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Nucci N, Degen R, Ekhtiari S, Gazendam A, Ayeni OR, Horner N, Wong I, Woodmass J, Grant J, Sheehan B, Pickell M, Kopka M, Khan M, Martin R, Tucker A, Sommerfeldt M, Gusnowski E, Rousseau-Saine A, Lebel ME, Karpyshyn J, Matache B, Carroll M, Da Cunha R, Kwapisz A, Martin RK. Arthroscopy Association of Canada Position Statement on Opioid Prescription After Arthroscopic Surgery. Orthop J Sports Med 2023; 11:23259671231214700. [PMID: 38145216 PMCID: PMC10748902 DOI: 10.1177/23259671231214700] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 06/23/2023] [Indexed: 12/26/2023] Open
Abstract
Background Despite the ongoing opioid epidemic, most patients are still prescribed a significant number of opioid medications for pain management after arthroscopic surgery. There is a need for consensus among orthopaedic surgeons and solutions to aid providers in analgesic strategies that reduce the use of opioid pain medications. Purpose This position statement was developed with a comprehensive systematic review and meta-analysis of exclusively randomized controlled trials (RCTs) to synthesize the best available evidence for managing acute postoperative pain after arthroscopic surgery. Study Design Position statement. Methods The Embase, MEDLINE, PubMed, Scopus, and Web of Science databases were searched from inception until August 10, 2022. Keywords included arthroscopy, opioids, analgesia, and pain, and associated variations. We included exclusively RCTs on adult patients to gather the best available evidence for managing acute postoperative pain after arthroscopic surgery. Patient characteristics, pain, and opioid data were extracted, data were analyzed, and trial bias was evaluated. Results A total of 21 RCTs were identified related to the prescription of opioid-sparing pain medication after arthroscopic surgery. The following recommendations regarding noninvasive, postoperative pain management strategies were made: (1) multimodal oral nonopioid analgesic regimens-including at least 1 of acetaminophen-a nonsteroidal anti-inflammatory drug-can significantly reduce opioid consumption with no change in pain scores; (2) cryotherapy is likely to help with pain management, although the evidence on the optimal method of application (continuous-flow vs ice pack application) is unclear; (3) and (4) limited RCT evidence supports the efficacy of transcutaneous electrical nerve stimulation and relaxation exercises in reducing opioid consumption after arthroscopy; and (5) limited RCT evidence exists against the efficacy of transdermal lidocaine patches in reducing opioid consumption. Conclusion A range of nonopioid strategies exist that can reduce postarthroscopic procedural opioid consumption with equivalent vocal pain outcomes. Optimal strategies include multimodal analgesia with education and restricted/reduced opioid prescription.
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Affiliation(s)
| | - Ryan Degen
- Western University, London, Ontario, Canada
| | | | | | | | - Nolan Horner
- Genesis Orthopaedics & Sports Medicine, Chicago, Illinois, USA
| | - Ivan Wong
- Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - John Grant
- University of Michigan, Ann Arbor, Michigan, USA
| | | | | | | | - Moin Khan
- Investigation performed at McMaster University, Hamilton, Ontario, Canada
| | - Ryan Martin
- University of Calgary, Calgary Alberta, Canada
| | - Allison Tucker
- Nova Scotia Health Authority, Halifax Nova Scotia, Canada
| | | | - Eva Gusnowski
- Saint John Orthopaedics, Saint John, New Brunswick, Canada
| | | | | | | | | | - Michael Carroll
- Queen Elizabeth Hospital, Charlottetown, Prince Edward Island, Canada
| | | | - Adam Kwapisz
- University of Manitoba, Winnipeg, Manitoba, Canada
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2
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Muhsin-Sharafaldine MR, Abdel Rahman L, Suwanarusk R, Grant J, Parslow G, French N, Tan KSW, Russell B, Morgan XC, Ussher JE. Dientamoeba fragilis associated with microbiome diversity changes in acute gastroenteritis patients. Parasitol Int 2023; 97:102788. [PMID: 37482266 DOI: 10.1016/j.parint.2023.102788] [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: 12/05/2022] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
This study examined the correlation between intestinal protozoans and the bacterial microbiome in faecal samples collected from 463 patients in New Zealand who were diagnosed with gastroenteritis. In comparison to traditional microscopic diagnosis methods, Multiplexed-tandem PCR proved to be more effective in detecting intestinal parasites. Among the identified protozoans, Blastocystis sp. and Dientamoeba fragilis were the most prevalent. Notably, D. fragilis was significantly associated with an increase in the alpha-diversity of host prokaryotic microbes. Although the exact role of Blastocystis sp. and D. fragilis as the primary cause of gastroenteritis remains debatable, our data indicates a substantial correlation between these protozoans and the prokaryote microbiome of their hosts, particularly when compared to other protists or patients with gastroenteritis but no detectable parasitic cause. These findings underscore the significance of comprehending the contributions of intestinal protozoans, specifically D. fragilis, to the development of gastroenteritis and their potential implications for disease management.
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Affiliation(s)
| | - L Abdel Rahman
- Department of Microbiology & Immunology, University of Otago, Dunedin, New Zealand
| | - R Suwanarusk
- Department of Microbiology & Immunology, University of Otago, Dunedin, New Zealand
| | - J Grant
- Southern Community Laboratories, Dunedin, New Zealand
| | - G Parslow
- Southern Community Laboratories, Dunedin, New Zealand
| | - N French
- Massey University, Palmerston North, New Zealand
| | - K S W Tan
- Department of Microbiology & Immunology, National University of Singapore, Singapore
| | - B Russell
- Department of Microbiology & Immunology, University of Otago, Dunedin, New Zealand; Department of Protozoology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan,.
| | - X C Morgan
- Department of Microbiology & Immunology, University of Otago, Dunedin, New Zealand
| | - J E Ussher
- Department of Microbiology & Immunology, University of Otago, Dunedin, New Zealand; Southern Community Laboratories, Dunedin, New Zealand
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Akbari SHA, Mooney J, Lepard J, Arynchyna-Smith A, McClugage S, Myers R, Grant J, Rozzelle C, Johnston JM. Racial differences in the care of pediatric sagittal craniosynostosis: a single-institution cohort study affecting state Medicaid policy. J Neurosurg Pediatr 2023; 32:464-471. [PMID: 37486863 DOI: 10.3171/2023.5.peds2335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/30/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE Although research has shown the cost-effectiveness of endoscopic versus open repair of sagittal synostosis, few studies have shown how race, insurance status, and area deprivation impact care for these patients. The authors analyzed data from children evaluated for sagittal synostosis at a single institution to assess how socioeconomic factors, race, and insurance status affect the surgical treatment of this population. They hypothesized that race and indicators of disadvantage negatively impact workup and surgical timing for craniosynostosis surgery. METHODS Medical records of patients treated for sagittal synostosis between 2010 and 2019 were reviewed. Area deprivation index (ADI) and rural-urban commuting area codes, as well as median income by zip code, were used to measure neighborhood disadvantage. Black and White patients were compared as well as patients using Medicaid versus private insurance. RESULTS Fifty patients were prospectively included in the study. Thirty-one underwent open repair; 19 had endoscopic repair. All 8 (100%) Black patients had open repair, compared to 54.8% of White patients (p = 0.018). Black patients were more likely to use Medicaid compared to White patients (75.0% vs 28.6%, p = 0.019). White patients were younger at surgery (5.5 vs 10.0 months, p = 0.001), and Black patients had longer surgeries (147.5 minutes vs 110.0 minutes, p = 0.021). The median household income by zip code was similar for the two groups. Black patients were generally from areas of greater disadvantage compared to White patients, based on both state and national ADI scores (state: 7.5 vs 4.0, p = 0.013; national: 83.5 vs 60.0, p = 0.013). All (94.7%) but 1 patient undergoing endoscopic repair used private insurance compared to 14 (45.2%) patients in the open repair group (p = 0.001). Patients using Medicaid were from areas of greater disadvantage compared to those using private insurance by both state and national ADI scores (state: 6.0 vs 3.0, p = 0.001; national: 75.0 vs 52.0, p = 0.001). CONCLUSIONS Because Medicaid in the geographic region of this study did not cover helmeting after endoscopic repair of sagittal synostosis, these patients usually had open repair, resulting in significant racial and socioeconomic disparities in treatment of sagittal synostosis. This research has led to a change in Alabama Medicaid policy to now cover the cost of postoperative helmeting.
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Affiliation(s)
- S Hassan A Akbari
- 1Department of Neurosurgery, Penn State College of Medicine, Hershey, Pennsylvania; and
| | | | | | | | | | - Rene Myers
- 3Plastic Surgery, The University of Alabama at Birmingham, Alabama
| | - John Grant
- 3Plastic Surgery, The University of Alabama at Birmingham, Alabama
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Rector ME, Filgueira R, Grant J. From farm sustainability to ecosystem sustainability: Exploring the limitations of farm-applied aquaculture eco-certification schemes. J Environ Manage 2023; 339:117869. [PMID: 37054590 DOI: 10.1016/j.jenvman.2023.117869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/29/2023] [Accepted: 04/02/2023] [Indexed: 05/03/2023]
Abstract
Aquaculture eco-certification schemes provide standards against which individual farms are assessed, and those farms that comply with eco-certification criteria receive certified status. These schemes aim to improve aquaculture sustainability, but the site-by-site approach of eco-certification can be a barrier to the inclusion of ecosystem perspectives in the evaluation of farm sustainability. However, the ecosystem approach to aquaculture demands a management approach that considers broader scale ecosystem impacts. This study explored how eco-certification schemes and processes account for potential ecosystem impacts of salmon farms. Interviews with eco-certification auditors, salmon producers, and eco-certification staff were conducted. The experience of participants and information from eco-certification scheme criteria and other eco-certification scheme documents were used to identify thematic challenges associated with the consideration of ecosystem impacts including: assessing far-field impacts, managing cumulative effects, and anticipating ecosystem risks. Results indicate that eco-certification schemes work within the limitations of farm-scale application of global eco-certification standards to address potential ecosystem impacts by: (1) including eco-certification scheme criteria that address ecosystem impacts, (2) relying on the experience, expertise, and judgement of eco-certification auditors, and (3) referencing and deferring to local regulations. Results indicate that eco-certification schemes can address ecosystem impacts to some degree, despite their site-by-site approach. The integration of additional tools while supporting the capacity of farms to apply those tools, as well as increasing transparency during compliance assessment could help eco-certification schemes shift from providing assurance of farm sustainability to providing assurance of ecosystem sustainability.
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Affiliation(s)
- M E Rector
- Marine Affairs Program, Life Sciences Centre, Dalhousie University, Halifax, NS, B3H 4J1, Canada.
| | - R Filgueira
- Marine Affairs Program, Life Sciences Centre, Dalhousie University, Halifax, NS, B3H 4J1, Canada
| | - J Grant
- Department of Oceanography, Dalhousie University, Halifax, NS, B3H 4J1, Canada
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Grant J, Hunter A. Semantic inconsistency measures using 3-valued logics. Int J Approx Reason 2023. [DOI: 10.1016/j.ijar.2023.02.008] [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: 03/08/2023]
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6
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Parisi F, Grant J. On Measuring Inconsistency in Definite and Indefinite Databases with Denial Constraints. ARTIF INTELL 2023. [DOI: 10.1016/j.artint.2023.103884] [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: 02/24/2023]
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7
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Bistline JET, Blanford G, Grant J, Knipping E, McCollum DL, Nopmongcol U, Scarth H, Shah T, Yarwood G. Economy-wide evaluation of CO 2 and air quality impacts of electrification in the United States. Nat Commun 2022; 13:6693. [PMID: 36335099 PMCID: PMC9637153 DOI: 10.1038/s41467-022-33902-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Adopting electric end-use technologies instead of fossil-fueled alternatives, known as electrification, is an important economy-wide decarbonization strategy that also reduces criteria pollutant emissions and improves air quality. In this study, we evaluate CO2 and air quality co-benefits of electrification scenarios by linking a detailed energy systems model and a full-form photochemical air quality model in the United States. We find that electrification can substantially lower CO2 and improve air quality and that decarbonization policy can amplify these trends, which yield immediate and localized benefits. In particular, transport electrification can improve ozone and fine particulate matter (PM2.5), though the magnitude of changes varies regionally. However, growing activity from non-energy-related PM2.5 sources-such as fugitive dust and agricultural emissions-can offset electrification benefits, suggesting that additional measures beyond CO2 policy and electrification are needed to meet air quality goals. We illustrate how commonly used marginal emissions approaches systematically underestimate reductions from electrification.
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Affiliation(s)
- John E. T. Bistline
- grid.418781.30000 0001 2359 3628Electric Power Research Institute, 3420 Hillview Avenue, Palo Alto, CA 94304 USA
| | - Geoffrey Blanford
- grid.418781.30000 0001 2359 3628Electric Power Research Institute, 3420 Hillview Avenue, Palo Alto, CA 94304 USA
| | - John Grant
- Ramboll, 7250 Redwood Blvd., Suite 105, Novato, CA 94945 USA
| | - Eladio Knipping
- grid.418781.30000 0001 2359 3628Electric Power Research Institute, 3420 Hillview Avenue, Palo Alto, CA 94304 USA
| | - David L. McCollum
- grid.135519.a0000 0004 0446 2659Oak Ridge National Laboratory, 2360 Cherahala Blvd, Knoxville, TN 37932 USA
| | | | - Heidi Scarth
- grid.418781.30000 0001 2359 3628Electric Power Research Institute, 3420 Hillview Avenue, Palo Alto, CA 94304 USA
| | - Tejas Shah
- Ramboll, 7250 Redwood Blvd., Suite 105, Novato, CA 94945 USA
| | - Greg Yarwood
- Ramboll, 7250 Redwood Blvd., Suite 105, Novato, CA 94945 USA
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8
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Olarte N, Vincent L, Ebner B, Grant J, Maning J, Hernandez R, Rivera-Rodriguez B, Giraldo M, Mendoza I. Atrioventricular nodal ablation with pacemaker implant is associated with improved safety outcomes compared to pulmonary vein isolation of atrial fibrillation with heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.567] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary vein isolation (PVI) and atrioventricular nodal ablation (AVNA) with pacemaker implant have both been advocated for patients with atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF). Direct comparisons between the two are limited.
Purpose
We sought to compare outcomes and complications following PVI versus AVNA with implant of a cardiac implantable electronic device (CIED) among patients with AF and HFrEF.
Methods
We queried the National Inpatient Sample from 2011 to 2019, using relevant ICD-9 and -10 diagnostic and procedural codes for AF, HFrEF, ablation, and CIED implant to identify our study cohort. Exclusion criteria included presence of a pre-existing CIED, ventricular arrhythmias, non-AF supraventricular arrhythmias, and surgical AF ablation. Baseline characteristics included age, sex, race, and comorbidities related to AF and cardiovascular disease. Severity of comorbidities was assessed via Deyo-Charlson Comorbidity Index (Deyo-CCI). Outcomes investigated include all-cause mortality, major adverse cardiovascular events (MACE), extra-cardiac procedural complications, length of stay, and total hospital charges. Outcomes associations were analyzed using multivariate logistic regression adjusted for baseline characteristics that were significantly different (P<0.05) between cohorts expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI). SPSS v28.0 (IBM, Armonk, NY) was used to carry out all calculations.
Results
We identified 3,565 encounters for PVI and 1,355 for AVNA with CIED implant among hospitalized patients with AF and HFrEF. Patients who underwent AVNA were more often older (73.8 vs 66.2 years), with more severe comorbidities (mean Deyo-CCI score 2.9 vs 2.6) and were more likely to have an emergent procedure performed (81.3% vs 69.7%; p<0.001 for all). However, the AVNA cohort had less mortality (0.5% vs 1.2%, p=0.03), MACE (6.1% vs 7.8%, p=0.04), and total complications (12.7% vs 16.3%, p=0.002), but longer hospital stay (8.0 vs 6.5 days) and higher total charges ($201,100 vs $159,382; p<0.001 for both). After adjusting for confounders, AVNA remained independently associated with decreased odds of mortality (aOR: 0.370; 95% CI [0.159–0.862], p=0.02), MACE (aOR: 0.552; 95% CI [0.420–0.726], p<0.001), and total complications (aOR: 0.708; 95% CI [0.589–0.852], p<0.001).
Conclusion
Despite older age with more severe comorbidities and less elective procedures, hospitalized patients with AF and HFrEF who underwent AVNA with CIED implant had improved safety outcomes compared to PVI. Further studies comparing the intermediate and long-term outcomes and efficacy between therapies are needed to better delineate which would best serve this population.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Olarte
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - L Vincent
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - B Ebner
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - J Grant
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - J Maning
- Northwestern University, Cardiology , Chicago , United States of America
| | - R Hernandez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - B Rivera-Rodriguez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - M Giraldo
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - I Mendoza
- Jackson Memorial Hospital, Cardiology , Miami , United States of America
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9
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Olarte N, Vincent L, Ebner B, Grant J, Maning J, Hernandez R, Rivera-Rodriguez B, Giraldo M, Grazette L. Assessing outcomes following catheter ablation of ventricular tachycardia in patients with durable left ventricular assist devices. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.692] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Management of ventricular tachycardia (VT) after implant of a durable left ventricular assist device (LVAD) is challenging, without consensus on optimal therapy. Multiple small studies have examined catheter ablation of VT in these patients with low reported incidence of complications.
Purpose
We sought to evaluate periprocedural outcomes following VT ablation among LVAD recipients.
Methods
We queried the National Inpatient Sample from 2011 to 2019 to conduct our study. Baseline characteristics include age, sex, race, and comorbidities related to cardiovascular disease. Comorbidity severity was assessed using the Deyo-Charlson Comorbidity Index (Deyo-CCI). Patients with any supraventricular arrhythmias were excluded. Outcomes investigated include heart transplant procedure, all-cause mortality, major adverse cardiovascular events (MACE), and periprocedural complications. Multivariate regression was used to analyze outcomes associations adjusted for baseline characteristics that were significantly different (P<0.05) between cohorts expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI). SPSS v28.0 (IBM, Armonk, NY) was used to carry out all calculations.
Results
We identified 56 patients who underwent ablation among 2,202 LVAD recipients hospitalized for VT. Patients who underwent ablation were more likely to have ischemic cardiomyopathy (33.9% vs. 22.2%, p=0.03) or an automated implantable cardioverter-defibrillator (55.4% vs 34.3%, p=0.001). There were otherwise no significant differences between cohorts (mean Deyo-CCI score of 2.3 for both, p=0.48). Between those who did and did not undergo ablation, there were no significant differences in heart transplant (5.4 vs 5.0%, p=0.9), mortality (7.1% vs 7.0%, p=0.96), total strokes (3.6% vs 5.0%, p=0.48), myocardial infarction (3.6% vs 4.6%, p=0.71), overall MACE (8.9% vs 10.2%, p=0.26) or total complications (35.7% vs 41.9%, p=0.35). There were no incidents of pump thrombosis in the ablation group, but 92 events (4.3%) were found in the medical therapy group. Multivariate analysis affirmed no significant association between ablation and mortality (aOR 1.277, CI [0.450–3.629]), MACE (aOR 1.125, CI [0.436–2.902]), or total complications (aOR 0.932, CI [0.528–1.645]).
Conclusion
Overall complications following VT ablation among LVAD patients were higher than previously reported but no statistically significant differences were found compared to conservative management. While ablation appears safe to perform, particularly among those with structural heart disease and ischemic cardiomyopathy, longer duration studies are needed to determine the efficacy of this procedure.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Olarte
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - L Vincent
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - B Ebner
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - J Grant
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - J Maning
- Northwestern University, Cardiology , Chicago , United States of America
| | - R Hernandez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - B Rivera-Rodriguez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - M Giraldo
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - L Grazette
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
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Olarte N, Vincent L, Loyd Q, Ebner B, Grant J, Maning J, Hernandez RJ, Rivera-Rodriguez B, Giraldo M, Lambrakos L. Gender disparities in ventricular tachycardia: evaluating clinical outcomes and interventions. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.675] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Gender differences in the etiology of ventricular arrhythmia are well-known and can potentially affect clinical outcomes. Women have been under-represented in studies investigating ventricular tachycardia (VT). Thus, gender differences in clinical outcomes of VT are poorly defined.
Purpose
We sought to elucidate the clinical outcomes and interventions among women with VT.
Methods
We used the National Inpatient Sample to identify patients aged 18 and older admitted with VT from 2011 to 2019. Observations missing data on age, sex and mortality were excluded. Baseline characteristics include age, race, and comorbidities related to cardiovascular disease. Severity of comorbidities was assessed via the Deyo-Charlson Comorbidity Index (Deyo-CCI) score. Outcomes investigated include all-cause mortality, major adverse cardiovascular events (MACE), and incidence of catheter ablation, cardioversion, and automated implantable cardioverter defibrillator (AICD) insertion. Gender and outcomes association were analyzed using multivariable logistic regression adjusted for baseline characteristics that were significantly different (P<0.05) between cohorts expressed as adjusted odds ratios (aOR) and 95% confidence intervals (CI). SPSS v28.0 (IBM, Armonk, NY) was used to carry out all calculations.
Results
Between 2011 and 2019, there were an estimated 3,544,445 hospital admissions for VT, of which, 33.8% were women, who were more likely to be older (69.2 vs 68.0 years) and of minority descent (30.3% vs 26.7%) compared to men. Women were less likely to have coronary artery disease (43.5% vs 62.2%) or ischemic cardiomyopathy (5.0% vs 11.9%) and had a lower mean Deyo-CCI score (2.2 vs 2.4; p<0.001 for all). Women had a higher incidence of mortality (10.6% vs 9.2%) and ischemic stroke (5.3% vs 4.5%), but less acute coronary syndrome (17.6% vs 21.4%; p<0.001 for all). Overall incidence of MACE was lower among women (28.6% vs 31.4%; p<0.001). Multivariate regression analysis demonstrated that female sex remained independently associated with increased odds for all-cause mortality (aOR: 1.089; 95% CI: [1.062–1.116], p<0.001) although decreased odds for MACE (aOR: 0.952; 95% CI: [0.939–0.965]). Female sex was also independently associated with decreased odds for cardioversion (aOR: 0.936; 95% CI: [0.910–0.963]), AICD insertion, (aOR: 0.737; 95% CI: [0.711–0.764]) and ablation (aOR: 0.806; 95% CI: [0.766–0.847]; all p<0.001).
Conclusion
In this retrospective analysis of patients hospitalized with VT, women had less coronary artery disease and less MACE, yet all-cause mortality was higher. Female sex was also independently associated with fewer interventions, including AICD insertion and ablation. Although there are gender differences in risk factors and causes of VT, this does not fully explain disparities in care and outcomes. Further studies are needed to explore and elucidate these gender disparities.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Olarte
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - L Vincent
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - Q Loyd
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - B Ebner
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
| | - J Grant
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - J Maning
- Northwestern University, Cardiology , Chicago , United States of America
| | - R J Hernandez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - B Rivera-Rodriguez
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - M Giraldo
- Jackson Memorial Hospital, Internal Medicine , Miami , United States of America
| | - L Lambrakos
- University of Miami Leonard M. Miller School of Medicine, Cardiovascular Disease , Miami , United States of America
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Daza JF, Cuthbertson BH, Myles PS, Shulman MA, Wijeysundera DN, Wijeysundera DN, Pearse RM, Myles PS, Abbott TEF, Shulman MA, Torres E, Ambosta A, Melo M, Mamdani M, Thorpe KE, Wallace S, Farrington C, Croal BL, Granton JT, Oh P, Thompson B, Hillis G, Beattie WS, Wijeysundera HC, Ellis M, Borg B, Kerridge RK, Douglas J, Brannan J, Pretto J, Godsall MG, Beauchamp N, Allen S, Kennedy A, Wright E, Malherbe J, Ismail H, Riedel B, Melville A, Sivakumar H, Murmane A, Kenchington K, Kirabiyik Y, Gurunathan U, Stonell C, Brunello K, Steele K, Tronstad O, Masel P, Dent A, Smith E, Bodger A, Abolfathi M, Sivalingam P, Hall A, Painter TW, Macklin S, Elliott A, Carrera AM, Terblanche NCS, Pitt S, Samuels J, Wilde C, Leslie K, MacCormick A, Bramley D, Southcott AM, Grant J, Taylor H, Bates S, Towns M, Tippett A, Marshall F, McCartney CJL, Choi S, Somascanthan P, Flores K, Karkouti K, Clarke HA, Jerath A, McCluskey SA, Wasowicz M, Day L, Pazmino-Canizares J, Belliard R, Lee L, Dobson K, Stanbrook M, Hagen K, Campbell D, Short T, Van Der Westhuizen J, Higgie K, Lindsay H, Jang R, Wong C, McAllister D, Ali M, Kumar J, Waymouth E, Kim C, Dimech J, Lorimer M, Tai J, Miller R, Sara R, Collingwood A, Olliff S, Gabriel S, Houston H, Dalley P, Hurford S, Hunt A, Andrews L, Navarra L, Jason-Smith A, Thompson H, McMillan N, Back G. Measurement properties of the WHO Disability Assessment Schedule 2.0 for evaluating functional status after inpatient surgery. Br J Surg 2022; 109:968-976. [PMID: 35929065 DOI: 10.1093/bjs/znac263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/17/2022] [Accepted: 07/08/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Expert recommendations propose the WHO Disability Assessment Schedule (WHODAS) 2.0 as a core outcome measure in surgical studies, yet data on its long-term measurement properties remain limited. These were evaluated in a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) prospective cohort. METHODS Participants were adults (40 years of age or older) who underwent inpatient non-cardiac surgery. The 12-item WHODAS and EQ-5DTM-3L questionnaires were administered preoperatively (in person) and 1 year postoperatively (by telephone). Responsiveness was characterized using standardized response means (SRMs) and correlation coefficients between change scores. Construct validity was evaluated using correlation coefficients between 1-year scores and comparisons of WHODAS scores across clinically relevant subgroups. RESULTS The analysis included 546 patients. There was moderate correlation between changes in WHODAS and various EQ-5DTM subscales. The strongest correlation was between changes in WHODAS and changes in the functional domains of the EQ-5D-3L-for example, mobility (Spearman's rho 0.40, 95 per cent confidence interval [c.i.] 0.32 to 0.48) and usual activities (rho 0.45, 95 per cent c.i. 0.30 to 0.52). When compared across quartiles of EQ-5D index change, median WHODAS scores followed expected patterns of change. In subgroups with expected functional status changes, the WHODAS SRMs ranged from 'small' to 'large' in the expected directions of change. At 1 year, the WHODAS demonstrated convergence with the EQ-5D-3L functional domains, and good discrimination between patients with expected differences in functional status. CONCLUSION The WHODAS questionnaire has construct validity and responsiveness as a measure of functional status at 1 year after major surgery.
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Affiliation(s)
- Julian F Daza
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Brian H Cuthbertson
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Paul S Myles
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Mark A Shulman
- Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Duminda N Wijeysundera
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Anesthesia, St. Michael's Hospital, Toronto, Ontario, Canada
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12
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Ciriano E, Marrington M, Grant J. Lung lobe torsion in association with a pulmonary papillary carcinoma in a dog. J S Afr Vet Assoc 2022; 93:147-150. [DOI: 10.36303/jsava.515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Affiliation(s)
- E Ciriano
- Northwest Veterinary Specialists,
United Kingdom
| | - M Marrington
- Northwest Veterinary Specialists,
United Kingdom
| | - J Grant
- Northwest Veterinary Specialists,
United Kingdom
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Voepel-Lewis T, Veliz P, Heinze J, Boyd CJ, Zikmund-Fisher B, Lenko R, Grant J, Bromberg H, Kelly A, Tait AR. Enhancing risk perception may be insufficient to curtail prescription opioid use and misuse among youth after surgery: A randomized controlled trial. Patient Educ Couns 2022; 105:2217-2224. [PMID: 35216854 PMCID: PMC9203921 DOI: 10.1016/j.pec.2022.01.015] [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] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This randomized controlled trial examined whether an interactive, risk-focused educational program was associated with higher risk perceptions and decreased prescription opioid use/misuse among emerging adults. METHODS 503 participants aged 15-24 years scheduled for ambulatory surgery were randomized to routine prescription education with or without our Scenario-Tailored Opioid Messaging Program (STOMP) provided prior to receipt of a prescribed opioid. Surveys were completed preoperatively, and at days 7&14, months 1&3 postoperatively. Outcomes included analgesic risk perceptions, opioid use, and misuse intentions/behavior. RESULTS Compared to Controls, STOMP was associated with stable but higher risk perceptions on day 14 (β = 1.76 [95% CI 0.53, 2.99], p = .005) and month 3 (β = 2.13 [95% CI 0.86, 3.40], p = .001). There was no effect of STOMP or analgesic misuse risk perceptions on days of opioid use or subsequent misuse intentions/behavior. The degree to which participants valued pain relief over analgesic risk (trade-off preference) was, however, associated with prolonged postoperative opioid use and later misuse. CONCLUSION Education emphasizing the risks of opioids was insufficient in reducing opioid use and misuse in youth who were prescribed these analgesics for acute pain relief. PRACTICE IMPLICATIONS Education may need to better address analgesic expectations to shorten opioid use and mitigate misuse.
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Affiliation(s)
- Terri Voepel-Lewis
- Department of Health Behavior and Biological Science at the School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pediatric Anesthesiology at Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Phillip Veliz
- Department of Pediatric Anesthesiology at Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Justin Heinze
- Department of Health Behavior and Health Education at the School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Carol J Boyd
- Department of Health Behavior and Biological Science at the School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA
| | - Brian Zikmund-Fisher
- Department of Health Behavior and Health Education at the School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Rachel Lenko
- Department of Pediatric Anesthesiology at Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - John Grant
- Department of Orthopedic Surgery at Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Harrison Bromberg
- Department of Pediatric Anesthesiology at Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alyssa Kelly
- Department of Pediatric Anesthesiology at Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alan R Tait
- Department of Pediatric Anesthesiology at Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
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Degen RM, Hiemstra LA, Lobo J, Woodmass JM, Sommerfeldt M, Khan M, Carsen S, Pauyo T, Chahal J, Urquhart N, Grant J, Rousseau-Saine A, Lebel ME, Sheehan B, Sandman E, Tucker A, Kopka M, Wong I. Arthroscopy Association of Canada Position Statement on Intra-articular Injections for Hip Osteoarthritis. Orthop J Sports Med 2022; 10:23259671211066966. [PMID: 35155702 PMCID: PMC8832617 DOI: 10.1177/23259671211066966] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ryan M. Degen
- Arthroscopy Association of Canada
- Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada
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15
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Annese VF, Giagkoulovits C, Hu C, Al-Rawhani MA, Grant J, Patil SB, Cumming DRS. Micromolar Metabolite Measurement in an Electronically Multiplexed Format. IEEE Trans Biomed Eng 2022; 69:2715-2722. [PMID: 35104208 DOI: 10.1109/tbme.2022.3147855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The detection of metabolites such as choline in blood are important in clinical care for patients with cancer and cardiovascular disease. Choline is only present in human blood at low concentrations hence accurate measurement in an affordable point-of-care format is extremely challenging. Integration of microfluidics on to complementary metal-oxide semiconductor (CMOS) technology has the potential to enable advanced sensing technologies with extremely low limit of detection that are well suited to multiple clinical metabolite measurements. Although CMOS and microfluidics are individually mature technologies, their integration has presented challenges that we overcome in a novel, cost-effective, single-step process. To demonstrate the process, we present the microfluidic integration of a metabolomics-on-CMOS point-of-care platform with four capillary microfluidic channels on top of a CMOS optical sensor array. The fabricated device was characterised to verify the required structural profile, mechanical strength, optical spectra, and fluid flow. As a proof of concept, we used the device for the in-vitro quantification of choline in human blood plasma with a limit of detection of 3.2 M and a resolution of 1.6 M.
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16
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Zhang D, Xu J, Zadorozhny V, Grant J. Fake news detection based on statement conflict. J Intell Inf Syst 2022. [DOI: 10.1007/s10844-021-00678-1] [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: 10/19/2022]
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17
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Bannon CD, Eckenberger J, Snelling WJ, Huseyin CE, Allsopp P, Strain C, Ramnani P, Chitarrari R, Grant J, Hotchkiss S, Philp K, Campbell R, Tuohy KM, Claesson MJ, Ternan NG, Dooley JSG, Sleator RD, Rowland I, Gill CIR. Low-Molecular-Weight Seaweed-Derived Polysaccharides Lead to Increased Faecal Bulk but Do Not Alter Human Gut Health Markers. Foods 2021; 10:foods10122988. [PMID: 34945540 PMCID: PMC8701010 DOI: 10.3390/foods10122988] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/24/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022] Open
Abstract
Seaweeds are potentially sustainable crops and are receiving significant interest because of their rich bioactive compound content; including fatty acids, polyphenols, carotenoids, and complex polysaccharides. However, there is little information on the in vivo effects on gut health of the polysaccharides and their low-molecular-weight derivatives. Herein, we describe the first investigation into the prebiotic potential of low-molecular-weight polysaccharides (LMWPs) derived from alginate and agar in order to validate their in vivo efficacy. We conducted a randomized; placebo-controlled trial testing the impact of alginate and agar LWMPs on faecal weight and other markers of gut health and on composition of gut microbiota. We show that these LMWPs led to significantly increased faecal bulk (20–30%). Analysis of gut microbiome composition by sequencing indicated no significant changes attributable to treatment at the phylum and family level, although FISH analysis showed an increase in Faecalibacterium prausnitzii in subjects consuming agar LMWP. Sequence analysis of gut bacteria corroborated with the FISH data, indicating that alginate and agar LWMPs do not alter human gut microbiome health markers. Crucially, our findings suggest an urgent need for robust and rigorous human in vivo testing—in particular, using refined seaweed extracts.
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Affiliation(s)
- Ciara D. Bannon
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster, Cromore Road, Coleraine, Co., Londonderry BT52 1SA, Northern Ireland, UK; (C.D.B.); (W.J.S.); (P.A.); (J.S.G.D.); (C.I.R.G.)
| | - Julia Eckenberger
- School of Microbiology and APC Microbiome Ireland, University College Cork, T12 K8AF Cork, Ireland; (J.E.); (C.E.H.); (M.J.C.)
| | - William John Snelling
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster, Cromore Road, Coleraine, Co., Londonderry BT52 1SA, Northern Ireland, UK; (C.D.B.); (W.J.S.); (P.A.); (J.S.G.D.); (C.I.R.G.)
| | - Chloe Elizabeth Huseyin
- School of Microbiology and APC Microbiome Ireland, University College Cork, T12 K8AF Cork, Ireland; (J.E.); (C.E.H.); (M.J.C.)
| | - Philip Allsopp
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster, Cromore Road, Coleraine, Co., Londonderry BT52 1SA, Northern Ireland, UK; (C.D.B.); (W.J.S.); (P.A.); (J.S.G.D.); (C.I.R.G.)
| | - Conall Strain
- Moorepark Food Research Centre, Teagasc, Fermoy, Co., P61 C966 Cork, Ireland;
| | - Priya Ramnani
- Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6AP, UK; (P.R.); (R.C.); (I.R.)
| | - Roberto Chitarrari
- Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6AP, UK; (P.R.); (R.C.); (I.R.)
| | - John Grant
- Kerry Global Technology and Innovation Centre, Millennium Park, Naas, Co., W91 W923 Kildare, Ireland;
| | - Sarah Hotchkiss
- CyberColloids Ltd., Carrigaline Industrial Estate, Carrigaline, Co., P43 VR72 Cork, Ireland; (S.H.); (K.P.); (R.C.)
| | - Kevin Philp
- CyberColloids Ltd., Carrigaline Industrial Estate, Carrigaline, Co., P43 VR72 Cork, Ireland; (S.H.); (K.P.); (R.C.)
| | - Ross Campbell
- CyberColloids Ltd., Carrigaline Industrial Estate, Carrigaline, Co., P43 VR72 Cork, Ireland; (S.H.); (K.P.); (R.C.)
| | - Kieran Michael Tuohy
- Nutrition and Nutrigenomics Unit, Research and Innovation Centre, Fondazione Edmund Mach, Via E. Mach 1, 38098 S. Michele all’Adige, TN, Italy;
| | - Marcus J. Claesson
- School of Microbiology and APC Microbiome Ireland, University College Cork, T12 K8AF Cork, Ireland; (J.E.); (C.E.H.); (M.J.C.)
| | - Nigel George Ternan
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster, Cromore Road, Coleraine, Co., Londonderry BT52 1SA, Northern Ireland, UK; (C.D.B.); (W.J.S.); (P.A.); (J.S.G.D.); (C.I.R.G.)
- Correspondence:
| | - James S. G. Dooley
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster, Cromore Road, Coleraine, Co., Londonderry BT52 1SA, Northern Ireland, UK; (C.D.B.); (W.J.S.); (P.A.); (J.S.G.D.); (C.I.R.G.)
| | - Roy D. Sleator
- Department of Biological Sciences, Munster Technological University, Bishopstown, T12 P928 Cork, Ireland;
| | - Ian Rowland
- Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6AP, UK; (P.R.); (R.C.); (I.R.)
| | - Chris I. R. Gill
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster, Cromore Road, Coleraine, Co., Londonderry BT52 1SA, Northern Ireland, UK; (C.D.B.); (W.J.S.); (P.A.); (J.S.G.D.); (C.I.R.G.)
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Yee LM, McGee P, Bailit JL, Wapner RJ, Varner MW, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Mallett G, Grobman W, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Leveno K, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, Zhao Y, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Differences in obstetrical care and outcomes associated with the proportion of the obstetrician's shift completed. Am J Obstet Gynecol 2021; 225:430.e1-430.e11. [PMID: 33812810 DOI: 10.1016/j.ajog.2021.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding and improving obstetrical quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been implemented to improve the quality of care provided to obstetrical patients. Although many factors contribute to delivery decisions, a reduced workload has addressed how provider issues such as fatigue or behaviors surrounding impending shift changes may influence the delivery mode and outcomes. OBJECTIVE The objective was to assess whether intrapartum obstetrical interventions and adverse outcomes differ based on the temporal proximity of the delivery to the attending's shift change. STUDY DESIGN This was a secondary analysis from a multicenter obstetrical cohort in which all patients with cephalic, singleton gestations who attempted vaginal birth were eligible for inclusion. The primary exposure used to quantify the relationship between the proximity of the provider to their shift change and a delivery intervention was the ratio of time from the most recent attending shift change to vaginal delivery or decision for cesarean delivery to the total length of the shift. Ratios were used to represent the proportion of time completed in the shift by normalizing for varying shift lengths. A sensitivity analysis restricted to patients who were delivered by physicians working 12-hour shifts was performed. Outcomes chosen included cesarean delivery, episiotomy, third- or fourth-degree perineal laceration, 5-minute Apgar score of <4, and neonatal intensive care unit admission. Chi-squared tests were used to evaluate outcomes based on the proportion of the attending's shift completed. Adjusted and unadjusted logistic models fitting a cubic spline (when indicated) were used to determine whether the frequency of outcomes throughout the shift occurred in a statistically significant, nonlinear pattern RESULTS: Of the 82,851 patients eligible for inclusion, 47,262 (57%) had ratio data available and constituted the analyzable sample. Deliveries were evenly distributed throughout shifts, with 50.6% taking place in the first half of shifts. There were no statistically significant differences in the frequency of cesarean delivery, episiotomy, third- or fourth-degree perineal lacerations, or 5-minute Apgar scores of <4 based on the proportion of the shift completed. The findings were unchanged when evaluated with a cubic spline in unadjusted and adjusted logistic models. Sensitivity analyses performed on the 22.2% of patients who were delivered by a physician completing a 12-hour shift showed similar findings. There was a small increase in the frequency of neonatal intensive care unit admissions with a greater proportion of the shift completed (adjusted P=.009), but the findings did not persist in the sensitivity analysis. CONCLUSION Clinically significant differences in obstetrical interventions and outcomes do not seem to exist based on the temporal proximity to the attending physician's shift change. Future work should attempt to directly study unit culture and provider fatigue to further investigate opportunities to improve obstetrical quality of care, and additional studies are needed to corroborate these findings in community settings.
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Phillips M, Bhandari M, Grant J, Bedi A, Trojian T, Johnson A, Schemitsch E. A Systematic Review of Current Clinical Practice Guidelines on Intra-articular Hyaluronic Acid, Corticosteroid, and Platelet-Rich Plasma Injection for Knee Osteoarthritis: An International Perspective. Orthop J Sports Med 2021; 9:23259671211030272. [PMID: 34485586 PMCID: PMC8414628 DOI: 10.1177/23259671211030272] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/01/2021] [Indexed: 12/31/2022] Open
Abstract
Background: There are many clinical practice guidelines (CPGs) for the prevention,
diagnosis, and treatment of knee osteoarthritis (OA). They differ by region,
considering local health care systems, along with cultural and economic
factors. Currently, there are conflicting CPG recommendations across the
various publications, which makes it difficult for clinicians to fully
understand the optimal treatment decisions for knee OA management. Purpose: To summarize the current published CPG recommendations for the role of
injections in the nonoperative management of knee OA, specifically with the
use of intra-articular hyaluronic acid (IA-HA), intra-articular
corticosteroids (IA-CS), and platelet-rich plasma (PRP). Study Design: Systematic review. Methods: A comprehensive search identified all nonoperative knee OA CPGs within the
ECRI (formerly Emergency Care Research Institute) Guidelines Trust database,
the Guidelines International Network database, Google Scholar, and the Trip
(formerly Turning Research Into Practice) database. Guideline
recommendations were categorized into strong, conditional, or uncertain
recommendations for or against the use of IA-HA, IA-CS, or PRP. Guideline
recommendations were summarized and depicted graphically to identify trends
in recommendations over time. Results: The search strategy identified 27 CPGs that provided recommendations. There
were 20 recommendations in favor of IA-HA use, 21 recommendations in favor
of IA-CS use, and 9 recommendations that were uncertain or unable to make a
formal recommendation for or against PRP use based on current evidence. Most
recommendations considered IA-HA and IA-CS use for symptom relief when other
nonoperative options are ineffective. IA-CS were noted to provide fast and
short-acting symptom relief for acute episodes of disease exacerbation,
while IA-HA may demonstrate a relatively delayed but prolonged effect in
comparison. The CPGs concluded that PRP recommendations currently lack
evidence to definitively recommend for or against use. Conclusion: Available CPGs provide recommendations on injectables for knee OA treatment.
General guidance from a global perspective concluded that IA-CS and IA-HA
are favored for different needed responses and can be utilized within the
knee OA treatment paradigm, while PRP currently has insufficient evidence to
make a conclusive recommendation for or against its use.
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Affiliation(s)
- Mark Phillips
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mohit Bhandari
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - John Grant
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Asheesh Bedi
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Thomas Trojian
- Department of Family Medicine, WellSpan Health, York, Pennsylvania, USA
| | - Aaron Johnson
- Department of Orthopaedics, University of Maryland, College Park, Maryland, USA
| | - Emil Schemitsch
- Department of Surgery, University of Western Ontario, London, Ontario, Canada
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Westerdahl JS, Grant J, Sontheimer R, Zussman J. Darier disease, radiation therapy, and herpesvirus -- an unfortunate triad. Dermatol Online J 2021; 27. [PMID: 34755961 DOI: 10.5070/d327854698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 11/08/2022] Open
Abstract
Darier disease (DD) is a rare autosomal dominant keratinizing disorder often characterized by brown scaly pruritic papules over the face, neck, and trunk. Herein is reported a patient who developed secondary cutaneous herpes simplex virus (HSV) following exacerbation of his DD as a result of radiation therapy. In November 2020, a 78-year-old man presented to clinic for a pruritic rash on his back consistent with DD. He had developed the rash after the conclusion of chemoradiation therapy for recently diagnosed urothelial carcinoma of the bladder with squamous differentiation. However, he returned two weeks later complaining of a marked worsening of the rash associated with a pain and burning sensations. Histopathology was non-conclusive, but the lesions were found to be positive for HSV-1 by PCR. The patient recovered without complication over a period of two weeks following a course of valacyclovir. There is precedent in the literature for ionizing radiation inducing flares of DD lesions in overlying skin. In addition, DD has been shown to put a patient at increased risk for secondary infections such as HSV. This case report demonstrates that HSV could pose a significant risk to those with DD receiving radiation therapy and thus could warrant prophylactic treatment.
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Grant J, Martinez MV, Molinaro C, Parisi F. Dimensional Inconsistency Measures and Postulates in Spatio-Temporal Databases. J ARTIF INTELL RES 2021. [DOI: 10.1613/jair.1.12435] [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: 11/04/2022] Open
Abstract
The problem of managing spatio-temporal data arises in many applications, such as location-based services, environmental monitoring, geographic information systems, and many others. Often spatio-temporal data arising from such applications turn out to be inconsistent, i.e., representing an impossible situation in the real world. Though several inconsistency measures have been proposed to quantify in a principled way inconsistency in propositional knowledge bases, little effort has been done so far on inconsistency measures tailored for the spatio-temporal setting.
In this paper, we define and investigate new measures that are particularly suitable for dealing with inconsistent spatio-temporal information, because they explicitly take into account the spatial and temporal dimensions, as well as the dimension concerning the identifiers of the monitored objects. Specifically, we first define natural measures that look at individual dimensions (time, space, and objects), and then propose measures based on the notion of a repair. We then analyze their behavior w.r.t. common postulates defined for classical propositional knowledge bases, and find that the latter are not suitable for spatio-temporal databases, in that the proposed inconsistency measures do not often satisfy them. In light of this, we argue that also postulates should explicitly take into account the spatial, temporal, and object dimensions and thus define “dimension-aware” counterparts of common postulates, which are indeed often satisfied by the new inconsistency measures. Finally, we study the complexity of the proposed inconsistency measures.
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Piqueux S, Müller N, Grott M, Siegler M, Millour E, Forget F, Lemmon M, Golombek M, Williams N, Grant J, Warner N, Ansan V, Daubar I, Knollenberg J, Maki J, Spiga A, Banfield D, Spohn T, Smrekar S, Banerdt B. Soil Thermophysical Properties Near the InSight Lander Derived From 50 Sols of Radiometer Measurements. J Geophys Res Planets 2021; 126:e2021JE006859. [PMID: 35845552 PMCID: PMC9285084 DOI: 10.1029/2021je006859] [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] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/12/2021] [Accepted: 04/19/2021] [Indexed: 06/11/2023]
Abstract
Measurements from the InSight lander radiometer acquired after landing are used to characterize the thermophysical properties of the Martian soil in Homestead hollow. This data set is unique as it stems from a high measurement cadence fixed platform studying a simple well-characterized surface, and it benefits from the environmental characterization provided by other instruments. We focus on observations acquired before the arrival of a regional dust storm (near Sol 50), on the furthest observed patch of soil (i.e., ∼3.5 m away from the edge of the lander deck) where temperatures are least impacted by the presence of the lander and where the soil has been least disrupted during landing. Diurnal temperature cycles are fit using a homogenous soil configuration with a thermal inertia of 183 ± 25 J m-2 K-1 s-1/2 and an albedo of 0.16, corresponding to very fine to fine sand with the vast majority of particles smaller than 140 μm. A pre-landing assessment leveraging orbital thermal infrared data is consistent with these results, but our analysis of the full diurnal temperature cycle acquired from the ground further indicates that near surface layers with different thermophysical properties must be thin (i.e., typically within the top few mm) and deep layering with different thermophysical properties must be at least below ∼4 cm. The low thermal inertia value indicates limited soil cementation within the upper one or two skin depths (i.e., ∼4-8 cm and more), with cement volumes <<1%, which is challenging to reconcile with visible images of overhangs in pits.
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Affiliation(s)
- Sylvain Piqueux
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - Nils Müller
- DLR Institute for Planetary ResearchBerlinGermany
| | | | | | | | | | | | - Matthew Golombek
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - Nathan Williams
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - John Grant
- National Air and Space MuseumSmithsonian InstitutionWashingtonDCUSA
| | | | | | | | | | - Justin Maki
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | | | | | - Tilman Spohn
- DLR Institute for Planetary ResearchBerlinGermany
- International Space Science Institute ISSIBernSwitzerland
| | - Susan Smrekar
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - Bruce Banerdt
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
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23
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Lepard J, Akbari SHA, Mooney J, Arynchyna A, Iii SGM, Myers RP, Grant J, Johnston JM. Comparison of aesthetic outcomes between open and endoscopically treated sagittal craniosynostosis. J Neurosurg Pediatr 2021; 28:432-438. [PMID: 34330097 DOI: 10.3171/2021.3.peds20894] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/02/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In the last several decades, there has been much debate regarding the ideal treatment for sagittal synostosis. The purpose of this study was to compare perioperative, anthropometric, and subjective assessments of cosmetic outcomes between open and endoscopic management of isolated sagittal synostosis. METHODS At their routine postoperative follow-up, pediatric patients with sagittal craniosynostosis were recruited to undergo digital cranial measurement and standardized photography for objective and subjective assessments of perioperative outcomes. Age-normalized z-scores for cephalic index, head circumference, euryon-euryon diameter (Eu-Eu), and glabella-opisthocranion diameter (G-Op) were calculated for each patient. Faculty surgeons, surgical trainees, nurses, and laypersons were asked to rate the normalcy of craniofacial appearances using a 5-point Likert scale. Outcomes were compared between patients treated with endoscopic correction and those treated with open repair. RESULTS A total of 50 patients were included in the study. Thirty-one had undergone open surgical correction, and 19 had undergone endoscopic treatment. Endoscopic repair involved significantly lower operative time, blood loss, transfusion rate, and hospital length of stay than those with open repair (p < 0.001). There was no significant difference between groups in terms of z-scores for head circumference (p = 0.22), cephalic index (p = 0.25), or Eu-Eu (p = 0.38). Endoscopic treatment was associated with a significantly lower G-Op (p = 0.009). Additionally, the average subjective rating of head shape was higher for endoscopic treatment when corrected for age, gender, and ethnicity (p = 0.02). CONCLUSIONS The study findings suggest that patients who are treated endoscopically may have an overall more normal appearance in skull morphology and cosmesis, although these results are limited by poor reliability.
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Affiliation(s)
| | - S Hassan A Akbari
- 3Department of Neurosurgery, Penn State College of Medicine, Hershey, Pennsylvania
| | | | | | | | - René P Myers
- 2Plastic Surgery, The University of Alabama at Birmingham, Alabama; and
| | - John Grant
- 2Plastic Surgery, The University of Alabama at Birmingham, Alabama; and
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Masud S, Sheehan B, Rousseau-Saine A, Tucker A, Sandman E, Wong I, Woodmass J, Chalal J, Lobo J, Grant J, LeBel ME, Sommerfeldt M, Kopka M, Urquhart N, Carsen S, Pauyo T, Khan M. Arthroscopy Association of Canada Position Statement on Exercise for Knee Osteoarthritis: A Systematic Review of Guidelines. Orthop J Sports Med 2021; 9:23259671211016900. [PMID: 34179210 PMCID: PMC8207290 DOI: 10.1177/23259671211016900] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Exercise is widely regarded to improve pain and function in patients with knee osteoarthritis (OA) through building supportive muscle mass, facilitating weight loss, and through the other beneficial effects associated with it. PURPOSE To explore literature that presents clinical guidelines for the use of exercise in the treatment of knee OA to inform an evidence-based position statement for the Arthroscopy Association of Canada. STUDY DESIGN Position statement. METHODS PubMed, MEDLINE, Embase, and Cochrane databases were searched for guidelines commenting on the role of exercise for knee OA. The search was limited to guidelines published in the last 10 years. Articles were screened for relevance, focusing on recently published research with clinical guidelines. Inclusion criteria involved all articles providing clinical guidelines for exercise and knee OA. RESULTS Eight guidelines were identified. All eight recommended exercise as an important component of treatment for knee OA, with 6/8 strongly recommending it. CONCLUSION Exercise is an effective and important component of the non-pharmacological management of knee OA. The Arthroscopy Association of Canada strongly recommends the use of exercise in the management of knee OA.
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Affiliation(s)
- Saad Masud
- Wayne State School of Medicine, Detroit, Michigan, USA
| | | | | | | | - Emilie Sandman
- Wayne State School of Medicine, Detroit, Michigan, USA
- Arthroscopy Association of Canada
| | | | | | | | | | | | | | | | | | | | | | | | - Moin Khan
- Arthroscopy Association of Canada
- McMaster University, Hamilton, Ontario, Canada
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Mooney D, Richards KG, Danaher M, Grant J, Gill L, Mellander PE, Coxon CE. An analysis of the spatio-temporal occurrence of anthelmintic veterinary drug residues in groundwater. Sci Total Environ 2021; 769:144804. [PMID: 33485200 DOI: 10.1016/j.scitotenv.2020.144804] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/16/2020] [Accepted: 12/20/2020] [Indexed: 06/12/2023]
Abstract
Anthelmintics are antiparasitic drugs used to control helminthic parasites such as nematodes and trematodes in animals, particularly those exposed through pasture-based production systems. Even though anthelmintics have been shown to be excreted into the environment in relatively high amounts as unmetabolized drug or transformation products (TPs), there is still only limited information available on their environmental occurrence, particularly in groundwater, which has resulted in them being considered as potential emerging contaminants of concern. A comprehensive study was carried out to investigate the occurrence of 40 anthelmintic residues (including 13 TPs) in groundwaters (and associated surface waters) throughout the Republic of Ireland. The study focused on investigating the occurrence of these contaminants in karst and fractured bedrock aquifers, with a total of 106 sites (88 groundwaters and 18 surface waters) samples during spring 2017. Seventeen anthelmintic compounds consisting of eight parent drugs and nine TPs were detected at 22% of sites at concentrations up to 41 ng L-1. Albendazole and its TPs were most frequently detected residues, found at 8% of groundwater sites and 28% of surface water sites. Multivariate statistical analysis identified several source and pathway factors as being significantly related to the occurrence of anthelmintics in groundwater, however there was an evident localised effect which requires further investigation. An investigation of the temporal variations in occurrence over a 13 month period indicated a higher frequency and concentration of anthelmintics during February/March and again later during August/September 2018, which coincided with periods of increased usage and intensive meteorological events. This work presents the first detections of these contaminants in Irish groundwater and it contributes to broadening our understanding of anthelmintics in the environment. It also provides insight to seasonal trends in occurrence, which is critical for assessing potential future effects and implications of climate change.
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Affiliation(s)
- D Mooney
- Geology Department/Trinity Centre for the Environment, School of Natural Sciences, Trinity College Dublin, Ireland; Food Safety Department, Teagasc, Ashtown Food Research Centre, Ashtown, Dublin 15, Ireland; Irish Centre for Research in Applied Geosciences (iCRAG), Ireland.
| | - K G Richards
- Irish Centre for Research in Applied Geosciences (iCRAG), Ireland; Environment, Soils and Land-Use Department, Environment Research Centre, Teagasc, Johnstown Castle, Wexford, Ireland
| | - M Danaher
- Food Safety Department, Teagasc, Ashtown Food Research Centre, Ashtown, Dublin 15, Ireland
| | - J Grant
- Statistics and Applied Physics, Research Operations Group, Teagasc, Ashtown, Dublin 15, Ireland
| | - L Gill
- Irish Centre for Research in Applied Geosciences (iCRAG), Ireland; Department of Civil, Structural and Environmental Engineering, Trinity College Dublin, Ireland
| | - P-E Mellander
- Environment, Soils and Land-Use Department, Environment Research Centre, Teagasc, Johnstown Castle, Wexford, Ireland
| | - C E Coxon
- Geology Department/Trinity Centre for the Environment, School of Natural Sciences, Trinity College Dublin, Ireland; Irish Centre for Research in Applied Geosciences (iCRAG), Ireland
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Abstract
Fumigant use in perennial crops can be reduced through prolonging the life of existing orchards. The longer an orchard remains healthy and productive, the less often it will be terminated, fumigated, and replanted. Two trials were conducted to determine the effectiveness of DiTera, a toxin produced by the fungus (Myrothecium verrucaria) and Nema-Q, an extract of the soap bark tree (Quillaja saponaria) for management of root-lesion (Pratylenchus vulnus) and ring (Mesocriconema xenopla) nematodes on walnuts. In the first trial, spring and fall treatments of DiTera were applied each year for four years to variety ‘Chandler’ scion on seedling ‘Paradox’ rootstock, and to own-rooted ‘Chandler’ trees. On ‘Paradox’ rootstock, both DiTera and Nema-Q increased walnut yields (P ≤ 0.05) and produced more vigorous trees (P ≤ 0.05) without significant reductions in nematode populations (P ≤ 0.05). A second trial was conducted with three rates of DiTera and four rates of Nema-Q, combinations of the two products, and an untreated control on ‘Chandler’ scion on ‘Paradox’ rootstock. The highest rate of Nema-Q (P ≤ 0.05), and a combination treatment of DiTera plus Nema-Q (P ≤ 0.05) increased trunk circumference. Several treatments showed reductions in root-lesion and ring nematodes (P ≤ 0.05). Bionematicides can improve yield, growth, and vigor in walnut orchards infested with plant-parasitic nematodes.
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Affiliation(s)
- B B Westerdahl
- Department of Entomology and Nematology, University of California, Davis, CA 95616
| | - J Hasey
- University of California Cooperative Extension, Yuba City, CA 95991
| | - J Grant
- University of California Cooperative Extension, Stockton, CA 95206
| | - L W Beem
- Beem Consulting, Sacramento, CA 95827
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Mooney D, Richards KG, Danaher M, Grant J, Gill L, Mellander PE, Coxon CE. An investigation of anticoccidial veterinary drugs as emerging organic contaminants in groundwater. Sci Total Environ 2020; 746:141116. [PMID: 32758987 DOI: 10.1016/j.scitotenv.2020.141116] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/14/2020] [Accepted: 07/18/2020] [Indexed: 05/23/2023]
Abstract
Intensification of the food production system to meet increased global demand for food has led to veterinary pharmaceuticals becoming a critical component in animal husbandry. Anticoccidials are a group of veterinary products used to control coccidiosis in food-producing animals, with primary prophylactic use in poultry production. Excretion in manure and subsequent land-spreading provides a potential pathway to groundwater. Information on the fate and occurrence of these compounds in groundwater is scant, therefore these substances are potential emerging organic contaminants of concern. A study was carried out to investigate the occurrence of anticoccidial compounds in groundwater throughout the Republic of Ireland. Twenty-six anticoccidials (6 ionophores and 20 synthetic anticoccidials) were analysed at 109 sites (63 boreholes and 46 springs) during November and December 2018. Sites were categorised and selected based on the following source and pathway factors: (a) the presence/absence of poultry activity (b) predominant aquifer category and (c) predominant groundwater vulnerability, within the zone of contribution (ZOC) for each site. Seven anticoccidials, including four ionophores (lasalocid, monensin, narasin and salinomycin) and three synthetic anticoccidials (amprolium, diclazuril and nicarbazin), were detected at 24% of sites at concentrations ranging from 1 to 386 ng L-1. Monensin and amprolium were the two most frequently detected compounds, detected at 15% and 7% of sites, respectively. Multivariate statistical analysis has shown that source factors are the most significant drivers of the occurrence of anticoccidials, with no definitive relationships between occurrence and pathway factors. The study found that the detection of anticoccidial compounds is 6.5 times more likely when poultry activity is present within the ZOC of a sampling point, compared to the absence of poultry activity. This work presents the first detections of these contaminants in Irish groundwater and it contributes to broadening our understanding of the environmental occurrence and fate of anticoccidial veterinary products.
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Affiliation(s)
- D Mooney
- Geology Department/Trinity Centre for the Environment, School of Natural Sciences, Trinity College Dublin, Ireland; Food Safety Department, Teagasc, Ashtown Food Research Centre, Ashtown, Dublin 15, Ireland; Irish Centre for Research in Applied Geosciences (iCRAG), Ireland.
| | - K G Richards
- Irish Centre for Research in Applied Geosciences (iCRAG), Ireland; Environment, Soils and Land-Use Department, Teagasc Environment Research Centre, Johnstown Castle, Wexford, Ireland
| | - M Danaher
- Food Safety Department, Teagasc, Ashtown Food Research Centre, Ashtown, Dublin 15, Ireland
| | - J Grant
- Statistics and Applied Physics, Research Operations Group, Teagasc, Ashtown, Dublin 15, Ireland
| | - L Gill
- Irish Centre for Research in Applied Geosciences (iCRAG), Ireland; Department of Civil, Structural and Environmental Engineering, Trinity College Dublin, Ireland
| | - P-E Mellander
- Agricultural Catchments Programme, Teagasc Environment Research Centre, Johnstown Castle, Wexford, Ireland
| | - C E Coxon
- Geology Department/Trinity Centre for the Environment, School of Natural Sciences, Trinity College Dublin, Ireland; Irish Centre for Research in Applied Geosciences (iCRAG), Ireland
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Golombek M, Williams N, Warner NH, Parker T, Williams MG, Daubar I, Calef F, Grant J, Bailey P, Abarca H, Deen R, Ruoff N, Maki J, McEwen A, Baugh N, Block K, Tamppari L, Call J, Ladewig J, Stoltz A, Weems WA, Mora‐Sotomayor L, Torres J, Johnson M, Kennedy T, Sklyanskiy E. Location and Setting of the Mars InSight Lander, Instruments, and Landing Site. Earth Space Sci 2020; 7:e2020EA001248. [PMID: 33134434 PMCID: PMC7583488 DOI: 10.1029/2020ea001248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 09/09/2020] [Accepted: 09/12/2020] [Indexed: 06/11/2023]
Abstract
Knowing precisely where a spacecraft lands on Mars is important for understanding the regional and local context, setting, and the offset between the inertial and cartographic frames. For the InSight spacecraft, the payload of geophysical and environmental sensors also particularly benefits from knowing exactly where the instruments are located. A ~30 cm/pixel image acquired from orbit after landing clearly resolves the lander and the large circular solar panels. This image was carefully georeferenced to a hierarchically generated and coregistered set of decreasing resolution orthoimages and digital elevation models to the established positive east, planetocentric coordinate system. The lander is located at 4.502384°N, 135.623447°E at an elevation of -2,613.426 m with respect to the geoid in Elysium Planitia. Instrument locations (and the magnetometer orientation) are derived by transforming from Instrument Deployment Arm, spacecraft mechanical, and site frames into the cartographic frame. A viewshed created from 1.5 m above the lander and the high-resolution orbital digital elevation model shows the lander is on a shallow regional slope down to the east that reveals crater rims on the east horizon ~400 m and 2.4 km away. A slope up to the north limits the horizon to about 50 m away where three rocks and an eolian bedform are visible on the rim of a degraded crater rim. Azimuths to rocks and craters identified in both surface panoramas and high-resolution orbital images reveal that north in the site frame and the cartographic frame are the same (within 1°).
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Affiliation(s)
- M. Golombek
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - N. Williams
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - N. H. Warner
- Department of Geological SciencesSUNY GeneseoGeneseoNYUSA
| | - T. Parker
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - M. G. Williams
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - I. Daubar
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
- Department of Earth, Environmental, and Planetary SciencesBrown UniversityProvidenceRIUSA
| | - F. Calef
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - J. Grant
- Smithsonian Institution, National Air and Space MuseumWashingtonDCUSA
| | - P. Bailey
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - H. Abarca
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - R. Deen
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - N. Ruoff
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - J. Maki
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - A. McEwen
- Lunar and Planetary LaboratoryUniversity of ArizonaTucsonAZUSA
| | - N. Baugh
- Lunar and Planetary LaboratoryUniversity of ArizonaTucsonAZUSA
| | - K. Block
- Lunar and Planetary LaboratoryUniversity of ArizonaTucsonAZUSA
| | - L. Tamppari
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - J. Call
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | | | | | | | - L. Mora‐Sotomayor
- Centro de Astrobiología (CSIC/INTA)Instituto Nacional de Técnica AeroespacialMadridSpain
| | - J. Torres
- Centro de Astrobiología (CSIC/INTA)Instituto Nacional de Técnica AeroespacialMadridSpain
| | | | | | - E. Sklyanskiy
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
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Geia L, Baird K, Bail K, Barclay L, Bennett J, Best O, Birks M, Blackley L, Blackman R, Bonner A, Bryant AO R, Buzzacott C, Campbell S, Catling C, Chamberlain C, Cox L, Cross W, Cruickshank M, Cummins A, Dahlen H, Daly J, Darbyshire P, Davidson P, Denney-Wilson E, De Souza R, Doyle K, Drummond A, Duff J, Duffield C, Dunning T, East L, Elliott D, Elmir R, Fergie OAM D, Ferguson C, Fernandez R, Flower AM D, Foureur M, Fowler C, Fry M, Gorman E, Grant J, Gray J, Halcomb E, Hart B, Hartz D, Hazelton M, Heaton L, Hickman L, Homer AO CSE, Hungerford C, Hutton A, Jackson AO D, Johnson A, Kelly MA, Kitson A, Knight S, Levett-Jones T, Lindsay D, Lovett R, Luck L, Molloy L, Manias E, Mannix J, Marriott AMR, Martin M, Massey D, McCloughen A, McGough S, McGrath L, Mills J, Mitchell BG, Mohamed J, Montayre J, Moroney T, Moyle W, Moxham L, Northam OAM H, Nowlan S, O'Brien AP, Ogunsiji O, Paterson C, Pennington K, Peters K, Phillips J, Power T, Procter N, Ramjan L, Ramsay N, Rasmussen B, Rihari-Thomas J, Rind B, Robinson M, Roche M, Sainsbury K, Salamonson Y, Sherwood J, Shields L, Sim J, Skinner I, Smallwood G, Smallwood R, Stewart L, Taylor S, Usher AM K, Virdun C, Wannell J, Ward R, West C, West R, Wilkes L, Williams R, Wilson R, Wynaden D, Wynne R. A unified call to action from Australian nursing and midwifery leaders: ensuring that Black lives matter. Contemp Nurse 2020; 56:297-308. [DOI: 10.1080/10376178.2020.1809107] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- L. Geia
- James Cook University, Townsville, QLD, Australia
| | - K. Baird
- University of Technology Sydney, Sydney, NSW, Australia
| | - K. Bail
- University of Canberra, Canberra, ACT, Australia
| | - L. Barclay
- University of Sydney, Sydney, NSW, Australia
| | - J. Bennett
- University of Newcastle, Callaghan, NSW, Australia
| | - O. Best
- University of Southern Queensland, Darling Heights, QLD, Australia
| | - M. Birks
- James Cook University, Townsville, QLD, Australia
| | - L. Blackley
- Queensland Health, Joyce Palmer Health Service, Palm Island, QLD, Australia
| | - R. Blackman
- Gidgee Healing Mt Isa, Mount Isa, QLD, Australia
| | - A. Bonner
- Griffith University, Brisbane, QLD, Australia
| | - R. Bryant AO
- Rosemary Bryant Foundation, South Australia, Australia
| | - C. Buzzacott
- Rhodanthe Lipsett Indigenous Midwifery Charitable Fund, Caringbah, NSW, Australia
| | - S. Campbell
- Charles Darwin University, Darwin, NT, Australia
| | - C. Catling
- University of Technology Sydney, Sydney, NSW, Australia
| | | | - L. Cox
- Queensland University of Technology, Brisbane, QLD, Australia
| | - W. Cross
- Federation University, Ballarat, VIC, Australia
| | - M. Cruickshank
- University of Technology Sydney, Sydney, NSW, Australia
- Sydney Children’s Hospital Network, Sydney, NSW, Australia
| | - A. Cummins
- University of Technology Sydney, Sydney, NSW, Australia
| | - H. Dahlen
- Western Sydney University, Sydney, NSW, Australia
| | - J. Daly
- University of Sydney, Sydney, NSW, Australia
| | - P. Darbyshire
- Philip Darbyshire Consulting, Highbury, South Australia, Australia
| | - P. Davidson
- University of Technology Sydney, Sydney, NSW, Australia
- Western Sydney University, Sydney, NSW, Australia
- John Hopkins University, Baltimore, USA
| | | | | | - K. Doyle
- Western Sydney University, Sydney, NSW, Australia
| | - A. Drummond
- Queensland University of Technology, Brisbane, QLD, Australia
| | - J. Duff
- Queensland University of Technology, Brisbane, QLD, Australia
| | - C. Duffield
- University of Technology Sydney, Sydney, NSW, Australia
- Edith Cowan University, Perth, Western Australia, Australia
| | - T. Dunning
- Deakin University, Melbourne, VIC, Australia
| | - L. East
- University of New England, Armidale, NSW, Australia
| | - D. Elliott
- University of Technology Sydney, Sydney, NSW, Australia
| | - R. Elmir
- Western Sydney University, Sydney, NSW, Australia
| | - D. Fergie OAM
- Australian Catholic University, Fitzroy, VIC, Australia
| | - C. Ferguson
- Western Sydney University, Sydney, NSW, Australia
| | - R. Fernandez
- University of Wollongong, Keiraville, NSW, Australia
| | | | - M. Foureur
- University of Newcastle, Callaghan, NSW, Australia
| | - C. Fowler
- University of Technology Sydney, Sydney, NSW, Australia
| | - M. Fry
- University of Technology Sydney, Sydney, NSW, Australia
| | - E. Gorman
- New South Wales Health, Sydney, NSW, Australia
| | - J. Grant
- Charles Sturt University, Dubbo, NSW, Australia
| | - J. Gray
- University of Technology Sydney, Sydney, NSW, Australia
| | - E. Halcomb
- University of Wollongong, Keiraville, NSW, Australia
| | - B. Hart
- University of Notre Dame, Darlinghurst, NSW, Australia
| | - D. Hartz
- Charles Darwin University, Darwin, NT, Australia
| | - M. Hazelton
- University of Newcastle, Callaghan, NSW, Australia
| | - L. Heaton
- Western Sydney University, Sydney, NSW, Australia
| | - L. Hickman
- University of Technology Sydney, Sydney, NSW, Australia
- Contemporary Nurse Journal
| | | | | | - A. Hutton
- University of Newcastle, Callaghan, NSW, Australia
| | - D. Jackson AO
- University of Technology Sydney, Sydney, NSW, Australia
| | - A. Johnson
- University of Newcastle, Callaghan, NSW, Australia
| | - M. A. Kelly
- Sydney Children’s Hospital Network, Sydney, NSW, Australia
| | - A. Kitson
- Western Sydney University, Sydney, NSW, Australia
| | - S. Knight
- James Cook University, Townsville, QLD, Australia
| | | | - D. Lindsay
- James Cook University, Townsville, QLD, Australia
| | - R. Lovett
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - L. Luck
- Western Sydney University, Sydney, NSW, Australia
| | - L. Molloy
- University of Wollongong, Keiraville, NSW, Australia
| | - E. Manias
- Deakin University, Melbourne, VIC, Australia
| | - J. Mannix
- Western Sydney University, Sydney, NSW, Australia
| | | | - M. Martin
- Queensland Aboriginal and Islander Health Council, Brisbane, QLD, Australia
| | - D. Massey
- Southern Cross University, Gold Coast Campus, QLD, Australia
| | | | - S. McGough
- Curtin University, Perth, Western Australia, Australia
| | - L. McGrath
- Aboriginal Medical Service Redfern, Sydney, NSW, Australia
| | - J. Mills
- La Trobe University, Melbourne, VIC, Australia
| | | | - J. Mohamed
- Lowitja Institute, Melbourne, VIC, Australia
| | - J. Montayre
- Western Sydney University, Sydney, NSW, Australia
| | - T. Moroney
- University of Wollongong, Keiraville, NSW, Australia
| | - W. Moyle
- Griffith University, Brisbane, QLD, Australia
| | - L. Moxham
- University of Wollongong, Keiraville, NSW, Australia
| | | | - S. Nowlan
- Queensland Health, Joyce Palmer Health Service, Palm Island, QLD, Australia
| | | | - O. Ogunsiji
- Western Sydney University, Sydney, NSW, Australia
| | - C. Paterson
- University of Canberra, Canberra, ACT, Australia
| | - K. Pennington
- Flinders University, Adelaide, South Australia, Australia
| | - K. Peters
- Western Sydney University, Sydney, NSW, Australia
| | - J. Phillips
- University of Technology Sydney, Sydney, NSW, Australia
| | - T. Power
- University of Technology Sydney, Sydney, NSW, Australia
| | - N. Procter
- University of South Australia, Adelaide, South Australia, Australia
| | - L. Ramjan
- Western Sydney University, Sydney, NSW, Australia
| | - N. Ramsay
- Queensland Health, Joyce Palmer Health Service, Palm Island, QLD, Australia
| | | | | | - B. Rind
- Aboriginal Health Unit Mt Druitt Hospital, Sydney, NSW, Australia
| | - M. Robinson
- Murdoch University, Perth, Western Australia, Australia
| | - M. Roche
- University of Technology Sydney, Sydney, NSW, Australia
| | - K. Sainsbury
- University of Canberra, Canberra, ACT, Australia
| | | | - J. Sherwood
- Charles Sturt University, Dubbo, NSW, Australia
| | - L. Shields
- University of Queensland, Brisbane, QLD, Australia
| | - J. Sim
- University of Wollongong, Keiraville, NSW, Australia
| | - I. Skinner
- James Cook University, Townsville, QLD, Australia
| | - G. Smallwood
- James Cook University, Townsville, QLD, Australia
| | - R. Smallwood
- University of Newcastle, Callaghan, NSW, Australia
- University of New England, Armidale, NSW, Australia
| | - L. Stewart
- James Cook University, Townsville, QLD, Australia
| | - S. Taylor
- Top End Health, Northern Territory, Darwin, NT, Australia
| | - K. Usher AM
- University of Technology Sydney, Sydney, NSW, Australia
- University of New England, Armidale, NSW, Australia
| | - C. Virdun
- University of Technology Sydney, Sydney, NSW, Australia
| | - J. Wannell
- Melbourne Poche Centre for Indigenous Health, Melbourne, VIC, Australia
| | - R. Ward
- University of Southern Queensland, Darling Heights, QLD, Australia
| | - C. West
- James Cook University, Townsville, QLD, Australia
| | - R. West
- Griffith University, Brisbane, QLD, Australia
| | - L. Wilkes
- Western Sydney University, Sydney, NSW, Australia
| | - R. Williams
- Charles Darwin University, Darwin, NT, Australia
| | - R. Wilson
- University of Newcastle, Callaghan, NSW, Australia
- University of New England, Armidale, NSW, Australia
| | - D. Wynaden
- Curtin University, Perth, Western Australia, Australia
| | - R. Wynne
- Western Sydney University, Sydney, NSW, Australia
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Votruba N, Grant J, Thornicroft G. The EVITA evidence action tool to improve evidence-based policymaking for public mental health. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1020] [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: 11/14/2022] Open
Abstract
Abstract
The estimated global disease burden of mental illness is 32.4% of years lived with disability. Mental health is a critical determinant for public health, and government-level action is needed for integration of mental health into public health. But in many low/middle-income countries (LMICs) mental health is absent on the policy agenda, despite up to 90% of people with mental illness lacking treatment. Evidence on cost-effective treatments is available, but translation of research into policy is a 'wicked' problem and often fails. We investigate the inter-relationships of research evidence and mental health policymaking in LMICs and present a framework/advocacy tool to guide and support evidence-based public mental health policymaking.
Using a mixed-methods approach, we conducted a systematic review, based on which we developed a provisional framework (EVITA), revised and validated it through expert in-depth interviews. We then empirically tested the EVITA framework against three case studies (provincial, national, global level, South Africa). We collected qualitative data through expert interviews/documentary analysis, coded and analysed the data in NVivo, and finalised the framework and action tool.
We identified agenda-setting as a research theory gap in the context of mental health knowledge translation in LMICs. Thus we developed the EVITA framework for evidence-based mental health policy agenda-setting, and validated it against empirical case studies. Our findings suggest that behavioural methods can support interventions to improve research uptake.
The EVITA action tool has been theoretically and empirically validated, and includes policy agenda-setting and behavioural methods as a novel, effective mechanisms for improving evidence-based policymaking in public mental health. EVITA has the potential to improve the challenging process of research evidence translation into policy/practice in LMICs, and may be applicable to other neglected health areas/countries.
Key messages
The new validated EVITA framework uses agenda-setting and behavioural methods to improve knowledge exchange for better evidence-informed, potentially more effective, public mental health policymaking. The EVITA action tool helps researchers, policymakers & others to strategically take action for public mental health agenda-setting and advocacy interventions for evidence-based policymaking in LMICs.
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Affiliation(s)
- N Votruba
- Centre for Implementation Science, IoPPN, King's College London, London, UK
- Centre for Global Mental Health, IoPPN, King’s College London, London, UK
| | - J Grant
- Policy Institute at King’s, King’s College London, King’s College London, UK
| | - G Thornicroft
- Centre for Implementation Science, IoPPN, King's College London, London, UK
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Grant J. Can you hear what I am saying? Can Fam Physician 2020; 66:476-477. [PMID: 32675089 PMCID: PMC7365153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- John Grant
- Assistant Professor at Dalhousie University in Halifax, NS, and a pediatric emergency physician at IWK Health Centre in Halifax.
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Grant J. [Not Available]. Can Fam Physician 2020; 66:483-485. [PMID: 32675091 PMCID: PMC7365151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- John Grant
- Professeur adjoint à l'Université Dalhousie à Halifax (Nouvelle-Écosse) et urgentologue pédiatrique à l'IWK Health Centre à Halifax.
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Grant J, Hopcraft C, Laurenson MK. Markus Borner, a life at the conservation front line. Conserv Biol 2020; 34:769-770. [PMID: 32450619 DOI: 10.1111/cobi.13507] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- J Grant
- Institute of Biodiversity Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, United Kingdom
| | - C Hopcraft
- Institute of Biodiversity Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, United Kingdom
| | - M Karen Laurenson
- Africa Department, Frankfurt Zoological Society, Bernhard Grzimek-Allee 1, Frankfurt am Main, D60316, Germany
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Grant J, Shafi A, Halsnad M. Aerosol prevention in osteosynthesis for maxillofacial trauma - a technical note. Br J Oral Maxillofac Surg 2020; 58:721-722. [PMID: 32418760 PMCID: PMC7200369 DOI: 10.1016/j.bjoms.2020.04.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/28/2020] [Indexed: 11/30/2022]
Affiliation(s)
- J Grant
- Institute of Neurological Sciences, Queen Elizabeth University Hospital, Site 1345 Govan Road, G51 4LB, United Kingdom.
| | - A Shafi
- Institute of Neurological Sciences, Queen Elizabeth University Hospital, Site 1345 Govan Road, G51 4LB, United Kingdom.
| | - M Halsnad
- Institute of Neurological Sciences, Queen Elizabeth University Hospital, Site 1345 Govan Road, G51 4LB, United Kingdom.
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Hanafi H, Grant J, Macdonald G. Concurrent Chemoradiotherapy or Radiotherapy Alone in Muscle-invasive Bladder Cancer: Retrospective Review of Treatment and Outcome in Aberdeen Royal Infirmary. Clin Oncol (R Coll Radiol) 2020. [DOI: 10.1016/j.clon.2020.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Voepel-Lewis T, Farley FA, Grant J, Tait AR, Boyd CJ, McCabe SE, Weber M, Harbagh CM, Zikmund-Fisher BJ. Behavioral Intervention and Disposal of Leftover Opioids: A Randomized Trial. Pediatrics 2020; 145:peds.2019-1431. [PMID: 31871245 PMCID: PMC6939843 DOI: 10.1542/peds.2019-1431] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Leftover prescription opioids pose risks to children and adolescents, yet many parents keep these medications in the home. Our objective in this study was to determine if providing a behavioral disposal method (ie, Nudge) with or without a Scenario-Tailored Opioid Messaging Program (STOMP) (risk-enhancement education) improves parents' opioid-disposal behavior after their children's use. METHODS Parents whose children were prescribed a short course of opioids were recruited and randomly assigned to the Nudge or control groups with or without STOMP. Parents completed surveys at baseline and 7 and 14 days. Main outcomes were (1) prompt disposal (ie, immediate disposal of leftovers after use) and (2) planned retention (intention to keep leftovers). RESULTS There were 517 parents who took part, and 93% had leftovers after use. Prompt disposal behavior was higher for parents who received both the STOMP and Nudge interventions (38.5%), Nudge alone (33.3%), or STOMP alone (31%) compared with controls (19.2%; P ≤ .02). Furthermore, the STOMP intervention independently decreased planned retention rates (5.6% vs 12.5% no STOMP; adjusted odds ratio [aOR] 0.40 [95% confidence interval (CI) 0.19-0.85]). Higher risk perception lowered the odds of planned retention (aOR 0.87 [95% CI 0.79-0.96]), whereas parental past opioid misuse increased those odds (aOR 4.44 [95% CI 1.67-11.79]). CONCLUSIONS Providing a disposal method nudged parents to dispose of their children's leftover opioids promptly after use, whereas STOMP boosted prompt disposal and reduced planned retention. Such strategies can reduce the presence of risky leftover medications in the home and decrease the risks posed to children and adolescents.
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Affiliation(s)
- Terri Voepel-Lewis
- Departments of Anesthesiology, .,Health Behaviors and Biological Science, School of Nursing, and
| | | | | | | | - Carol J. Boyd
- Psychiatry,,Health Behaviors and Biological Science, School of
Nursing, and
| | | | | | | | - Brian J. Zikmund-Fisher
- Internal Medicine, and,Division of Health Behavior and Health Education,
School of Public Health, University of Michigan, Ann Arbor, Michigan
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Rojas Canadas E, Herlihy M, Kenneally J, Grant J, Kearney F, Lonergan P, Butler S. Associations between postpartum phenotypes, cow factors, genetic traits, and reproductive performance in seasonal-calving, pasture-based lactating dairy cows. J Dairy Sci 2020; 103:1016-1030. [DOI: 10.3168/jds.2018-16001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 09/10/2019] [Indexed: 01/05/2023]
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Abstract
The aim of measuring inconsistency is to obtain an evaluation of the imperfections in a set of formulas, and this evaluation may then be used to help decide on some course of action (such as rejecting some of the formulas, resolving the inconsistency, seeking better sources of information, etc). A number of proposals have been made to define measures of inconsistency. Each has its rationale. But to date, it is not clear how to delineate the space of options for measures, nor is it clear how we can classify measures systematically. To address these problems, we introduce a general framework for comparing syntactic measures of inconsistency. It is based on the notion of an inconsistency graph for each knowledgebase (a bipartite graph with a set of vertices representing formulas in the knowledgebase, a set of vertices representing minimal inconsistent subsets of the knowledgebase, and edges representing that a formula belongs to a minimal inconsistent subset). We then show that various measures can be computed using the inconsistency graph. Then we introduce abstractions of the inconsistency graph and use them to construct a hierarchy of syntactic inconsistency measures. Furthermore, we extend the inconsistency graph concept with a labeling that extends the hierarchy to include some other types of inconsistency measures.
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Grant J. Politics of Fear or Complacency on Climatic and ecological Collapse? PPP 2019. [DOI: 10.3351/ppp.2019.7646852222] [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: 11/20/2022]
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Rojas Canadas E, Herlihy MM, Kenneally J, Grant J, Kearney F, Lonergan P, Butler ST. Associations between postpartum fertility phenotypes and genetic traits in seasonal-calving, pasture-based lactating dairy cows. J Dairy Sci 2019; 103:1002-1015. [PMID: 31677840 DOI: 10.3168/jds.2018-16000] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/27/2019] [Indexed: 12/14/2022]
Abstract
The objective of this study was to evaluate the associations between corpus luteum (CL) status, uterine health, body condition score (BCS), metabolic status, and parity at wk 3 and 7 postpartum in seasonal-calving, pasture-based, lactating dairy cows. The associations between those phenotypes and individual genetic traits were also evaluated. First- and second-parity spring-calving lactating dairy cows (n = 2,600) from 35 dairy farms in Ireland were enrolled. Farms were visited every 2 weeks; cows that were at wk 3 (range 14 to 27 DIM) and wk 7 (range 42 to 55 DIM) postpartum were examined. Body condition score was measured using a scale of 1 to 5 with 0.25 increments. Transrectal ultrasound examination was performed at wk 3 and 7 postpartum to determine presence or absence of CL and ultrasound reproductive tract score. Blood samples were collected at each visit and the concentrations of glucose, β-hydroxybutyrate (BHB), and fatty acids (FA) were analyzed by using enzymatic colorimetry. Cows were grouped into 3 BCS categories [low (≤2.5), target (≥2.75 and ≤3.25), and high (≥3.5)]; 2 CL status categories: (present or absent); 2 uterine health status (UHS) categories (normal and abnormal); and 3 metabolic status categories [good (high glucose, low fatty acids and BHB), poor (low glucose, high fatty acids and BHB), and moderate (all other combinations)]. Fisher's exact test was used to test associations between variables and was supplemented by logistic regression. We found associations between UHS (wk 3 and 7), BCS (wk 3 and 7), parity (wk 3 and 7) metabolic status (wk 3), and predicted transmitting ability for calving interval (PTA for CIV; wk 3) and CL status. Cows that had abnormal UHS, low BCS, primiparity, and poor metabolic status, and were in the quartile with the greatest PTA for CIV were less likely to have had CL present at wk 3 and 7 postpartum. We also found associations between CL status (wk 3 and 7), BCS (wk 3 and 7), parity (wk 3 and 7), and PTA for CIV (wk 3) and UHS. Cows that did not have a CL present had low BCS, primiparity, and that were in the quartile with greatest PTA for CIV, had a greater risk of abnormal UHS at wk 3 and 7 postpartum. We observed strong associations between CL status, UHS, BCS, metabolic status, parity, and individual genetic traits at wk 3 and 7 postpartum in seasonal-calving, pasture-based lactating dairy cows. Achieving target BCS and good metabolic status, and selecting cows based on PTA for CIV, are all expected to increase the likelihood of hastening the resumption of estrous cyclicity and enhancing uterine health during the postpartum period.
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Affiliation(s)
- E Rojas Canadas
- Animal and Grassland Research and Innovation Centre, Teagasc, Moorepark, Fermoy, Co. Cork, Ireland, P61 C996; School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland, D04 N2E
| | - M M Herlihy
- Animal and Grassland Research and Innovation Centre, Teagasc, Moorepark, Fermoy, Co. Cork, Ireland, P61 C996
| | - J Kenneally
- Animal and Grassland Research and Innovation Centre, Teagasc, Moorepark, Fermoy, Co. Cork, Ireland, P61 C996
| | - J Grant
- Research Operations Group, Teagasc, Ashtown, Dublin 15, Ireland, D15 DY05
| | - F Kearney
- Irish Cattle Breeding Association, Highfield House, Shinagh, Bandon, Co. Cork, Ireland, P72 X050
| | - P Lonergan
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland, D04 N2E
| | - S T Butler
- Animal and Grassland Research and Innovation Centre, Teagasc, Moorepark, Fermoy, Co. Cork, Ireland, P61 C996.
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Elghadi R, Uppal S, Chotalia M, Grant J. Escalation plans and DNACPR discussions in the unwell oncology patient. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz261.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Maicas C, Hutchinson IA, Kenneally J, Grant J, Cromie AR, Lonergan P, Butler ST. Fertility of fresh and frozen sex-sorted semen in dairy cows and heifers in seasonal-calving pasture-based herds. J Dairy Sci 2019; 102:10530-10542. [PMID: 31447149 DOI: 10.3168/jds.2019-16740] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/18/2019] [Indexed: 01/20/2023]
Abstract
Our objective in this study was to evaluate the reproductive performance of dairy heifers and cows inseminated with fresh or frozen sex-sorted semen (SS) in seasonal-calving pasture-based dairy herds. Ejaculates of 10 Holstein-Friesian bulls were split and processed to provide (1) fresh conventional semen at 3 × 106 sperm per straw (CONV); (2) fresh SS at 1 × 106 sperm per straw (SS-1M); (3) fresh SS semen at 2 × 106 sperm per straw (SS-2M); and (4) frozen SS at 2 × 106 sperm per straw (SS-FRZ). Generalized linear mixed models were used to evaluate the effect of semen treatment and other explanatory variables on pregnancy per artificial insemination (P/AI) in heifers (n = 3,214) and lactating cows (n = 5,457). In heifers, P/AI was greater for inseminations with CONV (60.9%) than with SS-FRZ (52.8%) but did not differ from SS-1M (54.2%) or SS-2M (53.5%). Cows inseminated with CONV had greater P/AI (48.0%) than cows inseminated with SS, irrespective of treatment (SS-1M, SS-2M, and S-FROZEN; 37.6, 38.9, and 40.6%, respectively). None of the SS treatments differed from each other with regard to P/AI in either heifers or cows. The relative performance of SS compared with CONV was also examined [i.e., relative P/AI = (SS P/AI)/(CONV P/AI) × 100]. Frozen SS achieved relative P/AI >84%. Bull affected P/AI in both heifers and cows, but no bull by semen treatment interaction was observed. In heifers, P/AI increased with increasing predicted transmitting ability for milk protein percentage. In cows, P/AI increased with increasing Economic Breeding Index (EBI) and with days in milk (DIM) at AI but decreased with increasing EBI milk subindex, parity and with DIM2. Cows in parity ≥5 had the lowest P/AI and differed from cows in parities 1, 2, or 3. Dispatch-to-AI interval of fresh semen did not affect P/AI in lactating cows, but a dispatch-to-AI interval by bull interaction was detected whereby P/AI was constant for most bulls but increased with greater dispatch-to-AI intervals for 2 bulls. In conclusion, frozen SS achieved greater P/AI relative to conventional semen than was previously reported in lactating cows. Fresh SS did not achieve greater P/AI than frozen SS, regardless of whether the sperm dose per straw was 1 × 106 or 2 × 106. A bull effect for all semen treatments, as well as a dispatch-to-AI interval by bull interaction for fresh semen, highlights the importance of using a large team of bulls for breeding management.
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Affiliation(s)
- C Maicas
- Animal and Grassland Research and Innovation Centre, Teagasc, Moorepark, Fermoy, Co. Cork, Ireland P61 P302; School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland D04 N2E5
| | - I A Hutchinson
- Animal and Grassland Research and Innovation Centre, Teagasc, Moorepark, Fermoy, Co. Cork, Ireland P61 P302
| | - J Kenneally
- Animal and Grassland Research and Innovation Centre, Teagasc, Moorepark, Fermoy, Co. Cork, Ireland P61 P302
| | - J Grant
- Research Operations Group, Teagasc, Ashtown, Dublin 15, Ireland D15 DY05
| | - A R Cromie
- Irish Cattle Breeding Federation, Highfield House, Shinagh, Bandon, Co. Cork, Ireland P72 X050
| | - P Lonergan
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland D04 N2E5
| | - S T Butler
- Animal and Grassland Research and Innovation Centre, Teagasc, Moorepark, Fermoy, Co. Cork, Ireland P61 P302.
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Bishop JY, Hidden KA, Jones GL, Hettrich CM, Wolf BR, Bollier M, Bravman J, McCarty EC, Brophy RH, Smith MV, Wright RW, Cox C, Kuhn J, Feely B, Ma CB, Zhang A, Grant J, Miller B, Marx RG. Factors Influencing Surgeon's Choice of Procedure for Anterior Shoulder Instability: A Multicenter Prospective Cohort Study. Arthroscopy 2019; 35:2014-2025. [PMID: 31208919 DOI: 10.1016/j.arthro.2019.02.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/15/2019] [Accepted: 02/17/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate preoperative factors associated with selection of surgical treatment for anterior shoulder instability. METHODS Patient demographics, initial physical examinations, and patient-oriented outcome questionnaires were collected prospectively from 26 shoulder surgeons at 10 sites. Symptom duration, number of dislocations, sport, history of prior stabilization procedure, Hill-Sachs/glenoid bone loss, pain level, and failure of conservative treatment were recorded. Statistical analysis was performed with Fisher's exact test and logistic regression analysis. RESULTS A total of 564 patients who underwent surgical treatment for anterior shoulder instability from November 2012 to June 2017 were enrolled. Of these, 426 shoulders underwent arthroscopic stabilization alone, 38 underwent arthroscopic stabilization with remplissage, 28 underwent open Bankart repair, and 72 underwent a Latarjet procedure. Predictors for undergoing Latarjet (P < .003) were symptom duration (75% had symptoms for >1 year), number of dislocations (47% had >5 dislocations), revision surgery (69%), Hill-Sachs lesion size (45% had a lesion between 11% and 20% of the humeral head), and glenoid bone loss (75% of Latarjet patients had 11% to 30% loss). Predictors for undergoing open Bankart repair (P < .001) were number of dislocations (32% had >5 dislocations), revision surgeries (54%), and glenoid bone loss (11% of open Bankart patients had 11% to 20% loss). History of prior shoulder surgery was the only significant predictor of open versus arthroscopic Bankart procedure. Prediction models showed athletes involved in high-risk sports were 2.61 times more likely to have a Latarjet (P < .01). CONCLUSIONS Indications for the Latarjet were: humeral and glenoid bone loss, duration of symptoms, number of dislocations, and revision stabilizations. Athletes involved in high-risk sports were more likely to undergo the Latarjet procedure, even if other predictive factors were not present. The open Bankart procedure was the least common procedure performed, with a history of prior shoulder surgery being the only predictor for use when treating recurrent instability. LEVEL OF EVIDENCE Level II, prospective prognostic cohort investigation.
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Affiliation(s)
- Julie Y Bishop
- The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A..
| | - Krystin A Hidden
- The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Grant L Jones
- The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
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Hopkins D, Joly TL, Sykes H, Waniandy A, Grant J, Gallagher L, Hansen L, Wall K, Fortna P, Bailey M. “Learning Together”: Braiding Indigenous and Western Knowledge Systems to Understand Freshwater Mussel Health in the Lower Athabasca Region of Alberta, Canada. J ETHNOBIOL 2019. [DOI: 10.2993/0278-0771-39.2.315] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Debra Hopkins
- Alberta Environment and Parks, Alberta Government, 10th Floor, Oxbridge Place, 9820-106 Street, Edmonton, Alberta, T5K 2J6
| | - Tara L. Joly
- Willow Springs Strategic Solutions, Inc., Cochrane, Alberta
| | - Harvey Sykes
- Fort McMurray Métis Local 1935, Fort McMurray, Alberta
| | | | - John Grant
- Fort McMurray Métis Local 1935, Fort McMurray, Alberta
| | | | | | - Kaitlyn Wall
- Alberta Environment and Parks, Alberta Government, 10th Floor, Oxbridge Place, 9820-106 Street, Edmonton, Alberta, T5K 2J6
| | - Peter Fortna
- Willow Springs Strategic Solutions, Inc., Cochrane, Alberta
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Stalker MR, Grant J, Yong CW, Ohene-Yeboah LA, Mays TJ, Parker SC. Molecular simulation of hydrogen storage and transport in cellulose. Molecular Simulation 2019. [DOI: 10.1080/08927022.2019.1593975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- M. R. Stalker
- Centre for Sustainable Chemical Technologies, University of Bath, Bath, UK
- Department of Chemistry, University of Bath, Bath, UK
| | - J. Grant
- Department of Chemistry, University of Bath, Bath, UK
- Computing Services, University of Bath, Bath, UK
| | - C. W. Yong
- Scientific Computing Department, STFC Daresbury Laboratory, Daresbury, UK
| | - L. A. Ohene-Yeboah
- Centre for Sustainable Chemical Technologies, University of Bath, Bath, UK
- Department of Chemistry, University of Bath, Bath, UK
| | - T. J. Mays
- Department of Chemical Engineering, University of Bath, Bath, UK
| | - S. C. Parker
- Department of Chemistry, University of Bath, Bath, UK
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48
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Werner J, Umstatter C, Kennedy E, Grant J, Leso L, Geoghegan A, Shalloo L, Schick M, O'Brien B. Identification of possible cow grazing behaviour indicators for restricted grass availability in a pasture-based spring calving dairy system. Livest Sci 2019. [DOI: 10.1016/j.livsci.2018.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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49
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Brukhno AV, Grant J, Underwood TL, Stratford K, Parker SC, Purton JA, Wilding NB. DL_MONTE: a multipurpose code for Monte Carlo simulation. Molecular Simulation 2019. [DOI: 10.1080/08927022.2019.1569760] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A. V. Brukhno
- Scientific Computing Department, STFC, Daresbury Laboratory, Warrington, UK
| | - J. Grant
- Department of Chemistry, University of Bath, Bath, UK
- Computing Services, University of Bath, Bath, UK
| | | | | | - S. C. Parker
- Department of Chemistry, University of Bath, Bath, UK
| | - J. A. Purton
- Scientific Computing Department, STFC, Daresbury Laboratory, Warrington, UK
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Shulman M, Cuthbertson B, Wijeysundera D, Pearse R, Thompson B, Torres E, Ambosta A, Wallace S, Farrington C, Myles P, Wallace S, Thompson B, Ellis M, Borg B, Kerridge R, Douglas J, Brannan J, Pretto J, Godsall M, Beauchamp N, Allen S, Kennedy A, Wright E, Malherbe J, Ismail H, Riedel B, Melville A, Sivakumar H, Murmane A, Kenchington K, Gurunathan U, Stonell C, Brunello K, Steele K, Tronstad O, Masel P, Dent A, Smith E, Bodger A, Abolfathi M, Sivalingam P, Hall A, Painter T, Macklin S, Elliott A, Carrera A, Terblanche N, Pitt S, Samuels J, Wilde C, MacCormick A, Leslie K, Bramley D, Southcott A, Grant J, Taylor H, Bates S, Towns M, Tippett A, Marshall F, McCartney C, Choi S, Somascanthan P, Flores K, Beattie W, Karkouti K, Clarke H, Jerath A, McCluskey S, Wasowicz M, Granton J, Day L, Pazmino-Canizares J, Hagen K, Campbell D, Short T, Van Der Westhuizen J, Higgie K, Lindsay H, Jang R, Wong C, Mcallister D, Ali M, Kumar J, Waymouth E, Kim C, Dimech J, Lorimer M, Tai J, Miller R, Sara R, Collingwood A, Olliff S, Gabriel S, Houston H, Dalley P, Hurford S, Hunt A, Andrews L, Navarra L, Jason-Smith A, Thompson H, McMillan N, Back G, Melo M, Mamdani M, Hillis G, Wijeysundera H. Using the 6-minute walk test to predict disability-free survival after major surgery. Br J Anaesth 2019; 122:111-119. [DOI: 10.1016/j.bja.2018.08.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/13/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022] Open
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