and care settings across the UK.
Results
At baseline, DNs did not perceive frailty as a long term condition. They identified a need for help to understand the concept of frailty and to build skills and confidence in delivering community interventions. Participants embraced the coaching and educational intervention and valued the opportunity for dialogue with peers and citizen co-coaches about what really matters to patients, families and professionals. Our survey of other disciplines and teams highlighted this educational programme is both relevant and transferable.
Conclusion
Through co-design we developed a contextually sensitive programme that makes sense of frailty in the reality of both community professionals and people living with frailty. Combining technical knowledge and relational skills-building with peer support and coaching helps prepare DNs to lead interprofessional teams caring for people living with frailty. The educational framework and combined coaching and educational package are highly applicable to interdisciplinary teams in other community settings.
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Affiliation(s)
| | | | - J Barrie
- University of the West of Scotland
| | | | - M Andrew
- Health and Social Care Alliance Scotland
| | - J Martin
- Health and Social Care Alliance Scotland
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van de Kuit A, Krishnan RJ, Mallee WH, Goedhart LM, Lambert B, Doornberg JN, Vervest TMJS, Martin J. Surgical site infection after wound closure with staples versus sutures in elective knee and hip arthroplasty: a systematic review and meta-analysis. Arthroplasty 2022; 4:12. [PMID: 35241172 PMCID: PMC8896293 DOI: 10.1186/s42836-021-00110-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose This systematic review and meta-analysis aimed to study surgical site infection of wound closure using staples versus sutures in elective knee and hip arthroplasties. Methods A systematic literature review was performed to search for randomized controlled trials that compared surgical site infection after wound closure using staples versus sutures in elective knee and hip arthroplasties. The primary outcome was surgical site infection. The risk of bias was assessed with the Cochrane risk of bias assessment tool. The relative risk and 95% confidence interval with a random-effects model were assessed. Results Eight studies were included in this study, including 2 studies with a low risk of bias, 4 studies having ‘some concerns’, and 2 studies with high risk of bias. Significant difference was not found in the risk of SSI for patients with staples (n = 557) versus sutures (n = 573) (RR: 1.70, 95% CI: 0.94–3.08, I2 = 16%). The results were similar after excluding the studies with a high risk of bias (RR: 1.67, 95% CI: 0.91–3.07, I2 = 32%). Analysis of studies with low risk of bias revealed a significantly higher risk of surgical site infection in patients with staples (n = 331) compared to sutures (n = 331) (RR: 2.56, 95% CI: 1.20–5.44, I2 = 0%). There was no difference between continuous and interrupted sutures (P > 0.05). In hip arthroplasty, stapling carried a significantly higher risk of surgical site infection than suturing (RR: 2.51, 95% CI: 1.15–5.50, I2 = 0%), but there was no significant difference in knee arthroplasty (RR: 0.87, 95% CI: 0.33–2.25, I2 = 22%; P > 0.05). Conclusions Stapling might carry a higher risk of surgical site infection than suturing in elective knee and hip arthroplasties, especially in hip arthroplasty. Supplementary Information The online version contains supplementary material available at 10.1186/s42836-021-00110-7.
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Affiliation(s)
- A van de Kuit
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - R J Krishnan
- Department of Anesthesia & Perioperative Medicine and Department of Epidemiology & Biostatistics, MEDICI Centre, University of Western Ontario, London, Canada
| | - W H Mallee
- Department of Orthopaedics, Joint Research, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - L M Goedhart
- Department of Orthopaedics, University Medical Center Groningen, Postbus 30.001, 9700 RB, Groningen, The Netherlands
| | - B Lambert
- Department of Orthopaedics, University Medical Center Groningen, Postbus 30.001, 9700 RB, Groningen, The Netherlands
| | - J N Doornberg
- Department of Orthopaedics, University Medical Center Groningen, Postbus 30.001, 9700 RB, Groningen, The Netherlands.
| | - T M J S Vervest
- Department of Orthopaedics, Tergooi Hospital, Hilversum, The Netherlands
| | - J Martin
- Department of Anesthesia & Perioperative Medicine and Department of Epidemiology & Biostatistics, MEDICI Centre, University of Western Ontario, London, Canada
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Yap C, Solovyeva O, Yin Z, Martin J, Manickavasagar T, Weir C, Lee S, Dimairo M, Liu R, Kightley A, de Bono J. 53P Assessing the reporting quality of early phase dose-finding trials. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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TALBOT B, Martin J, Burman J, Kaur N, Garvey V, Knight J. POS-713 PROOF OF CONCEPT FOR A POINT OF CARE AFFORDABLE DIALYSIS SYSTEM. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Beyer H, Lange N, Podtschaske AH, Martin J, Albers L, von Werder A, Ruland J, Schneider G, Meyer B, Kagerbauer SM, Gempt J. Anterior Pituitary Hormones in Blood and Cerebrospinal Fluid of Patients in Neurocritical Care. Endocrinology 2022; 18:71-79. [PMID: 35949361 PMCID: PMC9354947 DOI: 10.17925/ee.2022.18.1.71] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
Abstract
Background: Anterior pituitary hormones in blood follow a circadian rhythm, which
may be influenced by various factors such as intracranial pathologies. In
cerebrospinal fluid (CSF), pituitary hormones have been collected only
selectively and circadian rhythm has not yet been investigated. This pilot study
analysed diurnal variations of anterior pituitary hormones in patients in
neurocritical care to determine whether circadian rhythmicity exists in these
patients. Possible influences of intracranial pathologies were also
investigated. Blood and CSF concentrations were assessed simultaneously to
explore the value of blood concentrations as a surrogate parameter for CSF
levels. Methods: Blood and CSF samples of 20 non-sedated patients were collected
at 06:00, noon, 18:00 and midnight, and analysed for adrenocorticotropic hormone
(ACTH), cortisol, thyroid-stimulating hormone (TSH) and insulin-like growth
factor-1 (IGF-1) concentrations at each of the four time points. ACTH and IGF-1
were measured by sandwich chemiluminescence immunoassay. Cortisol and TSH were
measured by electrochemiluminescence immunoassay. Results: Results showed
inconsistent circadian rhythms. Less than 50% of the patients showed a circadian
rhythmicity of ACTH, cortisol, TSH or IGF-1. Significance of diurnal variations
was only present for blood concentrations of TSH. Correlations between blood and
CSF concentrations were strong for cortisol and TSH. Conclusions: CSF
concentrations were only in the measurable range in some of the patients. No
clear circadian rhythmicity could be identified, except for TSH in blood.
Absence of significant diurnal variations could be explained by the underlying
pathologies or disturbing influences of the intensive care unit. Blood
concentrations of cortisol and TSH may be suitable surrogate parameters for
CSF.
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Affiliation(s)
- Henriette Beyer
- Department of Neurosurgery, Technical University Munich, School of
Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Nicole Lange
- Department of Neurosurgery, Technical University Munich, School of
Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Armin H Podtschaske
- Department of Anesthesiology, Technical University Munich, School of
Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Jan Martin
- Department of Anesthesiology, Technical University Munich, School of
Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Lucia Albers
- Department of Medical Informatics, Statistics and Epidemiology, Technical
University Munich, School of Medicine, Klinikum rechts der Isar Munich,
Germany
| | - Alexander von Werder
- Department of Neuroendocrinology, Technical University Munich, School of
Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Jürgen Ruland
- Department of Clinical Chemistry, Technical University Munich, School of
Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Gerhard Schneider
- Department of Anesthesiology, Technical University Munich, School of
Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Technical University Munich, School of
Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Simone M Kagerbauer
- Department of Anesthesiology, Technical University Munich, School of
Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Jens Gempt
- Department of Neurosurgery, Technical University Munich, School of
Medicine, Klinikum rechts der Isar, Munich, Germany
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Bender Ignacio RA, Shapiro AE, Nance RM, Whitney BM, Delaney J, Bamford L, Wooten D, Karris M, Mathews WC, Kim HN, Van Rompaey SE, Keruly JC, Burkholder G, Napravnik S, Mayer KH, Jacobson J, Saag MS, Moore RD, Eron JJ, Willig AL, Christopoulos KA, Martin J, Hunt PW, Crane HM, Kitahata MM, Cachay E. Racial and ethnic disparities in COVID-19 disease incidence independent of comorbidities, among people with HIV in the US. medRxiv 2021:2021.12.07.21267296. [PMID: 34909782 PMCID: PMC8669849 DOI: 10.1101/2021.12.07.21267296] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To define the incidence of clinically-detected COVID-19 in people with HIV (PWH) in the US and evaluate how racial and ethnic disparities, comorbidities, and HIV-related factors contribute to risk of COVID-19. DESIGN Observational study within the CFAR Network of Integrated Clinical Systems cohort in 7 cities during 2020. METHODS We calculated cumulative incidence rates of COVID-19 diagnosis among PWH in routine care by key characteristics including race/ethnicity, current and lowest CD4 count, and geographic area. We evaluated risk factors for COVID-19 among PWH using relative risk regression models adjusted with disease risk scores. RESULTS Among 16,056 PWH in care, of whom 44.5% were Black, 12.5% were Hispanic, with a median age of 52 years (IQR 40-59), 18% had a current CD4 count < 350, including 7% < 200; 95.5% were on antiretroviral therapy, and 85.6% were virologically suppressed. Overall in 2020, 649 PWH were diagnosed with COVID-19 for a rate of 4.94 cases per 100 person-years. The cumulative incidence of COVID-19 was 2.4-fold and 1.7-fold higher in Hispanic and Black PWH respectively, than non-Hispanic White PWH. In adjusted analyses, factors associated with COVID-19 included female sex, Hispanic or Black identity, lowest historical CD4 count <350 (proxy for CD4 nadir), current low CD4/CD8 ratio, diabetes, and obesity. CONCLUSIONS Our results suggest that the presence of structural racial inequities above and beyond medical comorbidities increased the risk of COVID-19 among PWHPWH with immune exhaustion as evidenced by lowest historical CD4 or current low CD4:CD8 ratio had greater risk of COVID-19.
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Affiliation(s)
- R A Bender Ignacio
- University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center
| | - A E Shapiro
- University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center
| | - R M Nance
- University of Washington, Seattle, WA, USA
| | | | | | - L Bamford
- University of California San Diego, San Diego, CA, USA
| | - D Wooten
- University of California San Diego, San Diego, CA, USA
| | - M Karris
- University of California San Diego, San Diego, CA, USA
| | - W C Mathews
- University of California San Diego, San Diego, CA, USA
| | - H N Kim
- University of Washington, Seattle, WA, USA
| | | | - J C Keruly
- Johns Hopkins School of Medicine, Baltimore, MD
| | - G Burkholder
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - S Napravnik
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - K H Mayer
- Fenway Health and Harvard Medical School, Boston, MA, USA
| | - J Jacobson
- Case Western Reserve University, Cleveland, OH, USA
| | - M S Saag
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - R D Moore
- Johns Hopkins School of Medicine, Baltimore, MD
| | - J J Eron
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A L Willig
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - J Martin
- University of California, San Francisco, San Francisco, CA, USA
| | - P W Hunt
- University of California, San Francisco, San Francisco, CA, USA
| | - H M Crane
- University of Washington, Seattle, WA, USA
| | | | - E Cachay
- University of California San Diego, San Diego, CA, USA
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41
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Fuest KE, Lorenz M, Grunow JJ, Weiss B, Mörgeli R, Finkenzeller S, Bogdanski R, Heim M, Kapfer B, Kriescher S, Lingg C, Martin J, Ulm B, Jungwirth B, Blobner M, Schaller SJ. The Functional Trajectory in Frail Compared With Non-frail Critically Ill Patients During the Hospital Stay. Front Med (Lausanne) 2021; 8:748812. [PMID: 34805218 PMCID: PMC8600066 DOI: 10.3389/fmed.2021.748812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/28/2021] [Accepted: 10/01/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Long-term outcome is determined not only by the acute critical illness but increasingly by the reduced functional reserve of pre-existing frailty. The patients with frailty currently account for one-third of the critically ill, resulting in higher mortality. There is evidence of how frailty affects the intrahospital functional trajectory of critically ill patients since prehospital status is often missing. Methods: In this prospective single-center cohort study at two interdisciplinary intensive care units (ICUs) at a university hospital in Germany, the frailty was assessed using the Clinical Frailty Scale (CFS) in the adult patients with critical illness with an ICU stay >24 h. The functional status was assessed using the sum of the subdomains “Mobility” and “Transfer” of the Barthel Index (MTB) at three time points (pre-hospital, ICU discharge, and hospital discharge). Results: We included 1,172 patients with a median age of 75 years, of which 290 patients (25%) were frail. In a propensity score-matched cohort, the probability of MTB deterioration till hospital discharge did not differ in the patients with frailty (odds ratio (OR) 1.3 [95% CI 0.8–1.9], p = 0.301), confirmed in several sensitivity analyses in all the patients and survivors only. Conclusion: The patients with frailty have a reduced functional status. Their intrahospital functional trajectory, however, was not worse than those in non-frail patients, suggesting a rehabilitation potential of function in critically ill patients with frailty.
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Affiliation(s)
- K E Fuest
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Marco Lorenz
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Julius J Grunow
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Björn Weiss
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rudolf Mörgeli
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sebastian Finkenzeller
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Ralph Bogdanski
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Markus Heim
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Barbara Kapfer
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Silja Kriescher
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Charlotte Lingg
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan Martin
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Bernhard Ulm
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Bettina Jungwirth
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Anesthesiology, Universitätsklinikum Ulm, Ulm, Germany
| | - Manfred Blobner
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Anesthesiology, Universitätsklinikum Ulm, Ulm, Germany
| | - Stefan J Schaller
- Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Anesthesiology and Operative Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Brillant G, Martin J. Void fraction in a co-current two-phase flow through a prototypical PWR spent fuel assembly. Nuclear Engineering and Design 2021. [DOI: 10.1016/j.nucengdes.2021.111401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Interim data monitoring in cluster randomised trials: Practical issues and a case study. Clin Trials 2021; 18:552-561. [PMID: 34154426 PMCID: PMC8479148 DOI: 10.1177/17407745211024751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is an abundance of guidance for the interim monitoring of individually randomised trials. While methodological literature exists on how to extend these methods to cluster randomised trials, there is little guidance on practical implementation. Cluster trials have many features which make their monitoring needs different. We outline the methodological and practical challenges of interim monitoring of cluster trials; and apply these considerations to a case study. CASE STUDY The E-MOTIVE study is an 80-cluster randomised trial of a bundle of interventions to treat postpartum haemorrhage. The proposed data monitoring plan includes (1) monitor sample size assumptions, (2) monitor for evidence of selection bias, and (3) an interim assessment of the primary outcome, as well as monitoring data completeness. The timing of the sample size monitoring is chosen with both consideration of statistical precision and to allow time to recruit more clusters. Monitoring for selection bias involves comparing individual-level characteristics and numbers recruited between study arms to identify any post-randomisation participant identification bias. An interim analysis of outcomes presented with 99.9% confidence intervals using the Haybittle-Peto approach should mitigate any concern regarding the inflation of type-I error. The pragmatic nature of the trial means monitoring for adherence is not relevant, as it is built into a process evaluation. CONCLUSIONS The interim analyses of cluster trials have a number of important differences to monitoring individually randomised trials. In cluster trials, there will often be a greater need to monitor nuisance parameters, yet there will often be considerable uncertainty in their estimation. This means the utility of sample size re-estimation can be questionable particularly when there are practical or funding difficulties associated with making any changes to planned sample sizes. Perhaps most importantly interim monitoring has the potential to identify selection bias, particularly in trials with post-randomisation identification or recruitment. Finally, the pragmatic nature of cluster trials might mean that the utility of methods to allow for interim monitoring of outcomes based on statistical testing, or monitoring for adherence to study interventions, are less relevant. Our intention is to facilitate the planning of future cluster randomised trials and to promote discussion and debate to improve monitoring of these studies.
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Affiliation(s)
- K Hemming
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - J Martin
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - I Gallos
- University of Birmingham, Birmingham, UK
| | - A Coomarasamy
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - L Middleton
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Peacock S, Briggs D, Barnardo M, Battle R, Brookes P, Callaghan C, Clark B, Collins C, Day S, Diaz Burlinson N, Dunn P, Fernando R, Fuggle S, Harmer A, Kallon D, Keegan D, Key T, Lawson E, Lloyd S, Martin J, McCaughan J, Middleton D, Partheniou F, Poles A, Rees T, Sage D, Santos-Nunez E, Shaw O, Willicombe M, Worthington J. BSHI/BTS guidance on crossmatching before deceased donor kidney transplantation. Int J Immunogenet 2021; 49:22-29. [PMID: 34555264 PMCID: PMC9292213 DOI: 10.1111/iji.12558] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022]
Abstract
All UK H&I laboratories and transplant units operate under a single national kidney offering policy, but there have been variations in approach regarding when to undertake the pre‐transplant crossmatch test. In order to minimize cold ischaemia times for deceased donor kidney transplantation we sought to find ways to be able to report a crossmatch result as early as possible in the donation process. A panel of experts in transplant surgery, nephrology, specialist nursing in organ donation and H&I (all relevant UK laboratories represented) assessed evidence and opinion concerning five factors that relate to the effectiveness of the crossmatch process, as follows: when the result should be ready for reporting; what level of donor HLA typing is needed; crossmatch sample type and availability; fairness and equity; risks and patient safety. Guidelines aimed at improving practice based on these issues are presented, and we expect that following these will allow H&I laboratories to contribute to reducing CIT in deceased donor kidney transplantation.
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Affiliation(s)
- S Peacock
- Tissue Typing Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - D Briggs
- H&I Laboratory, NHSBT Birmingham Vincent Drive, Birmingham, UK
| | - M Barnardo
- Clinical Transplant Immunology, Churchill Hospital, Oxford, UK
| | - R Battle
- H&I Laboratory, SNBTS, Edinburgh, UK
| | - P Brookes
- H&I Laboratory, Harefield Hospital, Harefield, UK
| | - C Callaghan
- Department of Nephrology and Transplantation, Guy's Hospital, London, UK
| | - B Clark
- H&I Laboratory, Leeds Teaching Hospitals NHS Trust, UK
| | - C Collins
- H&I Laboratory, NHSBT Birmingham Vincent Drive, Birmingham, UK
| | - S Day
- H&I Laboratory, Southmead Hospital, Bristol, UK
| | - N Diaz Burlinson
- Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK
| | - P Dunn
- Transplant Laboratory, Leicester General Hospital, Leicester, UK
| | - R Fernando
- H&I Laboratory, The Anthony Nolan Laboratories, Royal Free Hospital, UK
| | - S Fuggle
- Organ Donation & Transplantation, NHSBT, Stoke Gifford, Bristol, UK
| | - A Harmer
- H&I Laboratory, NHSBT Barnsley Centre, Barnsley, UK
| | - D Kallon
- H & I Laboratory, Royal London Hospital, London, UK
| | - D Keegan
- Department of H&I, Beaumont Hospital, Dublin, UK
| | - T Key
- H&I Laboratory, NHSBT Barnsley Centre, Barnsley, UK
| | - E Lawson
- Organ Donation and Transplantation, NHSBT, Birmingham, UK
| | - S Lloyd
- Welsh Transplantation & Immunogenetics Laboratory, Cardiff, UK
| | - J Martin
- H&I Laboratory, Belfast Health and Social Care Trust, Belfast, UK
| | - J McCaughan
- H&I Laboratory, Belfast Health and Social Care Trust, Belfast, UK
| | - D Middleton
- H&I Laboratory, Liverpool Foundation Trust, Liverpool, UK
| | - F Partheniou
- H&I Laboratory, Liverpool Foundation Trust, Liverpool, UK
| | - A Poles
- H&I Laboratory, University Hospitals Plymouth, Plymouth, UK.,H&I Laboratory, NHSBT Filton, Bristol, UK
| | - T Rees
- Welsh Transplantation & Immunogenetics Laboratory, Cardiff, UK
| | - D Sage
- H&I Laboratory, NHSBT Tooting Centre, London, UK
| | - E Santos-Nunez
- H&I Laboratory, Imperial College Healthcare NHS Trust, London, UK
| | - O Shaw
- H&I Laboratory, Viapath, Guys & St Thomas, London, UK
| | - M Willicombe
- Department of Immunology and Inflammation, Imperial College London, UK
| | - J Worthington
- Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK
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45
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Hadaschik B, Fanti S, Ost P, Tunariu N, de Nunzio C, Antoni L, Lukac M, Martin J, Pissart G, Wapenaar R, Mottet N. 649TiP PRIMORDIUM: A randomized, international, trial-in-progress of adding apalutamide to radiotherapy and an LHRH agonist in high-risk patients with PSMA-PET-positive hormone-sensitive prostate cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1162] [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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46
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Führes T, Riexinger AJ, Loh M, Martin J, Wetscherek A, Kuder TA, Uder M, Hensel B, Laun FB. Echo time dependence of biexponential and triexponential intravoxel incoherent motion parameters in the liver. Magn Reson Med 2021; 87:859-871. [PMID: 34453445 DOI: 10.1002/mrm.28996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/12/2021] [Accepted: 08/12/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE Intravoxel incoherent motion (IVIM) studies are performed with different acquisition protocols. Comparing them requires knowledge of echo time (TE) dependencies. The TE-dependence of the biexponential perfusion fraction f is well-documented, unlike that of its triexponential counterparts f1 and f2 and the biexponential and triexponential pseudodiffusion coefficients D* , D 1 ∗ , and D 2 ∗ . The purpose was to investigate the TE-dependence of these parameters and to check whether the triexponential pseudodiffusion compartments are associated with arterial and venous blood. METHODS Fifteen healthy volunteers (19-58 y; mean: 24.7 y) underwent diffusion-weighted imaging of the abdomen with 24 b-values (0.2-800 s/mm2 ) at TEs of 45, 60, 75, and 90 ms. Regions of interest (ROIs) were manually drawn in the liver. One set of bi- and triexponential IVIM parameters per volunteer and TE was determined. The TE-dependence was assessed with the Kruskal-Wallis test. RESULTS TE-dependence was observed for f (P < .001), f1 (P = .001), and f2 (P < .001). Their median values at the four measured TEs were: f: 0.198/0.240/0.274/0.359, f1 : 0.113/0.139/0.146/0.205, f2 : 0.115/0.155/0.182/0.194. D, D* , D 1 ∗ , and D 2 ∗ showed no significant TE-dependence. Their values were: diffusion coefficient D (10-4 mm2 /s): 9.45/9.63/9.75/9.41, biexponential D* (10-2 mm2 /s): 5.26/5.52/6.13/5.82, triexponential D 1 ∗ (10-2 mm2 /s): 1.73/2.91/2.25/2.51, triexponential D 2 ∗ (mm2 /s): 0.478/1.385/0.616/0.846. CONCLUSION f1 and f2 show similar TE-dependence as f, ie, increase with rising TE; an effect that must be accounted for when comparing different studies. The diffusion and pseudodiffusion coefficients might be compared without TE correction. Because of the similar TE-dependence of f1 and f2 , the triexponential pseudodiffusion compartments are most probably not associated to venous and arterial blood.
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Affiliation(s)
- Tobit Führes
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andreas Julian Riexinger
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Martin Loh
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Andreas Wetscherek
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Tristan Anselm Kuder
- Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Bernhard Hensel
- Center for Medical Physics and Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Frederik Bernd Laun
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Ceci A, Muñoz-Ballester C, Tegge AN, Brown KL, Umans RA, Michel FM, Patel D, Tewari B, Martin J, Alcoreza O, Maynard T, Martinez-Martinez D, Bordwine P, Bissell N, Friedlander MJ, Sontheimer H, Finkielstein CV. Development and implementation of a scalable and versatile test for COVID-19 diagnostics in rural communities. Nat Commun 2021; 12:4400. [PMID: 34285229 PMCID: PMC8292415 DOI: 10.1038/s41467-021-24552-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/24/2021] [Indexed: 12/23/2022] Open
Abstract
Rapid and widespread testing of severe acute respiratory coronavirus 2 (SARS-CoV-2) is essential for an effective public health response aimed at containing and mitigating the coronavirus disease 2019 (COVID-19) pandemic. Successful health policy implementation relies on early identification of infected individuals and extensive contact tracing. However, rural communities, where resources for testing are sparse or simply absent, face distinctive challenges to achieving this success. Accordingly, we report the development of an academic, public land grant University laboratory-based detection assay for the identification of SARS-CoV-2 in samples from various clinical specimens that can be readily deployed in areas where access to testing is limited. The test, which is a quantitative reverse transcription polymerase chain reaction (RT-qPCR)-based procedure, was validated on samples provided by the state laboratory and submitted for FDA Emergency Use Authorization. Our test exhibits comparable sensitivity and exceeds specificity and inclusivity values compared to other molecular assays. Additionally, this test can be re-configured to meet supply chain shortages, modified for scale up demands, and is amenable to several clinical specimens. Test development also involved 3D engineering critical supplies and formulating a stable collection media that allowed samples to be transported for hours over a dispersed rural region without the need for a cold-chain. These two elements that were critical when shortages impacted testing and when personnel needed to reach areas that were geographically isolated from the testing center. Overall, using a robust, easy-to-adapt methodology, we show that an academic laboratory can supplement COVID-19 testing needs and help local health departments assess and manage outbreaks. This additional testing capacity is particularly germane for smaller cities and rural regions that would otherwise be unable to meet the testing demand.
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Affiliation(s)
- A Ceci
- Molecular Diagnostics Laboratory, Fralin Biomedical Research Institute, Virginia Tech, Roanoke, VA, USA
| | - C Muñoz-Ballester
- Center for Glial Biology in Health, Disease, and Cancer, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
| | - A N Tegge
- Department of Statistics, Virginia Tech, Blacksburg, VA, USA
| | - K L Brown
- Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - R A Umans
- Center for Glial Biology in Health, Disease, and Cancer, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
| | - F M Michel
- Department of Geosciences, Virginia Tech, Blacksburg, VA, USA
| | - D Patel
- Center for Glial Biology in Health, Disease, and Cancer, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
| | - B Tewari
- Center for Glial Biology in Health, Disease, and Cancer, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
| | - J Martin
- Center for Glial Biology in Health, Disease, and Cancer, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
- Translational Biology, Medicine, and Health Graduate Program, Virginia Tech, Roanoke, VA, USA
| | - O Alcoreza
- Center for Glial Biology in Health, Disease, and Cancer, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
- Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
- Translational Biology, Medicine, and Health Graduate Program, Virginia Tech, Roanoke, VA, USA
| | - T Maynard
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
| | - D Martinez-Martinez
- MRC London Institute of Medical Sciences, London, UK
- Institute of Clinical Sciences, Imperial College London, London, UK
| | - P Bordwine
- Division of Surveillance and Investigation, Office of Epidemiology, Virginia Department of Health, Christiansburg, USA
| | - N Bissell
- New River Valley Health District, Virginia Department of Health, Christiansburg, USA
| | - M J Friedlander
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
| | - H Sontheimer
- Center for Glial Biology in Health, Disease, and Cancer, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
| | - C V Finkielstein
- Molecular Diagnostics Laboratory, Fralin Biomedical Research Institute, Virginia Tech, Roanoke, VA, USA.
- Integrated Cellular Responses Laboratory, Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA.
- Department of Biological Sciences, Virginia Tech, Blacksburg, VA, USA.
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Ruggeri I, Martin J, Wohlfahrt-Mehrens M, Mancini M. Interfacial kinetics and low-temperature behavior of spheroidized natural graphite particles as anode for Li-ion batteries. J Solid State Electrochem 2021. [DOI: 10.1007/s10008-021-04974-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Waxenegger-Wilfing G, Sengupta U, Martin J, Armbruster W, Hardi J, Juniper M, Oschwald M. Early detection of thermoacoustic instabilities in a cryogenic rocket thrust chamber using combustion noise features and machine learning. Chaos 2021; 31:063128. [PMID: 34241297 DOI: 10.1063/5.0038817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 05/28/2021] [Indexed: 06/13/2023]
Abstract
We present a data-driven method for the early detection of thermoacoustic instabilities. Recurrence quantification analysis is used to calculate characteristic combustion features from short-length time series of dynamic pressure sensor data. Features like recurrence rate are used to train support vector machines to detect the onset of instability a few hundred milliseconds in advance. The performance of the proposed method is investigated on experimental data from a representative LOX/H 2 research thrust chamber. In most cases, the method is able to timely predict two types of thermoacoustic instabilities on test data not used for training. The results are compared with state-of-the-art early warning indicators.
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Affiliation(s)
| | - Ushnish Sengupta
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire CB2 1PZ, United Kingdom
| | - Jan Martin
- Institute of Space Propulsion, German Aerospace Center (DLR), 74239 Hardthausen, Germany
| | - Wolfgang Armbruster
- Institute of Space Propulsion, German Aerospace Center (DLR), 74239 Hardthausen, Germany
| | - Justin Hardi
- Institute of Space Propulsion, German Aerospace Center (DLR), 74239 Hardthausen, Germany
| | - Matthew Juniper
- Department of Engineering, University of Cambridge, Cambridge, Cambridgeshire CB2 1PZ, United Kingdom
| | - Michael Oschwald
- Institute of Space Propulsion, German Aerospace Center (DLR), 74239 Hardthausen, Germany
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Martin C, Burnet E, Ronayette-Preira A, de Carli P, Martin J, Delmas L, Prieur B, Burgel PR. Patient perspectives following initiation of elexacaftor-tezacaftor-ivacaftor in people with cystic fibrosis and advanced lung disease. Respir Med Res 2021; 80:100829. [PMID: 34091202 DOI: 10.1016/j.resmer.2021.100829] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 05/07/2021] [Indexed: 11/19/2022]
Abstract
BACKGOUND Elexacaftor-tezacaftor-ivacaftor partially restores cystic fibrosis transmembrane conductance regulator function, and has been shown to induce significant clinical improvement in patients with at least one Phe508del allele. Yet little data exist on patient perspectives following elexacaftor-tezacaftor-ivacaftor initiation. METHODS A mixed methods study was conducted using an online 13-item questionnaire (including 9 closed questions and 4 open questions), submitted from July 10th to August 21th 2020 to French patients aged 12 years and older with advanced CF who were treated with elexacaftor-tezacaftor-ivacaftor. Their responses were summarized as numbers (%), and free-text items were analysed using a grounded theory approach. RESULTS Of 245 patients who started elexacaftor-tezacaftor-ivacaftor in France, 101 (41%) participated. Median [IQR] age was 35 [28-41] years and duration of elexacaftor-tezacaftor-ivacaftor treatment was 4.3 [3.0-5.6] months. Patients generally reported a rapid impact on respiratory symptoms, sleep quality, general well-being and physical self-esteem, and a reduction in overall treatment burden. The majority of patients contrasted treatment burden, symptom severity, depression and a closed future marked by death or transplantation before elexacaftor-tezacaftor-ivacaftor, to renewed and unexpected physical strength, leading to greater self-confidence, autonomy and long-term planning, after treatment initiation. A small number of patients expressed concerns, mainly regarding changes in body representation and/or the fear of becoming dependent on the treatment. CONCLUSION After initiation of elexacaftor-tezacaftor-ivacaftor, CF patients with advanced disease reported rapid and positive physical, psychological and social effects, which translated into improved quality of life and the formulation of new life goals.
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Affiliation(s)
- C Martin
- Université de Paris, Institut Cochin, Inserm U1016, Paris, France; Respiratory Medicine and National Reference Cystic Fibrosis Reference Center, Cochin Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France; ERN-Lung CF network
| | - E Burnet
- Respiratory Medicine and National Reference Cystic Fibrosis Reference Center, Cochin Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France; ERN-Lung CF network
| | | | - P de Carli
- Vaincre la Mucoviscidose, 75013 Paris, France
| | | | | | - B Prieur
- Respiratory Medicine and National Reference Cystic Fibrosis Reference Center, Cochin Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France; ERN-Lung CF network
| | - P-R Burgel
- Université de Paris, Institut Cochin, Inserm U1016, Paris, France; Respiratory Medicine and National Reference Cystic Fibrosis Reference Center, Cochin Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France; ERN-Lung CF network.
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