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Siddiqi N, Lammers D, Hu P, Stonko D, DuBose J, Hurst S, Hashmi Z, Morrison J, Betzold R. Comparison of Contralateral vs Ipsilateral Vein Graft for Traumatic Vascular Injury Repair: A Cohort From PROOVIT. Am Surg 2024:31348241246167. [PMID: 38621410 DOI: 10.1177/00031348241246167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Traumatic injury leading to arterial damage has traditionally been repaired using autologous vein graft from the contralateral limb. This often requires a secondary surgical site and the potential of prolonged operative time for patients. We sought to assess the use of ipsilateral vs contralateral vein grafts in patients who experienced traumatic extremity vascular injury. A multicenter database was queried to identify arterial injuries requiring operative intervention with vein grafting. The primary outcome of interest was need for operative reintervention. Secondary outcomes included risk of thrombosis, infection, and intensive care unit length of stay. 358 patients (320 contralateral and 38 ipsilateral) were included in the analysis. The ipsilateral vein cohort did not display a statistically significant decrease in need for reoperation when compared to the contralateral group (11% vs 23%; OR 0.41, 95% CI -0.07-1.3; P = .14). Contralateral repair was associated with longer median intensive care unit (ICU) LOS (4.3 vs 3.1 days; P < .01).
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Affiliation(s)
- Noreen Siddiqi
- Department of Surgery, The University of Alabama at Birmingham Hospital, Birmingham, AL, USA
| | - Daniel Lammers
- Department of Surgery, The University of Alabama at Birmingham Hospital, Birmingham, AL, USA
| | - Parker Hu
- Department of Surgery, Chippenham Hospital, Richmond, VA, USA
| | - David Stonko
- Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Joseph DuBose
- Department of Surgery and Perioperative Care, The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Stuart Hurst
- Department of Surgery, The University of Alabama at Birmingham Hospital, Birmingham, AL, USA
| | - Zain Hashmi
- Department of Surgery, The University of Alabama at Birmingham Hospital, Birmingham, AL, USA
| | - Jonathan Morrison
- Department of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | - Richard Betzold
- Department of Surgery, The University of Alabama at Birmingham Hospital, Birmingham, AL, USA
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Khassan T, Smitten E, Wood N, Fotopoulou C, Morrison J, MacDonald M, Baxter K, Edmondson RJ. MDT practice determines treatment pathway for patients with advanced ovarian cancer: A multi-centre observational study. Eur J Surg Oncol 2023; 49:1504-1510. [PMID: 36958949 DOI: 10.1016/j.ejso.2023.03.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/27/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023]
Abstract
OBJECTIVE To investigate decision making for patients with advanced ovarian cancer as a possible explanation of geographical variation in treatment patterns. METHODS We carried out a multi-centre observational study in multidisciplinary teams meetings for five major UK cancer centres. All patients presenting to five cancer centres with advanced ovarian cancer over a six-week period. The GO-MDT-MODe tool was used to provide a measure of participation and quality of case discussion for all cases of advanced ovarian cancer. MDT scores were correlated with surgical data extracted from national audit data. Data were recorded for overall MDT performance. RESULTS A total of 870 case discussions, including 145 cases of advanced ovarian cancer, were observed. MDTs varied in structure, format and time allocation between centres. Cluster analysis showed significant variation in quality and participation of discussion between centres (p < 0.0025) and this correlated with the proportion of patients in the wider cancer alliance undergoing surgery. CONCLUSIONS We have shown that at least part of the variation in practice seen in the UK correlates with different behaviours within MDTs. Increasing time for discussion and encouraging participation from all staff groups may increase proportions of patients undergoing optimal treatment regimens.
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Affiliation(s)
- T Khassan
- Division of Medical Education, School of Medical Sciences, University of Manchester, UK
| | - E Smitten
- Division of Medical Education, School of Medical Sciences, University of Manchester, UK
| | - N Wood
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - C Fotopoulou
- Dept. of Gynaecologic Oncology, Division of Surgery and Cancer, Imperial College London, UK
| | - J Morrison
- Somerset NHS Foundation Trust, Taunton, Somerset, UK
| | - M MacDonald
- Sheffield Teaching Hospital NHS Foundation Trust, UK
| | - K Baxter
- Division of Cancer Sciences, Medicine & Health, University of Manchester, M13 9WL, UK; Department of Obstetrics and Gynaecology, Manchester Academic Health Science Centre, Saint Mary's Hospital, Oxford Rd, Manchester, M13 9WL, UK
| | - R J Edmondson
- Division of Cancer Sciences, Medicine & Health, University of Manchester, M13 9WL, UK; Department of Obstetrics and Gynaecology, Manchester Academic Health Science Centre, Saint Mary's Hospital, Oxford Rd, Manchester, M13 9WL, UK.
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Chipman AM, Ottochian M, Ricaurte D, Gunter G, DuBose JJ, Stonko DP, Feliciano DV, Scalea TM, Morrison J. Contemporary management and time to revascularization in upper extremity arterial injury. Vascular 2023; 31:284-291. [PMID: 35418267 DOI: 10.1177/17085381211062726] [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] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Upper extremity arterial injury is associated with significant morbidity and mortality for trauma patients, but there is a paucity of data to guide the clinician in the management of these injuries. The goals of this review were to characterize the demographics, presentation, clinical management, and outcomes, and to evaluate how time to intervention associates with outcomes in trauma patients with upper extremity vascular injuries. METHODS The National Trauma Data Bank (NTDB) Research Data Set for the years 2007-2016 was queried in order to identify adult patients (age ≥ 18) with an upper extremity arterial injury. Patients with brachiocephalic, subclavian, axillary, or brachial artery injury using the 1998 and 2005 versions of the Abbreviated Injury Scale were included. Patients with non-survivable injuries to the brain, traumatic amputation, or other major arterial injuries to the torso or lower extremities were excluded. RESULTS The data from 7908 patients with upper extremity arterial injuries was reviewed. Of those, 5407 (68.4%) underwent repair of the injured artery. The median Injury Severity Score (ISS) was 10 (IQR = 7-18), and 7.7% of patients had a severe ISS (≥ 25). Median time to repair was 120 min (IQR = 60-240 min). Management was open repair in 52.3%, endovascular repair in 7.3%, and combined open and endovascular repairs in 8.8%; amputation occurred in 1.8% and non-operative management was used in 31.6% of patients. Blunt mechanism of injury, crush injury, concomitant fractures/dislocations, and nerve injuries were associated with amputation, whereas simultaneous venous injury was not. There was a significant decrease in the rate of amputation when patients undergoing surgical revascularization did so within 90 min of injury (P = 0.007). CONCLUSION Injuries to arteries of the upper extremity are managed with open repair, endovascular repair, and, rarely, amputation. Expeditious transport to the operating room for revascularization is the key for limb salvage.
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Affiliation(s)
- Amanda M Chipman
- 12264University of Maryland School of Medicine, Baltimore, MD, United States
| | - Marcus Ottochian
- 137889R. Adams Cowley Shock Trauma Center, 12264University of Maryland Medical System, Baltimore, Maryland, USA
| | - Daniel Ricaurte
- 12264University of Maryland School of Medicine, Baltimore, MD, United States
| | - Grahya Gunter
- 12264University of Maryland School of Medicine, Baltimore, MD, United States
| | - Joseph J DuBose
- 137889R. Adams Cowley Shock Trauma Center, 12264University of Maryland Medical System, Baltimore, Maryland, USA
| | - David P Stonko
- Department of Surgery, 160877Johns Hopkins Hospital, Baltimore, MD, United States
| | - David V Feliciano
- 12264University of Maryland School of Medicine, Baltimore, MD, United States
| | - Thomas M Scalea
- 137889R. Adams Cowley Shock Trauma Center, 12264University of Maryland Medical System, Baltimore, Maryland, USA
| | - Jonathan Morrison
- 137889R. Adams Cowley Shock Trauma Center, 12264University of Maryland Medical System, Baltimore, Maryland, USA
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Morrison J, Jahangiri Y, Mowery M, Leach A, Musolf R, Knox M. Abstract No. 72 Factors Associated with Overall Survival after Thrombectomy for Massive and Submassive Pulmonary Embolism. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Nedbailo R, Park J, Hollinger R, Wang S, Mariscal D, Morrison J, Song H, Zeraouli G, Scott GG, Ma T, Rocca JJ. Compact high repetition rate Thomson parabola ion spectrometer. Rev Sci Instrum 2023; 94:023505. [PMID: 36859067 DOI: 10.1063/5.0101859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 01/04/2023] [Indexed: 06/18/2023]
Abstract
We present the development of a compact Thomson parabola ion spectrometer capable of characterizing the energy spectra of various ion species of multi-MeV ion beams from >1020W/cm2 laser produced plasmas at rates commensurate with the highest available from any of the current and near-future PW-class laser facilities. This diagnostic makes use of a polyvinyl toluene based fast plastic scintillator (EJ-260), and the emitted light is collected using an optical imaging system coupled to a thermoelectrically cooled scientific complementary metal-oxide-semiconductor camera. This offers a robust solution for data acquisition at a high repetition rate, while avoiding the added complications and nonlinearities of micro-channel plate based systems. Different ion energy ranges can be probed using a modular magnet setup, a variable electric field, and a varying drift-distance. We have demonstrated operation and data collection with this system at up to 0.2 Hz from plasmas created by irradiating a solid target, limited only by the targeting system. With the appropriate software, on-the-fly ion spectral analysis will be possible, enabling real-time experimental control at multi-Hz repetition rates.
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Affiliation(s)
- R Nedbailo
- Electrical and Computer Engineering Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - J Park
- Electrical and Computer Engineering Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - R Hollinger
- Electrical and Computer Engineering Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - S Wang
- Electrical and Computer Engineering Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - D Mariscal
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Morrison
- Electrical and Computer Engineering Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - H Song
- Electrical and Computer Engineering Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - G Zeraouli
- Electrical and Computer Engineering Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - G G Scott
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - T Ma
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J J Rocca
- Electrical and Computer Engineering Department, Colorado State University, Fort Collins, Colorado 80523, USA
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Mariscal DA, Djordjević BZ, Anirudh R, Bremer T, Campbell PC, Feister S, Folsom E, Grace ES, Hollinger R, Jacobs SA, Kailkhura B, Kalantar D, Kemp AJ, Kim J, Kur E, Liu S, Ludwig J, Morrison J, Nedbailo R, Ose N, Park J, Rocca JJ, Scott GG, Simpson RA, Song H, Spears B, Sullivan B, Swanson KK, Thiagarajan J, Wang S, Williams GJ, Wilks SC, Wyatt M, Van Essen B, Zacharias R, Zeraouli G, Zhang J, Ma T. A flexible proton beam imaging energy spectrometer (PROBIES) for high repetition rate or single-shot high energy density (HED) experiments (invited). Rev Sci Instrum 2023; 94:023507. [PMID: 36859040 DOI: 10.1063/5.0101845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 12/28/2022] [Indexed: 06/18/2023]
Abstract
The PROBIES diagnostic is a new, highly flexible, imaging and energy spectrometer designed for laser-accelerated protons. The diagnostic can detect low-mode spatial variations in the proton beam profile while resolving multiple energies on a single detector or more. When a radiochromic film stack is employed for "single-shot mode," the energy resolution of the stack can be greatly increased while reducing the need for large numbers of films; for example, a recently deployed version allowed for 180 unique energy measurements spanning ∼3 to 75 MeV with <0.4 MeV resolution using just 20 films vs 180 for a comparable traditional film and filter stack. When utilized with a scintillator, the diagnostic can be run in high-rep-rate (>Hz rate) mode to recover nine proton energy bins. We also demonstrate a deep learning-based method to analyze data from synthetic PROBIES images with greater than 95% accuracy on sub-millisecond timescales and retrained with experimental data to analyze real-world images on sub-millisecond time-scales with comparable accuracy.
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Affiliation(s)
- D A Mariscal
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Z Djordjević
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Anirudh
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - T Bremer
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - P C Campbell
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Feister
- Department of Computer Science, California State University Channel Islands, Camarillo, California 93012, USA
| | - E Folsom
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - E S Grace
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Hollinger
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - S A Jacobs
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Kailkhura
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D Kalantar
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - A J Kemp
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Kim
- Center for Energy Research, University of California San Diego, La Jolla, California 92093, USA
| | - E Kur
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Liu
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Ludwig
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Morrison
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - R Nedbailo
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - N Ose
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Park
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - J J Rocca
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - G G Scott
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R A Simpson
- Department of Nuclear Science and Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - H Song
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - B Spears
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Sullivan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - K K Swanson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Thiagarajan
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Wang
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - G J Williams
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S C Wilks
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M Wyatt
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Van Essen
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Zacharias
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G Zeraouli
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Zhang
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - T Ma
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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Zeraouli G, Mariscal D, Grace E, Scott GG, Swanson KK, Simpson R, Djordjevic BZ, Nedbailo R, Song H, Morrison J, Park J, Hollinger R, Wang S, Rocca JJ, Ma T. Ultra-compact x-ray spectrometer for high-repetition-rate laser-plasma experiments. Rev Sci Instrum 2022; 93:113508. [PMID: 36461516 DOI: 10.1063/5.0100970] [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] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/28/2022] [Indexed: 06/17/2023]
Abstract
We present in this work the development of an ultra-compact, multi-channel x-ray spectrometer (UCXS). This diagnostic has been specially built and adapted to perform at high-repetition-rate (>1 Hz) for high-intensity, short-pulse laser plasma experiments. X-ray filters of varying materials and thicknesses are chosen to provide spectral resolution up to ΔE ≈ 1 keV over the x-ray energy range of 1-30 keV. These filters are distributed over a total of 25 channels, where each x-ray filter is coupled to a single scintillator. The UCXS is designed to detect and resolve a large variety of laser-driven x-ray sources such as low energy bremsstrahlung emission, fluorescence, and betatron radiation (up to 30 keV). Preliminary results from commissioning experiments at the ABL laser facility at Colorado State University are provided.
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Affiliation(s)
- G Zeraouli
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - D Mariscal
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - E Grace
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G G Scott
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - K K Swanson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Simpson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Z Djordjevic
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Nedbailo
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - H Song
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - J Morrison
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - J Park
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - R Hollinger
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - S Wang
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - J J Rocca
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Ma
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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Ford J, Kayandabila J, Morrison J, Seth S, Lyimo B, Mukhtar A, Schick M, Mah L, Debes J. 209EMF Combined Hepatitis B Virus and Hepatocellular Carcinoma Screening Using Point-of-Care Testing and Ultrasound in a Tanzanian Emergency Department: A Preliminary Report. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hania A, Harnett C, Morrison J, Klemmer K, Costello J. Placenta Accreta Spectrum: A 2-year Retrospective Observational Study. Ir Med J 2022; 115:629. [PMID: 36300594] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Aims To assess the management and outcomes of Placenta Accreta Spectrum disorders and highlight the important management recommendations from international guidelines. Methods A retrospective audit of women diagnosed with Placenta Accreta Spectrum disorder from January 2018 to December 2019. Results Nine cases (0.16%) of placenta accreta from 5695 births were identified. All women received caesarean section under general anaesthesia. Caesarean hysterectomy occurred in seven cases (78%). Mean (±SD) age of women was (34.4 ± 3.9 years) and mean parity score was (3.2 ± 1.2). Mean gestational age at birth was 35.1 ± 0.8 weeks. Bilateral iliac artery balloon occlusion occurred in eight (89%) cases. Median estimated blood loss [range] was 1700 mL [1000-7000] with only 11% of patients (1/9) experiencing more than 3L of blood loss. Intraoperative red blood cell transfusion occurred in six cases (67%). Median number of units of red cell transfusion [range] was four units [0-10]. Mean hospital length of stay was (6.7 ± 1.1 days) and there were no maternal deaths. Multidisciplinary team involvement of senior anaesthetists and obstetricians was noted in all cases. Discussion Placenta accreta spectrum is increasing in incidence in obstetric practice and is associated with significant maternal morbidity and mortality. Implementing national guidelines can improve patient outcomes.
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Affiliation(s)
- A Hania
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Galway
| | - C Harnett
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Galway
| | - J Morrison
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Galway
| | - K Klemmer
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Galway
| | - J Costello
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Galway
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Kang H, Tillmann T, Morrison J. Gender bias in the primary prevention of cardiovascular disease. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.284] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/introduction
Women receive less aggressive treatment for cardiovascular disease (CVD), partly due to a delayed or incorrect diagnosis. However, there is little research into whether this gender bias extends to primary prevention of CVD (i.e. prevention of CVD in those individuals with no prior CVD events), and the reasons behind this bias.
Purpose
This study analysed gender differences in the primary prevention of CVD in the USA, using data from the National Health and Nutrition Examination Survey (NHANES) for the years 2015-2018. It also explored the drivers behind these differences. The hypothesis was that the known gender bias in CVD treatment also extends to primary prevention.
Methods
The risk of developing CVD over the next ten years was calculated using the Pooled Cohort Equations (PCEs) for 9,623 healthy men and women aged 40 to 79 years. 3,035 participants were found to be at higher CVD risk (ASCVD score above 7.5%) and potentially eligible for statins. Individuals with prior diagnosis of CVD were excluded from this study. Multivariable logistic regression was used to calculate adjusted odds ratios (AOR) in the usage of preventive treatment between genders.
Results
The results showed that men were 21% more likely to be prescribed statins than women whilst women were 20-37% more likely to be told to make behaviour modifications than men (Table 1). An interdisciplinary literature review showed that lower CVD risk perception in women is a likely driver of this gender difference.
Conclusion
The well-known gender bias in the treatment of CVD also appears to take place in the primary prevention of CVD with statin therapy. These findings have highlighted the gender bias in primary prevention of CVD, supporting the scarce existing literature on this topic and providing more recent evidence in line with the updated CVD prevention guidance. This has implications in developing interventions based in the health system and community context to improve the treatment and survival outcomes for women with CVD.
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Affiliation(s)
- H Kang
- University of Southampton, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - T Tillmann
- University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - J Morrison
- University College London, London, United Kingdom of Great Britain & Northern Ireland
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Goldsworthy S, Barker E, Durrant L, Morrison J, McGrail S, Eve A, Jankowska P, Mason J. PO-1848 Exploring uterus motion with full and empty bladder in preparation for adaptive cervix radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03811-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brenner M, Zakhary B, Coimbra R, Morrison J, Scalea T, Moore LJ, Podbielski J, Holcomb JB, Inaba K, Cannon JW, Seamon M, Spalding C, Fox C, Moore EE, Ibrahim JA. Resuscitative endovascular balloon occlusion of the aorta (REBOA) may be superior to resuscitative thoracotomy (RT) in patients with traumatic brain injury (TBI). Trauma Surg Acute Care Open 2022; 7:e000715. [PMID: 35372698 PMCID: PMC8928364 DOI: 10.1136/tsaco-2021-000715] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background The effects of aortic occlusion (AO) on brain injury are not well defined. We examined the impact of AO by resuscitative endovascular balloon occlusion of the aorta (REBOA) and resuscitative thoracotomy (RT) on outcomes in the setting of traumatic brain injury (TBI). Methods Patients sustaining TBI who underwent RT or REBOA in zone 1 (thoracic aorta) from September 2013 to December 2018 were identified. The indication for REBOA or RT was hemodynamic collapse due to hemorrhage below the diaphragm. Primary outcomes included mortality and systemic complications. Results 282 patients underwent REBOA or RT. Of these, 76 had mild TBI (40 REBOA, 36 RT) and 206 sustained severe TBI (107 REBOA, 99 RT). Overall, the mean (±SD) age was 42±17 years, with an Injury Severity Score (ISS) of 40±17 and mean systolic blood pressure (SBP) at the time of REBOA or RT of 81±34 mm Hg. REBOA patients had a mean SBP at the time of AO of 78.39±29.45 mm Hg, whereas RT patients had a mean SBP of 83.18±37.87 mm Hg at the time of AO (p=0.24). 55% had ongoing cardiopulmonary resuscitation (CPR) at the time of AO, and the in-hospital mortality was 86%. Binomial logistic regression controlling for TBI severity, age, ISS, SBP at the time of AO, crystalloid infusion, and CPR during AO demonstrated that the odds of mortality are 3.1 times higher for RT compared with REBOA. No significant differences were found in systemic complications between RT and REBOA. Discussion Patients with TBI who receive REBOA may have improved survival, but no difference in systemic complications, compared with patients who receive RT for the same indication. Although some patients are receiving RT prior to arrest for extrathoracic hemorrhagic shock, these results suggest that REBOA should be considered as an alternative to RT when RT is chosen for the sole purpose of resuscitation in the setting of TBI. Level of evidence 4.
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Affiliation(s)
- Megan Brenner
- Surgery, University of California Riverside, Riverside, California, USA.,Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, Moreno Valley, California, USA
| | - Bishoy Zakhary
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, Moreno Valley, California, USA
| | - Raul Coimbra
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System, Moreno Valley, California, USA
| | - Jonathan Morrison
- Trauma and Critical Care, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
| | - Thomas Scalea
- Trauma and Critical Care, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
| | - Laura J Moore
- Surgery, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Jeanette Podbielski
- Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - John B Holcomb
- Surgery, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Kenji Inaba
- Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Jeremy W Cannon
- Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Mark Seamon
- Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Chance Spalding
- Trauma and Acute Care Surgery, Grant Medical Center, Columbus, Ohio, USA
| | - Charles Fox
- Vascular Surgery, Denver Health and Hospital Authority, Denver, Colorado, USA
| | - Ernest E Moore
- Vascular Surgery, Denver Health and Hospital Authority, Denver, Colorado, USA
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Beyene R, Stonko DP, Mubang R, Gondek S, Morrison J, Dennis BM. 119 Identifying Temporal Patterns in Burn Admissions. J Burn Care Res 2022. [PMCID: PMC8945670 DOI: 10.1093/jbcr/irac012.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Introduction Temporal variations in trauma admissions, based on the time of day, day of week, and day of year, have been previously demonstrated. These variations, which could inform decision making regarding staffing and resource utilization, have not been evaluated with respect to burn admissions. Very little has been published on predicting temporal distribution stratified by total body surface area (TBSA). We hypothesize that temporal patterns exist in the distribution of burn admissions at all TBSA as it relates to time of day, day of week, and day of year. Methods This was a cross-sectional observational study of a single burn center over nearly 5 years, from 7/1/2016-3/31/2021, including both pediatric and adult admissions. We captured and plotted bivariate absolute and relative frequency data from all patients who met inclusion criteria in heat-maps showing time of day versus day of week. Frequency analysis was also performed grouped by TBSA against time of day and relative encounters against day of year. Results 2657 burn patient encounters were analyzed, averaging 1.53 burns per day. Temporal variations were skewed towards evening admission, primarily between 15:00-0:00 hours (p< 0.001). In figure 1, each block of the heatmap represents a one hour block of one day of the week over the nearly five year study period. The color corresponds to the relative frequency of contacts per hour, where 1 represents the mean number of trauma contacts per hour. Evenings (15:00-0:00) have more burn admissions than the rest of the day or night. Figure 2 shows this temporal trend is seen in burn encounters below 20% TBSA as well as those at or greater than 20% TBSA. Unlike trauma admission distribution, which has been shown to increase on weekend, day to day variation does not conform to weekend or weekday distribution. There is no cyclical yearly trend in burn admissions, suggesting that there is no seasonal variation to burn admissions, though individual holidays were not assessed. Conclusions We identify temporal variations in burn admissions, including the peak admission window late in the day. However, there is no predictable variation in weekend vs weekday distribution of burns. Furthermore, there is no cyclical annual variation to guide staffing and resource allocation. ![]()
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Affiliation(s)
- Robel Beyene
- Vanderbilt University Medical Center, Nashville, Tennessee; Johns Hopkins Hospital, Manchester, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt University Medical Center, Nashville, Tennessee; R Adams Crowley Shock Trauma Center, Baltimore, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee
| | - David P Stonko
- Vanderbilt University Medical Center, Nashville, Tennessee; Johns Hopkins Hospital, Manchester, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt University Medical Center, Nashville, Tennessee; R Adams Crowley Shock Trauma Center, Baltimore, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ronnie Mubang
- Vanderbilt University Medical Center, Nashville, Tennessee; Johns Hopkins Hospital, Manchester, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt University Medical Center, Nashville, Tennessee; R Adams Crowley Shock Trauma Center, Baltimore, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee
| | - Stephen Gondek
- Vanderbilt University Medical Center, Nashville, Tennessee; Johns Hopkins Hospital, Manchester, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt University Medical Center, Nashville, Tennessee; R Adams Crowley Shock Trauma Center, Baltimore, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jonathan Morrison
- Vanderbilt University Medical Center, Nashville, Tennessee; Johns Hopkins Hospital, Manchester, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt University Medical Center, Nashville, Tennessee; R Adams Crowley Shock Trauma Center, Baltimore, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee
| | - Bradley M Dennis
- Vanderbilt University Medical Center, Nashville, Tennessee; Johns Hopkins Hospital, Manchester, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt University Medical Center, Nashville, Tennessee; R Adams Crowley Shock Trauma Center, Baltimore, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee
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14
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Kundi R, Morrison J, Scalea T. EVTM After COVID. JEVTM 2022. [DOI: 10.26676/jevtm.v5i3.243] [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]
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15
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Cho S, Darby J, Williams G, Dimasi C, Holman S, Selvanayagam J, Macgowan C, Morrison J, Seed M. Regional Left Ventricular Myocardial Injury and Function Characterisation by Cardiac Magnetic Resonance Imaging in a Sheep Model of Myocardial Infarction. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.283] [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: 10/16/2022]
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Nahmias J, Byerly S, Stein D, Haut ER, Smith JW, Gelbard R, Ziesmann M, Boltz M, Zarzaur B, Biffl WL, Brenner M, DuBose J, Fox C, Galante J, Martin M, Moore EE, Moore L, Morrison J, Norii T, Scalea T, Yeh DD. A core outcome set for resuscitative endovascular balloon occlusion of the aorta: A consensus based approach using a modified Delphi method. J Trauma Acute Care Surg 2022; 92:144-151. [PMID: 34554137 DOI: 10.1097/ta.0000000000003405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The utilization of resuscitative endovascular balloon occlusion of the aorta (REBOA) in trauma has grown exponentially in recent years. However, inconsistency in reporting of outcome metrics related to this intervention has inhibited the development of evidence-based guidelines for REBOA application. This study sought to attain consensus on a core outcome set (COS) for REBOA. METHODS A review of "landmark" REBOA articles was performed, and panelists (first and senior authors) were contacted for participation in a modified Delphi study. In round 1, panelists provided a list of potential core outcomes. In round 2, using a Likert scale (1 [not important] to 9 [very important]), panelists scored the importance of each potential outcome. Consensus for core outcomes was defined a priori as greater than 70% of scores receiving 7 to 9 and less than 15% of scores receiving 1 to 3. Feedback was provided after round 2, and a third round was performed to reevaluate variables not achieving consensus and allow a final "write-in" round by the experts. RESULTS From 17 identified panelists, 12 participated. All panelists (12 of 12, 100%) participated in each subsequent round. Panelists initially identified 34 unique outcomes, with two outcomes later added upon write-in request after round 2. From 36 total potential outcomes, 20 achieved consensus as core outcomes, and this was endorsed by 100% of the participants. CONCLUSION Panelists successfully achieved consensus on a COS for REBOA-related research. This REBOA-COS is recommended for all clinical trials related to REBOA and should help enable higher-quality study designs, valid aggregation of published data, and development of evidence-based practice management guidelines. LEVEL OF EVIDENCE Diagnostic test or criteria, level V. TRIAL REGISTRATION Core Outcomes in Trauma Surgery: Development of a Core Outcome Set for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) http://www.comet-initiative.org/Studies/Details/1709.
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Affiliation(s)
- Jeffry Nahmias
- From the Department of Surgery (J.N.), University of California, Irvine, Orange, California; Department of Surgery (S.B.), University of Tennessee Health Science Campus, Memphis, Tennessee; Department of Surgery (D.S.), Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California; Division of Acute Care Surgery, Department of Surgery (E.R.H.), The Johns Hopkins University School of Medicine, Baltimore, Maryland; Hiram C. Polk Md Department of Surgery (J.W.S.), University of Louisville, Louisville, Kentucky; Division of Trauma and Acute Care Surgery, Department of Surgery (R.G.), University of Alabama at Birmingham, Boshell Building, Birmingham, Alabama; Department of Surgery (M.Z.), University of Manitoba, Winnipeg, Manitoba, Canada; Division of Trauma, Acute Care and Critical Care Surgery, Department of Surgery (Mel.B.), Penn State Hershey Medical Center, Hershey, Pennsylvania; Department of Surgery (B.Z.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Department of Surgery (W.L.B.), Scripps Clinic Medical Group, La Jolla, California; Department of Surgery (Meg.B.), University of California Riverside School of Medicine, Riverside CA; R Adams Cowley Shock Trauma Center (J.D., C.F., J.M., T.S.), University of Maryland School of Medicine, Baltimore, Maryland; Department of Surgery (J.G.), University of California, Davis, Sacramento; Department of Surgery (M.M.), Scripps Mercy Hospital, San Diego, California; Ernest E Moore Shock Trauma Center at Denver Health (E.E.M.), University of Colorado Denver, Denver Colorado; Department of Surgery (L.M.), The University of Texas Health McGovern Medical School, Houston, Houston, Texas; Department of Emergency Medicine (T.N.), University of New Mexico Health Sciences Center, Albuquerque, New Mexico; Department of Traumatology and Acute Critical Medicine (T.N.), Osaka University Graduate School of Medicine, Osaka, Japan; and Department of Surgery (D.D.Y.), University of Miami Miller School of Medicine, Miami, Florida
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Mitra J, Qiu J, MacDonald M, Venugopal P, Wallace K, Abdou H, Richmond M, Elansary N, Edwards J, Patel N, Morrison J, Marinelli L. Automatic Hemorrhage Detection From Color Doppler Ultrasound Using a Generative Adversarial Network (GAN)-Based Anomaly Detection Method. IEEE J Transl Eng Health Med 2022; 10:1800609. [PMID: 36051823 PMCID: PMC9423818 DOI: 10.1109/jtehm.2022.3199987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/21/2022] [Accepted: 08/10/2022] [Indexed: 11/21/2022]
Abstract
Hemorrhage control has been identified as a priority focus area both for civilian and military populations in the United States because exsanguination is the most common cause of preventable death in hemorrhagic injury. Non-compressible torso hemorrhage (NCTH) has high mortality rate and there are currently no broadly available therapies for NCTH outside of a surgical room environment. Novel therapies, which include High Intensity Focused Ultrasound (HIFU) have emerged as promising methods for hemorrhage control as they can non-invasively cauterize bleeding tissue deep within the body without injuring uninvolved regions. A major challenge in the application of HIFU with color Doppler US guidance is the interpretation and optimization of the blood flow images in real-time to identify the hemorrhagic focus. Today, this task requires an expert sonographer, limiting the utility of this therapy in non-clinical environments. In this work, we investigated the feasibility of an automated hemorrhage detection method using a Generative Adversarial Network (GAN) for anomaly detection that learns a manifold of normal blood flow variability and subsequently identifies anomalous flow patterns that fall outside the learned manifold. As an initial feasibility study, we collected ultrasound color Doppler images of femoral arteries in an animal model of vascular injury (N = 11 pigs). Velocity information of the blood flow were extracted from the color Doppler images that were used for training and testing the anomaly detection network. Normotensive images from 8 pigs were used for training, and testing was performed on normotensive, immediately after injury, 10 minutes post-injury and 30 minutes post-injury images from 3 other pigs. The residual images or the reconstructed error maps show promise in detecting hemorrhages with an AUC of 0.90, 0.87, 0.62 immediately, 10 minutes post-injury and 30 minutes post-injury respectively with an overall AUC of 0.83.
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Affiliation(s)
| | | | | | | | | | - Hossam Abdou
- School of Medicine, University of Maryland, Baltimore, Baltimore, MD, USA
| | - Michael Richmond
- School of Medicine, University of Maryland, Baltimore, Baltimore, MD, USA
| | - Noha Elansary
- School of Medicine, University of Maryland, Baltimore, Baltimore, MD, USA
| | - Joseph Edwards
- School of Medicine, University of Maryland, Baltimore, Baltimore, MD, USA
| | - Neerav Patel
- School of Medicine, University of Maryland, Baltimore, Baltimore, MD, USA
| | - Jonathan Morrison
- School of Medicine, University of Maryland, Baltimore, Baltimore, MD, USA
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Sundar S, Cummins C, Kumar S, Long J, Arora V, Balega J, Broadhead T, Duncan T, Edmondson R, Fotopoulou C, Glasspool R, Kolomainen D, Leeson S, Manchanda R, McNally O, Morrison J, Mukhopadhyay A, Paul J, Tidy J, Wood N. Quality of life from cytoreductive surgery in advanced Ovarian cancer: investigating association with disease burden and surgical complexity in the international, prospective, SOCQER2 cohort study. BJOG 2021; 129:1122-1132. [PMID: 34865316 PMCID: PMC9306902 DOI: 10.1111/1471-0528.17041] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/22/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate quality of life (QoL) and association with surgical complexity and disease burden after surgical resection for advanced ovarian cancer in centres with variation in surgical approach DESIGN: Prospective multicentre observational study SETTING: United Kingdom, Kolkata, India, and Melbourne, Australia gynaecological cancer surgery centres. PARTICIPANTS Patients undergoing surgical resection for late stage ovarian cancer. Exposure Low, intermediate or high Surgical Complexity Score (SCS) surgery MAIN OUTCOMES AND MEASURES: Primary: EORTC-QLQ-C30 Global score change. Secondary: EORTC OV28, progression free survival. RESULTS Patients' pre-operative disease burden and SCS varied between centres, confirming differences in surgical ethos. QoL response rates were 90% up to 18 months. Mean change from the pre-surgical baseline in the EORTC QLQ-C30 was 3.4 (SD 1.8, n=88) in the low, 4.0 (SD 2.1, n=55) in the intermediate and 4.3 (SD 2.1, n=52) in the high SCS group after 6 weeks (p=0.048) and 4.3 (SD 2.1, n=51), 5.1 (SD 2.2, n=41) and 5.1 (SD 2.2, n=35) respectively after 12 months (p=0.133). In a repeated measures model, there were no clinically or statistically meaningful differences in EORTC QLQ-C30 global scores between the three SCS groups, p= 0.840 but there was a small statistically significant improvement in all groups over time (p<0.001). The high SCS group experienced small to moderate decreases in physical (p=0.004), role (p=0.016) and emotional (p=0.001) function at 6 weeks post-surgery which resolved by 6-12 months. CONCLUSIONS AND RELEVANCE Global QoL of patients undergoing low, intermediate, and high SCS surgery improved at 12 months post operation and was no worse in patients undergoing extensive surgery.
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Affiliation(s)
- S Sundar
- Institute of Cancer and Genomic Sciences, University of Birmingham.,Sandwell and West Birmingham NHS Trust
| | - C Cummins
- Institute of Applied health Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - S Kumar
- Institute of Applied health Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - J Long
- Institute of Applied health Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - V Arora
- Bondi Women's Health, Sydney, NSW, Australia
| | - J Balega
- Sandwell and West Birmingham NHS Trust
| | - T Broadhead
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - T Duncan
- Norfolk & Norwich University Hospital, Norwich, UK
| | | | | | | | | | - S Leeson
- Betsi Cadwaladr University Health Board, Bangor, UK
| | - R Manchanda
- Wolfson Institute of Population Health, Queen Mary University of London
| | - O McNally
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - J Morrison
- Taunton and Somerset NHS Foundation Trust, Taunton, UK
| | | | - J Paul
- University of Glasgow, Glasgow, UK
| | - J Tidy
- University of Sheffield, Sheffield, UK
| | - N Wood
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
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Ko A, Radding S, Feliciano DV, DuBose JJ, Kozar RA, Morrison J, Kundi R, Maddox J, Scalea TM. Near Disappearance of Splenorrhaphy as an Operative Strategy for Splenic Preservation After Trauma. Am Surg 2021; 88:429-433. [PMID: 34732074 DOI: 10.1177/00031348211050591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Splenorrhaphy was once used to achieve splenic preservation in up to 40% of splenic injuries. With increasing use of nonoperative management and angioembolization, operative therapy is less common and splenic injuries treated operatively are usually high grade. Patients are often unstable, making splenic salvage unwise. Modern surgeons may no longer possess the knowledge to perform splenorrhaphy. METHODS The records of adult trauma patients with splenic injuries from September 2014 to November 2018 at an urban level I trauma center were reviewed retrospectively. Data including American Association for the Surgery of Trauma splenic organ injury scale, type of intervention, splenorrhaphy technique, and need for delayed splenectomy were collected. This contemporary cohort (CC) was compared to a historical cohort (HC) of splenic injuries at a single center from 1980 to 1989 (Ann Surg 1990; 211: 369). RESULTS From 2014 to 2018, 717 adult patients had splenic injuries. Initial management included 157 (21.9%) emergent splenectomy, 158 (22.0%) angiogram ± embolization, 371 (51.7%) observation, and only 10 (1.4%) splenorrhaphy. The HC included a total of 553 splenic injuries, of which 313 (56.6%) underwent splenectomy, while splenorrhaphy was performed in 240 (43.4%). Those who underwent splenorrhaphy in each cohort (CC vs HC) were compared. CONCLUSION The success rate of splenorrhaphy has not changed. However, splenorrhaphy now involves only electrocautery with topical hemostatic agents and is used primarily in low-grade injuries. Suture repair and partial splenectomy seem to be "lost arts" in modern trauma care.
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Affiliation(s)
- Ara Ko
- Department of Surgery, Section of Acute Care Surgery, 10624Stanford University, Stanford, CA, USA
| | - Sydney Radding
- R. Adams Cowley Shock Trauma Center, 12264University of Maryland, Baltimore, MD, USA
| | - David V Feliciano
- R. Adams Cowley Shock Trauma Center, 12264University of Maryland, Baltimore, MD, USA
| | - Joseph J DuBose
- R. Adams Cowley Shock Trauma Center, 12264University of Maryland, Baltimore, MD, USA
| | - Rosemary A Kozar
- R. Adams Cowley Shock Trauma Center, 12264University of Maryland, Baltimore, MD, USA
| | - Jonathan Morrison
- R. Adams Cowley Shock Trauma Center, 12264University of Maryland, Baltimore, MD, USA
| | - Rishi Kundi
- R. Adams Cowley Shock Trauma Center, 12264University of Maryland, Baltimore, MD, USA
| | - John Maddox
- R. Adams Cowley Shock Trauma Center, 12264University of Maryland, Baltimore, MD, USA
| | - Thomas M Scalea
- R. Adams Cowley Shock Trauma Center, 12264University of Maryland, Baltimore, MD, USA
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Gorman E, Nowak B, Klein M, Inaba K, Morrison J, Scalea T, Seamon M, Fox C, Moore L, Kauvar D, Spalding M, Dubose J, DiMaggio C, Livingston DH, Bukur M. High resuscitative endovascular balloon occlusion of the aorta procedural volume is associated with improved outcomes: An analysis of the AORTA registry. J Trauma Acute Care Surg 2021; 91:781-789. [PMID: 34695057 DOI: 10.1097/ta.0000000000003201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) is controversial. We hypothesize that REBOA outcomes are improved in centers with high REBOA utilization. METHODS We examined the Aortic Occlusion in Resuscitation for Trauma and Acute Care Surgery registry over a 5-year period (2014-2018). Resuscitative endovascular balloon occlusion of the aorta outcomes were analyzed by stratifying institutions into low-volume (<10), average-volume (11-30), and high-volume (>30) deployment centers. A multivariable model adjusting for volume group, mechanism of injury, signs of life, systolic blood pressure at initiation, operator level, device type, zone of placement, and hemodynamic response to aortic occlusion was created to analyze REBOA mortality and REBOA-related complications. RESULTS Four hundred ninety-five REBOA placements were included. High-volume centers accounted for 63%, while low accounted for 13%. High-volume institutions were more likely to place a REBOA in the emergency department (81% vs. 63% low volume, p = 0.003), had a lower mean systolic blood pressure at insertion (53 ± 38 vs. 64 ± 40, p = 0.001), and more Zone I deployments (64% vs. 55%, p = 0.002). Median time from admission to REBOA placement was significantly less in patients treated at high-volume centers (15 [7-30] minutes vs. 35 [20-65] minutes, p = 0.001). Resuscitative endovascular balloon occlusion of the aorta mortality was significantly higher at low-volume centers (67% vs. 57%; adjusted odds ratio, 1.29; adj p = 0.040), while average- and high-volume centers were similar. Resuscitative endovascular balloon occlusion of the aorta complications were less frequent at high-/average-volume centers, but did not reach statistical significance (adj p = 0.784). CONCLUSION Resuscitative endovascular balloon occlusion of the aorta survival is increased at high versus low utilization centers. Increased experience with REBOA may be associated with earlier deployment and subsequently improved patient outcomes. LEVEL OF EVIDENCE Therapeutic/Care Management, level IV.
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Affiliation(s)
- Elizabeth Gorman
- From the Department of Surgery, Rutgers New Jersey Medical School (E.G., D.H.L.), Newark, New Jersey; NYU Langone Department of Surgery, Division of Acute Care Surgery, Bellevue Hospital Center (B.N., M.K., C.DM., M.B.), New York, New York; Los Angeles County + University of Southern California Hospital (K.I.), Los Angeles, California; Los Angeles County + University of Southern California Medical Center, Division of Trauma/Surgical Critical Care, Los Angeles, California; R. Adams Cowley Shock Trauma Center/CSTARS (Center for the Sustainment of Trauma and Readiness Skills) (J.M., T.S., C.F., J.D.), University of Maryland, Baltimore, Maryland; Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania (M.Se.), Philadelphia, Pennsylvania; Memorial Hermann Texas Medical Center (L.M.), Department of Surgery, University of Texas Houston Medical School, San Antonio Military Medical Center/US Army Institute of Surgical Research (D.K.), San Antonio, Texas; and Ohio Health, Grant Medical Center (M.Sp.), Columbus, Ohio
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Guntur G, DuBose JJ, Bee TK, Fabian T, Morrison J, Skarupa DJ, Inaba K, Kundi R, Scalea T, Feliciano DV. Contemporary Management of Axillosubclavian Arterial Injuries Using Data from the AAST PROOVIT Registry. JEVTM 2021. [DOI: 10.26676/jevtm.v5i2.201] [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]
Abstract
Background: Endovascular repair has emerged as a viable repair option for axillosubclavian arterial injuries in select patients; however, further study of contemporary outcomes is warranted.
Methods: The American Association for the Surgery of Trauma (AAST) PROspective Observational Vascular Injury Treatment (PROOVIT) registry was used to identify patients with axillo-subclavian arterial injuries from 2013 – 2019. Demographics and outcomes were compared between patients undergoing endovascular repair versus open repair.
Results: 167 patients were identified, with intervention required in 107 (64.1%). Among these, 24 patients underwent open damage control surgery (primary amputation = 3, ligation = 17, temporary vascular shunt = 4). The remaining 83 patients (91.6% male; mean age 26.0 ± 16) underwent either endovascular repair (36, 43.4%) or open repair (47, 56.6%). Patients managed with definitive endovascular or open repair had similar demographics and presentation, with the only exception that endovascular repair was more commonly employed for traumatic pseudoaneurysms (p=0.004). Endovascular repair was associated with lower 24-hour transfusion requirements (p=0.012), but otherwise the two groups were similar with regards to in-hospital outcomes.
Conclusion: Endovascular repair is now employed in > 40% of axillo-subclavian arterial injuries undergoing repair at initial operation and is associated with lower 24 hour transfusion requirements, but otherwise outcomes are comparable to open repair.
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DuBose JJ, Burlew CC, Joseph B, Keville M, Harfouche M, Morrison J, Fox CJ, Mooney J, O'Toole R, Slobogean G, Marchand LS, Demetriades D, Werner NL, Benjamin E, Costantini T. Pelvic fracture-related hypotension: A review of contemporary adjuncts for hemorrhage control. J Trauma Acute Care Surg 2021; 91:e93-e103. [PMID: 34238857 DOI: 10.1097/ta.0000000000003331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Major pelvic hemorrhage remains a considerable challenge of modern trauma care associated with mortality in over a third of patients. Efforts to improve outcomes demand continued research into the optimal employment of both traditional and newer hemostatic adjuncts across the full spectrum of emergent care environments. The purpose of this review is to provide a concise description of the rationale for and effective use of currently available adjuncts for the control of pelvic hemorrhage. In addition, the challenges of defining the optimal order and algorithm for employment of these adjuncts will be outlined. LEVEL OF EVIDENCE Review, level IV.
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Affiliation(s)
- Joseph J DuBose
- From the R Adams Cowley Shock Trauma Center (J.J.D., M.K., M.H., J.M., C.J.F., R.O., G.S.), University of Maryland Medical System, Baltimore, Maryland; Department of Surgery (C.C.B., N.L.W.), Denver Health Medical Center, Denver, Colorado; Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery (B.J.), College of Medicine, University of Arizona, Tucson, Arizona; Baylor University Medical Center (J.M.), Dallas, Texas; Department of Orthopedic Surgery (L.S.M.), University of Utah, Salt Lake City, Utah; Division of Trauma and Surgical Critical Care (D.D., E.B.), LAC+USC Medical Center, University of Southern California, Los Angeles, California; Trauma/Surgical Critical Care (T.C.), Grady Memorial Hospital/Emory University School of Medicine, Atlanta, Georgia; and Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery (T.C.), University of California San Diego School of Medicine, San Diego, California
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Harfouche MN, Morrison J, Kundi R, DuBose JJ, Scalea TM. Open Balloon Tamponade and Hepatic Angiography for Hemorrhage Control of Transhepatic Gunshot Wounds in a Hybrid Trauma Operating Room Environment. JEVTM 2021. [DOI: 10.26676/jevtm.v40i(2).131] [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]
Abstract
The management of high-grade liver trauma is challenging and mortality rates are high. Balloon tamponade is a valuable tool for control of transhepatic penetrating injuries. We report three cases of hybrid management of penetrating liver trauma with balloon tamponade and hepatic angiography in a hybrid operating room environment. The combination of balloon tamponade with hepatic angioembolization provides an enhanced approach for the management of these injuries.
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Huang Y, Kruse RL, Ding H, Itani MI, Morrison J, Wang ZZ, Selaru FM, Kumbhari V. Parameters of biliary hydrodynamic injection during endoscopic retrograde cholangio-pancreatography in pigs for applications in gene delivery. PLoS One 2021; 16:e0249931. [PMID: 33909609 PMCID: PMC8081268 DOI: 10.1371/journal.pone.0249931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/27/2021] [Indexed: 11/23/2022] Open
Abstract
The biliary system is routinely accessed for clinical purposes via endoscopic retrograde cholangiopancreatography (ERCP). We previously pioneered ERCP-mediated hydrodynamic injection in large animal models as an innovative gene delivery approach for monogenic liver diseases. However, the procedure poses potential safety concerns related mainly to liver or biliary tree injury. Here, we sought to further define biliary hydrodynamic injection parameters that are well-tolerated in a human-sized animal model. ERCP was performed in pigs, and hydrodynamic injection carried out using a novel protocol to reduce duct wall stress. Each pig was subjected to multiple repeated injections to expedite testing and judge tolerability. Different injection parameters (volume, flow rate) and injection port diameters were tested. Vital signs were monitored throughout the procedure, and liver enzyme panels were collected pre- and post-procedure. Pigs tolerated repeated biliary hydrodynamic injections with only occasional, mild, isolated elevation in aspartate aminotransferase (AST), which returned to normal levels within one day post-injection. All other liver tests remained unchanged. No upper limit of volume tolerance was reached, which suggests the biliary tree can readily transmit fluid into the vascular space. Flow rates up to 10 mL/sec were also tolerated with minimal disturbance to vital signs and no anatomic rupture of bile ducts. Measured intrabiliary pressure was up to 150 mmHg, and fluid-filled vesicles were induced in liver histology at high flow rates, mimicking the changes in histology observed in mouse liver after hydrodynamic tail vein injection. Overall, our investigations in a human-sized pig liver using standard clinical equipment suggest that ERCP-guided hydrodynamic injection will be safely tolerated in patients. Future investigations will interrogate if higher flow rates and pressure mediate higher DNA delivery efficiencies.
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Affiliation(s)
- Yuting Huang
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, Maryland, United States of America
| | - Robert L. Kruse
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Hui Ding
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mohamad I. Itani
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Jonathan Morrison
- R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Zack Z. Wang
- Division of Hematology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Florin M. Selaru
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- * E-mail: (VK); (FMS)
| | - Vivek Kumbhari
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Division of Gastroenterology & Hepatology, Department of Medicine, Mayo Clinic College of Medicine and Science, Jacksonville, Florida, United States of America
- * E-mail: (VK); (FMS)
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Morrison J, Arjyal A. A funfair without the candy floss: engaging communities to prevent diabetes in Nepal. Public Health 2021; 193:23-25. [PMID: 33711779 PMCID: PMC8128096 DOI: 10.1016/j.puhe.2021.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/08/2020] [Accepted: 01/15/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The World Health Organization estimates that 422 million people have diabetes, three-quarters of whom live in low- and middle-income countries. Global action plans to address non-communicable diseases (NCDs) recognise the centrality of community engagement to create an enabling environment within which to address risk factors. STUDY DESIGN In this article, we describe and critically reflect on a cocreated community engagement approach to address type 2 diabetes in the southern plains of Nepal. We coproduced the engagement approach with 40 artists from the Janakpur Women's Development Centre to create an environment for dialogue about diabetes and NCD risk between artists and the general public. METHODS We used participatory action research to produce contextually relevant interactive methods and materials. Methods included artists' peer research to inform creative workshops, a drama performed in 19 villages and a two-day funfair in a public park. We used qualitative and participatory methods to analyse the effect of this engagement and reflect on lessons learned. RESULTS Around 2000 people saw the drama, and around 4000 people attended the funfair. Community dialogue about prevention of diabetes was facilitated by drama and through games and songs at the funfair. Artists grew confident to interact with their peers and drama audiences about the causes of diabetes and prevention strategies. Despite crowds at the funfair, it was difficult to reach women because the venue was often used by men and boys, and patriarchal norms prevent women from free movement. Village interactions were able to engage a more mixed audience. CONCLUSION Innovative, asset-based community engagement about diabetes and other NCDs at scale is possible through locating, building on and strengthening community resources to address local health issues. Engagement could be enhanced by considering the gendered nature of community engagement spaces and by increasing opportunities for interaction between artists and the general public through more intimate and large-scale events.
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Affiliation(s)
- J Morrison
- University College London, Institute of Global Health, London, UK.
| | - A Arjyal
- Herd International, Thapathali, Kathmandu, Nepal
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Johnson NL, Wade CE, Fox EE, Meyer DE, Fox CJ, Moore EE, Morrison J, Scalea T, Bulger EM, Inaba K, Morse BC, Moore LJ. Determination of optimal deployment strategy for REBOA in patients with non-compressible hemorrhage below the diaphragm. Trauma Surg Acute Care Open 2021; 6:e000660. [PMID: 33693060 PMCID: PMC7907878 DOI: 10.1136/tsaco-2020-000660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background Non-compressible truncal hemorrhage (NCTH) is the leading cause of preventable death after trauma. Resuscitative endovascular balloon occlusion of the aorta (REBOA) achieves temporary hemorrhage control, supporting cardiac and cerebral perfusion prior to definitive hemostasis. Aortic zone selection algorithms vary among institutions. We evaluated the efficacy of an algorithm for REBOA use. Methods A multicenter prospective, observational study conducted at six level 1 trauma centers over 12 months. Inclusion criteria were age >15 years with evidence of infradiaphragmatic NCTH needing emergent hemorrhage control within 60 min of ED arrival. An algorithm characterized by the results of focused assessment with sonography in trauma and pelvic X-ray was assessed post hoc for efficacy in a cohort of patients receiving REBOA. Results Of the 8166 patients screened, 78 patients had a REBOA placed. 21 patients were excluded, leaving 57 patients for analysis. The algorithm ensures REBOA deployment proximal to hemorrhage source to control bleeding in 98.2% of cases and accurately predicts the optimal REBOA zone in 78.9% of cases. If the algorithm was violated, bleeding was optimally controlled in only 43.8% (p=0.01). Three (75.0%) of the patients that received an inappropriate zone 1 REBOA died, two from multiple organ failure (MOF). All three patients that died with an inappropriate zone 3 REBOA died from exsanguination. Discussion This algorithm ensures proximal hemorrhage control and accurately predicts the primary source of hemorrhage. We propose a new algorithm that will be more inclusive. A zone 3 REBOA should not be performed when a zone 1 is indicated by the algorithm as 100% of these patients exsanguinated. MOF, perhaps from visceral ischemia in patients with an inappropriate zone 1 REBOA, may have been prevented with zone 3 placement or limited zone 1 occlusion time. Level of evidence Level III.
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Affiliation(s)
- Nicholas L Johnson
- Department of Surgery, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, USA
| | - Charles E Wade
- Department of Surgery, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, USA
| | - Erin E Fox
- Department of Surgery, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, USA
| | - David E Meyer
- Department of Surgery, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, USA
| | - Charles J Fox
- Department of Surgery, University of Colorado Denver Health Medical Center, Denver, Colorado, USA
| | - Ernest E Moore
- Department of Surgery, University of Colorado Denver Health Medical Center, Denver, Colorado, USA
| | - Jonathan Morrison
- Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Thomas Scalea
- Department of Surgery, University of Maryland, Baltimore, Maryland, USA
| | - Eileen M Bulger
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Kenji Inaba
- Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Bryan C Morse
- Department of Surgery, Emory University School of Medicine Atlanta, Atlanta, Georgia, USA
| | - Laura J Moore
- Department of Surgery, University of Texas McGovern Medical School, Houston, Texas, USA
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DuBose JJ, Charlton-Ouw K, Starnes B, Saqib N, Quiroga E, Morrison J, Gewertz B, Azizzadeh A. Do patients with minimal blunt thoracic aortic injury require thoracic endovascular repair? J Trauma Acute Care Surg 2021; 90:384-387. [PMID: 33075025 DOI: 10.1097/ta.0000000000002995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The optimal management of minimal blunt thoracic aortic injuries (BTAIs) remains controversial, with experienced centers using therapy ranging from medical management (MM) to thoracic endovascular aortic repair (TEVAR). METHODS The Aortic Trauma Foundation registry was used to examine demographics, injury characteristics, management, and outcomes of patients with BTAI. RESULTS Two hundred ninety-six patients from 28 international centers were analyzed (mean age, 44.5 years [SD, 18 years]; 76% [225/296] male; mean Injury Severity Score, 34 [SD, 14]). Blunt thoracic aortic injury was classified as Grade I, 22.6% (67/296); Grade II, 17.6% (52/296); Grade III, 47.3% (140/296); and Grade IV, 12.5% (37/296). Overall aortic-related mortality (ARM) was 4.7% (14/296). Among all deaths, 33% (14/42) were ARM. Open repair was required for only 2%, with most undergoing TEVAR (58.4%) or MM (28.0%). Thoracic endovascular repair complications occurred in 3.4% (6/173), most commonly Type 1 endoleak (2.3%; 4/173). Among patients with minimal aortic injury (Grades I and II), 59.7% (71/119) received MM, while 40.3% (48/119) underwent TEVAR. Two patients initially managed with MM required subsequent TEVAR for injury progression during initial hospital stay. No significant difference in ARM between MM and TEVAR was noted for Grades I and II injuries. CONCLUSION A third of the trauma victims with BTAI succumb to ARM. Thoracic endovascular repair has replaced open repair but remains equivalent in outcomes to MM for minimal injuries. These data support MM of patients with minimal aortic injury. LEVEL OF EVIDENCE Therapeutic study, level IV.
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Affiliation(s)
- Joseph J DuBose
- From the R Adams Cowley Shock Trauma Center (J.J.D., J.M.), University of Maryland Medical System; Division of Vascular Surgery, University of Texas Health Sciences Center (K.C.-O., N.S.), Houston; Division of Vascular Surgery, University of Washington (B.S., E.Q.), Harborview; and Smidt Heart Institute (B.G., A.A.), Cedars-Sinai Medical Center, Los Angeles
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Romagnoli AN, DuBose J, Dua A, Betzold R, Bee T, Fabian T, Morrison J, Skarupa D, Podbielski J, Inaba K, Feliciano D, Kauvar D. Hard signs gone soft: A critical evaluation of presenting signs of extremity vascular injury. J Trauma Acute Care Surg 2021; 90:1-10. [PMID: 33017355 DOI: 10.1097/ta.0000000000002958] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite advances in management of extremity vascular injuries, "hard signs" remain the primary criterion to determine need for imaging and urgency of exploration. We propose that hard signs are outdated and that hemorrhagic and ischemic signs of vascular injury may be of greater clinical utility. METHODS Extremity arterial injuries from the American Association for the Surgery of Trauma PROspective Observational Vascular Injury Treatment registry were analyzed to examine the relationships between hard signs, ischemic signs, and hemorrhagic signs of extremity vascular injury with workup, diagnosis, and management. RESULTS Of 1,910 cases, 1,108 (58%) had hard signs of vascular injury. Computed tomography angiography (CTA) was more commonly used as the diagnostic modality in patients without hard signs, while operative exploration was primarily used for diagnosis in hard signs. Patients undergoing CTA were more likely to undergo endovascular or hybrid repair (EHR) (10.7%) compared with patients who underwent exploration for diagnosis (1.5%). Of 915 patients presenting with hemorrhagic signs, CTA was performed 14.5% of the time and was associated with a higher rate of EHR and observation. Of the 490 patients presenting with ischemic signs, CTA was performed 31.6% of the time and was associated with higher rates of EHR and observation. Hemorrhagic signs were associated with arterial transection, while ischemic signs were associated with arterial occlusion. Patients with ischemic signs undergoing exploration for diagnosis received more units of packed red blood cells during the first 24 hours. There was no difference in amputation rate, reintervention rate, hospital length of stay, or mortality in comparing groups who underwent CTA versus exploration. CONCLUSION Hard signs have limitations in identification and characterization of extremity arterial injuries. A strategy of using hemorrhagic and ischemic signs of vascular injury is of greater clinical utility. Further prospective study is needed to validate this proposed redefinition of categorization of presentations of extremity arterial injury. LEVEL OF EVIDENCE Diagnostic, level III.
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Affiliation(s)
- Anna Noel Romagnoli
- From the Division of Vascular and Endovascular Surgery, Massachusetts General Hospital (A.N.R., A.D.), Boston, MA; Division of Trauma and Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center (J.D., R.B., J.M., D.F.), Baltimore MD; Division of Trauma/Surgical Critical Care, University of Tennessee Health Science Center (T.B., T.F.), Memphis, TN; Division of Acute Care Surgery, University of Florida Health Jacksonville (D.S.), Jacksonville, FL; Center for Translational Injury Research, University of Texas Health Science Center at Houston (J.P.), Houston TX; Division of Trauma and Critical Care, University of Southern California (K.I.), Los Angeles; and Vascular Surgery Service, Brook Army Medical Center (D.K.), San Antonio, TX
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Vongsachang H, Menendez T, Morrison J, Schneberk T. 215 Understanding and Improving Population Health from the Emergency Department Through Medical-Legal Partnerships. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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30
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Petersen K, Morrison J, Oprea V, Grischkan D, Koch A, Lorenz R, Bendavid R, Iakovlev V. Necessary duration of follow-up to assess complications of mesh in hernia surgery: a time-lapse study based on 460 explants. Hernia 2020; 25:1239-1251. [PMID: 32960368 DOI: 10.1007/s10029-020-02297-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/01/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Risk of complications following hernia repair is the key parameter to assess risk/benefit ratio of a technique. As mesh devices are permanent, their risks are life-long. Too many reports in the past assessed mesh safety prematurely after short follow-ups. We aimed to explore what length of follow up would reveal the full extent of complications. METHODS Time lapses between implantation and excision were analyzed in 460 cases of meshes excised for complications after hernia repair. Patterns of percentage growth and time lapses at 50th and 95th percentiles were used to compare groups of different hernia type, age, gender and reason for excision. RESULTS The 50th and 95th case percentiles in the dataset were at 3.75 and 15.0 years between mesh implantation and excision. For hernia types, the longest time lapses were for groin hernias (4.0 and 16.11 years at 50th and 95th percentiles). The shortest were for umbilical hernias (2.16 and 9.68 years). Males had later excisions than females (4.11 and 16.1 vs. 2.47 and 9.79 years). Younger patients (< 45 y.o.) had later excisions than older patients (4.12 and 17.68 vs. 3.37 and 10.0 years). Out of all subgroups, the longest time lapses were for groin hernias in younger males (4.77 and 18.89 years) and for mesh erosion into organs (4.67 and 17.0 years). CONCLUSIONS Follow-up of more than 15 years is needed to fully assess complications after mesh hernia repair. Especially longer periods are needed to detect mesh erosion into organs and complications in younger males. Presently, short observations and lack of reporting standard in the literature prohibit accurate assessment of complication risks. We propose to use cumulative incidence for standardized risk reporting (y% risk at x years). This will show time-dependent patterns and allow comparisons between different techniques and studies of variable duration. Standardization will also help to predict long-term risks beyond shorter (practical) follow-ups and facilitate real-time monitoring during surveillance.
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Affiliation(s)
| | - J Morrison
- Chatham Kent Health Alliance, Chatham, Ontario, Canada
| | - V Oprea
- Military Hospital of Cluj, Cluj-Napoca, Romania, Romania
| | | | - A Koch
- Day Surgery and Hernia Center, Cottbus, Germany
| | - R Lorenz
- , Hernia Center 3+CHIRURGEN, Berlin, Germany
| | - R Bendavid
- Department of Surgery, Shouldice Hospital, Thornhill, University of Toronto, Toronto, ON, Canada
| | - V Iakovlev
- Department of Laboratory Medicine, St. Michael's Hospital, Keenan Research Centre of the Li Ka Shing Knowledge Institute, University of Toronto, Toronto, ON, Canada.
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DuBose JJ, Morrison J, Moore LJ, Cannon JW, Seamon MJ, Inaba K, Fox CJ, Moore EE, Feliciano DV, Scalea T. Does Clamshell Thoracotomy Better Facilitate Thoracic Life-Saving Procedures Without Increased Complication Compared with an Anterolateral Approach to Resuscitative Thoracotomy? Results from the American Association for the Surgery of Trauma Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery Registry. J Am Coll Surg 2020; 231:713-719.e1. [PMID: 32947036 DOI: 10.1016/j.jamcollsurg.2020.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/12/2020] [Accepted: 09/02/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Resuscitative thoracotomy (RT) is life-saving in select patients and can be accomplished through a left anterolateral (AT) or clamshell thoracotomy (CT). CT may provide additional exposure, facilitating certain operative procedures, but the added blood and heat loss and time to perform it may increase complications. No prospective multicenter comparison of techniques has yet been reported. STUDY DESIGN The observational AAST Aortic Occlusion for Resuscitation in Trauma and Acute care surgery (AORTA) registry was used to compare AT and CT in RT. RESULTS AORTA recorded 1,218 RTs at 46 trauma centers from June 2014 to January 2020. Overall survival after RT was 6.0% (AT 6.6%; [59 of 900]; CT 4.2% [13 of 296], p = 0.132). Among all RTs, 11.1% (142 of 1,278) surviving at least 24 hours were used tocompare AT (112) and CT (30). There was no difference between the 2 groups withregard to age, sex, Injury Severity Score, or mechanism of injury (Table 1). CT was significantly more likely to be used in patients needing resection of the lung or cardiac repair. CT was not associated with increased local thoracic/systemic complications, higher transfusion requirement, or greater ventilator, ICU, or hospital days compared with AT. CONCLUSIONS Clamshell thoracotomy facilitates thoracic life-saving procedures withoutincreased systemic or thoracic complications compared with AT in patients undergoing RT.
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Affiliation(s)
- Joseph J DuBose
- Department of Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, MD.
| | - Jonathan Morrison
- Department of Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, MD
| | - Laura J Moore
- Department of Surgery, University of Texas Health Sciences Center-Houston, Houston, TX
| | - Jeremy W Cannon
- Department of Surgery, University of Pennsylvania, Philadelphia, PA
| | - Mark J Seamon
- Department of Surgery, University of Pennsylvania, Philadelphia, PA
| | - Kenji Inaba
- Department of Surgery, Los Angeles County + University of Southern California Hospital, Los Angeles, CA
| | - Charles J Fox
- Department of Surgery, Denver Health and Hospital Authority, Denver, CO
| | - Ernest E Moore
- Department of Surgery, Denver Health and Hospital Authority, Denver, CO
| | - David V Feliciano
- Department of Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, MD
| | - Thomas Scalea
- Department of Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, MD
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Kumar R, Feltch C, Richards K, Morrison J, Rangel A, Janney R, Shayesteh S, Allen R, Banerjee N. 0438 Automatic Nighttime Agitation and Sleep Disruption Detection Using a Wearable Ankle Device and Machine Learning. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Nighttime agitation behavior such as wandering and restlessness during awake and sleep in people with Alzheimer’s disease (AD) is expensive to manage and adversely affects sleep. Nighttime agitation is mostly noted by subjective caregiver reports. An automated process for this assessment would improve clinical management. Here we report on the RestEaZeTM system that uses an ankle band and machine learning to automatically classify sleep status and nighttime agitation behaviors in older adults with AD.
Methods
We collected data on 7 adults (mean: 81 years, SD: 10.6) with AD. They wore the RestEaZeTM ankle band with a 3-axis accelerometer, a 3-axis gyroscope, and three textile capacitive sensors. A trained Research Assistant (RA) continuously observed for wandering, restlessness, wake, and sleep between 5pm and 7am using the Cohen Mansfield Agitation Inventory (CMAI). We merged, and band-pass filtered the data and divided it into 10-second non-overlapping windows. CMAI labels and time-series features (scaled using StandardScaler) extracted from the RestEaZeTM data were used to train a Random Forest binary classifier. The significant features were extracted based on the impact on the p-value for the classifier. We used the Synthetic Minority Oversampling Technique (SMOTE) to balance the dataset and performed 5-fold cross-validation with a 67-33 train-test split.
Results
We report the sensitivity, specificity, accuracy, and Area-under-the Curve (AUC) for the ROC curve for the classifiers: (1) Sleep/Awake: sensitivity=0.95, specificity=0.87, accuracy=0.92, AUC=0.97; (2) Wandering/Non-Wandering: sensitivity=0.85, specificity=0.99, accuracy=0.98, AUC=0.99; and (3) Restless/Non-Restless: sensitivity=0.84, specificity=0.84, accuracy=0.84, AUC=0.92. The significant features were related to the intensity of movements.
Conclusion
Our preliminary results show the feasibility of using RestEaZeTM for quantitatively measuring nighttime agitation. These can provide clinically useful objective measures of agitation that can be automatically transmitted to clinical or research records with minimal staff time requirements.
Support
The authors acknowledge the funding support from the National Institute on Aging under award R01AG051588 and Arbor Pharmaceuticals for support for Horizant and the matching placebo.
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Affiliation(s)
- R Kumar
- University of Maryland, Baltimore County, Catonsville, MD
| | - C Feltch
- Tanzen Medical, Inc., Baltimore, MD
| | | | | | - A Rangel
- University of Texas, Austin, Austin, TX
| | - R Janney
- University of Texas, Austin, Austin, TX
| | | | - R Allen
- Johns Hopkins University, Baltimore, MD
| | - N Banerjee
- University of Maryland, Baltimore County, Catonsville, MD
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Richards KC, Vallabhaneni V, Moelter S, Davis EM, Morrison J, Lozano A, Hanlon A, Wang Y, Wolk D, Gooneratne N. 0861 Age, Race, And Continuous Positive Airway Pressure (CPAP) Confidence Score At 1-week Predict 3-month CPAP Adherence In Older Adults With Amnestic Mild Cognitive Impairment And Moderate To Severe Obstructive Sleep Apnea. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Adherence to continuous positive airway pressure (CPAP) may delay cognitive decline in older adults with obstructive sleep apnea (OSA) and amnestic mild cognitive impairment (MCI), defined as deficits in memory that do not significantly impact daily functioning. The aim of this analysis was to identify predictors of CPAP adherence in this population.
Methods
Data are from Memories 2, an ongoing multisite clinical trial on the effect of treatment of moderate to severe OSA on cognitive decline in older adults 65-85 years of age who have amnestic MCI. Unadjusted and adjusted linear models were used to examine predictors of mean hours of CPAP use at 3 months. Predictors were age, sex (male/female), race (White/Non-White), education (more than high school, less than high school), Apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), and CPAP Comfort and Confidence scores at 7 days. Collinearity in the adjusted model for CPAP use at 3 months was examined using the variance inflation factor.
Results
Of 57 participants, most were male (54%), White (72%), with a mean age of 66.3 years (SD: 6.1). Mean AHI in this sample was 35.1 (SD: 19.9), with mean daily hours of CPAP use at 3 months 5.3 hours (SD: 2.3). Adjusted linear model results demonstrated that younger age (β=-0.13, SE=0.04, p=0.0032), White race (β=2.56, SE=0.58, p<0.0001), and higher 7-day CPAP Confidence score (β=0.48, SE=0.17, p=0.0086) were significantly associated with CPAP use at 3 months. Sex, education, AHI, ESS, and CPAP comfort were not statistically significant predictors of adherence.
Conclusion
Tailored interventions to increase self-efficacy during the first 7 days of CPAP treatment, especially in Non-Whites and those older than 74 years, may improve long-term CPAP adherence in older adults with amnestic MCI.
Support
R01AG054435
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Affiliation(s)
| | - V Vallabhaneni
- Sleep 360 Diagnostic Center, Austin, TX
- Texas A&M University, College Station, TX
| | - S Moelter
- University of the Sciences, Philadelphia, PA
| | - E M Davis
- University of Virginia, Charlottesville, VA
| | - J Morrison
- University of Texas at Austin, Austin, TX
| | | | | | - Y Wang
- University of Texas at Austin, Austin, TX
| | - D Wolk
- University of Pennsylvania, Philadelphia, PA
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Abe K, Akutsu R, Ali A, Alt C, Andreopoulos C, Anthony L, Antonova M, Aoki S, Ariga A, Asada Y, Ashida Y, Atkin ET, Awataguchi Y, Ban S, Barbi M, Barker GJ, Barr G, Barrow D, Barry C, Batkiewicz-Kwasniak M, Beloshapkin A, Bench F, Berardi V, Berkman S, Berns L, Bhadra S, Bienstock S, Blondel A, Bolognesi S, Bourguille B, Boyd SB, Brailsford D, Bravar A, Bravo Berguño D, Bronner C, Bubak A, Buizza Avanzini M, Calcutt J, Campbell T, Cao S, Cartwright SL, Catanesi MG, Cervera A, Chappell A, Checchia C, Cherdack D, Chikuma N, Christodoulou G, Coleman J, Collazuol G, Cook L, Coplowe D, Cudd A, Dabrowska A, De Rosa G, Dealtry T, Denner PF, Dennis SR, Densham C, Di Lodovico F, Dokania N, Dolan S, Doyle TA, Drapier O, Dumarchez J, Dunne P, Eklund L, Emery-Schrenk S, Ereditato A, Fernandez P, Feusels T, Finch AJ, Fiorentini GA, Fiorillo G, Francois C, Friend M, Fujii Y, Fujita R, Fukuda D, Fukuda R, Fukuda Y, Fusshoeller K, Gameil K, Giganti C, Golan T, Gonin M, Gorin A, Guigue M, Hadley DR, Haigh JT, Hamacher-Baumann P, Hartz M, Hasegawa T, Hastings NC, Hayashino T, Hayato Y, Hiramoto A, Hogan M, Holeczek J, Hong Van NT, Iacob F, Ichikawa AK, Ikeda M, Ishida T, Ishii T, Ishitsuka M, Iwamoto K, Izmaylov A, Jakkapu M, Jamieson B, Jenkins SJ, Jesús-Valls C, Jiang M, Johnson S, Jonsson P, Jung CK, Kabirnezhad M, Kaboth AC, Kajita T, Kakuno H, Kameda J, Karlen D, Kasetti SP, Kataoka Y, Katori T, Kato Y, Kearns E, Khabibullin M, Khotjantsev A, Kikawa T, Kim H, Kim J, King S, Kisiel J, Knight A, Knox A, Kobayashi T, Koch L, Koga T, Konaka A, Kormos LL, Koshio Y, Kostin A, Kowalik K, Kubo H, Kudenko Y, Kukita N, Kuribayashi S, Kurjata R, Kutter T, Kuze M, Labarga L, Lagoda J, Lamoureux M, Laveder M, Lawe M, Licciardi M, Lindner T, Litchfield RP, Liu SL, Li X, Longhin A, Ludovici L, Lu X, Lux T, Machado LN, Magaletti L, Mahn K, Malek M, Manly S, Maret L, Marino AD, Marti-Magro L, Martin JF, Maruyama T, Matsubara T, Matsushita K, Matveev V, Mavrokoridis K, Mazzucato E, McCarthy M, McCauley N, McFarland KS, McGrew C, Mefodiev A, Metelko C, Mezzetto M, Minamino A, Mineev O, Mine S, Miura M, Molina Bueno L, Moriyama S, Morrison J, Mueller TA, Munteanu L, Murphy S, Nagai Y, Nakadaira T, Nakahata M, Nakajima Y, Nakamura A, Nakamura KG, Nakamura K, Nakayama S, Nakaya T, Nakayoshi K, Nantais C, Ngoc TV, Niewczas K, Nishikawa K, Nishimura Y, Nonnenmacher TS, Nova F, Novella P, Nowak J, Nugent JC, O'Keeffe HM, O'Sullivan L, Odagawa T, Okumura K, Okusawa T, Oser SM, Owen RA, Oyama Y, Palladino V, Palomino JL, Paolone V, Parker WC, Pasternak J, Paudyal P, Pavin M, Payne D, Penn GC, Pickering L, Pidcott C, Pintaudi G, Pinzon Guerra ES, Pistillo C, Popov B, Porwit K, Posiadala-Zezula M, Pritchard A, Quilain B, Radermacher T, Radicioni E, Radics B, Ratoff PN, Reinherz-Aronis E, Riccio C, Rondio E, Roth S, Rubbia A, Ruggeri AC, Ruggles CA, Rychter A, Sakashita K, Sánchez F, Schloesser CM, Scholberg K, Schwehr J, Scott M, Seiya Y, Sekiguchi T, Sekiya H, Sgalaberna D, Shah R, Shaikhiev A, Shaker F, Shaykina A, Shiozawa M, Shorrock W, Shvartsman A, Smirnov A, Smy M, Sobczyk JT, Sobel H, Soler FJP, Sonoda Y, Steinmann J, Suvorov S, Suzuki A, Suzuki SY, Suzuki Y, Sztuc AA, Tada M, Tajima M, Takeda A, Takeuchi Y, Tanaka HK, Tanaka HA, Tanaka S, Thompson LF, Toki W, Touramanis C, Towstego T, Tsui KM, Tsukamoto T, Tzanov M, Uchida Y, Uno W, Vagins M, Valder S, Vallari Z, Vargas D, Vasseur G, Vilela C, Vinning WGS, Vladisavljevic T, Volkov VV, Wachala T, Walker J, Walsh JG, Wang Y, Wark D, Wascko MO, Weber A, Wendell R, Wilking MJ, Wilkinson C, Wilson JR, Wilson RJ, Wood K, Wret C, Yamada Y, Yamamoto K, Yanagisawa C, Yang G, Yano T, Yasutome K, Yen S, Yershov N, Yokoyama M, Yoshida T, Yu M, Zalewska A, Zalipska J, Zaremba K, Zarnecki G, Ziembicki M, Zimmerman ED, Zito M, Zsoldos S, Zykova A. Search for Electron Antineutrino Appearance in a Long-Baseline Muon Antineutrino Beam. Phys Rev Lett 2020; 124:161802. [PMID: 32383902 DOI: 10.1103/physrevlett.124.161802] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/26/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
Electron antineutrino appearance is measured by the T2K experiment in an accelerator-produced antineutrino beam, using additional neutrino beam operation to constrain parameters of the Pontecorvo-Maki-Nakagawa-Sakata (PMNS) mixing matrix. T2K observes 15 candidate electron antineutrino events with a background expectation of 9.3 events. Including information from the kinematic distribution of observed events, the hypothesis of no electron antineutrino appearance is disfavored with a significance of 2.40σ and no discrepancy between data and PMNS predictions is found. A complementary analysis that introduces an additional free parameter which allows non-PMNS values of electron neutrino and antineutrino appearance also finds no discrepancy between data and PMNS predictions.
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Affiliation(s)
- K Abe
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - R Akutsu
- University of Tokyo, Institute for Cosmic Ray Research, Research Center for Cosmic Neutrinos, Kashiwa, Japan
| | - A Ali
- Kyoto University, Department of Physics, Kyoto, Japan
| | - C Alt
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - C Andreopoulos
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - L Anthony
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - M Antonova
- IFIC (CSIC & University of Valencia), Valencia, Spain
| | - S Aoki
- Kobe University, Kobe, Japan
| | - A Ariga
- University of Bern, Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics (LHEP), Bern, Switzerland
| | - Y Asada
- Yokohama National University, Faculty of Engineering, Yokohama, Japan
| | - Y Ashida
- Kyoto University, Department of Physics, Kyoto, Japan
| | - E T Atkin
- Imperial College London, Department of Physics, London, United Kingdom
| | - Y Awataguchi
- Tokyo Metropolitan University, Department of Physics, Tokyo, Japan
| | - S Ban
- Kyoto University, Department of Physics, Kyoto, Japan
| | - M Barbi
- University of Regina, Department of Physics, Regina, Saskatchewan, Canada
| | - G J Barker
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - G Barr
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - D Barrow
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - C Barry
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | | | - A Beloshapkin
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - F Bench
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - V Berardi
- INFN Sezione di Bari and Università e Politecnico di Bari, Dipartimento Interuniversitario di Fisica, Bari, Italy
| | - S Berkman
- University of British Columbia, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- TRIUMF, Vancouver, British Columbia, Canada
| | - L Berns
- Tokyo Institute of Technology, Department of Physics, Tokyo, Japan
| | - S Bhadra
- York University, Department of Physics and Astronomy, Toronto, Ontario, Canada
| | - S Bienstock
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - A Blondel
- University of Geneva, Section de Physique, DPNC, Geneva, Switzerland
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | | | - B Bourguille
- Institut de Fisica d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra (Barcelona) Spain
| | - S B Boyd
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - D Brailsford
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - A Bravar
- University of Geneva, Section de Physique, DPNC, Geneva, Switzerland
| | - D Bravo Berguño
- University Autonoma Madrid, Department of Theoretical Physics, Madrid, Spain
| | - C Bronner
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - A Bubak
- University of Silesia, Institute of Physics, Katowice, Poland
| | - M Buizza Avanzini
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, Palaiseau, France
| | - J Calcutt
- Michigan State University, Department of Physics and Astronomy, East Lansing, Michigan, USA
| | - T Campbell
- University of Colorado at Boulder, Department of Physics, Boulder, Colorado, USA
| | - S Cao
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - S L Cartwright
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - M G Catanesi
- INFN Sezione di Bari and Università e Politecnico di Bari, Dipartimento Interuniversitario di Fisica, Bari, Italy
| | - A Cervera
- IFIC (CSIC & University of Valencia), Valencia, Spain
| | - A Chappell
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - C Checchia
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - D Cherdack
- University of Houston, Department of Physics, Houston, Texas, USA
| | - N Chikuma
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - G Christodoulou
- CERN European Organization for Nuclear Research, CH-1211 Genève 23, Switzerland
| | - J Coleman
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - G Collazuol
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - L Cook
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - D Coplowe
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - A Cudd
- Michigan State University, Department of Physics and Astronomy, East Lansing, Michigan, USA
| | - A Dabrowska
- H. Niewodniczanski Institute of Nuclear Physics PAN, Cracow, Poland
| | - G De Rosa
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - T Dealtry
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - P F Denner
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - S R Dennis
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - C Densham
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - F Di Lodovico
- King's College London, Department of Physics, Strand, London WC2R 2LS, United Kingdom
| | - N Dokania
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - S Dolan
- CERN European Organization for Nuclear Research, CH-1211 Genève 23, Switzerland
| | - T A Doyle
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - O Drapier
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, Palaiseau, France
| | - J Dumarchez
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - P Dunne
- Imperial College London, Department of Physics, London, United Kingdom
| | - L Eklund
- University of Glasgow, School of Physics and Astronomy, Glasgow, United Kingdom
| | | | - A Ereditato
- University of Bern, Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics (LHEP), Bern, Switzerland
| | - P Fernandez
- IFIC (CSIC & University of Valencia), Valencia, Spain
| | - T Feusels
- University of British Columbia, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- TRIUMF, Vancouver, British Columbia, Canada
| | - A J Finch
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - G A Fiorentini
- York University, Department of Physics and Astronomy, Toronto, Ontario, Canada
| | - G Fiorillo
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - C Francois
- University of Bern, Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics (LHEP), Bern, Switzerland
| | - M Friend
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - Y Fujii
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - R Fujita
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - D Fukuda
- Okayama University, Department of Physics, Okayama, Japan
| | - R Fukuda
- Tokyo University of Science, Faculty of Science and Technology, Department of Physics, Noda, Chiba, Japan
| | - Y Fukuda
- Miyagi University of Education, Department of Physics, Sendai, Japan
| | - K Fusshoeller
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - K Gameil
- University of British Columbia, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- TRIUMF, Vancouver, British Columbia, Canada
| | - C Giganti
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - T Golan
- Wroclaw University, Faculty of Physics and Astronomy, Wroclaw, Poland
| | - M Gonin
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, Palaiseau, France
| | - A Gorin
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M Guigue
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - D R Hadley
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - J T Haigh
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | | | - M Hartz
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- TRIUMF, Vancouver, British Columbia, Canada
| | - T Hasegawa
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - N C Hastings
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - T Hayashino
- Kyoto University, Department of Physics, Kyoto, Japan
| | - Y Hayato
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - A Hiramoto
- Kyoto University, Department of Physics, Kyoto, Japan
| | - M Hogan
- Colorado State University, Department of Physics, Fort Collins, Colorado, USA
| | - J Holeczek
- University of Silesia, Institute of Physics, Katowice, Poland
| | - N T Hong Van
- Institute For Interdisciplinary Research in Science and Education (IFIRSE), ICISE, Quy Nhon, Vietnam
- International Centre of Physics, Institute of Physics (IOP), Vietnam Academy of Science and Technology (VAST), 10 Dao Tan, Ba Dinh, Hanoi, Vietnam
| | - F Iacob
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - A K Ichikawa
- Kyoto University, Department of Physics, Kyoto, Japan
| | - M Ikeda
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - T Ishida
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - T Ishii
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - M Ishitsuka
- Tokyo University of Science, Faculty of Science and Technology, Department of Physics, Noda, Chiba, Japan
| | - K Iwamoto
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - A Izmaylov
- IFIC (CSIC & University of Valencia), Valencia, Spain
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M Jakkapu
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - B Jamieson
- University of Winnipeg, Department of Physics, Winnipeg, Manitoba, Canada
| | - S J Jenkins
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - C Jesús-Valls
- Institut de Fisica d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra (Barcelona) Spain
| | - M Jiang
- Kyoto University, Department of Physics, Kyoto, Japan
| | - S Johnson
- University of Colorado at Boulder, Department of Physics, Boulder, Colorado, USA
| | - P Jonsson
- Imperial College London, Department of Physics, London, United Kingdom
| | - C K Jung
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - M Kabirnezhad
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - A C Kaboth
- Royal Holloway University of London, Department of Physics, Egham, Surrey, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - T Kajita
- University of Tokyo, Institute for Cosmic Ray Research, Research Center for Cosmic Neutrinos, Kashiwa, Japan
| | - H Kakuno
- Tokyo Metropolitan University, Department of Physics, Tokyo, Japan
| | - J Kameda
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - D Karlen
- TRIUMF, Vancouver, British Columbia, Canada
- University of Victoria, Department of Physics and Astronomy, Victoria, British Columbia, Canada
| | - S P Kasetti
- Louisiana State University, Department of Physics and Astronomy, Baton Rouge, Louisiana, USA
| | - Y Kataoka
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - T Katori
- King's College London, Department of Physics, Strand, London WC2R 2LS, United Kingdom
| | - Y Kato
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - E Kearns
- Boston University, Department of Physics, Boston, Massachusetts, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - M Khabibullin
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - A Khotjantsev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - T Kikawa
- Kyoto University, Department of Physics, Kyoto, Japan
| | - H Kim
- Osaka City University, Department of Physics, Osaka, Japan
| | - J Kim
- University of British Columbia, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- TRIUMF, Vancouver, British Columbia, Canada
| | - S King
- Queen Mary University of London, School of Physics and Astronomy, London, United Kingdom
| | - J Kisiel
- University of Silesia, Institute of Physics, Katowice, Poland
| | - A Knight
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - A Knox
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - T Kobayashi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - L Koch
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - T Koga
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - A Konaka
- TRIUMF, Vancouver, British Columbia, Canada
| | - L L Kormos
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - Y Koshio
- Okayama University, Department of Physics, Okayama, Japan
| | - A Kostin
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - K Kowalik
- National Centre for Nuclear Research, Warsaw, Poland
| | - H Kubo
- Kyoto University, Department of Physics, Kyoto, Japan
| | - Y Kudenko
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - N Kukita
- Osaka City University, Department of Physics, Osaka, Japan
| | - S Kuribayashi
- Kyoto University, Department of Physics, Kyoto, Japan
| | - R Kurjata
- Warsaw University of Technology, Institute of Radioelectronics and Multimedia Technology, Warsaw, Poland
| | - T Kutter
- Louisiana State University, Department of Physics and Astronomy, Baton Rouge, Louisiana, USA
| | - M Kuze
- Tokyo Institute of Technology, Department of Physics, Tokyo, Japan
| | - L Labarga
- University Autonoma Madrid, Department of Theoretical Physics, Madrid, Spain
| | - J Lagoda
- National Centre for Nuclear Research, Warsaw, Poland
| | - M Lamoureux
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - M Laveder
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - M Lawe
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - M Licciardi
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, Palaiseau, France
| | - T Lindner
- TRIUMF, Vancouver, British Columbia, Canada
| | - R P Litchfield
- University of Glasgow, School of Physics and Astronomy, Glasgow, United Kingdom
| | - S L Liu
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - X Li
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - A Longhin
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - L Ludovici
- INFN Sezione di Roma and Università di Roma "La Sapienza", Roma, Italy
| | - X Lu
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - T Lux
- Institut de Fisica d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra (Barcelona) Spain
| | - L N Machado
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - L Magaletti
- INFN Sezione di Bari and Università e Politecnico di Bari, Dipartimento Interuniversitario di Fisica, Bari, Italy
| | - K Mahn
- Michigan State University, Department of Physics and Astronomy, East Lansing, Michigan, USA
| | - M Malek
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - S Manly
- University of Rochester, Department of Physics and Astronomy, Rochester, New York, USA
| | - L Maret
- University of Geneva, Section de Physique, DPNC, Geneva, Switzerland
| | - A D Marino
- University of Colorado at Boulder, Department of Physics, Boulder, Colorado, USA
| | - L Marti-Magro
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - J F Martin
- University of Toronto, Department of Physics, Toronto, Ontario, Canada
| | - T Maruyama
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - T Matsubara
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - K Matsushita
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - V Matveev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - K Mavrokoridis
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | | | - M McCarthy
- York University, Department of Physics and Astronomy, Toronto, Ontario, Canada
| | - N McCauley
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - K S McFarland
- University of Rochester, Department of Physics and Astronomy, Rochester, New York, USA
| | - C McGrew
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - A Mefodiev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - C Metelko
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - M Mezzetto
- INFN Sezione di Padova and Università di Padova, Dipartimento di Fisica, Padova, Italy
| | - A Minamino
- Yokohama National University, Faculty of Engineering, Yokohama, Japan
| | - O Mineev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - S Mine
- University of California, Irvine, Department of Physics and Astronomy, Irvine, California, USA
| | - M Miura
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - L Molina Bueno
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - S Moriyama
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - J Morrison
- Michigan State University, Department of Physics and Astronomy, East Lansing, Michigan, USA
| | - Th A Mueller
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, Palaiseau, France
| | - L Munteanu
- IRFU, CEA Saclay, Gif-sur-Yvette, France
| | - S Murphy
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - Y Nagai
- University of Colorado at Boulder, Department of Physics, Boulder, Colorado, USA
| | - T Nakadaira
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - M Nakahata
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - Y Nakajima
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - A Nakamura
- Okayama University, Department of Physics, Okayama, Japan
| | - K G Nakamura
- Kyoto University, Department of Physics, Kyoto, Japan
| | - K Nakamura
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - S Nakayama
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - T Nakaya
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- Kyoto University, Department of Physics, Kyoto, Japan
| | - K Nakayoshi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - C Nantais
- University of Toronto, Department of Physics, Toronto, Ontario, Canada
| | - T V Ngoc
- Institute For Interdisciplinary Research in Science and Education (IFIRSE), ICISE, Quy Nhon, Vietnam
| | - K Niewczas
- Wroclaw University, Faculty of Physics and Astronomy, Wroclaw, Poland
| | - K Nishikawa
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - Y Nishimura
- Keio University, Department of Physics, Kanagawa, Japan
| | - T S Nonnenmacher
- Imperial College London, Department of Physics, London, United Kingdom
| | - F Nova
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - P Novella
- IFIC (CSIC & University of Valencia), Valencia, Spain
| | - J Nowak
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - J C Nugent
- University of Glasgow, School of Physics and Astronomy, Glasgow, United Kingdom
| | - H M O'Keeffe
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - L O'Sullivan
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - T Odagawa
- Kyoto University, Department of Physics, Kyoto, Japan
| | - K Okumura
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Research Center for Cosmic Neutrinos, Kashiwa, Japan
| | - T Okusawa
- Osaka City University, Department of Physics, Osaka, Japan
| | - S M Oser
- University of British Columbia, Department of Physics and Astronomy, Vancouver, British Columbia, Canada
- TRIUMF, Vancouver, British Columbia, Canada
| | - R A Owen
- Queen Mary University of London, School of Physics and Astronomy, London, United Kingdom
| | - Y Oyama
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - V Palladino
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - J L Palomino
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - V Paolone
- University of Pittsburgh, Department of Physics and Astronomy, Pittsburgh, Pennsylvania, USA
| | - W C Parker
- Royal Holloway University of London, Department of Physics, Egham, Surrey, United Kingdom
| | - J Pasternak
- Imperial College London, Department of Physics, London, United Kingdom
| | - P Paudyal
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - M Pavin
- TRIUMF, Vancouver, British Columbia, Canada
| | - D Payne
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - G C Penn
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - L Pickering
- Michigan State University, Department of Physics and Astronomy, East Lansing, Michigan, USA
| | - C Pidcott
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - G Pintaudi
- Yokohama National University, Faculty of Engineering, Yokohama, Japan
| | - E S Pinzon Guerra
- York University, Department of Physics and Astronomy, Toronto, Ontario, Canada
| | - C Pistillo
- University of Bern, Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics (LHEP), Bern, Switzerland
| | - B Popov
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - K Porwit
- University of Silesia, Institute of Physics, Katowice, Poland
| | | | - A Pritchard
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - B Quilain
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - T Radermacher
- RWTH Aachen University, III. Physikalisches Institut, Aachen, Germany
| | - E Radicioni
- INFN Sezione di Bari and Università e Politecnico di Bari, Dipartimento Interuniversitario di Fisica, Bari, Italy
| | - B Radics
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - P N Ratoff
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - E Reinherz-Aronis
- Colorado State University, Department of Physics, Fort Collins, Colorado, USA
| | - C Riccio
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - E Rondio
- National Centre for Nuclear Research, Warsaw, Poland
| | - S Roth
- RWTH Aachen University, III. Physikalisches Institut, Aachen, Germany
| | - A Rubbia
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - A C Ruggeri
- INFN Sezione di Napoli and Università di Napoli, Dipartimento di Fisica, Napoli, Italy
| | - C A Ruggles
- University of Glasgow, School of Physics and Astronomy, Glasgow, United Kingdom
| | - A Rychter
- Warsaw University of Technology, Institute of Radioelectronics and Multimedia Technology, Warsaw, Poland
| | - K Sakashita
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - F Sánchez
- University of Geneva, Section de Physique, DPNC, Geneva, Switzerland
| | - C M Schloesser
- ETH Zurich, Institute for Particle Physics and Astrophysics, Zurich, Switzerland
| | - K Scholberg
- Duke University, Department of Physics, Durham, North Carolina, USA
| | - J Schwehr
- Colorado State University, Department of Physics, Fort Collins, Colorado, USA
| | - M Scott
- Imperial College London, Department of Physics, London, United Kingdom
| | - Y Seiya
- Osaka City University, Department of Physics, Osaka, Japan
| | - T Sekiguchi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - H Sekiya
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - D Sgalaberna
- CERN European Organization for Nuclear Research, CH-1211 Genève 23, Switzerland
| | - R Shah
- Oxford University, Department of Physics, Oxford, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - A Shaikhiev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - F Shaker
- University of Winnipeg, Department of Physics, Winnipeg, Manitoba, Canada
| | - A Shaykina
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M Shiozawa
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - W Shorrock
- Imperial College London, Department of Physics, London, United Kingdom
| | - A Shvartsman
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - A Smirnov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M Smy
- University of California, Irvine, Department of Physics and Astronomy, Irvine, California, USA
| | - J T Sobczyk
- Wroclaw University, Faculty of Physics and Astronomy, Wroclaw, Poland
| | - H Sobel
- University of California, Irvine, Department of Physics and Astronomy, Irvine, California, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - F J P Soler
- University of Glasgow, School of Physics and Astronomy, Glasgow, United Kingdom
| | - Y Sonoda
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - J Steinmann
- RWTH Aachen University, III. Physikalisches Institut, Aachen, Germany
| | - S Suvorov
- IRFU, CEA Saclay, Gif-sur-Yvette, France
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | | | - S Y Suzuki
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - Y Suzuki
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - A A Sztuc
- Imperial College London, Department of Physics, London, United Kingdom
| | - M Tada
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - M Tajima
- Kyoto University, Department of Physics, Kyoto, Japan
| | - A Takeda
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - Y Takeuchi
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- Kobe University, Kobe, Japan
| | - H K Tanaka
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - H A Tanaka
- SLAC National Accelerator Laboratory, Stanford University, Menlo Park, California, USA
- University of Toronto, Department of Physics, Toronto, Ontario, Canada
| | - S Tanaka
- Osaka City University, Department of Physics, Osaka, Japan
| | - L F Thompson
- University of Sheffield, Department of Physics and Astronomy, Sheffield, United Kingdom
| | - W Toki
- Colorado State University, Department of Physics, Fort Collins, Colorado, USA
| | - C Touramanis
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - T Towstego
- University of Toronto, Department of Physics, Toronto, Ontario, Canada
| | - K M Tsui
- University of Liverpool, Department of Physics, Liverpool, United Kingdom
| | - T Tsukamoto
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - M Tzanov
- Louisiana State University, Department of Physics and Astronomy, Baton Rouge, Louisiana, USA
| | - Y Uchida
- Imperial College London, Department of Physics, London, United Kingdom
| | - W Uno
- Kyoto University, Department of Physics, Kyoto, Japan
| | - M Vagins
- University of California, Irvine, Department of Physics and Astronomy, Irvine, California, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
| | - S Valder
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - Z Vallari
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - D Vargas
- Institut de Fisica d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra (Barcelona) Spain
| | - G Vasseur
- IRFU, CEA Saclay, Gif-sur-Yvette, France
| | - C Vilela
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - W G S Vinning
- University of Warwick, Department of Physics, Coventry, United Kingdom
| | - T Vladisavljevic
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba, Japan
- Oxford University, Department of Physics, Oxford, United Kingdom
| | - V V Volkov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - T Wachala
- H. Niewodniczanski Institute of Nuclear Physics PAN, Cracow, Poland
| | - J Walker
- University of Winnipeg, Department of Physics, Winnipeg, Manitoba, Canada
| | - J G Walsh
- Lancaster University, Physics Department, Lancaster, United Kingdom
| | - Y Wang
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - D Wark
- Oxford University, Department of Physics, Oxford, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - M O Wascko
- Imperial College London, Department of Physics, London, United Kingdom
| | - A Weber
- Oxford University, Department of Physics, Oxford, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington, United Kingdom
| | - R Wendell
- Kyoto University, Department of Physics, Kyoto, Japan
| | - M J Wilking
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - C Wilkinson
- University of Bern, Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics (LHEP), Bern, Switzerland
| | - J R Wilson
- King's College London, Department of Physics, Strand, London WC2R 2LS, United Kingdom
| | - R J Wilson
- Colorado State University, Department of Physics, Fort Collins, Colorado, USA
| | - K Wood
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - C Wret
- University of Rochester, Department of Physics and Astronomy, Rochester, New York, USA
| | - Y Yamada
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
| | - K Yamamoto
- Osaka City University, Department of Physics, Osaka, Japan
| | - C Yanagisawa
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - G Yang
- State University of New York at Stony Brook, Department of Physics and Astronomy, Stony Brook, New York, USA
| | - T Yano
- University of Tokyo, Institute for Cosmic Ray Research, Kamioka Observatory, Kamioka, Japan
| | - K Yasutome
- Kyoto University, Department of Physics, Kyoto, Japan
| | - S Yen
- TRIUMF, Vancouver, British Columbia, Canada
| | - N Yershov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M Yokoyama
- University of Tokyo, Department of Physics, Tokyo, Japan
| | - T Yoshida
- Tokyo Institute of Technology, Department of Physics, Tokyo, Japan
| | - M Yu
- York University, Department of Physics and Astronomy, Toronto, Ontario, Canada
| | - A Zalewska
- H. Niewodniczanski Institute of Nuclear Physics PAN, Cracow, Poland
| | - J Zalipska
- National Centre for Nuclear Research, Warsaw, Poland
| | - K Zaremba
- Warsaw University of Technology, Institute of Radioelectronics and Multimedia Technology, Warsaw, Poland
| | - G Zarnecki
- National Centre for Nuclear Research, Warsaw, Poland
| | - M Ziembicki
- Warsaw University of Technology, Institute of Radioelectronics and Multimedia Technology, Warsaw, Poland
| | - E D Zimmerman
- University of Colorado at Boulder, Department of Physics, Boulder, Colorado, USA
| | - M Zito
- Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Paris, France
| | - S Zsoldos
- Queen Mary University of London, School of Physics and Astronomy, London, United Kingdom
| | - A Zykova
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
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Abe K, Akutsu R, Ali A, Alt C, Andreopoulos C, Anthony L, Antonova M, Aoki S, Ariga A, Arihara T, Asada Y, Ashida Y, Atkin ET, Awataguchi Y, Ban S, Barbi M, Barker GJ, Barr G, Barrow D, Barry C, Batkiewicz-Kwasniak M, Beloshapkin A, Bench F, Berardi V, Berkman S, Berns L, Bhadra S, Bienstock S, Blondel A, Bolognesi S, Bourguille B, Boyd SB, Brailsford D, Bravar A, Berguño DB, Bronner C, Bubak A, Avanzini MB, Calcutt J, Campbell T, Cao S, Cartwright SL, Catanesi MG, Cervera A, Chappell A, Checchia C, Cherdack D, Chikuma N, Cicerchia M, Christodoulou G, Coleman J, Collazuol G, Cook L, Coplowe D, Cudd A, Dabrowska A, De Rosa G, Dealtry T, Denner PF, Dennis SR, Densham C, Di Lodovico F, Dokania N, Dolan S, Doyle TA, Drapier O, Dumarchez J, Dunne P, Eguchi A, Eklund L, Emery-Schrenk S, Ereditato A, Fernandez P, Feusels T, Finch AJ, Fiorentini GA, Fiorillo G, Francois C, Friend M, Fujii Y, Fujita R, Fukuda D, Fukuda R, Fukuda Y, Fusshoeller K, Gameil K, Giganti C, Golan T, Gonin M, Gorin A, Guigue M, Hadley DR, Haigh JT, Hamacher-Baumann P, Hartz M, Hasegawa T, Hassani S, Hastings NC, Hayashino T, Hayato Y, Hiramoto A, Hogan M, Holeczek J, Hong Van NT, Iacob F, Ichikawa AK, Ikeda M, Ishida T, Ishii T, Ishitsuka M, Iwamoto K, Izmaylov A, Jakkapu M, Jamieson B, Jenkins SJ, Jesús-Valls C, Jiang M, Johnson S, Jonsson P, Jung CK, Junjie X, Jurj PB, Kabirnezhad M, Kaboth AC, Kajita T, Kakuno H, Kameda J, Karlen D, Kasetti SP, Kataoka Y, Katori T, Kato Y, Kearns E, Khabibullin M, Khotjantsev A, Kikawa T, Kikutani H, Kim H, Kim J, King S, Kisiel J, Knight A, Knox A, Kobayashi T, Koch L, Koga T, Konaka A, Kormos LL, Koshio Y, Kostin A, Kowalik K, Kubo H, Kudenko Y, Kukita N, Kuribayashi S, Kurjata R, Kutter T, Kuze M, Labarga L, Lagoda J, Lamoureux M, Laveder M, Lawe M, Licciardi M, Lindner T, Litchfield RP, Liu SL, Li X, Longhin A, Ludovici L, Lu X, Lux T, Machado LN, Magaletti L, Mahn K, Malek M, Manly S, Maret L, Marino AD, Marti-Magro L, Martin JF, Maruyama T, Matsubara T, Matsushita K, Matveev V, Mavrokoridis K, Mazzucato E, McCarthy M, McCauley N, McElwee J, McFarland KS, McGrew C, Mefodiev A, Metelko C, Mezzetto M, Minamino A, Mineev O, Mine S, Miura M, Bueno LM, Moriyama S, Morrison J, Mueller TA, Munteanu L, Murphy S, Nagai Y, Nakadaira T, Nakahata M, Nakajima Y, Nakamura A, Nakamura KG, Nakamura K, Nakayama S, Nakaya T, Nakayoshi K, Nantais C, Naseby CER, Ngoc TV, Niewczas K, Nishikawa K, Nishimura Y, Noah E, Nonnenmacher TS, Nova F, Novella P, Nowak J, Nugent JC, O’Keeffe HM, O’Sullivan L, Odagawa T, Okumura K, Okusawa T, Oser SM, Owen RA, Oyama Y, Palladino V, Palomino JL, Paolone V, Pari M, Parker WC, Parsa S, Pasternak J, Paudyal P, Pavin M, Payne D, Penn GC, Pickering L, Pidcott C, Pintaudi G, Guerra ESP, Pistillo C, Popov B, Porwit K, Posiadala-Zezula M, Pritchard A, Quilain B, Radermacher T, Radicioni E, Radics B, Ratoff PN, Reinherz-Aronis E, Riccio C, Rondio E, Roth S, Rubbia A, Ruggeri AC, Ruggles CA, Rychter A, Sakashita K, Sánchez F, Santucci G, Schloesser CM, Scholberg K, Schwehr J, Scott M, Seiya Y, Sekiguchi T, Sekiya H, Sgalaberna D, Shah R, Shaikhiev A, Shaker F, Shaykina A, Shiozawa M, Shorrock W, Shvartsman A, Smirnov A, Smy M, Sobczyk JT, Sobel H, Soler FJP, Sonoda Y, Steinmann J, Suvorov S, Suzuki A, Suzuki SY, Suzuki Y, Sztuc AA, Tada M, Tajima M, Takeda A, Takeuchi Y, Tanaka HK, Tanaka HA, Tanaka S, Thompson LF, Toki W, Touramanis C, Towstego T, Tsui KM, Tsukamoto T, Tzanov M, Uchida Y, Uno W, Vagins M, Valder S, Vallari Z, Vargas D, Vasseur G, Vilela C, Vinning WGS, Vladisavljevic T, Volkov VV, Wachala T, Walker J, Walsh JG, Wang Y, Wark D, Wascko MO, Weber A, Wendell R, Wilking MJ, Wilkinson C, Wilson JR, Wilson RJ, Wood K, Wret C, Yamada Y, Yamamoto K, Yanagisawa C, Yang G, Yano T, Yasutome K, Yen S, Yershov N, Yokoyama M, Yoshida T, Yu M, Zalewska A, Zalipska J, Zaremba K, Zarnecki G, Ziembicki M, Zimmerman ED, Zito M, Zsoldos S, Zykova A. Constraint on the matter–antimatter symmetry-violating phase in neutrino oscillations. Nature 2020; 580:339-344. [DOI: 10.1038/s41586-020-2177-0] [Citation(s) in RCA: 188] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 03/03/2020] [Indexed: 11/09/2022]
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Smith M, Francq B, McConnachie A, Wetherall K, Pelosi A, Morrison J. Clinical judgement, case complexity and symptom scores as predictors of outcome in depression: an exploratory analysis. BMC Psychiatry 2020; 20:125. [PMID: 32183799 PMCID: PMC7076946 DOI: 10.1186/s12888-020-02532-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/04/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Clinical guidelines for depression in adults recommend the use of outcome measures and stepped care models in routine care. Such measures are based on symptom severity, but response to treatment is likely to also be influenced by personal and contextual factors. This observational study of a routine clinical sample sought to examine the extent to which "symptom severity measures" and "complexity measures" assess different aspects of patient experience, and how they might relate to clinical outcomes, including disengagement from treatment. METHODS Subjects with symptoms of depression (with or without comorbid anxiety) were recruited from people referred to an established Primary Care Mental Health Team using a stepped care model. Each participant completed three baseline symptom measures (the Personal Health Questionnaire (PHQ), Generalised Anxiety Disorder questionnaire (GAD) and Clinical Outcomes in Routine Evaluation (CORE-10)), and two assessments of "case complexity" (the Minnesota-Edinburgh Complexity Assessment Measure (MECAM) and a local complexity assessment). Clinician perception of likely completion of treatment and patient recovery was also assessed. Outcome measures were drop out and clinical improvement on the PHQ. RESULTS 298 subjects were recruited to the study, of whom 258 had a sufficient dataset available for analysis. Data showed that the three measures of symptom severity used in this study (PHQ, GAD and CORE-10) seemed to be measuring distinct characteristics from those associated with the measures of case complexity (MECAM, previous and current problem count). Higher symptom severity scores were correlated with improved outcomes at the end of treatment, but there was no association between outcome and complexity measures. Clinicians could predict participant drop-out from care with some accuracy, but had no ability to predict outcome from treatment. CONCLUSIONS These results highlight the extent to which drop-out complicates recovery from depression with or without anxiety in real-world settings, and the need to consider other factors beyond symptom severity in planning care. The findings are discussed in relation to a growing body of literature investigating prognostic indicators in the context of models of collaborative care for depression.
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Affiliation(s)
- M. Smith
- grid.413301.40000 0001 0523 9342NHS Greater Glasgow and Clyde, Glasgow, UK
| | - B. Francq
- grid.7942.80000 0001 2294 713XInstitute of Statistics, Biostatistics and Actuarial Sciences, Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - A. McConnachie
- grid.8756.c0000 0001 2193 314XRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - K. Wetherall
- grid.8756.c0000 0001 2193 314XRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | | | - J. Morrison
- grid.8756.c0000 0001 2193 314XSenate Office, University of Glasgow, Glasgow, UK
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Kinnear D, Allan L, Morrison J, Finlayson J, Sherriff A, Macpherson L, Henderson A, Ward L, Muir M, Cooper SA. Prevalence of factors associated with edentulousness (no natural teeth) in adults with intellectual disabilities. J Intellect Disabil Res 2019; 63:1475-1481. [PMID: 31062460 DOI: 10.1111/jir.12628] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Poor oral health is largely preventable. Prevention includes toothbrushing and regular dental checks. Oral health has important consequences for general nutrition, chewing, communication, wider systemic disease, self-confidence and participation in society. This study investigated the prevalence of edentulousness (no natural teeth) in adults with intellectual disabilities (IDs) compared with the general population and associated factors. METHODS An adult cohort with IDs residing in Greater Glasgow and Clyde, Scotland, underwent detailed health assessments between 2002 and 2004. Between 2004 and 2006, a subsample had an oral check. Data on edentulousness in the cohort were compared with adult participants from Greater Glasgow and Clyde in the 2008 Scottish Health Survey. Within the IDs cohort, binary logistic regression analyses investigated potential relationships between edentulousness and demographic and clinical factors. RESULTS Five hundred sixty adults with IDs were examined [53.2% (298) male, mean age = 46.3 years, range 18-81 years] and compared with 2547 general population: edentulousness was 9% vs. 1% aged 25-34 years; 22% vs. 2% aged 35-44 years; 39% vs. 7% aged 45-54 years; 41% vs. 18% aged 55-64 years; and 76% vs. 34% aged 65-74 years. In both groups, edentulousness increased with age. After stratification for age, rates of edentulousness were consistently higher in the ID cohort. Odds ratios within age strata were not homogenous (Mantel-Haenszel test, P < 0.0001). Edentulousness was more likely in those with more severe IDs (adjusted odds ratio (AOR) = 2.36; 95% confidence interval (CI) [1.23 to 4.51]); those taking antipsychotics (AOR = 2.09; 95% CI [1.25 to 3.51]) and those living in the most deprived neighbourhoods (AOR = 2.69; 95% CI [1.11 to 6.50]). There was insufficient evidence for associations with sex, type of accommodation/support, antiepileptics, problem behaviours or autism. CONCLUSIONS Adults with IDs have a high prevalence of edentulousness and need supported daily oral care to reduce the need for extractions. Despite previous reports on poor oral care and the move towards person-centred care, carers and care-giving organisations need greater support to implement daily oral care. Prescribers need awareness of the potentially contributory role of antipsychotics, which may relate to xerostomia.
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Affiliation(s)
- D Kinnear
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - L Allan
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - J Morrison
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - J Finlayson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - A Sherriff
- School of Medicine, Dentistry & Nursing, Glasgow Dental Hospital & School, Glasgow, UK
| | - L Macpherson
- School of Medicine, Dentistry & Nursing, Glasgow Dental Hospital & School, Glasgow, UK
| | - A Henderson
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - L Ward
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - M Muir
- Department of Public Health, NHS Ayrshire and Arran, Ayr, South Ayrshire, UK
| | - S A Cooper
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
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Vella MA, Dumas RP, DuBose J, Morrison J, Scalea T, Moore L, Podbielski J, Inaba K, Piccinini A, Kauvar DS, Baggenstoss VL, Spalding C, Fox C, Moore EE, Cannon JW. Intraoperative REBOA: an analysis of the American Association for the Surgery of Trauma AORTA registry. Trauma Surg Acute Care Open 2019; 4:e000340. [PMID: 31799415 PMCID: PMC6861115 DOI: 10.1136/tsaco-2019-000340] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/08/2019] [Accepted: 08/10/2019] [Indexed: 11/04/2022] Open
Abstract
Background Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a less-invasive technique for aortic occlusion (AO). Commonly performed in the emergency department (ED), the role of intraoperative placement is less defined. We hypothesized that operating room (OR) placement is associated with increased in-hospital mortality. Methods The American Association for the Surgery of Trauma AORTA registry was used to identify patients undergoing REBOA. Injury characteristics and outcomes data were compared between OR and ED groups. The primary outcome was in-hospital mortality; secondary outcomes included total AO time, transfusion requirements, and acute kidney injury. Results Location and timing of catheter insertion were available for 305 of 321 (95%) subjects. 58 patients underwent REBOA in the OR (19%). There were no differences with respect to sex, admission lactate, and Injury Severity Score. The OR group was younger (33 years vs. 41 years, p=0.01) and with more penetrating injuries (36% vs. 15%, p<0.001). There were significant differences with respect to admission physiology. Time from admission to AO was longer in the OR group (75 minutes vs. 23 minutes, p<0.001) as was time to definitive hemostasis (116 minutes vs. 79 minutes, p=0.01). Unadjusted mortality was lower in the OR group (36.2% vs. 68.8%, p<0.001). There were no differences in secondary outcomes. After controlling for covariates, there was no association between insertion location and in-hospital mortality (OR 1.8, 95% CI 0.30 to 11.50). Discussion OR REBOA placement is common and generally employed in patients with more stable admission physiology. OR placement was not associated with increased in-hospital mortality despite longer times to AO and definite hemostasis when compared with catheters placed in the ED. Level of evidence IV; therapeutic/care management.
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Affiliation(s)
- Michael A Vella
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ryan Peter Dumas
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Division of General and Acute Care Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Joseph DuBose
- R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Jonathan Morrison
- R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Thomas Scalea
- R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Laura Moore
- Division of Trauma and Surgical Critical Care, University of Texas, Houston, Texas, USA
| | - Jeanette Podbielski
- Division of Trauma and Surgical Critical Care, University of Texas, Houston, Texas, USA
| | - Kenji Inaba
- Division of Surgical Critical Care and Trauma, Los Angeles County + University of Southern California Hospital, Los Angeles, California, USA
| | - Alice Piccinini
- Division of Surgical Critical Care and Trauma, Los Angeles County + University of Southern California Hospital, Los Angeles, California, USA
| | - David S Kauvar
- Division of Trauma and Surgical Critical Care, San Antonio Military Medical Center/US Army Institute of Surgical Research, San Antonio, Texas, USA
| | - Valorie L Baggenstoss
- Division of Trauma and Surgical Critical Care, San Antonio Military Medical Center/US Army Institute of Surgical Research, San Antonio, Texas, USA
| | - Chance Spalding
- Department of Surgery, Grant Medical Center, Columbus, Ohio, USA
| | - Charles Fox
- Department of Surgery, Denver Health Medical Center, Denver, Colorado, USA
| | - Ernest E Moore
- Department of Surgery, Denver Health Medical Center, Denver, Colorado, USA
| | - Jeremy W Cannon
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Goussard P, Rabie H, Morrison J, Schubert PT. Superinfection with Mycobacteria goodii in a young infant with exogenous lipoid pneumonia. Pediatr Pulmonol 2019; 54:1345-1347. [PMID: 31206238 DOI: 10.1002/ppul.24355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/17/2019] [Accepted: 04/24/2019] [Indexed: 11/11/2022]
Affiliation(s)
- P Goussard
- Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Tygerberg, South Africa
| | - H Rabie
- Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Tygerberg, South Africa
| | - J Morrison
- Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Tygerberg, South Africa
| | - P T Schubert
- Department of Pathology, Division of Anatomical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Tygerberg, South Africa
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Yoo S, Sheng Y, Blitzblau R, Suneja G, O'Neill L, Morrison J, Catalano S, Yin F, Wu Q. Implementation of Machine Learning-Based Treatment Planning Tool for Whole Breast Radiotherapy Using Irregular Surface Compensator Technique. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.572] [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: 10/26/2022]
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Trinca V, Morrison J, Slaughter S, Keller H. Making the Most of Mealtimes (M3): effect of eating occasions and other covariates on energy and protein intake among Canadian older adult residents in long‐term care. J Hum Nutr Diet 2019; 33:3-11. [DOI: 10.1111/jhn.12686] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- V. Trinca
- Kinesiology Department University of Waterloo Waterloo Ontario Canada
| | - J. Morrison
- Kinesiology Department University of Waterloo Waterloo Ontario Canada
| | - S. Slaughter
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
| | - H. Keller
- Kinesiology Department University of Waterloo Waterloo Ontario Canada
- Research Institute for Aging Schlegel‐University of Waterloo Waterloo Ontario Canada
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Cannon J, Morrison J, Lauer C, Grabo D, Polk T, Blackbourne L, Dubose J, Rasmussen T. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Hemorrhagic Shock. Mil Med 2019; 183:55-59. [PMID: 30189087 DOI: 10.1093/milmed/usy143] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Indexed: 11/13/2022] Open
Abstract
This clinical practice guideline (CPG) reviews the range of accepted management approaches to profound shock and post-traumatic cardiac arrest and establishes indications for considering Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as a hemorrhage control adjunct. The specific management approach - within the parameters of mission, resources, and tactical situation - will depend on the casualty's physical location, mechanism and pattern of injury, and the experience level of the surgeon. The optimal management strategy is best determined by the surgeon at the bedside.
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Affiliation(s)
- Jeremy Cannon
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Jonathan Morrison
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Cynthia Lauer
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Daniel Grabo
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Travis Polk
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Lorne Blackbourne
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Joseph Dubose
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
| | - Todd Rasmussen
- Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX
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Swain F, Daly J, Baidya S, Wilson B, Morrison J, Liew Y‐W, Powley T, Jivan Y, Bryant S, Allen A, Crampton N. Acute haemolytic reaction secondary to an ABO minor mismatched platelet transfusion from a group A blood donor. Transfus Med 2019; 29:133-135. [DOI: 10.1111/tme.12591] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/18/2019] [Accepted: 02/12/2019] [Indexed: 12/23/2022]
Affiliation(s)
- F. Swain
- Princess Alexandra Hospital Brisbane Queensland Australia
| | - J. Daly
- Australian Red Cross Blood Service Brisbane Queensland Australia
| | - S. Baidya
- Australian Red Cross Blood Service Brisbane Queensland Australia
| | - B. Wilson
- Australian Red Cross Blood Service Brisbane Queensland Australia
| | - J. Morrison
- Australian Red Cross Blood Service Brisbane Queensland Australia
| | - Y. ‐W. Liew
- Australian Red Cross Blood Service Brisbane Queensland Australia
| | - T. Powley
- Australian Red Cross Blood Service Brisbane Queensland Australia
| | - Y. Jivan
- QML Pathology Brisbane Queensland Australia
| | - S. Bryant
- Australian Red Cross Blood Service Brisbane Queensland Australia
| | - A. Allen
- Australian Red Cross Blood Service Brisbane Queensland Australia
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Khabbaz R, Morrison J, Lokken R, Gaba R. 03:45 PM Abstract No. 223 Conventional versus drug-eluting embolic transarterial chemoembolization with doxorubicin: comparative pharmacokinetics and drug delivery in a rabbit VX2 tumor model. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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DuBose RJ, Morrison J, Brenner M, Moore L, Holcomb JB, Inaba K, Cannon J, Seamon M, Skarupa D, Moore E, Fox C, Ibrahim J, Scalea T. AORTA Registry 7F vs 11-12 F access. JEVTM 2019. [DOI: 10.26676/jevtm.v3i1.79] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ABSTRACT
Introduction: The introduction of low profile devices designed for Resuscitative
Endovascular Balloon Occlusion of the Aorta (REBOA) after trauma has the potential to
change practice, outcomes and complication profiles related to this procedure.
Methods: The AAST Aortic Occlusion for Resuscitation in Trauma and Acute Care
Surgery (AORTA) registry was utilized to identify REBOA patients from 16 centers
-comparing presentation, intervention and outcome variables for those REBOA via
traditional 11-12 access platforms and trauma-specific devices requiring only 7 F access.
Results:From Nov 2013-Dec 2017, 242 patients with completed data were identified,
constituting 124 7F and 118 11-12F uses. Demographics of presentation were not
different between the two groups, except that the 7F patients had a higher mean ISS (39.2
34.1, p = 0.028). 7F device use was associated with a lower cut-down requirement for
access (22.6% vs. 37.3%, p = 0.049) and increased ultrasound guidance utilization (29.0%
23.7%, p = 0.049). 7F device afforded earlier aortic occlusion in the course of
resuscitation (median 25.0 mins vs. 30 mins, p = 0.010), and had lower median PRBC
(10.0 vs. 15.5 units, p = 0.006) and FFP requirements (7.5 vs. 14.0 units, p = 0.005). 7F
patients were more likely to survive 24 hrs (58.1% vs. 42.4%, p = 0.015) and less likely
to suffer in-hospital mortality (57.3% vs. 75.4%, p = 0.003). Finally, 7F device use was
associated with a 4X lower rate of distal extremity embolism (20.0% vs. 5.6%, p =
0.014;OR 95% CI 4.25 [1.25-14.45]) compared to 11-12F counterparts.
Conclusion: The introduction of trauma specific 7F REBOA devices appears to have
influenced REBOA practices, with earlier utilization in severely injured hypotensive
patients via less invasive means that are associated with lower transfusion requirements
fewer thrombotic complications and improved survival. Additional study is required to determine optimal REBOA
utilization.
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Abstract
BACKGROUND AND OBJECTIVES The Mealtime Scan (MTS) was developed to assess the dining environment in Long Term Care (LTC). MTS has been reviewed and updated to ensure its standardization and responsiveness to changes in the dining environment. The objectives of this paper are to provide an overview of the changes made in the new MTS+ tool and to describe its inter-rater reliability. RESEARCH DESIGN AND METHODS The observational and scoring methods used to evaluate the physical, social, and relational-centered dining environments in LTC homes were reviewed and updated into MTS+ and an overall quality of dining rating derived. Two trained assessors were evaluated for the inter-rater reliability. Nine dining rooms in three LTC homes at different meals were observed for a total of 45 observations. Interclass Correlation Coefficient (ICC) was used to assess reliability. RESULTS MTS+ demonstrated good reliability on the orientation cues, social environment, and relationship-centered activities (orientation cues ICC: 0.75, social ICC: 0.78, relational ICC: 0.78). However, the tool's reliability was poor for the physical environment, ICC: 0.48 and moderate for the overall rating of the quality of the dining environment, ICC: 0.67. Discussion and Implications: Although deemed more effective and practical for use in intervention studies, MTS+ has some limitations with respect to its reliability, particularly in assessing the physical environment. It is hypothesized that more extensive training of the assessors may lead to improvements in the reliability of MTS+. MTS+ can be used in intervention research when one assessor completes repeat observations of a dining area.
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Affiliation(s)
- H Keller
- Heather Keller, Schlegel -University of Waterloo Research Institute for Aging, 250 Laurelwood Dr, Waterloo, ON, N2J0E2, Canada,
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Affiliation(s)
- J Morrison
- Musgrove Park Hospital, Taunton, TA1 5DA, UK
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Morrison J, Fisher WP. Connecting Learning Opportunities in STEM Education: Ecosystem Collaborations across Schools, Museums, Libraries, Employers, and Communities. ACTA ACUST UNITED AC 2018. [DOI: 10.1088/1742-6596/1065/2/022009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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