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Morad A, Johnson K, Bate S, Birkby I, Schofield S, Harvey J. Ten-year trend analysis of breast cancer, oncoplastic, and reconstructive breast surgery in a single institution (2010-2019), what has not changed? Breast Cancer Res Treat 2024:10.1007/s10549-024-07294-x. [PMID: 38689173 DOI: 10.1007/s10549-024-07294-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/08/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE There has been a UK national directive to ensure that patients are offered reconstructive surgical options. We aimed to assess any change in oncoplastic practice over a 10-year period. METHODS The surgical management of 7019 breast cancers was retrospectively assessed at Nightingale Breast Centre, Manchester University UK, from 2010 to 2019. The procedures were categorised into breast conservative surgery (BCS) and mastectomy ± immediate reconstruction. The data were analysed using inclusion and exclusion criteria. RESULTS The overall rates of BCS and mastectomy were 60.1% and 39.9% respectively. No statistically significant change in the overall rates of BCS or mastectomy was observed over the last decade (p = 0.08). The rate of simple wide local excision (WLE) decreased from 98.7% to 89.3% (p < 0.001), whilst the rate of therapeutic mammoplasty (TM) increased from 1.3% to 8% (p < 0.01). The rate of chest wall perforator flaps (CWPF) changed from zero to account for 2.7% of all BCS by 2019. The overall rate of immediate breast reconstruction (IBR) did not significantly change over the study period, but it consistently remained above the national average of 27%. The rate of implant-based IBR increased from 61.3% to 76.5% (p = 0.012), whilst the rate of Latissimus Dorsi (LD) reconstruction decreased from 26.7% to 5.1% (p < 0.05). Additionally, the rate of nipple-sparing mastectomy significantly increased from 5.2% to 24%. CONCLUSION No significant changes in the overall rates of BCS was observed, the rates of advanced breast conservation techniques, nipple-sparing mastectomy, and implant-based IBR all have increased, whilst the use of LD reconstruction decreased.
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Affiliation(s)
- A Morad
- Nightingale Breast Cancer Centre, Manchester University, NHS Foundation Trust, Manchester, UK.
- Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Hucknall Rd, Nottingham, NG5 1PB, UK.
| | - K Johnson
- Nightingale Breast Cancer Centre, Manchester University, NHS Foundation Trust, Manchester, UK
| | - S Bate
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - I Birkby
- Nightingale Breast Cancer Centre, Manchester University, NHS Foundation Trust, Manchester, UK
| | - S Schofield
- Nightingale Breast Cancer Centre, Manchester University, NHS Foundation Trust, Manchester, UK
| | - J Harvey
- Nightingale Breast Cancer Centre, Manchester University, NHS Foundation Trust, Manchester, UK
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Rangwala SD, Johnson K, See AP, Smith ER, Orbach DB. Direct Transverse Sinus Puncture for Transvenous Coil Embolization of Vein of Galen Malformations: Innovating Existing Techniques. Oper Neurosurg (Hagerstown) 2023; 25:e352-e358. [PMID: 37819101 DOI: 10.1227/ons.0000000000000883] [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: 04/14/2023] [Accepted: 06/21/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND AND IMPORTANCE Vein of Galen malformations (VOGMs) are complex arteriovenous malformations in neonates and young children. Recent advances in endovascular interventions have drastically improved treatment and clinical outcomes in what was previously high-morbidity, high-mortality disease. The high-flow shunt pathophysiology in VOGMs can lead to dynamic changes in the malformation angioarchitecture, and over time patients can develop jugular bulb stenosis. In the setting of inaccessible transvenous access to the malformation for endovascular embolization in cases where transarterial embolization is inadequate, a combined surgical and endovascular technique must be used. We present the first successful modern-day application of direct puncture through transverse sinus for transvenous embolization of a VOGM. CLINICAL PRESENTATION We present 2 unique cases of complex VOGM malformations in patients who had previously undergone staged endovascular embolization for reduction of flow within the malformation. On follow-up, in both cases, there was development of severe sigmoid sinus and jugular bulb stenosis, increasing intracranial venous congestion and causing marked clinical deterioration. The stenosis prevented traditional transvenous access and treatment. We describe a direct puncture transverse sinus access using a burr hole approach for endovascular transvenous embolization in both cases with successful clinical outcomes. CONCLUSION Direct access using burr hole craniotomy to the transverse sinus for transvenous endovascular embolization is a safe approach in the setting of severe jugular bulb stenosis for treatment of VOGMs. This technique can be done efficiently to achieve complete flow elimination in the malformation, in cases where that is called for, without significant risks or complications related to the approach.
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Affiliation(s)
- Shivani D Rangwala
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston , Massachusetts , USA
| | - Kristin Johnson
- Vascular Biology Program, Boston Children's Hospital, Boston , Massachusetts , USA
| | - Alfred P See
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston , Massachusetts , USA
- Neurointerventional Radiology, Boston Children's Hospital, Harvard Medical School, Boston , Massachusetts , USA
| | - Edward R Smith
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston , Massachusetts , USA
| | - Darren B Orbach
- Neurointerventional Radiology, Boston Children's Hospital, Harvard Medical School, Boston , Massachusetts , USA
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Johnson K, Olinder J, Rosso A, Andersson I, Lång K, Zackrisson S. False-positive recalls in the prospective Malmö Breast Tomosynthesis Screening Trial. Eur Radiol 2023; 33:8089-8099. [PMID: 37145147 PMCID: PMC10597871 DOI: 10.1007/s00330-023-09705-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/20/2023] [Accepted: 03/25/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVES To evaluate the total number of false-positive recalls, including radiographic appearances and false-positive biopsies, in the Malmö Breast Tomosynthesis Screening Trial (MBTST). METHODS The prospective, population-based MBTST, with 14,848 participating women, was designed to compare one-view digital breast tomosynthesis (DBT) to two-view digital mammography (DM) in breast cancer screening. False-positive recall rates, radiographic appearances, and biopsy rates were analyzed. Comparisons were made between DBT, DM, and DBT + DM, both in total and in trial year 1 compared to trial years 2 to 5, with numbers, percentages, and 95% confidence intervals (CI). RESULTS The false-positive recall rate was higher with DBT, 1.6% (95% CI 1.4; 1.8), compared to screening with DM, 0.8% (95% CI 0.7; 1.0). The proportion of the radiographic appearance of stellate distortion was 37.3% (91/244) with DBT, compared to 24.0% (29/121) with DM. The false-positive recall rate with DBT during trial year 1 was 2.6% (95% CI 1.8; 3.5), then stabilized at 1.5% (95% CI 1.3; 1.8) during trial years 2 to 5. The percentage of stellate distortion with DBT was 50% (19/38) trial year 1 compared to 35.0% (72/206) trial years 2 to 5. CONCLUSIONS The higher false-positive recall rate with DBT compared to DM was mainly due to an increased detection of stellate findings. The proportion of these findings, as well as the DBT false-positive recall rate, was reduced after the first trial year. CLINICAL RELEVANCE STATEMENT Assessment of false-positive recalls gives information on potential benefits and side effects in DBT screening. KEY POINTS • The false-positive recall rate in a prospective digital breast tomosynthesis screening trial was higher compared to digital mammography, but still low compared to other trials. • The higher false-positive recall rate with digital breast tomosynthesis was mainly due to an increased detection of stellate findings; the proportion of these findings was reduced after the first trial year.
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Affiliation(s)
- Kristin Johnson
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Malmö, Sweden.
- Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden.
| | - Jakob Olinder
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Malmö, Sweden
- Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
| | - Aldana Rosso
- Department of Clinical Sciences, Geriatric Medicine, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ingvar Andersson
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Malmö, Sweden
- Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden
| | - Kristina Lång
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Malmö, Sweden
- Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden
| | - Sophia Zackrisson
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Malmö, Sweden
- Department of Medical Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
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Dahlblom V, Dustler M, Bolejko A, Bakic PR, Granberg H, Johnson K, Förnvik D, Lång K, Tingberg A, Zackrisson S. Malmö Breast ImaginG database: objectives and development. J Med Imaging (Bellingham) 2023; 10:061402. [PMID: 36779038 PMCID: PMC9905220 DOI: 10.1117/1.jmi.10.6.061402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/09/2023] [Indexed: 02/10/2023] Open
Abstract
Purpose We describe the design and implementation of the Malmö Breast ImaginG (M-BIG) database, which will support research projects investigating various aspects of current and future breast cancer screening programs. Specifically, M-BIG will provide clinical data to:1.investigate the effect of breast cancer screening on breast cancer prognosis and mortality;2.develop and validate the use of artificial intelligence and machine learning in breast image interpretation; and3.develop and validate image-based radiological breast cancer risk profiles. Approach The M-BIG database is intended to include a wide range of digital mammography (DM) and digital breast tomosynthesis (DBT) examinations performed on women at the Mammography Clinic in Malmö, Sweden, from the introduction of DM in 2004 through 2020. Subjects may be included multiple times and for diverse reasons. The image data are linked to extensive clinical, diagnostic, and demographic data from several registries. Results To date, the database contains a total of 451,054 examinations from 104,791 women. During the inclusion period, 95,258 unique women were screened. A total of 19,968 examinations were performed using DBT, whereas the rest used DM. Conclusions We describe the design and implementation of the M-BIG database as a representative and accessible medical image database linked to various types of medical data. Work is ongoing to add features and curate the existing data.
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Affiliation(s)
- Victor Dahlblom
- Lund University, Department of Translational Medicine, Diagnostic Radiology, Malmö, Sweden
- Skåne University Hospital, Department of Medical Imaging and Physiology, Malmö, Sweden
| | - Magnus Dustler
- Lund University, Department of Translational Medicine, Diagnostic Radiology, Malmö, Sweden
- Lund University, Department of Translational Medicine, Medical Radiation Physics, Malmö, Sweden
| | - Anetta Bolejko
- Lund University, Department of Translational Medicine, Diagnostic Radiology, Malmö, Sweden
- Skåne University Hospital, Department of Medical Imaging and Physiology, Malmö, Sweden
| | - Predrag R. Bakic
- Lund University, Department of Translational Medicine, Diagnostic Radiology, Malmö, Sweden
- Lund University, Department of Translational Medicine, Medical Radiation Physics, Malmö, Sweden
| | - Henrik Granberg
- Skåne University Hospital, Department of Medical Imaging and Physiology, Malmö, Sweden
| | - Kristin Johnson
- Lund University, Department of Translational Medicine, Diagnostic Radiology, Malmö, Sweden
- Skåne University Hospital, Department of Medical Imaging and Physiology, Malmö, Sweden
| | - Daniel Förnvik
- Lund University, Department of Translational Medicine, Medical Radiation Physics, Malmö, Sweden
- Skåne University Hospital, Radiation Physics, Malmö, Sweden
| | - Kristina Lång
- Lund University, Department of Translational Medicine, Diagnostic Radiology, Malmö, Sweden
- Skåne University Hospital, Unilabs Breast Centre, Malmö, Sweden
| | - Anders Tingberg
- Lund University, Department of Translational Medicine, Medical Radiation Physics, Malmö, Sweden
- Skåne University Hospital, Radiation Physics, Malmö, Sweden
| | - Sophia Zackrisson
- Lund University, Department of Translational Medicine, Diagnostic Radiology, Malmö, Sweden
- Skåne University Hospital, Department of Medical Imaging and Physiology, Malmö, Sweden
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Olinder J, Johnson K, Åkesson A, Förnvik D, Zackrisson S. Impact of breast density on diagnostic accuracy in digital breast tomosynthesis versus digital mammography: results from a European screening trial. Breast Cancer Res 2023; 25:116. [PMID: 37794480 PMCID: PMC10548633 DOI: 10.1186/s13058-023-01712-6] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/17/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND The diagnostic accuracy of digital breast tomosynthesis (DBT) and digital mammography (DM) in breast cancer screening may vary per breast density subgroup. The purpose of this study was to evaluate which women, based on automatically assessed breast density subgroups, have the greatest benefit of DBT compared with DM in the prospective Malmö Breast Tomosynthesis Screening Trial. MATERIALS AND METHODS The prospective European, Malmö Breast Tomosynthesis Screening Trial (n = 14,848, Jan. 27, 2010-Feb. 13, 2015) compared one-view DBT and two-view DM, with consensus meeting before recall. Breast density was assessed in this secondary analysis with the automatic software Laboratory for Individualized Breast Radiodensity Assessment. DBT and DM's diagnostic accuracies were compared by breast density quintiles of breast percent density (PD) and absolute dense area (DA) with confidence intervals (CI) and McNemar's test. The association between breast density and cancer detection was analyzed with logistic regression, adjusted for ages < 55 and ≥ 55 years and previous screening participation. RESULTS In total, 14,730 women (median age: 58 years; inter-quartile range = 16) were included in the analysis. Sensitivity was higher and specificity lower for DBT compared with DM for all density subgroups. The highest breast PD quintile showed the largest difference in sensitivity and specificity at 81.1% (95% CI 65.8-90.5) versus 43.2% (95% CI 28.7-59.1), p < .001 and 95.5% (95% CI 94.7-96.2) versus 97.2% (95% CI 96.6-97.8), p < 0.001, respectively. Breast PD quintile was also positively associated with cancer detected via DBT at odds ratio 1.24 (95% CI 1.09-1.42, p = 0.001). CONCLUSION Women with the highest breast density had the greatest benefit from digital breast tomosynthesis compared with digital mammography with increased sensitivity at the cost of slightly lower specificity. These results may influence digital breast tomosynthesis's use in an individualized screening program stratified by, for instance, breast density. TRIAL REGISTRATION Trial registration at https://www. CLINICALTRIALS gov : NCT01091545, registered March 24, 2010.
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Affiliation(s)
- Jakob Olinder
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Skåne University Hospital, Carl-Bertil Laurells Gata 9, 20502, Malmö, Sweden.
- Department of Imaging and Physiology, Skåne University Hospital, Malmö, Sweden.
| | - Kristin Johnson
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Skåne University Hospital, Carl-Bertil Laurells Gata 9, 20502, Malmö, Sweden
- Department of Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
| | - Anna Åkesson
- Clinical Studies Sweden-Forum South, Skåne University Hospital, Lund, Sweden
| | - Daniel Förnvik
- Department of Translational Medicine, Medical Radiation Physics, Lund University, Skåne University Hospital, Malmö, Sweden
- Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Sophia Zackrisson
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Skåne University Hospital, Carl-Bertil Laurells Gata 9, 20502, Malmö, Sweden
- Department of Imaging and Physiology, Skåne University Hospital, Malmö, Sweden
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Berman AT, Schmidt C, Truong D, Reddy S, Avalos-Reyes E, Yeon H, Brito R, Verbrugge D, Johnson K. Differences in Radiotherapy-Treated Members with Cancer during COVID-19 Pandemic Using Nationwide Claim Data. Int J Radiat Oncol Biol Phys 2023; 117:e567. [PMID: 37785733 DOI: 10.1016/j.ijrobp.2023.06.1892] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) This study aimed to identify the impact of the pandemic on radiotherapy activity among members with cancer. MATERIALS/METHODS This retrospective study included fully-insured commercial members of a large national payor with cancer aged ≥18 years undergoing radiotherapy from March 1, 2018 to February 28, 2022. Radiotherapy activity was defined as the mean weekly number of treatment courses and attendances (fractions) per month pre-COVID (March 2018 to February 2020); during COVID (March 2020 to February 2021); and post-COVID (March 2021 to February 2022). T-tests assessed differences between pre-COVID and post-COVID on radiotherapy activity by age, gender, and cancer type. Interrupted time series analysis (ITS) assessed change in activity overtime, controlling for pre-COVID trends and other potential confounders. A p-value of <0.05 was considered significant. RESULTS The study included 9,275 members, 10,121 courses, and 169,257 fractions; most members were female (57%), the mean age was 57 years (SD = 12). Overall, there was a decline in mean weekly number of courses from the pre-COVID to post-COVID (-18%, p<0.05) timeframe. Females < 70 years experienced the largest decline in mean weekly number of courses (-23%, p<0.05) followed by males aged 70+ (-16%, p<0.05) and males < 70 years (-16%, p<0.05). All cancer types saw a significant decline (p<0.05); breast cancer reported the largest decline (-21%, p<0.05). Fraction numbers significantly declined overall by 27% (p<0.05) from the pre-COVID to post-COVID timeframe. The largest decline in fraction numbers was observed in females < 70 (-28%, p<0.05) followed by males < 70 years (-24%, p<0.05) and males aged 70+ (-22%, p<0.05). No difference between COVID and pre-COVID weeks for courses was observed once pre-COVID trends were accounted for using ITS. Females aged 70+ received 25% (p<0.05) fewer fractions during COVID compared to pre-COVID; a decline which continued to grow even as the pandemic eased (March 2021 to February 2022). Males aged 70+ also experienced a decreased level of fractions during the pandemic (-30%, p<0.05), but increased in the recovery period (+24%, p<0.05). Males < 70 years had an increased level of fractions during the pandemic (+14%, p<0.05). CONCLUSION Radiation mean weekly number of courses and fractions between pre-COVID and post-COVID declined with the effect more pronounced in females < 70 years. A decrease in fraction number was observed in all cancer types; specifically, breast cancer had the largest decline. ITS analysis revealed no difference between COVID and pre-COVID weeks for courses as the downward trend was already present prior to the pandemic. These findings suggest while radiotherapy courses and fractions were significantly impacted, fractionation was decreased to a greater extent, indicating an increased adoption of hypofractionation during the pandemic.
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Barnes JM, Johnson K. State Mandatory Paid Family Leave and Survival among Children with Cancer. Int J Radiat Oncol Biol Phys 2023; 117:S16-S17. [PMID: 37784400 DOI: 10.1016/j.ijrobp.2023.06.235] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Childhood cancer treatment is often costly and time intensive and may require parents/caregivers to stop working. Since 2012, several states have introduced mandatory paid family leave policies. We hypothesized that such policies, whether by reducing financial toxicity or by providing parents greater flexibility to care for their sick children, would improve outcomes among children with cancer. MATERIALS/METHODS Children ages 0-18 years diagnosed with cancer between 2010 and 2019 were identified from the Surveillance, Epidemiology, and End Results program (SEER) database. The primary outcome was overall survival (OS). The exposure of interest was state mandatory paid family leave. Difference-in-differences (DID) analyses with additive hazards regression models were utilized to compare changes in OS from pre- to post- mandatory paid sick leave policy implementation in states with vs. without paid sick leave policies. The models were adjusted for year fixed effects, state fixed effects, state Medicaid expansion status, age, race, sex, metropolitan residence status, county-level income and education, cancer site, cancer stage, and insurance status. Clustered standard errors by state were achieved via the cluster bootstrap. The plausibility of the common trends assumption was tested using event study analyses and was satisfied for all analyses. RESULTS A total of 38,053 children with cancer were identified. In adjusted difference-in-differences analyses, there was no significant change in OS in states with vs. without state mandatory paid family leave policies after policy enactment (hazard difference: 0.0001, 95% CI = -0.0002 to 0.0016, P = .47). However, among non-metropolitan residents, 1-year OS improved from 93.0% to 95.5% (2-year OS: 88.6% to 93.4%) in states with mandatory paid family leave policies compared to 92.7% to 92.5% (2-year OS: 88.0% to 87.7%) in states without such policies after policy enactment. This translates to a 2.7% improvement in 1-year OS (5.2%, 2-year OS) (hazard difference: -0.0021, 95% CI = -0.0034 to -0.0005, P = .037). There was no corresponding change for metropolitan residents (hazard DID = 0.0001, P = .47). By cancer site, the largest policy-associated improvements in survival were observed for rhabdomyosarcoma (hazard DID = -0.0037, P = .11), osteosarcoma (hazard DID = -0.0036, P<.001), and Intracranial and intraspinal embryonal tumors (hazard DID = -0.0026, P = .061). CONCLUSION State mandatory paid family leave policies were associated with improved survival for some children with cancer, most notably for those residing in non-metropolitan areas. The improvements for non-metropolitan residents may be related to alleviating otherwise increased travel burdens for cancer treatment if treatment occurs out-of-town, where working while taking care of a child is less feasible. These data also suggest a slight narrowing in rural-urban-metropolitan childhood cancer disparities associated with paid family leave policies.
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Affiliation(s)
- J M Barnes
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, Saint Louis, MO
| | - K Johnson
- Washington University in St. Louis, St. Louis, MO
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Senis L, Rathore V, Andersson P, Johnson K, Jädernäs D, Losin C, Minghetti D, Wright J, Schrire D. Performance evaluation of a novel gamma transmission micro-densitometer for PIE of nuclear fuel. ANN NUCL ENERGY 2023. [DOI: 10.1016/j.anucene.2023.109783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Bangaru S, Uppalapati S, Palluri S, Ram K, Sudheendra K, Jain S, Johnson K, Hynes D, Madhushankar A, Grinstein J, Pinney S, Onsager D, Rodgers D, Jeevanandam V. A Less Restrictive Approach to Procuring Organs is Not an Indicator of Prognostic Survival in Heart Transplantation: A Retrospective Analysis of 118 Adult Heart Transplant Centers from 2020 to 2022. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Ochoa E, Jain S, Rodgers D, de Matos SN, Uppalapati S, Bangaru S, Johnson K, Sudheendra K, Ram K, Hynes D, Sorensen K, Paluri S, Madhushankar A, Jeevanandam V. As Comfortable as a Pillow: The Superiority of the Sternasafe® Device Over the Standard of Care. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Paluri S, Siddiqi U, Rodgers D, Uppalapati S, Bangaru S, Ram K, Sorensen K, Sudheendra K, Madhushankar A, Johnson K, Hynes D, Jain S, Jeevanandam V. A Probable Winner in the Race for the Best Cardiac Preservation Solution: A Single-Center's Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Uppalapati S, Rodgers D, Paluri S, Ram K, Jain S, Sorensen K, Bangaru S, Madhushankar A, Sudheendra K, Johnson K, Hynes D, Grinstein J, Kalathiya R, Jeevanandam V. Changes in Echocardiographic Parameters after Transcatheter Aortic Valve Replacement in Patients with a Left Ventricular Assist Device: A Case Series. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Sorensen K, Rodgers D, Uppalapati SC, Siddiqi U, Jain S, Paluri S, Madhushanka A, Sudheendra K, Johnson K, Bangaru S, Ram K, Hynes D, Ozcan C, Lee L, Kim G, Jeevanandam V. A Retrospective Study on Gender, LAA Morphology and Stroke Risk. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Bangaru S, Uppalapati S, Palluri S, Ram K, Madhushankar A, Johnson K, Hynes D, Jain S, Sudheendra K, Rodgers D, Jeevanandam V, Onsager D. Continuous Temperature Measurements in Donor Hearts During Cold Organ Procurement. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Fisher L, Ahmed O, Chalchal H, Deobald R, El-Gayed A, Graham P, Groot G, Haider K, Iqbal N, Johnson K, Le D, Mahmood S, Manna M, Meiers P, Pauls M, Salim M, Sami A, Wright P, Younis M, Ahmed S. P058 Outcomes of Rural Men With Breast Cancer: A Multicenter Population Based Retrospective Cohort Study. Breast 2023. [DOI: 10.1016/s0960-9776(23)00177-7] [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: 03/15/2023] Open
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Ulfsdottir H, Johnson K, Rubertsson C, Ekelin M, Edqvist M. A complex and demanding situation - Midwifery preceptors and midwifery students' experiences of teaching and learning prevention of severe perineal trauma. Women Birth 2023; 36:e118-e124. [PMID: 35568665 DOI: 10.1016/j.wombi.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Many high-income countries have seen an increase in severe perineal trauma. Teaching strategies and conditions for learning during the active second stage of labour are scarcely described. AIM To describe midwifery preceptors and midwifery students' experiences' of teaching and learning how to manage the second stage of labour, with the specific aim of preventing severe perineal trauma. METHODS A qualitative study with focus group discussions and individual in depth-interviews with preceptor midwives (n = 23) and student midwives (n = 10). Data were analysed by qualitative content analysis. RESULTS "A complex and demanding situation with mutual need for feedback, reflection and safety" was the overall theme describing the conditions. Three sub-themes were identified. "Adapting to a unique situation" refers to the difficulty of teaching and learning the aspects needed to prevent severe perineal trauma, and to provide care during this stage. "Hindering and limiting circumstances" describes teaching strategies that were perceived negatively, and how midwifery students tried to adapt to the preceptors rather than the birthing women. "A trustful and communicative relationship" describes the importance of the relationship between the student and the preceptor, where communication was a central, but not obvious part. CONCLUSION An increased awareness among preceptors is needed to optimize teaching strategies, enabling the students to focus on learning the art of the second stage of labour; supporting the woman, preventing severe perineal trauma and ensuring the safety of the unborn baby. Future research should address how existing prevention models can include training to increase preceptors' confidence in teaching.
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Affiliation(s)
- H Ulfsdottir
- Department of Women's Health and Health professions Karolinska University Hospital, Stockholm, Sweden
| | - K Johnson
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - C Rubertsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
| | - M Ekelin
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
| | - M Edqvist
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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17
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Berman A, Warde P, Avalos-Reyes E, Yeon H, Cavers W, Reddy S, Brito R, Johnson K. Predicting Total Hospitalizations and Emergency Visits in Radiotherapy Patients: A Claims-Based Model. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1435] [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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18
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Johnson K. Findings in breast tomosynthesis screening - What do they look like? Eur J Radiol 2022; 156:110508. [PMID: 36108475 DOI: 10.1016/j.ejrad.2022.110508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Kristin Johnson
- Department of Translational Medicine, Radiology Diagnostics, Lund University, Skåne University Hospital, Malmö, Sweden.
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19
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Yeon H, Warde P, Avalos-Reyes E, Cavers W, Reddy S, Johnson K, Brito R, Berman A. Defining the Cost Variation by Site-of-Care for Radiotherapy: A Claims-Based Analysis. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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20
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Barnes J, Johnson K, Osazuwa-Peters N, Spraker M. The Impact of Federal Poverty Level on the Association between Insurance Status and Overall Survival among Adults with Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Rubery MS, Ose N, Schneider M, Moore AS, Carrera J, Mariscal E, Ayers J, Bell P, Mackinnon A, Bradley D, Landen OL, Thompson N, Carpenter A, Winters S, Ehrlich B, Sarginson T, Rendon A, Liebman J, Johnson K, Merril D, Grant G, Shingleton N, Taylor A, Ruchonnet G, Stanley J, Cohen M, Kohut T, Issavi R, Norris J, Wright J, Stevers J, Masters N, Latray D, Kilkenny J, Stolte WC, Conlon CS, Troussel P, Villette B, Emprin B, Wrobel R, Lejars A, Chaleil A, Bridou F, Delmotte F. A 2-4 keV multilayer mirrored channel for the NIF Dante system. Rev Sci Instrum 2022; 93:113502. [PMID: 36461505 DOI: 10.1063/5.0101695] [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: 06/02/2022] [Accepted: 09/09/2022] [Indexed: 06/17/2023]
Abstract
During inertial confinement fusion experiments at the National Ignition Facility (NIF), a capsule filled with deuterium and tritium (DT) gas, surrounded by a DT ice layer and a high-density carbon ablator, is driven to the temperature and densities required to initiate fusion. In the indirect method, 2 MJ of NIF laser light heats the inside of a gold hohlraum to a radiation temperature of 300 eV; thermal x rays from the hohlraum interior couple to the capsule and create a central hotspot at tens of millions degrees Kelvin and a density of 100-200 g/cm3. During the laser interaction with the gold wall, m-band x rays are produced at ∼2.5 keV; these can penetrate into the capsule and preheat the ablator and DT fuel. Preheat can impact instability growth rates in the ablation front and at the fuel-ablator interface. Monitoring the hohlraum x-ray spectrum throughout the implosion is, therefore, critical; for this purpose, a Multilayer Mirror (MLM) with flat response in the 2-4 keV range has been installed in the NIF 37° Dante calorimeter. Precision engineering and x-ray calibration of components mean the channel will report 2-4 keV spectral power with an uncertainty of ±8.7%.
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Affiliation(s)
- M S Rubery
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - N Ose
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - M Schneider
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - A S Moore
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Carrera
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - E Mariscal
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Ayers
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - P Bell
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - A Mackinnon
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - D Bradley
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - O L Landen
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - N Thompson
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - A Carpenter
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - S Winters
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - B Ehrlich
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - T Sarginson
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - A Rendon
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Liebman
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - K Johnson
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - D Merril
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - G Grant
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - N Shingleton
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - A Taylor
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - G Ruchonnet
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Stanley
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - M Cohen
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - T Kohut
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - R Issavi
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Norris
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Wright
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Stevers
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - N Masters
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - D Latray
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Kilkenny
- General Atomics, San Diego, California 92121, USA
| | - W C Stolte
- MSTS, Mission Support and Test Services LLC, Livermore, California 94550-9239, USA
| | - C S Conlon
- MSTS, Mission Support and Test Services LLC, Livermore, California 94550-9239, USA
| | - Ph Troussel
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - B Villette
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - B Emprin
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - R Wrobel
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - A Lejars
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - A Chaleil
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - F Bridou
- Laboratoire Charles Fabry, 2, Av. Augustin Fresnel, 91127 Palaiseau Cedex, France
| | - F Delmotte
- Laboratoire Charles Fabry, 2, Av. Augustin Fresnel, 91127 Palaiseau Cedex, France
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22
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Johnson K, Freedman S, Braun R, LaBonne C. Quantitative analysis of transcriptome dynamics provides novel insights into developmental state transitions. BMC Genomics 2022; 23:723. [PMID: 36273135 PMCID: PMC9588240 DOI: 10.1186/s12864-022-08953-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/19/2022] [Indexed: 11/30/2022] Open
Abstract
Background During embryogenesis, the developmental potential of initially pluripotent cells becomes progressively restricted as they transit to lineage restricted states. The pluripotent cells of Xenopus blastula-stage embryos are an ideal system in which to study cell state transitions during developmental decision-making, as gene expression dynamics can be followed at high temporal resolution. Results Here we use transcriptomics to interrogate the process by which pluripotent cells transit to four different lineage-restricted states: neural progenitors, epidermis, endoderm and ventral mesoderm, providing quantitative insights into the dynamics of Waddington’s landscape. Our findings provide novel insights into why the neural progenitor state is the default lineage state for pluripotent cells and uncover novel components of lineage-specific gene regulation. These data reveal an unexpected overlap in the transcriptional responses to BMP4/7 and Activin signaling and provide mechanistic insight into how the timing of signaling inputs such as BMP are temporally controlled to ensure correct lineage decisions. Conclusions Together these analyses provide quantitative insights into the logic and dynamics of developmental decision making in early embryos. They also provide valuable lineage-specific time series data following the acquisition of specific lineage states during development. Supplementary Information The online version contains supplementary material available at 10.1186/s12864-022-08953-3.
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Affiliation(s)
- Kristin Johnson
- Department of Molecular Biosciences, Northwestern University, Evanston, IL, USA.,NSF-Simons Center for Quantitative Biology, Northwestern University, Evanston, IL, 60208, USA
| | - Simon Freedman
- NSF-Simons Center for Quantitative Biology, Northwestern University, Evanston, IL, 60208, USA.,Department of Engineering Sciences and Applied Math, Northwestern University, Evanston, IL, USA
| | - Rosemary Braun
- Department of Molecular Biosciences, Northwestern University, Evanston, IL, USA.,NSF-Simons Center for Quantitative Biology, Northwestern University, Evanston, IL, 60208, USA.,Department of Engineering Sciences and Applied Math, Northwestern University, Evanston, IL, USA.,Northwestern Institute On Complex Systems, Northwestern University, Evanston, IL, USA
| | - Carole LaBonne
- Department of Molecular Biosciences, Northwestern University, Evanston, IL, USA. .,NSF-Simons Center for Quantitative Biology, Northwestern University, Evanston, IL, 60208, USA.
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23
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Ruiz Munoz A, Guala A, Dux-Santoy L, Rodriguez-Palomares JF, Garcia-Duran A, Garrido-Oliver J, Galian-Gay L, Valente F, Casas G, Fernandez-Galera R, Johnson K, Wieben O, Ferreira-Gonzalez I, Evangelista A, Teixido-Tura G. Aortic flow patterns by 4D flow CMR in Marfan and Loeys-Dietz patients before and after valve sparing aortic root replacement: a comparison with healthy volunteers. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1944] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Abnormal aortic flow patterns in patients with a connective tissue disorder (CTD), such as Marfan or Loeys-Dietz syndrome, may contribute to aortic root dilation [1,2]. Valve sparing aortic root replacement, which is effective in reducing the risk of aortic dissection in case of severe dilation, may also normalize flow patterns beyond the replaced aorta and potentially slow its progressive aortic dilation.
Purpose
To assess aortic flow dynamics in patients with a CTD by 4D flow cardiovascular magnetic resonance (CMR) before and after valve sparing aortic root replacement, and to compare the results with those of healthy volunteers (HV).
Methods
Patients with Marfan or Loeys-Dietz syndrome underwent two non-contrast enhanced 4D flow CMR, one before and another after undergoing valve sparing aortic root replacement. Healthy volunteers matched for age, sex and BSA were also included for comparison. Maximum velocity, in-plane rotational flow (IRF), systolic flow reversal ratio (SFRR) and wall shear stress (WSS) magnitude and its axial and circumferential components were obtained at 24 planes covering the thoracic aorta from the sinotubular junction to the descending aorta at the diaphragmatic level [3–5].
Results
Sixteen patients and 21 healthy volunteers were included. Demographic and clinical data is presented in Table. The mean time between the CMR prior and posterior to surgery was 15 months. Compared to HV, patients with CTD before intervention presented lower maximum velocity at the proximal ascending aorta (Fig. 1A), lower IRF and circumferential WSS at the arch and the proximal descending aorta (Fig. 1B and F), lower magnitude and axial WSS at the proximal ascending and descending aorta (Fig. 1E and D), and increased SFRR at the proximal descending aorta (Fig. 1C). The intervention completely restored maximum velocity and partially-restored physiological helical flow and circumferential WSS, but barely improved axial WSS and SFRR.
Conclusion
Valve sparing aortic root replacement in patients with Marfan or Loeys-Dietz syndrome partially restore to physiological level both in-plane rotational flow and circumferential wall shear stress in the descending aorta. This flow normalization may contribute to prevent progressive dilation after the surgery.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Instituto de Salud Carlos III (Spain) (PI17/00381)Spanish Society of Cardiology (SEC/FEC-INV-CLI 20/015)
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Affiliation(s)
- A Ruiz Munoz
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - A Guala
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - L Dux-Santoy
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | | | - A Garcia-Duran
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - J Garrido-Oliver
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - L Galian-Gay
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - F Valente
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - G Casas
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | | | - K Johnson
- University of Wisconsin , Wisconsin , United States of America
| | - O Wieben
- University of Wisconsin , Wisconsin , United States of America
| | | | - A Evangelista
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - G Teixido-Tura
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
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24
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Johnson K. The Return of the Geneticist: Theodosius Dobzhansky, Edward Chapin, and Museum Taxonomy. J Hist Biol 2022; 55:443-463. [PMID: 36326953 DOI: 10.1007/s10739-022-09694-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
In Fall 1939, as war engulfed Europe, the author of one of the most influential texts on genetics and evolution, Theodosius Dobzhansky, wrote a letter to curator of insects at the United States National Museum, Edward Albert Chapin. Dobzhansky wished to know what Chapin thought about his pursuing some taxonomic work on an old fascination of his: lady-bird beetles. This paper examines the resulting correspondence as a window into Dobzhansky's attitude toward taxonomy, the different pressures on geneticists and taxonomists when wrestling with how to name species, the relation between biological theory and taxonomic practice, and how claims regarding human races may have motivated Dobzhansky's continued interest in the work of beetle taxonomists. In doing so, this article builds on the work of Paul Farber and others to highlight the importance of including museums, taxonomy, and the naturalist tradition within the history of twentieth-century biology.
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Hafez S, Munyati BM, Zeno K, Gbozee CKZ, Jusu M, Reeves MS, Wesseh CS, Wiah SO, AlKhaldi M, Johnson K, Subah M. Examining the gender imbalance in the National Community Health Assistant Programme in Liberia: a qualitative analysis of policy and Programme implementation. Health Policy Plan 2022; 38:181-191. [PMID: 36069652 PMCID: PMC9923372 DOI: 10.1093/heapol/czac075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 11/12/2022] Open
Abstract
The Revised National Community Health Services Policy (2016-2021) (RNCHSP) and its programme implementation, the Liberian National Community Health Assistant Programme (NCHAP), exhibit a critical gender imbalance among the Community Health Assistants (CHAs) as only 17% are women. This study was designed to assess the gender responsiveness of the RNCHSP and its programme implementation in five counties across Liberia to identify opportunities to improve gender equity in the programme. Using qualitative methods, 16 semi-structured interviews were conducted with policymakers and 32 with CHAs, other members of the community health workforce and community members. The study found that despite the Government of Liberia's intention to prioritize women in the recruitment and selection of CHAs, the planning and implementation of the RNCHSP were not gender responsive. While the role of community structures, such as Community Health Committees, in the nomination and selection of CHAs is central to community ownership of the programme, unfavourable gender norms influenced women's nomination to become CHAs. Cultural, social and religious perceptions and practices of gender created inequitable expectations that negatively influenced the recruitment of women CHAs. In particular, the education requirement for CHAs posed a significant barrier to women's nomination and selection as CHAs, due to disparities in access to education for girls in Liberia. The inequitable gender balance of CHAs has impacted the accessibility, acceptability and affordability of community healthcare services, particularly among women. Strengthening the gender responsiveness within the RNCHSP and its programme implementation is key to fostering gender equity among the health workforce and strengthening a key pillar of the health system. Employing gender responsive policies and programme will likely increase the effectiveness of community healthcare services.
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Affiliation(s)
- Sali Hafez
- *Corresponding author. Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, 9 Tavistock PI, London WC1H 9SH, United Kingdom. E-mail:
| | | | - Katie Zeno
- American University School of International Service, 4400 Massachusetts Avenue NW, Washington, DC 20016, United States
| | - Catherine K Z Gbozee
- Cuttington Graduate School of Professional Study and Health System Strengthening Unit, Last Mile Health Liberia, 77C6+984, Monrovia, Liberia
| | - Mbalu Jusu
- Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, 9 Tavistock PI, London WC1H 9SH, United Kingdom
| | - Mantue S Reeves
- Mekelle University and the Monitoring, Evaluation and Research Unit, Last Mile Health Liberia, 77C6+984, Monrovia, Liberia
| | - C Sanford Wesseh
- The Department of Health and Vital Statistics, the Ministry of Health, SKD Boulevard, Congo Town 1000, Monrovia, Liberia
| | - S Olasford Wiah
- Director, Community Health Services Division, the Ministry of Health, SKD Boulevard, Congo Town 1000, Monrovia, Liberia
| | - Mohammed AlKhaldi
- Faculty of Medicine, School of Physical and Occupational Therapy, Person-Centred Health Informatics Research-PCHI lab, McGill University, 3605 Rue de la Montagne, Montréal, QC H3G 2M1, Canada
| | - Kristin Johnson
- Department of Public Health, Boston University, Boston, MA 02215, United States
| | - Marion Subah
- Department of Nursing, Catholic University of America, United States and Country Director, Last Mile Health Liberia, 77C6+984, Monrovia, Liberia
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Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D'Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T'Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, Arcelus J. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health 2022; 23:S1-S259. [PMID: 36238954 PMCID: PMC9553112 DOI: 10.1080/26895269.2022.2100644] [Citation(s) in RCA: 455] [Impact Index Per Article: 227.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
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Affiliation(s)
- E Coleman
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A E Radix
- Callen-Lorde Community Health Center, New York, NY, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - W P Bouman
- Nottingham Centre for Transgender Health, Nottingham, UK
- School of Medicine, University of Nottingham, Nottingham, UK
| | - G R Brown
- James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
- James H. Quillen VAMC, Johnson City, TN, USA
| | - A L C de Vries
- Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M B Deutsch
- Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA
- UCSF Gender Affirming Health Program, San Francisco, CA, USA
| | - R Ettner
- New Health Foundation Worldwide, Evanston, IL, USA
- Weiss Memorial Hospital, Chicago, IL, USA
| | - L Fraser
- Independent Practice, San Francisco, CA, USA
| | - M Goodman
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - J Green
- Independent Scholar, Vancouver, WA, USA
| | - A B Hancock
- The George Washington University, Washington, DC, USA
| | - T W Johnson
- Department of Anthropology, California State University, Chico, CA, USA
| | - D H Karasic
- University of California San Francisco, San Francisco, CA, USA
- Independent Practice at dankarasic.com
| | - G A Knudson
- University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health, Vancouver, Canada
| | - S F Leibowitz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - H F L Meyer-Bahlburg
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - J Motmans
- Transgender Infopunt, Ghent University Hospital, Gent, Belgium
- Centre for Research on Culture and Gender, Ghent University, Gent, Belgium
| | - L Nahata
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - T O Nieder
- University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany
| | - S L Reisner
- Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - C Richards
- Regents University London, UK
- Tavistock and Portman NHS Foundation Trust, London, UK
| | | | - V Tangpricha
- Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - A C Tishelman
- Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA
| | - M A A Van Trotsenburg
- Bureau GenderPRO, Vienna, Austria
- University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria
| | - S Winter
- School of Population Health, Curtin University, Perth, WA, Australia
| | - K Ducheny
- Howard Brown Health, Chicago, IL, USA
| | - N J Adams
- University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada
- Transgender Professional Association for Transgender Health (TPATH)
| | - T M Adrián
- Asamblea Nacional de Venezuela, Caracas, Venezuela
- Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela
| | - L R Allen
- University of Nevada, Las Vegas, NV, USA
| | - D Azul
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - H Bagga
- Monash Health Gender Clinic, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - K Başar
- Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - D S Bathory
- Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA
| | - J J Belinky
- Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina
| | - D R Berg
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J U Berli
- Oregon Health & Science University, Portland, OR, USA
| | - R O Bluebond-Langner
- NYU Langone Health, New York, NY, USA
- Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA
| | - M-B Bouman
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - M L Bowers
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - P J Brassard
- GrS Montreal, Complexe CMC, Montreal, Quebec, Canada
- Université de Montreal, Quebec, Canada
| | - J Byrne
- University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - L Capitán
- The Facialteam Group, Marbella International Hospital, Marbella, Spain
| | | | - J M Carswell
- Harvard Medical School, Boston, MA, USA
- Boston's Children's Hospital, Boston, MA, USA
| | - S C Chang
- Independent Practice, Oakland, CA, USA
| | - G Chelvakumar
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University, College of Medicine, Columbus, OH, USA
| | - T Corneil
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
| | - K B Dalke
- Penn State Health, PA, USA
- Penn State College of Medicine, Hershey, PA, USA
| | - G De Cuypere
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
| | - E de Vries
- Nelson Mandela University, Gqeberha, South Africa
- University of Cape Town, Cape Town, South Africa
| | - M Den Heijer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - A H Devor
- University of Victoria, Victoria, BC, Canada
| | - C Dhejne
- ANOVA, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - A D'Marco
- UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas
- D M A R C O Organization, Nassau, The Bahamas
| | - E K Edmiston
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L Edwards-Leeper
- Pacific University, Hillsboro, OR, USA
- Independent Practice, Beaverton, OR, USA
| | - R Ehrbar
- Whitman Walker Health, Washington, DC, USA
- Independent Practice, Maryland, USA
| | - D Ehrensaft
- University of California San Francisco, San Francisco, CA, USA
| | - J Eisfeld
- Transvisie, Utrecht, The Netherlands
| | - E Elaut
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium
| | - L Erickson-Schroth
- The Jed Foundation, New York, NY, USA
- Hetrick-Martin Institute, New York, NY, USA
| | - J L Feldman
- Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A D Fisher
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | - M M Garcia
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA
| | - L Gijs
- Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - B P Hall
- Duke University Medical Center, Durham, NC, USA
- Duke Adult Gender Medicine Clinic, Durham, NC, USA
| | - T L D Hardy
- Alberta Health Services, Edmonton, Alberta, Canada
- MacEwan University, Edmonton, Alberta, Canada
| | - M S Irwig
- Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - A C Janssen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - K Johnson
- RMIT University, Melbourne, Australia
- University of Brighton, Brighton, UK
| | - D T Klink
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium
- Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
| | - B P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - L E Kuper
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA
- Department of Endocrinology, Children's Health, Dallas, TX, USA
| | - E J Kvach
- Denver Health, Denver, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - M A Malouf
- Malouf Counseling and Consulting, Baltimore, MD, USA
| | - R Massey
- WPATH Global Education Institute
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - T Mazur
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- John R. Oishei Children's Hospital, Buffalo, NY, USA
| | - C McLachlan
- Professional Association for Transgender Health, South Africa
- Gender DynamiX, Cape Town, South Africa
| | - S D Morrison
- Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
| | - S W Mosser
- Gender Confirmation Center, San Francisco, CA, USA
- Saint Francis Memorial Hospital, San Francisco, CA, USA
| | - P M Neira
- Johns Hopkins Center for Transgender Health, Baltimore, MD, USA
- Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA
| | - U Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - J M Oates
- La Trobe University, Melbourne, Australia
- Melbourne Voice Analysis Centre, East Melbourne, Australia
| | - J Obedin-Maliver
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford, CA, USA
| | - G Pagkalos
- Independent PracticeThessaloniki, Greece
- Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece
| | - J Patton
- Talkspace, New York, NY, USA
- CytiPsychological LLC, San Diego, CA, USA
| | - N Phanuphak
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - K Rachlin
- Independent Practice, New York, NY, USA
| | - T Reed
- Gender Identity Research and Education Society, Leatherhead, UK
| | - G N Rider
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Ristori
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | | | - S A Roberts
- Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA
| | - K A Rodriguez-Wallberg
- Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - S M Rosenthal
- Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA
- UCSF Child and Adolescent Gender Center
| | - K Sabir
- FtM Phoenix Group, Krasnodar Krai, Russia
| | - J D Safer
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA
| | - A I Scheim
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - L J Seal
- Tavistock and Portman NHS Foundation Trust, London, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - K Spencer
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C St Amand
- University of Houston, Houston, TX, USA
- Mayo Clinic, Rochester, MN, USA
| | - T D Steensma
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - J F Strang
- Children's National Hospital, Washington, DC, USA
- George Washington University School of Medicine, Washington, DC, USA
| | - G B Taylor
- Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA
| | - K Tilleman
- Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - G G T'Sjoen
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Endocrinology, Ghent University Hospital, Gent, Belgium
| | - L N Vala
- Independent Practice, Campbell, CA, USA
| | - N M Van Mello
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - J F Veale
- School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - J A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - B Vincent
- Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK
| | - L M Wesp
- College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA
- Health Connections Inc., Glendale, WI, USA
| | - M A West
- North Memorial Health Hospital, Robbinsdale, MN, USA
- University of Minnesota, Minneapolis, MN, USA
| | - J Arcelus
- School of Medicine, University of Nottingham, Nottingham, UK
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
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Corvaro M, Johnson K, Himmelstein M, Bianchi E, Mingoia R, Bartels M, Reiss R, Terry C, LaRocca J, Murphy L, Gehen S. P06-13 Spinosad – mode of action and human relevance assessment of dystocia in rats. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.331] [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: 11/25/2022]
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Montoya L, Johnson K, O'Haver J, Price H. 356 Infantile hemangioma referral delays persist despite 2019 American Academy of Pediatrics Clinical Practice Guideline: Experience at a single quaternary pediatric institution. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hafeez K, Kushlaf H, Al-Sultani H, Joseph AC, Zaeem Z, Siddiqi Z, Laboy S, Pulley M, Habib AA, Robbins NM, Zadeh S, Hafeez MU, Hussain Y, Melendez-Zaidi A, Kassardjian C, Johnson K, Leonhard H, Biliciler S, Patino Murillas JE, Shaibani AI. Patient preference for virtual versus in-person visits in neuromuscular clinical practice. Muscle Nerve 2022; 66:142-147. [PMID: 35596667 PMCID: PMC9540760 DOI: 10.1002/mus.27641] [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] [Received: 04/11/2021] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 11/11/2022]
Abstract
Introduction/Aims It is unknown if patients with neuromuscular diseases prefer in‐person or virtual telemedicine visits. We studied patient opinions and preference on virtual versus in‐person visits, and the factors influencing such preferences. Methods Telephone surveys, consisting of 11 questions, of patients from 10 neuromuscular centers were completed. Results Five hundred and twenty surveys were completed. Twenty‐six percent of respondents preferred virtual visits, while 50% preferred in‐person visits. Sixty‐four percent reported physical interaction as “very important.” For receiving a new diagnosis, 55% preferred in‐person vs 35% reporting no preference. Forty percent were concerned about a lack of physical examination vs 20% who were concerned about evaluating vital signs. Eighty four percent reported virtual visits were sufficiently private. Sixty eight percent did not consider expenses a factor in their preference. Although 92% were comfortable with virtual communication technology, 55% preferred video communications, and 19% preferred phone calls. Visit preference was not significantly associated with gender, diagnosis, disease severity, or symptom management. Patients who were concerned about a lack of physical exam or assessment of vitals had significantly higher odds of selecting in‐person visits than no preference. Discussion Although neither technology, privacy, nor finance burdened patients in our study, more patients preferred in‐person visits than virtual visits and 40% were concerned about a lack of physical examination. Interactions that occur with in‐person encounters had high importance for patients, reflecting differences in the perception of the patient‐physician relationship between virtual and in‐person visits.
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Affiliation(s)
- Komal Hafeez
- Baylor College of Medicine, Houston, TX, Nerve and Muscle Center of Texas, Houston, Texas, USA
| | | | - Husam Al-Sultani
- Baylor College of Medicine, Houston, TX, Nerve and Muscle Center of Texas, Houston, Texas, USA
| | | | - Zoya Zaeem
- University of Alberta, Canada, University of Alberta, Alberta, Canada
| | - Zaeem Siddiqi
- University of Alberta, Canada, University of Alberta, Alberta, Canada
| | | | | | - Ali A Habib
- University of California, Irvine, California, USA
| | | | - Sean Zadeh
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Muhammad Ubaid Hafeez
- Baylor College of Medicine, Houston, TX, Nerve and Muscle Center of Texas, Houston, Texas, USA
| | | | | | | | | | | | - Suur Biliciler
- UT Health Science Center at Houston, Houston, Texas, USA
| | | | - Aziz I Shaibani
- Baylor College of Medicine, Houston, TX, Nerve and Muscle Center of Texas, Houston, Texas, USA
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Patil YSS, Yu J, Frazier S, Wang Y, Johnson K, Fox J, Reichel J, Harris JGE. Measuring High-Order Phonon Correlations in an Optomechanical Resonator. Phys Rev Lett 2022; 128:183601. [PMID: 35594119 DOI: 10.1103/physrevlett.128.183601] [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: 01/18/2022] [Accepted: 03/18/2022] [Indexed: 06/15/2023]
Abstract
We use single photon detectors to probe the motional state of a superfluid ^{4}He resonator of mass ∼1 ng. The arrival times of Stokes and anti-Stokes photons (scattered by the resonator's acoustic mode) are used to measure the resonator's phonon coherences up to the fourth order. By postselecting on photon detection events, we also measure coherences in the resonator when ≤3 phonons have been added or subtracted. These measurements are found to be consistent with predictions that assume the acoustic mode to be in thermal equilibrium with a bath through a Markovian coupling.
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Affiliation(s)
- Y S S Patil
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J Yu
- Department of Applied Physics, Yale University, New Haven, Connecticut 06520, USA
| | - S Frazier
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Wang
- Department of Applied Physics, Yale University, New Haven, Connecticut 06520, USA
| | - K Johnson
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J Fox
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J Reichel
- Laboratoire Kastler Brossel, ENS-Université PSL, CNRS, Sorbonne Université, Collège de France 24 rue Lhomond, 75005 Paris, France
| | - J G E Harris
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
- Department of Applied Physics, Yale University, New Haven, Connecticut 06520, USA
- Yale Quantum Institute, Yale University, New Haven, Connecticut 06520, USA
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31
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Tomic H, Bjerkén A, Hellgren G, Johnson K, Förnvik D, Zackrisson S, Tingberg A, Dustler M, Bakic PR. Development and evaluation of a method for tumor growth simulation in virtual clinical trials of breast cancer screening. J Med Imaging (Bellingham) 2022; 9:033503. [PMID: 35685119 PMCID: PMC9168969 DOI: 10.1117/1.jmi.9.3.033503] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 05/12/2022] [Indexed: 09/27/2023] Open
Abstract
Purpose: Image-based analysis of breast tumor growth rate may optimize breast cancer screening and diagnosis by suggesting optimal screening intervals and guide the clinical discussion regarding personalized screening based on tumor aggressiveness. Simulation-based virtual clinical trials (VCTs) can be used to evaluate and optimize medical imaging systems and design clinical trials. This study aimed to simulate tumor growth over multiple screening rounds. Approach: This study evaluates a preliminary method for simulating tumor growth. Clinical data on tumor volume doubling time (TVDT) was used to fit a probability distribution ("clinical fit") of TVDTs. Simulated tumors with TVDTs sampled from the clinical fit were inserted into 30 virtual breasts ("simulated cohort") and used to simulate mammograms. Based on the TVDT, two successive screening rounds were simulated for each virtual breast. TVDTs from clinical and simulated mammograms were compared. Tumor sizes in the simulated mammograms were measured by a radiologist in three repeated sessions to estimate TVDT. Results: The mean TVDT was 297 days (standard deviation, SD, 169 days) in the clinical fit and 322 days (SD, 217 days) in the simulated cohort. The mean estimated TVDT was 340 days (SD, 287 days). No significant difference was found between the estimated TVDTs from simulated mammograms and clinical TVDT values ( p > 0.5 ). No significant difference ( p > 0.05 ) was observed in the reproducibility of the tumor size measurements between the two screening rounds. Conclusions: The proposed method for tumor growth simulation has demonstrated close agreement with clinical results, supporting potential use in VCTs of temporal breast imaging.
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Affiliation(s)
- Hanna Tomic
- Lund University, Medical Radiation Physics, Department of Translational Medicine, Malmö, Sweden
- Skåne University Hospital, Radiation Physics, Malmö, Sweden
| | - Anna Bjerkén
- Lund University, Medical Radiation Physics, Department of Translational Medicine, Malmö, Sweden
- Skåne University Hospital, Radiation Physics, Malmö, Sweden
| | - Gustav Hellgren
- Lund University, Medical Radiation Physics, Department of Translational Medicine, Malmö, Sweden
- Skåne University Hospital, Radiation Physics, Malmö, Sweden
| | - Kristin Johnson
- Lund University, Diagnostic Radiology, Department of Translational Medicine, Malmö, Sweden
- Skåne University Hospital, Department of Medical Imaging and Physiology, Malmö, Sweden
| | - Daniel Förnvik
- Lund University, Medical Radiation Physics, Department of Translational Medicine, Malmö, Sweden
- Skåne University Hospital, Radiation Physics, Malmö, Sweden
| | - Sophia Zackrisson
- Lund University, Diagnostic Radiology, Department of Translational Medicine, Malmö, Sweden
- Skåne University Hospital, Department of Medical Imaging and Physiology, Malmö, Sweden
| | - Anders Tingberg
- Lund University, Medical Radiation Physics, Department of Translational Medicine, Malmö, Sweden
- Skåne University Hospital, Radiation Physics, Malmö, Sweden
| | - Magnus Dustler
- Lund University, Medical Radiation Physics, Department of Translational Medicine, Malmö, Sweden
- Lund University, Diagnostic Radiology, Department of Translational Medicine, Malmö, Sweden
| | - Predrag R. Bakic
- Lund University, Medical Radiation Physics, Department of Translational Medicine, Malmö, Sweden
- Lund University, Diagnostic Radiology, Department of Translational Medicine, Malmö, Sweden
- University of Pennsylvania, Department of Radiology, Philadelphia, Pennsylvania, United States
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Suleman NJ, Oates AJ, Johnson K. Re: value of additional lateral radiographs in paediatric skeletal surveys for suspected physical abuse. Clin Radiol 2022; 77:474-475. [PMID: 35339250 DOI: 10.1016/j.crad.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 11/29/2022]
Affiliation(s)
- N J Suleman
- Birmingham Children's Hospital, Birmingham, UK.
| | - A J Oates
- Birmingham Children's Hospital, Birmingham, UK
| | - K Johnson
- Birmingham Children's Hospital, Birmingham, UK
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Johnson K, Pushparajan J, Anjana P, Gopinadh SV, Anoopkumar V, Peddinti VP, John B, Mercy T. Synthesis, characterisation and electrochemical evaluation of lithium titanate anode for lithium ion cells. INORG CHEM COMMUN 2022. [DOI: 10.1016/j.inoche.2021.109188] [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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Amaral J, Paulus J, Johnson K, Gregg W. An integrated method for contained laparoscopic specimen removal. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.068] [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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Low S, Tan Y, Patel H, Johnson K. Four-year experience of paediatric penetrating injuries: findings from a paediatric major trauma centre in the UK. Clin Radiol 2022; 77:244-254. [DOI: 10.1016/j.crad.2022.01.037] [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] [Received: 02/02/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022]
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Evenson A, Doan C, Johnson K, Berens B. Dietary Intake Changes in College Students During the COVID-19 Pandemic. J Acad Nutr Diet 2021. [PMCID: PMC8372426 DOI: 10.1016/j.jand.2021.06.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Evenson A, Johnson K, Berens B, Wachowiak J, Knapek J, Giachino C, Keyler T, Bohn-Gettler C. The Relationship Between GI symptoms, State and Trait Anxiety, and Lifestyle Factors in Males and Females During the SARS-CoV-2 Pandemic. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.101] [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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Kocakavuk E, Anderson K, Varn F, Johnson K, Amin S, Barthel F, Verhaak R. 340O Radiotherapy is associated with deletion signatures that contribute to poor survival outcomes in cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.004] [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: 10/20/2022] Open
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Guala A, Teixido-Tura G, Dux-Santoy L, Ruiz-Munoz A, Valente F, Galian L, Gutierrez L, Gonzalez-Alujas T, Johnson K, Wieben O, Sao-Aviles A, Ferreira-Gonzalez I, Evangelista A, Rodriguez-Palomares J. Bicuspid aortic valve fusion length correlates with maximum aortic diameter and heamodynamic abnormalities: a 4D flow CMR study. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Guala A. received funding from the Spanish Ministry of Science, Innovation and Universities.
Background
Bicuspid aortic valve (BAV), a congenital heart defect, is associated with ascending aorta dilation, possibly via alteration of aortic blood flow [1]. In BAV abnormal flow condition have been associated with aortic extracellular matrix dysregulation and elastic fiber degeneration [2]. Current morphological classification of BAV patients with aortic valve with a single fusion between two adjacent leaflets does not allow for risk stratification.
Purpose
This research work tested whether the extent of fusion between leaflets is related to AAo diameter and flow alterations.
Methods
Ninety BAV patients free from moderate and severe aortic valve disease and with no previous aortic or aortic valve surgery or replacement were prospectively enrolled. A comprehensive magnetic resonance protocol comprised a stack of double-oblique 2D balanced steady-state free-precession (bSSFP) cine CMR of the aortic valve, which was used to measure the length of the fusion between leaflets, a cine CMR at the level of the pulmonary bifurcation to assess aortic diameter and 4D flow MRI sequence to assess flow characteristics and regional stiffness [3]. Jet angle and flow radial displacement, quantifying the extent of flow eccentricity, and systolic flow reversal ratio (SFRR), assessing the relative amount of backward flow during systole, were computed at 8 equidistant planes in the ascending aorta and 4 equidistant planes in the aortic arch [4]. A two-tailed p-value < 0.05 was considered statistically significant.
Results
The length of leaflet fusion varied widely (median 7.7 mm, inter-quartile range [5.5; 10.2]), Table 1). In bivariate analysis, fusion length was also associated to ascending aortic diameter (R = 0.391, p < 0.001), age (R = 0.313, p = 0.005) and body surface area (R = 0.396, p < 0.001). It was also positively related to flow abnormalities: like displacement in the proximal and distal ascending aorta, jet angle in the mid ascending aorta, and SFRR in the ascending aorta and the aortic arch (see Figure 1). The association between fusion length and ascending aorta diameter persisted in multivariate analysis after correction for age (p = 0.006).
Conclusions
Bicuspid aortic valve fusion extent varies greatly and it is associated with aortic diameter, possibly through flow alterations. Prospective longitudinal studies are needed to establish whether fusion length may allow for risk stratification in bicuspid aortic valve patients.
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Affiliation(s)
- A Guala
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - L Dux-Santoy
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Galian
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - K Johnson
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - O Wieben
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - A Sao-Aviles
- University Hospital Vall d"Hebron, Barcelona, Spain
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Ruiz Munoz A, Guala A, Rodriguez-Palomares JF, Dux-Santoy L, Servato L, Lopez-Sainz A, La Mura L, Gonzalez-Alujas T, Galian-Gay L, Gutierrez L, Johnson K, Wieben O, Ferreira I, Evangelista A, Teixido-Tura G. Aortic rotational flow patterns and stiffness by 4D flow CMR in patients with Loeys-Dietz syndrome compared to healthy volunteers and patients with Marfan syndrome. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.078] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): La Marató de TV3, Instituto de Salud Carlos III through the project and Spanish Ministry of Science, Innovation and Universities.
BACKGROUND
Loeys-Dietz (LDS) and Marfan (MFS) syndromes are rare genetic connective tissue disorders associated with progressive aortic dilation, however, aortic dissections have been observed at lower aortic root diameters in LDS than in MFS. Recent CMR studies in MFS patients reported increased aortic stiffness (1–3) and altered rotational flow (4), but research on aortic flow dynamics and biomechanics in LDS is lacking.
PURPOSE
The aim of this study was to assess rotational aortic flow and aortic stiffness in LDS compared to healthy volunteers (HV) and MFS patients, using 4Dflow CMR.
METHODS
Twenty-one LDS and 44 MFS patients, without previous aortic dissection or surgery, and 43 HV underwent a non-contrast-enhanced 4D flow CMR. Aortic stiffness was quantified at the AAo and DAo using pulse wave velocity (PWV). In-plane rotational flow (IRF), systolic flow reversal ratio (SFRR) (5) and local aortic diameters were obtained at 20 equidistant planes from the ascending (AAo) to the proximal descending aorta (DAo).
RESULTS
LDS patients had lower IRF at the distal AAo and proximal DAo compared to HV (p = 0.053 and 0.004, respectively), once adjusted for age, stroke volume and local aortic diameter; but no differences were found with respect to MFS (Figure). Although SFRR at the proximal DAo was increased in LDS patients compared to both HV (p = 0.037) and MFS populations (p = 0.015), once adjusted for age and aortic diameter, the difference in magnitude was small (Figure). On the other hand, AAo and DAo PWV revealed stiffer aortas in LDS patients compared to HV but no differences versus MFS patients (Table).
CONCLUSIONS
Patients with Loeys-Dietz syndrome showed decreased in-plane rotational flow and abnormally-high regional aortic stiffness compared to healthy controls, and similar hemodynamics and aortic stiffness with respect to patients with Marfan syndrome.
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Affiliation(s)
- A Ruiz Munoz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Guala
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | | - L Dux-Santoy
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Servato
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Lopez-Sainz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L La Mura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | | - L Galian-Gay
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - K Johnson
- University of Wisconsin, Wisconsin, United States of America
| | - O Wieben
- University of Wisconsin, Wisconsin, United States of America
| | - I Ferreira
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - G Teixido-Tura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
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Hendry J, Ali S, Ahmed O, Chalchal H, El-Gayed A, Haider K, Iqbal N, Johnson K, Le D, Maas B, Manna M, Pauls M, Salim M, Sami A, Wright P, Younis M, Ahmed S. 59P Outcomes of women HER2 positive T1a/bN0M0 breast cancer treated with adjuvant trastuzumab: A retrospective population-based cohort study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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42
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Patel PG, Keen P, McManus H, Duck T, Callander D, Selvey C, Power C, Gray RT, Knight V, Asselin J, Read P, Johnson K, Bavinton BR, Bowden VJ, Grulich AE, Guy R. Increased targeted HIV testing and reduced undiagnosed HIV infections among gay and bisexual men. HIV Med 2021; 22:605-616. [PMID: 33876526 DOI: 10.1111/hiv.13102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 02/17/2021] [Accepted: 02/24/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To evaluate the impact of government HIV strategies that aimed to increase HIV testing uptake and frequency among gay and bisexual men (GBM) in New South Wales (NSW), Australia. DESIGN We analysed HIV testing data from existing passive and sentinel surveillance systems between 2010 and 2018. METHODS Six indicators were measured: (1) state-wide total HIV laboratory tests; (2) number of GBM attending publicly-funded clinics; (3) 12-monthly testing uptake; (4) annual testing frequency; (5) HIV testing with a STI diagnosis; and (6) HIV positivity. Mathematical modelling was used to estimate (7) the proportion of men with undiagnosed HIV. Indicators were stratified by Australian vs. overseas-born. RESULTS Overall, 43,560 GBM attended participating clinics (22,662 Australian-born, 20,834 overseas-born) from 2010-2018. Attendees increased from 5,186 in 2010 to 16,507 in 2018. There were increasing trends (p<0.001 for all) in testing uptake (83.9% to 95.1%); testing with a STI diagnosis (68.7% to 94.0%); annual HIV testing frequency (1.4 to 2.7); and a decreasing trend (p<0.01) in HIV positivity (1.7% to 0.9%).Increases in testing were similar in Australian-born and overseas-born GBM. However, there were decreasing trends in the estimated undiagnosed HIV proportion overall (9.5% to 7.7%) and in Australian-born GBM (7.1% to 2.8%), but an increasing trend in overseas-born GBM (15.3% to 16.9%) (p<0.001 for all).
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Affiliation(s)
- P G Patel
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - P Keen
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - H McManus
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - T Duck
- New South Wales Ministry of Health, Sydney, NSW, Australia
| | - D Callander
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.,New York University Spatial Epidemiology Lab, School of Medicine, New York University, New York, NY, USA
| | - C Selvey
- Health Protection NSW, Sydney, Australia
| | - C Power
- New South Wales Ministry of Health, Sydney, NSW, Australia
| | - R T Gray
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - V Knight
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.,Sydney Sexual Health Centre, Sydney, NSW, Australia
| | - J Asselin
- Burnet Institute, Melbourne, NSW, Australia
| | - P Read
- Kirketon Road Centre, Kings Cross, NSW, Australia
| | | | - B R Bavinton
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - V J Bowden
- Health Protection NSW, Sydney, Australia
| | - A E Grulich
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - R Guy
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Johnson K, Lång K, Ikeda DM, Åkesson A, Andersson I, Zackrisson S. Interval Breast Cancer Rates and Tumor Characteristics in the Prospective Population-based Malmö Breast Tomosynthesis Screening Trial. Radiology 2021; 299:559-567. [PMID: 33825509 DOI: 10.1148/radiol.2021204106] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Interval cancer rates can be used to evaluate whether screening with digital breast tomosynthesis (DBT) contributes to a screening benefit. Purpose To compare interval cancer rates and tumor characteristics in DBT screening to those in a contemporary population screened with digital mammography (DM). Materials and Methods The prospective population-based Malmö Breast Tomosynthesis Screening Trial (MBTST) was designed to compare one-view DBT to two-view DM in breast cancer detection. The interval cancer rates and cancer characteristics in the MBTST were compared with an age-matched contemporary control group, screened with two-view DM at the same center. Conditional logistic regression was used for data analysis. Results There were 14 848 women who were screened with DBT and DM in the MBTST between January 2010 and February 2015. The trial women were matched with two women of the same age and screening occasion at DM screening during the same period. Matches for 13 369 trial women (mean age, 56 years ± 10 [standard deviation]) were found with 26 738 women in the control group (mean age, 56 years ± 10). The interval cancer rate in the MBTST was 1.6 per 1000 screened women (21 of 13 369; 95% CI: 1.0, 2.4) compared with 2.8 per 1000 screened women in the control group (76 of 26 738 [95% CI: 2.2, 3.6]; conditional odds ratio, 0.6 [95% CI: 0.3, 0.9]; P = .02). The invasive interval cancers in the MBTST and in the control group showed in general high Ki-67 (63% [12 of 19] and 75% [54 of 72]), and low proportions of luminal A-like subtype (26% [five of 19] and 17% [12 of 72]), respectively. Conclusion The reduced interval cancer rate after screening with digital breast tomosynthesis compared with a contemporary age-matched control group screened with digital mammography might translate into screening benefits. Interval cancers in the trial generally had nonfavorable characteristics. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Mann in this issue.
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Affiliation(s)
- Kristin Johnson
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, Malmö 20502, Sweden (K.J., K.L., I.A., S.Z.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (D.M.I.); and Clinical Studies Sweden-Forum South, Skåne University Hospital, Lund, Sweden (A.Å.)
| | - Kristina Lång
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, Malmö 20502, Sweden (K.J., K.L., I.A., S.Z.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (D.M.I.); and Clinical Studies Sweden-Forum South, Skåne University Hospital, Lund, Sweden (A.Å.)
| | - Debra M Ikeda
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, Malmö 20502, Sweden (K.J., K.L., I.A., S.Z.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (D.M.I.); and Clinical Studies Sweden-Forum South, Skåne University Hospital, Lund, Sweden (A.Å.)
| | - Anna Åkesson
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, Malmö 20502, Sweden (K.J., K.L., I.A., S.Z.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (D.M.I.); and Clinical Studies Sweden-Forum South, Skåne University Hospital, Lund, Sweden (A.Å.)
| | - Ingvar Andersson
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, Malmö 20502, Sweden (K.J., K.L., I.A., S.Z.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (D.M.I.); and Clinical Studies Sweden-Forum South, Skåne University Hospital, Lund, Sweden (A.Å.)
| | - Sophia Zackrisson
- From the Department of Translational Medicine, Diagnostic Radiology, Lund University, Skåne University Hospital, Carl Bertil Laurells gata 9, Malmö 20502, Sweden (K.J., K.L., I.A., S.Z.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (D.M.I.); and Clinical Studies Sweden-Forum South, Skåne University Hospital, Lund, Sweden (A.Å.)
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Houssami N, Hofvind S, Soerensen AL, Robledo KP, Hunter K, Bernardi D, Lång K, Johnson K, Aglen CF, Zackrisson S. Interval breast cancer rates for digital breast tomosynthesis versus digital mammography population screening: An individual participant data meta-analysis. EClinicalMedicine 2021; 34:100804. [PMID: 33997729 PMCID: PMC8102709 DOI: 10.1016/j.eclinm.2021.100804] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Digital breast tomosynthesis (DBT) improves breast cancer (BC) detection compared to mammography, however, it is unknown whether this reduces interval cancer rate (ICR) at follow-up. METHODS Using individual participant data (IPD) from DBT screening studies (identified via periodic literature searches July 2016 to November 2019) we performed an IPD meta-analysis. We estimated ICR for DBT-screened participants and the difference in pooled ICR for DBT and mammography-only screening, and compared interval BC characteristics. Two-stage meta-analysis (study-specific estimation, pooled synthesis) of ICR included random-effects, adjusting for study and age, and was estimated in age and density subgroups. Comparative screening sensitivity was calculated using screen-detected and interval BC data. FINDINGS Four prospective DBT studies, from European population-based programs, contributed IPD for 66,451 DBT-screened participants: age-adjusted pooled ICR was 13.17/10,000 (95%CI: 8.25-21.02). Pooled ICR was higher in the high-density (21.08/10,000; 95%CI: 6.71-66.27) than the low-density (8.63/10,000; 95%CI: 5.25-14.192) groups (P = 0.03) however estimates did not differ across age-groups (P = 0.32). Based on two studies that also provided data for 153,800 mammography screens (age-adjusted ICR 17.69/10,000; 95%CI: 13.22-23.66), DBT's pooled ICR was 16.83/10,000 (95%CI: 11.89-23.82). Comparative meta-analysis showed a non-significant difference in ICR (-0.44/10,000; 95%CI: -11.00-10.11) and non-significant difference in screening sensitivity (6.79%; 95%CI: -0.73-14.87%) between DBT and DM but a significant pooled difference in cancer detection rate of 33.49/10,000 (95%CI: 23.88-43.10). Distribution of interval BC prognostic characteristics did not differ between screening modalities except that those occurring in DBT-screened participants were significantly more likely to be negative for axillary-node metastases (P = 0.005). INTERPRETATION Although heterogeneity in ICR estimates and few datasets limit recommendations, there was no difference between DBT and mammography in pooled ICR despite DBT increasing cancer detection.
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Affiliation(s)
- Nehmat Houssami
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Corresponding author.
| | - Solveig Hofvind
- Section of Breast Screening, Cancer Registry of Norway, Oslo, Norway
| | - Anne L. Soerensen
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Kristy P. Robledo
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Kylie Hunter
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Daniela Bernardi
- Breast Imaging and Screening Unit, Department of Radiology, Humanitas Research Hospital, Milan, Italy
| | - Kristina Lång
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Kristin Johnson
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Camilla F. Aglen
- Section of Breast Screening, Cancer Registry of Norway, Oslo, Norway
| | - Sophia Zackrisson
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Skane University Hospital, Malmö, Sweden
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Andrahennadi S, Sami A, Haider K, Chalchal H, Le D, Iqbal N, Ahmed O, Salim M, Manna M, Elgayed A, Wright P, Johnson K, Ahmed S. Efficacy of fulvestrant in hormone refractory metastatic breast cancer (mBC): a Canadian province experience. Breast 2021. [DOI: 10.1016/s0960-9776(21)00144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Guala A, Dux-Santoy L, Teixido-Tura G, Ruiz-Munoz A, Lopez-Sainz A, La Mora L, Galian L, Gutierrez L, Valente F, Gonzalez-Alujas T, Johnson K, Wieben O, Ferreira I, Evangelista A, Rodriguez-Palomares J. Regional curvature in thoracic aortic aneurysms of different aetiologies and its relationship with established risk factors. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spanish Ministry of Science, Innovation and Universities ; Instituto de Salud Carlos III
Introduction
The aorta is a 3D hollow, curvilinear elastic structure whose diseases have life-threatening consequences. Despite much effort has been paid to study aortic diameter, diameter is a poor predictor of events. Conversely, much less is known about aortic curvature, its distribution in the thoracic aorta and the potential impact of risk factors in aneurysms associated with different conditions. Currently, 4D flow magnetic resonance imaging (4D flow CMR) allows to obtain 3D geometry, 4D flow data and regional aortic stiffness.
Purpose
We aim to study regional aortic curvature in thoracic aorta aneurysms of different aetiologies and define its relationship with established risk factors.
Methods
One-hundred twenty patients (40 for each group, selected out of prospective cohorts of 156 bicuspid aortic valve – BAV-, 77 Marfan –MFS- and 67 patients with a degenerative aneurysm – TAVdeg-) were matched for age, sex and BSA via propensity score with 40 healthy volunteers (HV). The thoracic aorta was semi-automatically segmented from angiograms and the centreline was computed. Local curvature was assessed at 20 planes covering the thoracic aorta from the sinotubular junction to the proximal descending aorta (DAo) at the level of the pulmonary artery bifurcation. Local curvature was normalized by subject mean thoracic aorta curvature. Length was measured as centreline length. Aortic stiffness was measured in the DAo by pulse wave velocity (PWV). Aneurysm was defined by z-score ≥ 2 using diameters measured by double-oblique cine CMR.
Results
Matching was successful in all groups with the exception of a residual age difference between HV and TAVdeg. Curvature in HV showed a fairly smooth transition between the straighter ascending aorta (AAo) and DAo to a more curved aortic arch, with a peak in the mid aortic arch (Figure 1A). Conversely, all patients’ groups presented a peak in curvature in the proximal DAo and a decreased local curvature in the aortic arch and mid DAo close to the level of the pulmonary artery. BAV and TAVdeg patients showed also increased curvature in the mid AAo, were dilation is prevalent. Conversely, in the same area MFS showed a reduced curvature and limited prevalence of aneurysm. In the overall population, age, AAo and root diameters, mean blood pressure, DAo PWV and aortic length, all established risk factors for aortic events, were inversely related to curvature in the distal AAo and aortic arch (Figure 1B).
Conclusions
Aneurysms related to different aetiologies show similar abnormalities in aortic curvature, with limited curvature in the aortic arch and a peak soon after the third supra-aortic vessel. Age, aortic diameter, length, stiffness and blood pressure, all known risk factors, are all related to reduced curvature in the distal ascending aorta and aortic arch.
Abstract Figure.
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Affiliation(s)
- A Guala
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - A Ruiz-Munoz
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - L La Mora
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Galian
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - K Johnson
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - O Wieben
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - I Ferreira
- University Hospital Vall d"Hebron, Barcelona, Spain
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Aisen PS, Bateman RJ, Carrillo M, Doody R, Johnson K, Sims JR, Sperling R, Vellas B. Platform Trials to Expedite Drug Development in Alzheimer's Disease: A Report from the EU/US CTAD Task Force. J Prev Alzheimers Dis 2021; 8:306-312. [PMID: 34101788 PMCID: PMC8136263 DOI: 10.14283/jpad.2021.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A diverse range of platforms has been established to increase the efficiency and speed of clinical trials for Alzheimer's disease (AD). These platforms enable parallel assessment of multiple therapeutics, treatment regimens, or participant groups; use uniform protocols and outcome measures; and may allow treatment arms to be added or dropped based on interim analyses of outcomes. The EU/US CTAD Task Force discussed the lessons learned from the Dominantly Inherited Alzheimer's Network Trials Unit (DIAN-TU) platform trial and the challenges addressed by other platform trials that have launched or are in the planning stages. The landscape of clinical trial platforms in the AD space includes those testing experimental therapies such as DIAN-TU, platforms designed to test multidomain interventions, and those designed to streamline trial recruitment by building trial-ready cohorts. The heterogeneity of the AD patient population, AD drugs, treatment regimens, and analytical methods complicates the design and execution of platform trials, yet Task Force members concluded that platform trials are essential to advance the search for effective AD treatments, including combination therapies.
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Affiliation(s)
- P S Aisen
- P.S. Aisen, University of Southern California Alzheimer's Therapeutic Research Institute, San Diego, CA, USA,
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Sturesdotter L, Sandsveden M, Johnson K, Larsson AM, Zackrisson S, Sartor H. Mammographic tumour appearance is related to clinicopathological factors and surrogate molecular breast cancer subtype. Sci Rep 2020; 10:20814. [PMID: 33257731 PMCID: PMC7705680 DOI: 10.1038/s41598-020-77053-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 11/05/2020] [Indexed: 11/12/2022] Open
Abstract
Mammographic tumour appearance may provide prognostic useful information. For example, spiculation indicates invasiveness, but also better survival compared to tumours with other appearances. We aimed to study the relationship between mammographic tumour appearance and established clinicopathological factors, including surrogate molecular breast cancer subtypes, in the large Malmö Diet and Cancer Study. A total of 1116 women with invasive breast cancer, diagnosed between 1991 and 2014, were included. Mammographic tumour appearance in relation to status for oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2, histological grade, Ki67 and molecular subtype was analysed using various regression models. All models were adjusted for relevant confounders, including breast density, which can affect mammographic appearance. The results consistently showed that spiculated tumours are indicative of favourable characteristics, as they are more likely to be ER and PR positive, and more often exhibit lower histological grade and lower Ki67 expression. Furthermore, spiculated tumours tend to be of luminal A-like subtype, which is associated with a good prognosis. The establishment of associations between mammographic tumour appearance and clinicopathological factors may aid in characterizing breast cancer at an earlier stage. This could contribute to more individualized breast cancer treatment in the future.
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Affiliation(s)
- Li Sturesdotter
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Lund, Sweden. .,Department of Medical Imaging and Physiology, Skåne University Hospital, Lund/Malmö, Sweden.
| | - Malte Sandsveden
- Department of Clinical Sciences Malmö, Surgery, Lund University, Lund, Sweden.,Department of Surgery, Skåne University Hospital, Malmö, Sweden
| | - Kristin Johnson
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Lund, Sweden.,Department of Medical Imaging and Physiology, Skåne University Hospital, Lund/Malmö, Sweden
| | - Anna-Maria Larsson
- Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden.,Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Sophia Zackrisson
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Lund, Sweden.,Department of Medical Imaging and Physiology, Skåne University Hospital, Lund/Malmö, Sweden
| | - Hanna Sartor
- Department of Translational Medicine, Diagnostic Radiology, Lund University, Lund, Sweden.,Department of Medical Imaging and Physiology, Skåne University Hospital, Lund/Malmö, Sweden
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Krittanawong C, Narasimhan B, Hahn J, Wang Z, Johnson K, Tang W, Baber U, Amos C. A genome-wide association study identifies novel genetic loci associated with pulmonary embolism. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary embolism (PE) is a life-threatening cardiovascular condition. Studies showed that PE patients were associated with disorders of lipid metabolism and had higher triglyceride and lower HDL-C levels compared with healthy. We conducted the genome-wide association study to identify novel loci contributing to PE.
Methods
We conducted a large-scale GWAS of PE in 5,466 PE cases and 461,219 controls of European ancestry from the UK Biobank (466,685 participants total). We used genome-wide summary statistics to test for enrichment of functional annotations using ENRICHR. Example pathways included in Enrichr for testing include membership of genes in pathway databases such as the Kyoto Encyclopedia of Genes and Genomes (KEGG), Wikipathway, PANTHER, BioCarta or NCI-Nature pathways. We analyzed the pathways using combined score and p-values which were well validated by comparing to several methods. For pathway analyses, we considered a nominal P-value threshold of 0.05.
Results
We identified genome-wide significant genetic associations in 63 independent genetic loci for PE (P<5.0x10–7). Our findings for top pathways highlight that lipid metabolism (LIPC, LCAT, NPC2), caffeine metabolism (NAT2), and sudden cardiac death (ABCG8) related genetic loci play an important role in PE alongside genes already associated with coagulation-thrombosis pathway (VWF, THPO, PTPN11, INPP5D, UROS, HMBS) (all p-values p-values <0.05).
Conclusion
Our findings uncovered unexpected novel factors of PE etiology, suggesting novel mechanistic concepts of PE pathophysiology.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Krittanawong
- Baylor College of Medicine, Houston, United States of America
| | - B Narasimhan
- Mount Sinai School of Medicine, New York, United States of America
| | - J Hahn
- Baylor College of Medicine, Houston, United States of America
| | - Z Wang
- Mayo Clinic, Rochester, United States of America
| | - K Johnson
- Mount Sinai School of Medicine, New York, United States of America
| | - W Tang
- Baylor College of Medicine, Houston, United States of America
| | - U Baber
- Mount Sinai School of Medicine, New York, United States of America
| | - C Amos
- Baylor College of Medicine, Houston, United States of America
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50
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Barnes J, Srivastava A, Johnson K, Perkins S. Risk of Suicide Among Survivors of Childhood Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1463] [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: 11/24/2022]
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