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Shields W, Dong Y, Jager L, Shiang E, Frattaroli S, Omaki E. Using the NEISS database to understand pressure cooker related injuries in the USA. Inj Prev 2023; 29:506-510. [PMID: 37666516 DOI: 10.1136/ip-2023-044910] [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: 03/25/2023] [Accepted: 08/02/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE To determine the incidence of pressure cooker related injuries in US hospital emergency departments. To quantify injury patterns associated with pressure cookers and inform prevention recommendation messaging. METHODS The National Electronic Injury Surveillance System (NEISS) was queried to identify injuries associated with pressure cookers between 1 January 2003 and 31 December 2019. Case narratives were reviewed to identify precipitating or contributing factors of pressure cooker related injuries. Negative binomial regression was employed to test for trends over time. RESULTS The NEISS query identified 759 actual pressure cooker injuries between 2003 and 2019, yielding a national estimate of 28 337 (95% CI 24 588 to 32,086) injuries treated in US emergency departments, 1667 cases annually. Analysis of case narratives resulted in the identification of four predominant precipitating or contributing factors to injury: burning agent, struck by product, injured while opening and other. CONCLUSION NEISS is a valuable tool for determining injury incidence and understanding common injury patterns associated with specific products. Consumers and manufacturers of pressure cookers can develop safety strategies targeted at preventing the product's main injury risks.
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Affiliation(s)
- Wendy Shields
- Center for Injury Research and Policy, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yanan Dong
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Leah Jager
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Evelyn Shiang
- Center for Injury Research and Policy, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shannon Frattaroli
- Center for Injury Research and Policy, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elise Omaki
- Center for Injury Research and Policy, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Barbur I, Etchill EW, Giuliano K, McGoldrick MT, Jager L, Whitman G, Kilic A. Heart Allocation Change and Multiple Temporary Circulatory Support as Bridge-to-Bridge. J Surg Res 2023; 285:35-44. [PMID: 36640608 DOI: 10.1016/j.jss.2022.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/13/2022] [Accepted: 12/24/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION We investigated how the 2018 Organ Procurement and Transplantation Network heart allocation policy change was associated with changes in characteristics and outcomes of candidates receiving multiple temporary mechanical circulatory support (mtMCS) devices. MATERIALS AND METHODS We included adult heart transplant candidates listed October 2014-January 2018 and October 2018-January 2022 in the United Network of Organ Sharing dataset. Prepolicy and postpolicy mtMCS recipients were compared at listing, transplant, 90-days, and 1-year post-transplant. Time between first and second devices and time between first device and transplant were modeled via multivariable linear regression. Transplantation likelihood was modeled using competing risks analysis. RESULTS Postpolicy, a higher proportion of transplant candidates received mtMCS (4% versus 1%, P < 0.001), and received their second device an adjusted 49 d sooner versus prepolicy (P = 0.001). Time to transplant was also an adjusted 35 d shorter postpolicy, with an 80% increased transplantation likelihood versus prepolicy (95% confidence interval: 1.6-1.9, P < 0.001). Postpolicy patients experienced reduced waitlist mortality (8% versus 14%, P = 0.04) with marked improvements in 90-day (93% versus 85%, P < 0.001) and 1-year (88% versus 70%, P = 0.01) post-transplant survival. CONCLUSIONS Postpolicy mtMCS recipients are more likely to progress to transplantation sooner on the waitlist and their shorter waitlist course together with earlier change to a secondary device was associated with improved post-transplant survival versus prepolicy.
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Affiliation(s)
- Iulia Barbur
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Eric W Etchill
- Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Katherine Giuliano
- Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | | | - Leah Jager
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Glenn Whitman
- Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Ahmet Kilic
- Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, Maryland.
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Jager L, Jennings LJ, Blanco J, Choy B, Nayar R. Supernatant Fluid from Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Rapid Next-Generation Sequencing. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction/Objective
The aims of our study were to optimize the workflow of non-small cell carcinoma (NSCC) endobronchial ultrasound-guided bronchoscopy with transbronchial needle aspiration (EBUS-TBNA) samples to maximize tissue available for next-generation sequencing (NGS), preserve formalin-fixed paraffin-embedded (FFPE) cell blocks (CBs) for future testing, and shorten turnaround time (TAT) of NGS results. We evaluated the performance of supernatant fluid (SNF) processed from a dedicated aspirate for NGS testing.
Methods/Case Report
20 EBUS-TBNA samples positive for NSCC on rapid on-site evaluation were collected and processed using a new workflow (Figure 1). Five aspirates were collected in formalin. One additional dedicated pass was collected fresh and centrifuged. The resulting cell pellet was added to the passes in formalin for FFPE CB processing. The SNF was recentrifuged. DNA and RNA were extracted from concentrated SNF for targeted testing using the Oncomine™ Precision Assay (Thermo Scientific™, Waltham, MA). NGS results from the corresponding FFPE CBs were used as “controls” for comparison.
Results (if a Case Study enter NA)
A total of 31 mutations were detected in SNF (Table 1). The most frequently mutated genes were TP53 (35%), EGFR (23%), KRAS (13%), CTNNB1 (6%), and ERBB2 (6%). EGFR and KRAS amplification, CDKN2A deletion, and SQSTM1-NTRK3 fusion alteration were also detected. There was 100% concordance between the mutations detected in SNF and corresponding FFPE CBs with comparable variant allele frequencies. TAT of NGS results was 1 day for SNF compared to 4 – 10 days for FFPE CB.
Conclusion
In our study, we were able to demonstrate the usefulness of NGS on SNF to provide reliable, rapid molecular results. This testing strategy was successfully incorporated into the workflow for tissue handling and processing between our clinical, cytopathology, and molecular teams. Molecular results were available at the same time as the cytologic diagnosis, allowing for timely reporting of a comprehensive diagnosis. This approach is particularly useful in patients with advanced disease requiring urgent management.
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Affiliation(s)
- L Jager
- Department of Pathology, Northwestern University Feinberg School of Medicine , Chicago, Illinois , United States
| | - L J Jennings
- Department of Pathology, Northwestern University Feinberg School of Medicine , Chicago, Illinois , United States
| | - J Blanco
- Department of Pathology, Northwestern University Feinberg School of Medicine , Chicago, Illinois , United States
| | - B Choy
- Department of Pathology, Northwestern University Feinberg School of Medicine , Chicago, Illinois , United States
| | - R Nayar
- Department of Pathology, Northwestern University Feinberg School of Medicine , Chicago, Illinois , United States
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Mohapatra S, Sankaramangalam K, Lopimpisuth C, Moninuola O, Simons M, Nanavati J, Jager L, Goldstein D, Broder A, Akshintala V, Chowdhury R, Parian A, Lazarev MG, Ngamruengphong S. Advanced endoscopic resection for colorectal dysplasia in inflammatory bowel disease: a meta-analysis. Endosc Int Open 2022; 10:E593-E601. [PMID: 35571465 PMCID: PMC9106415 DOI: 10.1055/a-1784-7063] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 11/26/2021] [Indexed: 11/03/2022] Open
Abstract
Background and study aims Little is known about outcomes of advanced endoscopic resection (ER) for patients with inflammatory bowel disease (IBD) with dysplasia. The aim of our meta-analysis was to estimate the safety and efficacy of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for dysplastic lesions in patients with IBD. Methods We performed a systematic review through Jan 2021 to identify studies of IBD with dysplasia that was treated by EMR or ESD. We estimated the pooled rates of complete ER, adverse events, post-ER surgery, and recurrence. Proportions were pooled by random effect models. Results Eleven studies including 506 patients and 610 lesions were included. Mean lesion size was 23 mm. The pooled rate of complete ER was 97.9 % (95 % confidence interval [CI]: 95.3 % to 99.7 %). The pooled rate of endoscopic perforation was 0.8 % (95 % CI:0.1 % to 2.2 %) while bleeding occurred in 1.6 % of patients (95 %CI:0.4 % to 3.3 %). Overall, 6.6 % of patients (95 %CI:3.6 % to 10.2 %) underwent surgery after an ER. Among 471 patients who underwent surveillance, local recurrence occurred in 4.9 % patients (95 % CI:1.0 % to 10.7 %) and metachronous lesions occurred in 7.4 % patients (95 %CI:1.5 % to 16 %) over a median follow-up of 33 months. Metachronous colorectal cancer (CRC) was detected in 0.2 % of patients (95 %CI:0 % to 2.2 %) during the surveillance period. Conclusions Advanced ER is safe and effective in the management of large dysplastic lesions in IBD and warrants consideration as first-line therapy. Although the risk of developing CRC after ER is low, meticulous endoscopic surveillance is crucial to monitor for local or metachronous recurrence of dysplasia.
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Affiliation(s)
- Sonmoon Mohapatra
- Division of Gastroenterology and Hepatology, Saint Peter’s University Hospital – Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, United States,Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
| | - Kesavan Sankaramangalam
- Division of Gastroenterology and Hepatology, Saint Peter’s University Hospital – Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, United States
| | - Chawin Lopimpisuth
- Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
| | - Oluwatoba Moninuola
- Division of Gastroenterology and Hepatology, Saint Peter’s University Hospital – Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, United States
| | - Malorie Simons
- Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
| | - Julie Nanavati
- Welch Medical Library, Johns Hopkins University, Baltimore, Maryland, United States
| | - Leah Jager
- Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland, United States
| | - Debra Goldstein
- Division of Gastroenterology and Hepatology, Saint Peter’s University Hospital – Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, United States
| | - Arkady Broder
- Division of Gastroenterology and Hepatology, Saint Peter’s University Hospital – Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, United States
| | - Venkata Akshintala
- Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
| | - Reezwana Chowdhury
- Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
| | - Alyssa Parian
- Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
| | - Mark G. Lazarev
- Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
| | - Saowanee Ngamruengphong
- Department of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
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Daimee UA, Akhtar T, Boyle TA, Jager L, Arbab-Zadeh A, Marine JE, Berger RD, Calkins H, Spragg DD. Repeat catheter ablation for recurrent atrial fibrillation: Electrophysiologic findings and clinical outcomes. J Cardiovasc Electrophysiol 2021; 32:628-638. [PMID: 33410561 DOI: 10.1111/jce.14867] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/04/2020] [Accepted: 12/19/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Atrial fibrillation (AF) ablation is successful in 60%-80% of optimal candidates, with many patients requiring repeat procedures. We performed a detailed examination of electrophysiologic findings and clinical outcomes associated with first repeat AF ablations in the era of contact force-sensing radiofrequency (RF) catheters. METHODS We retrospectively studied patients who underwent their first repeat AF ablations for symptomatic, recurrent AF at our center between 2013 and 2019. All repeat ablations were performed using contact force-sensing RF catheters. Pulmonary vein (PV) reconnections at repeat ablation and freedom from atrial arrhythmia 1 year after repeat ablation were evaluated. We further assessed these findings based on AF classification at the time of presentation for repeat ablation, index RF versus cryoballoon (CB) ablation, and duration (≥3 versus <3 years) between index and repeat procedures. RESULTS Among 300 patients, there were 136 (45.3%) who presented for their first repeat ablations in persistent AF. During repeat ablation, at least one PV reconnection was found in 257 (85.6%) patients, while 159 (53%) had three to four reconnections. There was a similar distribution of reconnections among patients with persistent versus paroxysmal AF (mean: 2.7 ± 1.3 vs. 2.9 ± 1.2; p = .341), index RF versus CB ablation (mean: 2.8 ± 1.3 vs. 2.9 ± 1.2; p = .553), and ≥3 versus <3 years between index and repeat procedures (mean: 3.0 ± 1.1 vs. 2.7 ± 1.3; p = .119). At repeat ablation, the PVs were re-isolated in all patients, and additional non-PV ablation was performed in 171 (57%) patients. Freedom from atrial arrhythmia at 1-year follow-up after repeat ablation was 66%, similar among those with persistent versus paroxysmal AF (65.4% vs. 66.5%; p = .720), index RF versus CB ablation (66.7% vs. 68.9%; p = .930), and ≥3 versus <3 years between index and repeat ablations (64.4% vs. 66.7%; p = .760). Major complications occurred in a total of 4 (1.3%) patients. CONCLUSION In a contemporary cohort of patients receiving their first repeat AF ablations using contact force-sensing RF catheters, PV reconnections were common, and freedom from atrial arrhythmia was 66% at 1-year follow-up. The distributions of PV reconnections and rates of freedom from atrial arrhythmia were similar, based on persistent versus paroxysmal AF at presentation for repeat ablation, index RF versus CB ablation, and duration between index and repeat procedures. The incidence of major complications was very low.
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Affiliation(s)
- Usama A Daimee
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Tauseef Akhtar
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Thomas A Boyle
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Leah Jager
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Armin Arbab-Zadeh
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joseph E Marine
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ronald D Berger
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hugh Calkins
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David D Spragg
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Aboumatar H, Naqibuddin M, Neiman J, Saunders J, Kim S, Chaudhry H, Garcia-Morales E, Robinson N, McBurney M, Jager L, Ajayi T, Bone L, Chung S, Farrell B, Joo Jin H, Linnell J, Pirfo M, Rand C, Riley P, Salvaterra C, Shea K, Singh J, Wise R. Methodology and baseline characteristics of a randomized controlled trial testing a health care professional and peer-support program for patients with chronic obstructive pulmonary disease: The BREATHE2 study. Contemp Clin Trials 2020; 94:106023. [PMID: 32360887 DOI: 10.1016/j.cct.2020.106023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Self-management support (SMS) for patients with COPD can improve health-related quality of life (HRQOL). However, it remains unclear what SMS strategies are most effective. Using peer support to advance self-management is promising, as peer supporters possess credibility and can serve as role models. METHODS We conducted a single-blinded RCT comparing the effectiveness of two strategies to support patients with COPD. The strategies were 'Health Care Professional (HCP)' and 'HCP Plus Peer' support. Peer support was provided by patients with COPD who have stopped smoking, completed an acute pulmonary rehabilitation program, and met the requirements for becoming a peer supporter. We enrolled patients receiving treatment at inpatient and outpatient settings. Patients were encouraged to invite one family-caregiver to enroll with them. The primary outcome measure was the change in HRQOL at 6 months post enrollment. Secondary outcomes included COPD-related and all-cause hospitalizations and ED visits. Caregiver outcomes included preparedness for caregiving, caregiver stress, and coping. RESULTS A total of 292 patients as well as 50 family-caregivers were enrolled. The average patient age was 67.3 yrs. (SD 9.4), 61% were female and 26% were African-Americans. The majority of caregivers were females (68%) and were a spouse/partner (58%). DISCUSSION This study tested a dual strategy for providing support to patients with COPD that incorporates peer and health care professional support. The study had minimal exclusion criteria. If shown effective, the study offers a program of peer support that can be readily implemented in health care settings.
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Affiliation(s)
- Hanan Aboumatar
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, 601 North Caroline Street, Suite 2080, Baltimore, MD 21205, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Baltimore, MD 21287, USA.
| | - Mohammad Naqibuddin
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Joseph Neiman
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA; Department of Internal Medicine, Hackensack University Medical Center, 30 Prospect Avenue, Hackensack, NJ 07601, USA
| | - Jamia Saunders
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Samuel Kim
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Hina Chaudhry
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Emmanuel Garcia-Morales
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA; Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Nancy Robinson
- Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224, USA
| | - Marjorie McBurney
- Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224, USA
| | - Leah Jager
- Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Tokunbo Ajayi
- Howard County General Hospital, 5755 Cedar Lane, Columbia, MD 21044, USA
| | - Lee Bone
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, 601 North Caroline Street, Suite 2080, Baltimore, MD 21205, USA
| | - Suna Chung
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Baltimore, MD 21287, USA
| | - Bernard Farrell
- Howard County General Hospital, 5755 Cedar Lane, Columbia, MD 21044, USA
| | - Hui Joo Jin
- Department of Psychiatry, Johns Hopkins School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - John Linnell
- BREATHE2 Study, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Marlene Pirfo
- Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224, USA
| | - Cynthia Rand
- Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
| | - Peggy Riley
- BREATHE2 Study, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Carmen Salvaterra
- Pulmonary Disease & Critical Care Medicine, Johns Hopkins Community Physicians, 11085 Little Patuxent Parkway, Columbia, MD 21044, USA
| | - Kai Shea
- Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224, USA
| | - Jorawar Singh
- Howard County General Hospital, 5755 Cedar Lane, Columbia, MD 21044, USA
| | - Robert Wise
- Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
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Myint L, Hadavand A, Jager L, Leek J. Comparison of beginning R students' perceptions of peer-made plots created in two plotting systems: a randomized experiment. J Stat Educ 2019; 28:98-108. [PMID: 33762806 PMCID: PMC7986299 DOI: 10.1080/10691898.2019.1695554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We performed an empirical study of the perceived quality of scientific graphics produced by beginning R users in two plotting systems: the base graphics package ("base R") and the ggplot2 add-on package. In our experiment, students taking a data science course on the Coursera platform were randomized to complete identical plotting exercises using either base R or ggplot2. This exercise involved creating two plots: one bivariate scatterplot and one plot of a multivariate relationship that necessitated using color or panels. Students evaluated their peers on visual characteristics key to clear scientific communication, including plot clarity and sufficient labeling. We observed that graphics created with the two systems rated similarly on many characteristics. However, ggplot2 graphics were generally perceived by students to be slightly more clear overall with respect to presentation of a scientific relationship. This increase was more pronounced for the multivariate relationship. Through expert analysis of submissions, we also find that certain concrete plot features (e.g., trend lines, axis labels, legends, panels, and color) tend to be used more commonly in one system than the other. These observations may help educators emphasize the use of certain plot features targeted to correct common student mistakes.
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Affiliation(s)
- Leslie Myint
- Department of Mathematics, Statistics, and Computer Science, Macalester College, 1600 Grand Ave, Saint Paul, MN 55105
| | - Aboozar Hadavand
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21212
| | - Leah Jager
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21212
| | - Jeffrey Leek
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21212
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Thomaier L, Jager L, Tanner E. Assessing the risk of empty lymph node packets in patients undergoing sentinel lymph node mapping for endometrial cancer using indocyanine green dye. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Thomaier L, Jager L, Stone R, Wethington S, Fader A, Tanner EJ. Risk of empty lymph node packets in sentinel lymph node mapping for endometrial cancer using indocyanine green. Int J Gynecol Cancer 2019; 29:513-517. [DOI: 10.1136/ijgc-2019-000215] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 11/04/2022] Open
Abstract
ObjectiveTo determine whether the rate of sentinel lymph node (SLN) dissections that do not yield a lymph node on pathological analysis ('empty packet dissection') changes with increasing surgeon experience in the setting of patients undergoing minimally invasive hysterectomy and SLN mapping using indocyanine green dye for endometrial cancer.MethodsAll patients undergoing SLN mapping using indocyanine green dye at the time of minimally invasive hysterectomy for endometrial cancer or complex atypical hyperplasia were identified between January 2013 and September 2017 at our institution. All surgeons had prior experience performing SLN mapping for endometrial cancer using other methods. The rate of empty packet dissections and SLN counts were evaluated using a logistic regression model analysis.ResultsIn total, 236 patients undergoing SLN mapping for either endometrial cancer (85%) or complex atypical hyperplasia (15%) were identified from a prospectively maintained database. When examining all six surgeons together, the percentage of empty packet dissections decreased with increasing number of procedures performed. Each additional procedure was associated with a 3.6% reduction in the odds of an empty packet SLN dissection. After adjusting for individual surgeons, each additional procedure was associated with a 4.9% reduction in the odds of an empty packet. The expected odds of an empty packet after 10 additional procedures decreased by 40.1% (95% CI 12.4% to 58.6%). The addition of two covariates (age and body mass index) did not contribute significantly to the model (likelihood ratio test: X2=2.75, p=0.25). The rate of empty packets appeared to stabilize after approximately 30 procedures. The number of SLNs removed did not change with increasing surgeon experience.ConclusionThe rate of empty packet SLN dissections using indocyanine green dye decreases with increasing number of procedures. This stabilizes after 30 procedures, suggesting completion of a learning curve.
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Kroegel C, Jager L, Walker C. Is there a place for intrinsic asthma as a distinct immunopathological entity? Eur Respir J 1997. [DOI: 10.1183/09031936.97.10030513] [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: 11/05/2022]
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Fritsch A, Junker U, Vogelsang H, Jager L. On interleukins 4, 6 and 10 and their interrelationship with immunoglobulins G and M in common variable immunodeficiency. Cell Biol Int 1994; 18:1067-75. [PMID: 7894390 DOI: 10.1006/cbir.1994.1030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Following culture of human peripheral blood mononuclear cells (PBMNC) from 25 normal donors and 15 patients with common variable immunodeficiency (CVID), we were unable to identify any IL10-defective patients. Clear-cut effects of IL4 could be demonstrated in controls, while in CVID all effects are less pronounced. While in both controls and CVID baseline levels of IL6, IgG and IgM were found to be correlated, this was altered by the addition of either IL4 or Poke Weed Mitogen (PWM). We therefore conclude that the inability of PBMNC to produce IL10 is not the cause of CVID in our patients. In CVID, the regulating circuitry triggered by IL4 remains principally intact, however, some subgroups of CVID behave significantly differently.
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Affiliation(s)
- A Fritsch
- Institute of Clinical Immunology, F.-Schiller-University, Jena, Germany
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Abstract
The role of chloride channels has been examined in canine tracheal smooth muscle by recording mechanical responses to field stimulation and to acetylcholine (ACh) and by sucrose gap recording of excitatory junction potentials and ACh-induced electrical changes. The results of substitution studies using isethionate for chloride provided evidence that a chloride conductance contributes to the resting potential. The extrapolated reversal potential for ACh-induced depolarization was positive to the resting potential. Isethionate substitution inhibited ACh-induced depolarization, consistent with a contribution from increased Cl- conductance to the depolarization induced by ACh. However, closure of K+ channels and opening of a non-specific cation channel could also contribute to depolarization. Further study of the effects of isethionate substitution during prolonged tissue exposure to chloride-free medium showed that retention or the accumulation of Ca2+ in intracellular stores was impaired. We conclude that effects of chloride deprivation on responses to ACh may reflect an early increase in Cl- conductance, but longer term changes reflect the requirement for this anion to maintain internal Ca2+ stores.
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Affiliation(s)
- E E Daniel
- McMaster University, Department of Biomedical Sciences, Hamilton, ON, Canada
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Jager L. Die Bestimmung des Gesamtstickstoffs mittels Formoltitration. Anal Bioanal Chem 1912. [DOI: 10.1007/bf01452765] [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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15
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Henriques V, Jager L, S�rensen SPL, Jessen-Hansen H, Malfatti H, Spindler O, Bj�rn-Andersen H, Laritzen M, Yoshida T, Frey W, Gigon A. Harn: Formoltitration. Anal Bioanal Chem 1911. [DOI: 10.1007/bf01307172] [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: 10/25/2022]
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