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Stone CA, Yeung K, Shaw L, Billi R. Gambling in Victoria: Changes in Participation, Problem Gambling and Gambling Environment Between 2008 and 2018. J Gambl Stud 2024:10.1007/s10899-024-10282-x. [PMID: 38311695 DOI: 10.1007/s10899-024-10282-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/06/2024]
Abstract
Gambling and its impacts are an important public health issue. The relationship between gambling, problem gambling and gambling harm is complex and dynamic. Replicate prevalence studies are useful for surveillance and monitoring gambling impacts within jurisdictions. The purpose of this study was to compare changes in gambling and problem gambling in the Victorian adult population between 2008 and 2018 by investigating individual gambling activities and exploring their relationship with the Victorian gambling ecosystem. Gambling participation has decreased; problem gambling prevalence has not. Investigation beyond these summary measures reveals important details: (a) Electronic Gaming Machines (EGMs), casino table games, race and sports betting ('high-risk activities'), informal private betting, and Keno, and their associations with problem gambling endure. Further, the strength of this association is unaffected by changes in product technology, delivery, or the Victorian environment in which they reside, (b) participation in high-risk activities, excluding EGMs, increased while for other activities they decreased, (c) EGMs continue to pose the greatest risk for Victorians, (d) males and young adults continue having a higher problem gambling prevalence rate and preferring both online gambling and high-risk activities (excluding racing favoured by an ageing, older cohort, and Keno, by all ages), and (e) gambling access and exposure proliferated enabling single site multiple gambling opportunities on high-risk activities. Young adults represented a new vulnerable group as they reach the legal gambling age. The most effective interventions (based on major falls in real expenditure (losses) on EGMs, the highest risk activity) were the smoking bans, removal of ATMs from venues and decreases in bet size. There is great potential for prevention, intervention, and minimising harm in the gambling environment.
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Affiliation(s)
| | - Kristal Yeung
- Victorian Responsible Gambling Foundation, Melbourne, Victoria, Australia
| | - Lindsay Shaw
- Victorian Responsible Gambling Foundation, Melbourne, Victoria, Australia
| | - Rosa Billi
- Victorian Responsible Gambling Foundation, Melbourne, Victoria, Australia
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Flohr C, Rosala-Hallas A, Jones AP, Beattie P, Baron S, Browne F, Brown SJ, Gach JE, Greenblatt D, Hearn R, Hilger E, Esdaile B, Cork MJ, Howard E, Lovgren ML, August S, Ashoor F, Williamson PR, McPherson T, O'Kane D, Ravenscroft J, Shaw L, Sinha MD, Spowart C, Taams LS, Thomas BR, Wan M, Sach TH, Irvine AD. Efficacy and safety of ciclosporin versus methotrexate in the treatment of severe atopic dermatitis in children and young people (TREAT): a multicentre parallel group assessor-blinded clinical trial. Br J Dermatol 2023; 189:674-684. [PMID: 37722926 DOI: 10.1093/bjd/ljad281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/01/2023] [Accepted: 09/17/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Conventional systemic drugs are used to treat children and young people (CYP) with severe atopic dermatitis (AD) worldwide, but no robust randomized controlled trial (RCT) evidence exists regarding their efficacy and safety in this population. While novel therapies have expanded therapeutic options, their high cost means traditional agents remain important, especially in lower-resource settings. OBJECTIVES To compare the safety and efficacy of ciclosporin (CyA) with methotrexate (MTX) in CYP with severe AD in the TREatment of severe Atopic Eczema Trial (TREAT) trial. METHODS We conducted a parallel group assessor-blinded RCT in 13 UK and Irish centres. Eligible participants aged 2-16 years and unresponsive to potent topical treatment were randomized to either oral CyA (4 mg kg-1 daily) or MTX (0.4 mg kg-1 weekly) for 36 weeks and followed-up for 24 weeks. Co-primary outcomes were change from baseline to 12 weeks in Objective Severity Scoring of Atopic Dermatitis (o-SCORAD) and time to first significant flare (relapse) after treatment cessation. Secondary outcomes included change in quality of life (QoL) from baseline to 60 weeks; number of participant-reported flares following treatment cessation; proportion of participants achieving ≥ 50% improvement in Eczema Area and Severity Index (EASI 50) and ≥ 75% improvement in EASI (EASI 75); and stratification of outcomes by filaggrin status. RESULTS In total, 103 participants were randomized (May 2016-February 2019): 52 to CyA and 51 to MTX. CyA showed greater improvement in disease severity by 12 weeks [mean difference in o-SCORAD -5.69, 97.5% confidence interval (CI) -10.81 to -0.57 (P = 0.01)]. More participants achieved ≥ 50% improvement in o-SCORAD (o-SCORAD 50) at 12 weeks in the CyA arm vs. the MTX arm [odds ratio (OR) 2.60, 95% CI 1.23-5.49; P = 0.01]. By 60 weeks MTX was superior (OR 0.33, 95% CI 0.13-0.85; P = 0.02), a trend also seen for ≥ 75% improvement in o-SCORAD (o-SCORAD 75), EASI 50 and EASI 75. Participant-reported flares post-treatment were higher in the CyA arm (OR 3.22, 95% CI 0.42-6.01; P = 0.02). QoL improved with both treatments and was sustained after treatment cessation. Filaggrin status did not affect outcomes. The frequency of adverse events (AEs) was comparable between both treatments. Five (10%) participants on CyA and seven (14%) on MTX experienced a serious AE. CONCLUSIONS Both CyA and MTX proved effective in CYP with severe AD over 36 weeks. Participants who received CyA showed a more rapid response to treatment, while MTX induced more sustained disease control after discontinuation.
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Affiliation(s)
- Carsten Flohr
- Department of Paediatric Dermatology, St John's Institute of Dermatology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Anna Rosala-Hallas
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
| | - Ashley P Jones
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
| | | | - Susannah Baron
- Department of Paediatric Dermatology, St John's Institute of Dermatology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Fiona Browne
- Paediatric Dermatology, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Sara J Brown
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Joanna E Gach
- University Hospitals Coventry and Warwickshire, Coventry, UK
| | - Danielle Greenblatt
- Department of Paediatric Dermatology, St John's Institute of Dermatology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ross Hearn
- Ninewells Hospital and Medical School, Dundee, UK
| | - Eva Hilger
- Department of Paediatric Dermatology, St John's Institute of Dermatology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ben Esdaile
- Whittington Hospital, Whittington Health NHS Trust, London, UK
| | - Michael J Cork
- Sheffield Children's NHS Foundation Trust and Sheffield Dermatology Research, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Emma Howard
- Department of Paediatric Dermatology, St John's Institute of Dermatology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Marie-Louise Lovgren
- Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Farhiya Ashoor
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
| | - Paula R Williamson
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
| | - Tess McPherson
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Donal O'Kane
- Department of Dermatology, Belfast Health and Social Care Trust, Belfast, UK
| | | | - Lindsay Shaw
- Bristol Royal Hospital for Children, Bristol, UK
| | - Manish D Sinha
- Kings College London, Department of Paediatric Nephrology, Evelina London Children's Hospital, Guy's & St Thomas's Foundation Hospitals NHS Trust, London
| | - Catherine Spowart
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
| | - Leonie S Taams
- Centre for Inflammation Biology and Cancer Immunology, King's College London, UK
| | - Bjorn R Thomas
- Royal Free Hospital and Blizard Institute, Queen Mary University London, UK
| | - Mandy Wan
- Evelina London Children's Hospital, Guys' and St Thomas' NHS Foundation Trust, London, UK
- Institute of Pharmaceutical Science, King's College London, London, UK
| | - Tracey H Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Alan D Irvine
- Paediatric Dermatology, Children's Health Ireland at Crumlin, Dublin, Ireland
- Clinical Medicine, Trinity College Dublin, Ireland
- National Children's Research Centre, Crumlin, Dublin, Ireland
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Rindler K, Drach M, Shaw L, Weninger W, Farlik M, Jonak C, Brunner P. 369 Single-cell RNA sequencing analysis of a COVID-19-associated maculopapular rash in a psoriasis patient treated with ustekinumab. J Invest Dermatol 2022. [PMCID: PMC9672431 DOI: 10.1016/j.jid.2022.09.382] [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: 11/19/2022]
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Alkon N, Drach M, Shaw L, Mann U, Valencak J, Weninger W, Griss J, Farlik M, Jonak C, Brunner P. 437 Single-cell RNA sequencing reveals specific T cell and fibroblast populations that can distinguish early mycosis fungoides from parapsoriasis and atopic dermatitis lesions. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.451] [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: 11/19/2022]
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Kiegaldie D, Pepe A, Shaw L, Evans T. Implementation of a collaborative online international learning program in nursing education: protocol for a mixed methods study. BMC Nurs 2022; 21:252. [PMID: 36076220 PMCID: PMC9458312 DOI: 10.1186/s12912-022-01031-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An essential component of becoming a professional nurse is a perspective of global health issues and an awareness of diverse populations. Collaborative online international learning (COIL) using digital technologies, offers meaningful and rewarding opportunities to develop international partnerships between nurses from other countries, without economic, organisational or geographical barriers. Despite reported advantages of using COIL, few COIL interventions have been identified in the nursing literature. The aims of this study are to develop, implement and evaluate a COIL program between Australian and Canadian pre-registration nursing students. METHODS The study will utilize a mixed methods approach incorporating pre and post-test surveys, focus groups, and semi-structured interviews of key stakeholders. The design will adhere to The State University of New York (SUNY) COIL's criteria for intercultural/international learning opportunities. Participants will be recruited from nursing programs at an Australian Training and Further Education Institute and a Canadian college. Bennett's stages of intercultural competence will provide the theoretical framework for the research. Four specific research interventions will be developed for this project. For students, there will be an online virtual community to allow students and teachers to communicate, socially connect and share resources with each other. Virtual reality simulations will be employed within a virtual global classroom to promote collaborative, intercultural learning. For faculty, a virtual community of practice will provide a platform for faculty to share education and research ideas and participate in collaborate research opportunities. DISCUSSION This study will evaluate the outcomes of a nursing COIL program. It will measure participants' views on COIL, its contribution to student learning, changes in cultural awareness, organisational impact and research productivity. It will provide nursing students with the opportunity to become global leaders in nursing care and for faculty to develop international research skills and outputs. The findings from the study will allow further refinement of future nursing COIL programs.
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Affiliation(s)
- D Kiegaldie
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, VIC, 3189, Moorabbin, Australia.,Eastern Health Clinical School, Monash University, VIC, 3128, Box Hill, Australia.,Healthscope, Holmesglen Private Hospital, 488 South Road, VIC, 3189, Moorabbin, Australia
| | - A Pepe
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, VIC, 3189, Moorabbin, Australia.,Faculty of Health Sciences, School of Behavioural and Health Science, Australian Catholic University, 115 Victoria Parade, VIC, 3065, Fitzroy, Australia
| | - L Shaw
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, VIC, 3189, Moorabbin, Australia. .,ARCH, School Allied Health, Human Services and Sport, La Trobe University, VIC, 3086, Bundoora, Australia.
| | - T Evans
- Department of Nursing Education and Health Studies, Northwestern Polytechnic, Grande Prairie, Alberta, Canada
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Griss JG, Drach M, Thaler F, Shaw L, Mann U, Wagner C, Wagner S, Weninger W, Simonitsch-Klupp I, Farlik M, Jonak C, Brunner PM. Single-cell RNA sequencing analyses of primary cutaneous B-cell disorders reveal distinct molecular patterns consistent with clinical behavior. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00555-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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7
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Alkon N, Drach M, Bangert C, Kurz H, Shaw L, Stingl G, Weninger W, Farlik M, Jonak C, Brunner P. 111 Cellular and molecular profiling of early-stage mycosis fungoides in comparison to parapsoriasis and atopic dermatitis reveals disease-specific biomarkers. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rupawalla Z, Shaw L, Ross IL, Schmidt S, Hankamer B, Wolf J. Germination screen for microalgae-generated plant growth biostimulants. ALGAL RES 2022. [DOI: 10.1016/j.algal.2022.102784] [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: 01/09/2023]
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Tolaney SM, Shaw L. Immunotherapy for the Treatment of Triple-Negative Breast Cancer. J Adv Pract Oncol 2022; 13:298-301. [PMID: 35663156 PMCID: PMC9126339 DOI: 10.6004/jadpro.2022.13.3.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
At JADPRO Live Virtual 2021, Sara M. Tolaney, MD, MPH, and Lindsay Shaw, ANP-BC, AOCNP®, presented on recent clinical trial data for approved immune checkpoint inhibitors and antibody-drug conjugates, and their implications in the current treatment landscape, for metastatic triple-negative breast cancer. Dr. Tolaney and Ms. Shaw also discussed principles of monitoring and managing adverse events associated with immunotherapies.
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Affiliation(s)
| | - Lindsay Shaw
- Dana-Farber Cancer Institute, Boston, Massachusetts
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Shaw L, Rea K, Lachowsky NJ, Roth EA. Magic Mushroom Use: A Qualitative Interview Study of Post-Trip Impacts and Strategies for Optimizing Experiences. J Psychoactive Drugs 2022; 55:151-158. [PMID: 35315749 DOI: 10.1080/02791072.2022.2054746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The field of psychedelic research is undergoing a revival, yet research focused on non-clinical psychedelic use remains relatively limited. The current qualitative study sheds light on how people use magic mushrooms, what they perceive the effects of such use to be, and the meanings that users attach to their magic mushroom experiences. To be eligible to participate in the study, participants were required to be young adults who had used magic mushrooms within the past three months and residents of Victoria, Canada. Semi-structured, one-on-one in-person interviews regarding magic mushroom use habits, culture, knowledge and other factors were conducted with each participant and subsequently analyzed thematically. Participants associated magic mushroom use with lasting impacts on their lives including transformation and learning experiences. Additionally, participants described strategies to optimize their magic mushroom experiences, including engaging in research regarding magic mushrooms as well as making use of peer supports. Furthermore, aspects of magic mushroom experiences conceptualized as harmful in previous studies were described by participants as associated with learning experiences and few harms. Participants' perceived positive outcomes and relatively low risk profile warrants further research to inform how magic mushroom users can maximize potential positive outcomes and also minimize harms.
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Affiliation(s)
- Lindsay Shaw
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kerri Rea
- School of Social Work, University of Victoria, Victoria, BC, Canada
| | - Nathan J Lachowsky
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.,School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Eric Abella Roth
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.,Department of Anthropology, University of Victoria, Victoria, BC, Canada
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Shaw L, Maggs T, Braude P, Shipway D, Srivastava S, Kelly M. 805 UPPER LIMB FRACTURE PATHWAYS IN FRAILTY ENABLE EARLIER RETURN TO FUNCTION WITH ASSOCIATED REDUCED LENGTH OF HOSPITAL STAY. Age Ageing 2022. [DOI: 10.1093/ageing/afac035.805] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Upper limb fractures are the second most common fracture requiring admission to hospital after hip fracture [Jennison, 2019]. At 1-year 20.5% have died, compared to 29.5% in hip fracture [Wiedl, 2021]. Local Problems: At North Bristol Trust most patients with upper limb fractures and a Clinical Frailty Score ≥ 5 are managed non-operatively on medical wards. Local service evaluation identified a long length of stay of 23 days. Case note review revealed: • Delayed transfers of care (DTOCs) had been managed non-weight bearing in slings for 4–6 weeks. • Non-weight bearing status resulted in DTOC due to declined access to social care and rehabilitation due to perceived health needs. • A high rate of hospital-acquired complications and failure to rehabilitate. • Breakdown in interdisciplinary communication and ownership across the pathway.
Methods
A multidisciplinary QI project was commenced. Using local data through business analytics, clinician and patient feedback, a new Trust guideline was developed for older people with frailty and upper limb fractures. Data collected determined average length of stay before and after implementation of the service change. A standard process control chart was created monitoring the effect of the changes in the pathway. The multidisciplinary team met regularly to make alterations during implementation. The resulting intervention included: • Removal of functional restrictions; allow free use of limb as comfort permits. • Simplified slings and minimised light weight casts. • Proactive integration of orthopaedic plan into CGA documentation. • Proactive interdisciplinary communication across pathways. • Patient information leaflets.
Results
Pre-intervention average length of stay was 23 days. Post-intervention was 14 days.
Conclusion
Proactive, structured management of upper limb fractures in people with frailty is associated with significant reduction in acute hospital length of stay. Next steps include a business case for a frailty trauma specialist therapist embedded into medicine.
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Affiliation(s)
- L Shaw
- Frailty Team North Bristol NHS Trust
| | - T Maggs
- Physiotherapy Department North Bristol NHS Trust
| | - P Braude
- Department of Geriatric Medicine North Bristol NHS Trust
| | - D Shipway
- Department of Geriatric Medicine North Bristol NHS Trust
| | | | - M Kelly
- Department of Trauma and Orthopaedic Medicine North Bristol NHS Trust
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Desai Y, Jaki T, Beresford MW, Burnett T, Eleftheriou D, Jacobe H, Leone V, Li S, Mozgunov P, Ramanan AV, Torok KS, Anderson ME, Anton J, Avcin T, Felton J, Foeldvari I, Laguda B, McErlane F, Shaw L, Zulian F, Pain CE. Prior elicitation of the efficacy and tolerability of Methotrexate and Mycophenolate Mofetil in Juvenile Localised Scleroderma. AMRC Open Res 2021; 3:20. [PMID: 38708070 PMCID: PMC11064983 DOI: 10.12688/amrcopenres.13008.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/30/2021] [Indexed: 05/07/2024]
Abstract
Background Evidence is lacking for safe and effective treatments for juvenile localised scleroderma (JLS). Methotrexate (MTX) is commonly used first line and mycophenolate mofetil (MMF) second line, despite a limited evidence base. A head to head trial of these two medications would provide data on relative efficacy and tolerability. However, a frequentist approach is difficult to deliver in JLS, because of the numbers needed to sufficiently power a trial. A Bayesian approach could be considered. Methods An international consensus meeting was convened including an elicitation exercise where opinion was sought on the relative efficacy and tolerability of MTX compared to MMF to produce prior distributions for a future Bayesian trial. Secondary aims were to achieve consensus agreement on critical aspects of a future trial. Results An international group of 12 clinical experts participated. Opinion suggested superior efficacy and tolerability of MMF compared to MTX; where most likely value of efficacy of MMF was 0.70 (95% confidence interval (CI) 0.34-0.90) and of MTX was 0.68 (95% CI 0.41-0.8). The most likely value of tolerability of MMF was 0.77 (95% CI 0.3-0.94) and of MTX was 0.62 (95% CI 0.32-0.84). The wider CI for MMF highlights that experts were less sure about relative efficacy and tolerability of MMF compared to MTX. Despite using a Bayesian approach, power calculations still produced a total sample size of 240 participants, reflecting the uncertainty amongst experts about the performance of MMF. Conclusions Key factors have been defined regarding the design of a future Bayesian approach clinical trial including elicitation of prior opinion of the efficacy and tolerability of MTX and MMF in JLS. Combining further efficacy data on MTX and MMF with prior opinion could potentially reduce the pre-trial uncertainty so that, when combined with smaller trial sample sizes a compelling evidence base is available.
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Affiliation(s)
- Yasin Desai
- MPS Research Unit, Department of Mathematics and Statistics, Lancaster University, Lancaster, LA1 4YF, UK
| | - Thomas Jaki
- MPS Research Unit, Department of Mathematics and Statistics, Lancaster University, Lancaster, LA1 4YF, UK
- MRC Biostatistics Unit, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Michael W Beresford
- Department of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust, Liverpool, L12 2AP, UK
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L69 3BX, UK
| | - Thomas Burnett
- MPS Research Unit, Department of Mathematics and Statistics, Lancaster University, Lancaster, LA1 4YF, UK
| | - Despina Eleftheriou
- University College London Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
- Department of Paediatric Rheumatology, Great Ormond St Hospital NHS Foundation Trust, London, WC1N 3JH, UK
| | - Heidi Jacobe
- UT Southwestern Medical Center, Dallas, Texas, TX 75390, USA
| | - Valentina Leone
- Paediatric Rheumatology Department, Leeds Children Hospital (Leeds Teaching Hospitals) and University of Leeds, Leeds, LS1 3EX, UK
| | - Suzanne Li
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center & Hackensack Meridian School of Medicine, Hackensack, New Jersey, NJ 07601, USA
| | - Pavel Mozgunov
- MPS Research Unit, Department of Mathematics and Statistics, Lancaster University, Lancaster, LA1 4YF, UK
| | - Athimalaipet V Ramanan
- University Hospitals Bristol NHS Foundation Trust & Translational Health Sciences, Bristol, BS1 3NU, UK
| | - Kathryn S Torok
- Division of Rheumatology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Marina E Anderson
- Department of Rheumatology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L9 7AL, UK
- Lancaster Medical School, Lancaster University, Lancaster, LA1 4YF, UK
| | - Jordi Anton
- Pediatric Rheumatology, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Barcelona, 08007, UK
| | - Tadej Avcin
- Department of Allergology, Rheumatology and Clinical Immunology, University Children's Hospital, University Medical Centre, Ljubljana, 1000 Ljubljana, Slovenia
| | - Jessie Felton
- Department of Dermatology, Brighton and Sussex University Hospitals & Royal Alexandra Children’s Hospital, Brighton, BN2 1DH, UK
| | - Ivan Foeldvari
- Hamburg Centre for Pediatric and Adolescence Rheumatology, Hamburg, 22081 Hamburg, Germany
| | - Bisola Laguda
- Department of Paediatric Dermatology, Chelsea and Westminster Hospital, London, SW10 9NH, UK
| | - Flora McErlane
- Department of Paediatric Rheumatology, Great North Children's Hospital, Newcastle, NE1 4LP, UK
| | - Lindsay Shaw
- Department of Paediatric Rheumatology, Great Ormond St Hospital NHS Foundation Trust, London, WC1N 3JH, UK
- University Hospitals Bristol NHS Foundation Trust & Translational Health Sciences, Bristol, BS1 3NU, UK
| | - Francesco Zulian
- Department of Woman's and Child's Health, University of Padova, Padua, 35122 Padua, Italy
| | - Clare E Pain
- Department of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust, Liverpool, L12 2AP, UK
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Marcellus L, MacKinnon K, Gordon C, Shaw L. Interventions and programs that support the health and development of infants with prenatal substance exposure in foster care: a scoping review. JBI Evid Synth 2021; 19:1844-1886. [PMID: 33993147 DOI: 10.11124/jbies-20-00071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this scoping review was to describe the characteristics of interventions and programs that support the health and development of infants in foster care who have prenatal substance exposure, their foster care providers, and birth families. INTRODUCTION Infants in foster care may have experienced prenatal substance exposure, neglect, and maltreatment, as well as disruptions in their relationships with primary caregivers. Despite multiple vulnerabilities, they also have great capacity for overcoming early adversities. Enhanced foster care has been identified as a key influence on the positive development of infants in the child welfare system. INCLUSION CRITERIA This scoping review considered publications that described interventions and programs designed to support foster care providers who care for infants less than 12 months of age with prenatal substance exposure. This review included research studies and gray literature. This scoping review focused on sources that described caregiving interventions and elements of programs that took place within the context of family or home-based foster care. METHODS A three-step search strategy was used to identify publications in the English language from January 2000 to December 2019. A literature search was conducted using MEDLINE, Academic Search Premier, PsycINFO, and CINAHL databases. Titles and abstracts were initially screened to assess if publications met the inclusion criteria, followed by full-text review. Publications that met the inclusion criteria were assessed by two independent reviewers using a data extraction tool developed for this review. Findings were thematically analyzed on the basis of similarity in focus and descriptively presented with tables and figures to support the findings. RESULTS Eighty-one publications were included, including 48 research papers and 33 gray literature sources. Thematic analysis of the focus of each publication resulted in identification of four core themes: i) mental health promotion for infants in care; ii) child welfare program elements; iii) identification of infants and families at risk of requiring foster care; and iv) outcomes for infants in care and their families. The interventions and programs identified during this scoping review were primarily focused on supporting social-emotional development. With the significant focus on infant mental health, supporting birth parents to stay attached to their infants was a key focus of the majority of publications. The concept of being able to proactively identify risk factors that were associated with infants requiring foster care emerged in relation to how family preservation could be supported. Strategies identified as contributing to the development of successful interventions and programs included having foster care providers participate as collaborators in designing services, designing services that are adaptable to a range of contexts, involving community partners outside child welfare, and having developmentally appropriate programs. CONCLUSIONS Infants represent a significant proportion of children in foster care. A developmental perspective is needed for child welfare service planning to address their unique needs. Intervention during the early years holds significant potential for promoting positive developmental pathways and family preservation.
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Affiliation(s)
- Lenora Marcellus
- The University of Victoria (UVic) Centre for Evidence-Informed Nursing and HealthCare (CEiNHC): A JBI Affiliated Group, Victoria, BC, Canada
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Han D, Achenbach S, Al-Mallah M, Budoff M, Cademartiri F, Maffei E, Callister T, Chinnaiyan K, Chow B, DeLago A, Hadamitzky M, Hausleiter J, Kaufmann P, Villines T, Kim Y, Leipsic J, Feuchtner G, Cury R, Pontone G, Andreini D, Marques H, Rubinshtein R, Rubinshtein R, Chang H, Lin F, Shaw L, Min J, Berman D. Prognostic Significance Of Plaque Location In Non-obstructive Coronary Artery Disease: From The Confirm Registry. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.201] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Tzolos E, Williams M, McElhinney P, Lin A, Grodecki K, Guadalupe F, Cadet S, Kwiecinski J, Doris M, Adamson P, Moss A, Alam S, Hunter A, Shah A, Mills N, Pawade T, Wang C, Weir-McCall J, Roditi G, van Beek E, Shaw L, Nicol E, Berman D, Slomka P, Dweck M, Newby D, Dey D. Pericoronary Adipose Tissue Attenuation, Low Attenuation Plaque Burden And 5-year Risk Of Myocardial Infarction. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.198] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Takagi H, Leipsic J, Lin F, Shaw L, Lee S, Andreini D, Al-Mallah M, Budoff M, Cademartiri F, Chinnaiyan K, Choi J, Conte E, Marques H, Gonçalves P, Gottlieb I, Hadamitzky M, Maffei E, Pontone G, Shin S, Kim Y, Lee B, Chun E, Sung J, Virmani R, Samady H, Stone P, Berman D, Min J, Narula J, Bax J, Chang H. Association Of Tube Voltage With Plaque Composition On Coronary Ct Angiography: Results From Paradigm Registry. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.297] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Han D, Lin A, Kuronuma K, Tzolos E, Kwan A, Klein E, Andreini D, Bax J, Cademartiri F, Chinnaiyan K, Chow B, Cury R, Feuchtner G, Hadamitzky M, Leipsic J, Maffei E, Marques H, Plank F, Pontone G, Villines T, Al-Mallah M, de Araújo Gonçalves P, danad I, Gransar H, Lu Y, lee J, Baskaran L, Al'Aref S, Budoff M, Samady H, Virmani R, Narula J, Chang H, Min J, Lin F, Shaw L, Slomka P, Dey D, Berman D. Plaque Location And Vessel Geometry On Coronary Computed Tomography Angiography Predict Future Culprit Lesions Associated With Acute Coronary Syndrome: Results From The ICONIC Study. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.258] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Williams M, Kwiecinski J, Doris M, McElhinney P, Cadet S, Adamson P, Moss A, Alam S, Hunter A, Shah A, Mills N, Pawade T, Wang C, Weir-McCall J, Roditi G, van Beek E, Shaw L, Nicol E, Berman D, Slomka P, Newby D, Dweck M, Dey D. Sex-specific CT Coronary Plaque Characterization And Risk Of Myocardial Infarction. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.254] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Han D, Kuronuma K, Rozanski A, Budoff M, Miedema M, Nasir K, Shaw L, Rumberger J, Gransar H, Blumenthal R, Blaha M, Berman D. Implication Of Thoracic Aortic Calcification Over Coronary Calcium Score Regarding The 2018 Acc/aha Cholesterol Guideline: Results From The Cac Consortium. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.229] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Eleftheriadou V, Atkar R, Batchelor J, McDonald B, Novakovic L, Patel JV, Ravenscroft J, Rush E, Shah D, Shah R, Shaw L, Thompson AR, Hashme M, Exton LS, Mohd Mustapa MF, Manounah L. British Association of Dermatologists guidelines for the management of people with vitiligo 2021. Br J Dermatol 2021; 186:18-29. [PMID: 34160061 DOI: 10.1111/bjd.20596] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2021] [Indexed: 11/29/2022]
Affiliation(s)
- V Eleftheriadou
- Queen Elizabeth Hospital, Mindelsohn Way, Birmingham, B15 2TH, UK
| | - R Atkar
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - J Batchelor
- Centre for Evidence Based Dermatology, University of Nottingham, Nottingham, NG7 2NR, UK
| | - B McDonald
- The Royal London Hospital, Whitechapel Road, Whitechapel, London, E1 1FR, UK
| | - L Novakovic
- Queen Elizabeth Hospital, Department of Dermatology, Lewisham and Greenwich NHS Trust, London, SE18 4QH, UK.,St John's Institute of Dermatology, Department of Photodermatology, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, UK
| | | | | | - E Rush
- Patient representative.,Vitiligo Support UK, London, UK
| | - D Shah
- Amersham Hospital, Amersham, HP7 0JD, UK
| | - R Shah
- Central & North West London NHS Trust, London, NW1 2PL, UK.,British Psychological Society, Leicester, LE1 7DR, UK
| | - L Shaw
- Bristol Royal Infirmary, Bristol, BS2 8HW, UK
| | - A R Thompson
- British Psychological Society, Leicester, LE1 7DR, UK.,South Wales Clinical Psychology Training, Cardiff University, Cardiff, CF10 3AT, UK
| | - M Hashme
- British Association of Dermatologists, Willan House, London, W1T 5HQ, UK
| | - L S Exton
- British Association of Dermatologists, Willan House, London, W1T 5HQ, UK
| | - M F Mohd Mustapa
- British Association of Dermatologists, Willan House, London, W1T 5HQ, UK
| | - L Manounah
- British Association of Dermatologists, Willan House, London, W1T 5HQ, UK
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Shaw L, Kiegaldie D, Morris ME. Educating health professionals to implement evidence-based falls screening in hospitals. Nurse Educ Today 2021; 101:104874. [PMID: 33774527 DOI: 10.1016/j.nedt.2021.104874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/10/2021] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE International evidence-based guidelines advise traditional Falls Risk Assessment Tools (FRATs) should not be routinely used to predict the risk of a patient falling in hospital. However, disinvestment from existing services can be challenging. This study applied evidence-based approaches to education design to implement best practice guidelines. DESIGN Mixed methods using questionnaires to evaluate health professionals' knowledge of evidence-based falls risk assessment and mitigation, followed by semi-structured interviews with individual health professionals. SETTING Five Australian hospitals. PARTICIPANTS There were two cohorts per hospital; Cohort 1 (C1) comprised 10 clinical leaders from nursing and allied health professions. Cohort 2 (C2) included clinicians involved in routine hospital falls screening and prevention. METHODS 46 clinical leaders received a 3-h high quality education workshop on the latest evidence in hospital falls risk assessment and how to implement a new falls screening and management tool. They were also taught the practical skills to deliver a 1-h education session to C2 (n = 129). RESULTS The education workshop significantly changed C1's views about evidence-based guidelines for falls screening and prevention. C1 were significantly more likely than C2 to feel confident in assessing falls risk and judging and implementing the best mitigation strategies. After the workshop, C1 were prepared and motivated to educate others on falls prevention and were satisfied with the skills gained. Six months after the workshop, C1 reported feeling more prepared for preventing falls. CONCLUSION Health professionals benefitted from an interactive education workshop on how to use a new evidence-based hospital falls screening tool to help mitigate risk. An abridged version of the workshop did not result in long lasting effects. Education is an important element aiding disinvestment from non-evidence-based services, and implementation of clinical guidelines.
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Affiliation(s)
- L Shaw
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, Moorabbin, Vic 3189, Australia; Healthscope, Melbourne, Victoria, 3004, Australia.
| | - D Kiegaldie
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, Moorabbin, Vic 3189, Australia; Faculty of Medicine, Nursing & Health Sciences, Monash University, Australia; Healthscope, Holmesglen Private Hospital, 488 South Road, Moorabbin, Victoria 3189, Australia.
| | - M E Morris
- ARCH, School Allied Health, Human Services and Sport, La Trobe University, Victoria 3086, Australia; Healthscope, Melbourne, Victoria, 3004, Australia.
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Shaw L, Altman Y, Eyal S, Baharav A. 314 Alcohol and the Sleep of Elite Athletes. Sleep 2021. [DOI: 10.1093/sleep/zsab072.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Extensive evidence indicates that alcohol adversely affects athletic performance, increases the chance of injury, impairs aerobic metabolism, and has detrimental psychological influence. Alcohol consumption was also shown to be significant in young adults, with many elite athletes reporting alcohol intake. Sleep is essential to musculoskeletal recovery, acquisition of new skills, and emotional regulation in athletes. As insufficient sleep has detrimental effects on athletic performances and increases the risk of injury, we aimed to analyze the relation between alcohol consumption and sleep parameters among elite athletes.
Methods
We studied 9,164 nights recorded with the Boost application by 66 adult elite athletes from various sports during October 2019-December 2020. In addition to perceived and measured sleep parameters, nightly data included the previous day reported alcohol consumption and the number of training sessions. For each athlete, the average nightly mean heart rate (HR) in nights with reported alcohol consumption (AY) and without (AN) was calculated, as were the bedtime and the number of training sessions.
Results
In nights with reported alcohol, mean HR was higher (AY: 56.1±7.8 BPM, mean±SD, AN: 52.9±7.3 BPM, p<.05), while bedtime was later (AY: 23:16±70 minutes, AN: 22:52±55 minutes, p<.05) and fewer training sessions were reported in the following day (AY: 0.88±0.59 sessions, AN: 1.1±0.59 sessions, p<.05). No correlation was found between mean HR and bedtime in nights without alcohol consumption (r=0.3). 24% of Saturday night recordings included alcohol consumption reports, with 16% of Friday nights and 12–13% for each of the remaining weeknights.
Conclusion
Adult elite athletes report consuming alcohol, especially during weekends when the probability for a training session the following day is lower. Our data support the well documented physiological effect of alcohol via elevated mean HR values throughout the night. Athletes and coaches should be educated about the impacts of alcohol and insufficient sleep on wellbeing and performance.
Support (if any):
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O’Kane D, Davis L, Ardern-Jones M, Laws P, Shaw L, Cork M, Velangi S, Cooper HL, Hudson R, Smith AB, Rout R. Treatment outcomes of patients with Atopic Dermatitis (AD) treated with dupilumab through the Early Access to Medicines Scheme (EAMS) in the UK. Ulster Med J 2021; 90:70-76. [PMID: 34276083 PMCID: PMC8278937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dupilumab, a monoclonal antibody against interleukin (IL)-4 receptor alpha that inhibits IL-4/IL-13 signalling is indicated in dermatology for the treatment of moderate-to-severe atopic dermatitis (AD) in adult and adolescent patients 12 years and older and severe AD in children 6-11 years, who are candidates for systemic therapy. Dupilumab received Early Access to Medicines Scheme (EAMS) approval for adults in March 2017. OBJECTIVES The purpose of this study was to assess the efficacy outcomes of treatment with dupilumab in EAMS. METHODS A retrospective analysis of adult patients enrolled in the dupilumab EAMS in the UK. Scores were assessed at baseline and follow up, including the Eczema Area and Severity Index (EASI), Investigator's Global Assessment Score (IGA) and Dermatology Life Quality Index (DLQI). RESULTS Data were available for 57 adult patients treated with dupilumab for at least 12 weeks; 73.6% of patients had received prior treatment with 3 or 4 immunosuppressants. Baseline scores for the EASI and DLQI were 27.93 (standard deviation, SD 13.09) and 18.26 (SD 6.18) respectively. AD severity scores showed statistically significant improvement at week 16±4 weeks (p <0.001 for all). The mean change in EASI was 14.13 points with 66.7% and 36.7% achieving a 50% (EASI-50) and 75% (EASI-75) improvement in EASI, respectively at 16+/- 4 weeks. IGA scores improved by at least two categories for 75% patients. DLQI scores decreased by a mean of 9.0 points, with 80% patients demonstrating a MCID 4-point improvement. For 85% patients, clinicians rated the treatment response as being either 'better' (19%) or 'much better' (65%). CONCLUSIONS Dupilumab is associated with a significant and clinically relevant improvements in AD as measured by patient- and physician-reported outcome measures. Importantly, the clinical efficacy, despite the refractory disease of this EAMS cohort, is comparable to that previously reported in clinical trials.
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Knights H, Minas E, Khan F, Shaw L, Al Obaidi M, Mankad K, Eleftheriou D. Magnetic resonance imaging findings in children with Parry-Romberg syndrome and en coup de sabre. Pediatr Rheumatol Online J 2021; 19:42. [PMID: 33757522 PMCID: PMC7986399 DOI: 10.1186/s12969-021-00512-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/28/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The aim of this study was to: (i) describe the abnormalities seen on brain imaging in a group of children with en coup de sabre (EDCS) with/without Parry-Romberg syndrome (PRS); and (ii) identify clinical predictors of brain imaging abnormalities. METHODS This was a single centre (Great Ormond Street Hospital, London) retrospective case series of patients with ECDS/PRS seen from 2000 to 2018. We identified patients with cutaneous manifestations consistent with the clinical descriptions of ECDS/PRS. Presenting clinical, laboratory, and radiological brain findings are described. Results are expressed as medians and ranges or frequencies and percentages. Fisher's exact test was used to identify clinical associations with magnetic resonance imaging (MRI) abnormalities. RESULTS Fourteen patients were studied: 6 males and 8 females; median age 14 years (range 3-20). We observed neuroimaging abnormalities in 2/6 ECDS and 5/8 ECDS/PRS patients. White matter signal abnormality, dystrophic calcification, leptomeningeal enhancement, and sulcal crowding were the typical findings on brain imaging. A total of 50% of patients had no MRI abnormality despite some of these patients having neurological symptoms. The presence of seizures was significantly associated with ipsilateral enhanced white matter signalling on MRI (p < 0.05). CONCLUSIONS In summary, we observed several distinct radiographic patterns associated with ECDS/PRS. Seizure disorder was strongly associated with the presence of ipsilateral enhanced white matter signalling. Improved neuroimaging techniques that combine morphological with functional imaging may improve the detection rate of brain involvement in children with ECDS/PRS in the future.
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Affiliation(s)
- Harry Knights
- Department of Paediatric Rheumatology, University College London Institute of Child Health and Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. .,Imperial College School of Medicine, Imperial College London, London, UK.
| | - Elizabeth Minas
- grid.413820.c0000 0001 2191 5195Department of Radiology, Charing Cross Hospital, London, UK
| | - Faraan Khan
- grid.451349.eDepartment of Radiology, St George’s University Hospitals NHS Foundation Trust, London, UK
| | - Lindsay Shaw
- grid.424537.30000 0004 5902 9895Department of Paediatric Dermatology, University College London Institute of Child Health and Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Muthana Al Obaidi
- grid.424537.30000 0004 5902 9895Department of Paediatric Rheumatology, University College London Institute of Child Health and Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Kshitij Mankad
- grid.424537.30000 0004 5902 9895Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Despina Eleftheriou
- grid.424537.30000 0004 5902 9895Department of Paediatric Rheumatology, University College London Institute of Child Health and Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK ,grid.83440.3b0000000121901201Centre for Adolescent Rheumatology Versus Arthritis, University College London, London, UK
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O'Sullivan P, Younger J, Van Pelt N, O'Malley S, Lenturut-Katal D, Hirschfeld C, Vitola J, Cerci R, Williams M, Shaw L, Raggi P, Villines T, Dorbala S, Choi A, Cohen Y, Goebel B, Malkovskiy E, Randazzo M, Pascual T, Pynda Y, Dondi M, Paez D, Einstein A, Better N. Impact of COVID-19 Pandemic on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-invasive Cardiology Protocol Survey on COVID-19. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.215] [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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Shaw L, Kiegaldie D, Farlie MK. Education interventions for health professionals on falls prevention in health care settings: a 10-year scoping review. BMC Geriatr 2020; 20:460. [PMID: 33167884 PMCID: PMC7653707 DOI: 10.1186/s12877-020-01819-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 06/03/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023] Open
Abstract
Background Falls in hospitals are a major risk to patient safety. Health professional education has the potential to be an important aspect of falls prevention interventions. This scoping review was designed to investigate the extent of falls prevention education interventions available for health professionals, and to determine the quality of reporting. Method A five stage scoping review process was followed based on Arksey and O’Malley’s framework and refined by the Joanna Briggs Institute Methodology for JBI Scoping Reviews. Five online databases identified papers published from January 2008 until May 2019. Papers were independently screened by two reviewers, and data extracted and analysed using a quality reporting framework. Results Thirty-nine publications were included. Interventions included formal methods of educational delivery (for example, didactic lectures, video presentations), interactive learning activities, experiential learning, supported learning such as coaching, and written learning material. Few studies employed comprehensive education design principles. None used a reporting framework to plan, evaluate, and document the outcomes of educational interventions. Conclusions Although health professional education is recognised as important for falls prevention, no uniform education design principles have been utilised in research published to date, despite commonly reported program objectives. Standardised reporting of education programs has the potential to improve the quality of clinical practice and allow studies to be compared and evaluated for effectiveness across healthcare settings.
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Affiliation(s)
- L Shaw
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, Moorabbin, VIC, 3189, Australia. .,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, 3086, Australia.
| | - D Kiegaldie
- Faculty of Health Science, Youth and Community Studies and Healthscope Hospitals, Holmesglen Institute, 488 South Road, Moorabbin, VIC, 3189, Australia.,Eastern Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
| | - M K Farlie
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Moorooduc Highway, Frankston, VIC, 3199, Australia
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Quesada O, Wei J, Suppogu N, Kelsey S, Reis S, Shaw L, Sopko G, Handberg E, Pepine C, Bairey Merz C. Role of physical fitness in the obesity paradox. Long-term major adverse cardiovascular events in the Women's Ischemia Syndrome Evaluation (WISE). Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3023] [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
Emerging data suggests there is an “obesity paradox” where obesity may be protective against cardiovascular morbidity and mortality in patients with cardiovascular disease. However, weight status primarily assessed through body mass index (BMI) is limited in its ability to discern contributions from fat vs. lean muscle mass. Most studies on BMI have not accounted for physical fitness, which is a known modifier of weight status and a potential mediator of effects of obesity on major adverse cardiovascular events (MACE).
Purpose
To investigate the relationship between BMI and physical fitness, measured by self-reported Duke Activity Status Index (DASI) score, with long-term MACE in women evaluated for suspected myocardial ischemia.
Methods
The National Heart, Lung, and Blood Institute Women's Ischemia Syndrome Evaluation (WISE) study is a multicenter prospective cohort study. From 1996–2000, 936 women were enrolled at the time of clinically indicated coronary angiography and assessed with a median follow up of 5.8 (range 0–9 years) for MACE. MACE was defined as a composite of death, nonfatal myocardial infarction, stroke, or congestive heart failure. Proportional hazards regression was used to estimate adjusted hazard ratios of MACE in relation to metabolic status and physical fitness. DASI scores ≥25, equivalent to ≥7 metabolic equivalents [METs]) was used as cut point to define high physical fitness, in our prior studies DASI >25 approximates completion of the second stage of a Bruce treadmill protocol.
Results
Among the 899 women with complete data, 69.5% had low physical fitness (DASI scores <25), 34.9% overweight (BMl ≥25 to 30), 40.5% obese (BMI ≥30). In fit women, obesity was associated with lower hazard ratio for MACE (HR 0.64, p=0.01); while low fitness in normal weight women was associated with 60% excess risk of MACE (HR 1.61, p=0.01) (Figure 1).
Conclusions
Among women undergoing coronary angiography for suspected myocardial ischemia, obesity was inversely related with long-term MACE in physically fit women. Our findings suggest that physical fitness may play a role in the obesity paradox. These results support the inclusion of fitness in understanding the relations between body weight and long-term MACE. The DASI is a simple, self reported tool that can identify higher-risk symptomatic women and should be considered in future investigations and routine examination of normal, overweight and obese women.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): U01 HL064829
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Affiliation(s)
- O Quesada
- Cedars-Sinai smidt Heart Institute, Los Angeles, United States of America
| | - J Wei
- Cedars-Sinai smidt Heart Institute, Los Angeles, United States of America
| | - N Suppogu
- Cedars-Sinai smidt Heart Institute, Los Angeles, United States of America
| | - S.F Kelsey
- University of Pittsburgh, Epidemiology, Pittsburgh, United States of America
| | - S Reis
- University of Pittsburgh, Epidemiology, Pittsburgh, United States of America
| | - L Shaw
- Weill Cornell Medicine, New York, United States of America
| | - G Sopko
- National Institutes of Health, Bethesda, United States of America
| | - E.M Handberg
- University of Florida, Gainesville, United States of America
| | - C.J Pepine
- University of Florida, Gainesville, United States of America
| | - C.N Bairey Merz
- Cedars-Sinai smidt Heart Institute, Los Angeles, United States of America
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Dulay D, Burden L, Shaw L, Town R, Franco C. IT'S IN THE BLACK BOX - A QUALITY IMPROVEMENT PROJECT TO STREAMLINE AUTOMATIC EXTERNAL DEFIBRILLATOR INFORMATION FOR OUT OF HOSPITAL ARREST PATIENTS ADMITTED TO THE CORONARY CARE UNIT. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.171] [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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Gianni U, Tantawy S, Amoa F, Dwivedi A, Sato Y, Wijeratne R, Hollenberg E, Alawamlh O. AH, Elshafeey A, Lu Y, van den Hoogen I., van Rosendael A., Bax M, Yahagi K, Torii S, Jinnouchi H, Romero M, Surve D, Finn A, Earls J, Min J, Shaw L, Fowler D, Virmani R, Lin F. Dual-energy Coronary Computed Tomography Angiography Is Superior To Single Energy Computed Tomography For Evaluation Of Necrotic Core In Sudden Cardiac Death. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.154] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Shaw L, Cohen R, Altman Y, Eyal S, Baharav A. 0206 Sleep Opportunity and Duration are Related to Risk Injury in Elite Athletes. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Sleep is essential to musculoskeletal recovery, acquisition of new skills and emotional regulation in athletes. Insufficient sleep is detrimental to performance. Recent publications indicate that sleep duration is related to risk for injury in young athletes. We aimed at analyzing the relation between sleep opportunity and duration and the likelihood of an injury among adult elite athletes.
Methods
We studied 7,237 nights recorded with the Sleeprate application by 71 adult elite athletes from diverse sports, during the period September 2018-October 2019. Night recordings included perceived and measured sleep parameters. In addition, athletes reported their previous day nap duration, injuries and illness status. Out of the total number of nights, 4,205 included reported injury status with no injury and no illness for the previous night. Nightly total time in bed (TIB), TIB including reported naps (TIB24hr) and measured total sleep time (TST) were examined.
Results
Average TIB was significantly shorter (508±77 minutes, mean±STD) in healthy days preceding injuries than in healthy days preceding days with no injury (525±70 minutes, p<.001). Similar results were found when comparing the TIB24hr (injury: 517±83 minutes, no injury: 543±76 minutes, p<.001) and TST (injury: 443±72 minutes, no injury: 457±69 minutes, p<.001).
Conclusion
Average sleep opportunities of the elite athletes in this study were in accordance with their age and workouts load. The time athletes allow themselves as an opportunity for sleep is inversely correlated to the chances of developing an injury. These findings corroborate published research regarding sleep duration and risk of injury in athletes, yet our findings are based on real life data of elite athletes, and demonstrate the importance of sleep as part of the elite or professional athlete’s routine, suggesting that even as little as around 20 minutes of added sleep may be efficient in preventing injury.
Support
N/A
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Affiliation(s)
- L Shaw
- United States Olympic & Paralympic Committee, Colorado Springs, CO
| | - R Cohen
- Wingate Institute, Netanya, ISRAEL
| | | | - S Eyal
- HypnoCore, Petach Tiqva, ISRAEL
| | - A Baharav
- HypnoCore, Petach Tiqva, ISRAEL
- Wingate Institute, Netanya, ISRAEL
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Shaw L, Williams RL, Hamill KJ. CRISPR-Cas9-mediated labelling of the C-terminus of human laminin β1 leads to secretion inhibition. BMC Res Notes 2020; 13:90. [PMID: 32085798 PMCID: PMC7035763 DOI: 10.1186/s13104-020-04956-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 02/14/2020] [Indexed: 11/19/2022] Open
Abstract
Objectives The laminins (LM) are a family of basement membranes glycoproteins with essential roles in supporting epithelia, endothelia, nerves and muscle adhesion, and in regulating a range of processes including cell migration, stem cell maintenance and differentiation. However, surprisingly little is known about the mechanisms of turnover and remodelling of LM networks due to lack of appropriate tools to study these processes at the necessary resolution. Recently, the nematode C. elegans ortholog of human the LMβ1 chain was labelled at the C-terminus with the photoconvertible fluorophore Dendra2. Here we used genome editing to establish a similar system in a mammalian cell line as proof of concept for future mammalian models. Results CRISPR-Cas9 was used to introduce the Dendra2 sequence at the C-terminus of LMβ1 in the human lung adenocarcinoma cell line A549. Despite expression of the tagged protein within cells, no detectable LMβ1-Dendra2 protein was deposited to the extracellular matrices or conditioned media of edited cells. Moreover, the edited cells displayed reduced proliferation rates. Together, these data suggest that, in humans, addition of C-terminal Dendra2 tag to LMβ1 inhibits LM secretion, and is not a viable approach for use in animal models.
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Affiliation(s)
- L Shaw
- Institute of Ageing and Chronic Disease, University of Liverpool, 6 West Derby Street, Liverpool, L78TX, UK.
| | - R L Williams
- Institute of Ageing and Chronic Disease, University of Liverpool, 6 West Derby Street, Liverpool, L78TX, UK
| | - K J Hamill
- Institute of Ageing and Chronic Disease, University of Liverpool, 6 West Derby Street, Liverpool, L78TX, UK
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Shaw L, Kiegaldie D, Morris ME. Educating health professionals to optimise falls screening in hospitals: protocol for a mixed methods study. BMC Health Serv Res 2020; 20:54. [PMID: 31969145 PMCID: PMC6977326 DOI: 10.1186/s12913-020-4899-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/08/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Falls in hospitals remain a major challenge to patient safety. All hospitalised adults are at risk of falling during their inpatient stay, though this risk is not always realised by patients and clinicians. This study will evaluate the outcomes of a hospital clinician education program that teaches clinicians how to screen for falls risk and assign mitigation strategies using clinical reasoning, rather than relying on a standardised falls risk assessment tool (FRAT). The education program aims to increase clinician knowledge, motivation and confidence in screening falls risk and selecting individual falls prevention interventions. Perceptions of the education intervention will also be examined. METHODS Participants will be a sample of convenience of nurses and allied health professionals from five Australian hospitals. For each hospital there will be two cohorts. Cohort 1 will be clinical leaders who shall receive a three-hour education program on the latest evidence in hospital falls risk assessment and how to implement a new falls screening and management tool. They will also be taught practical skills to enable them to deliver an effective one-hour in-service training session to Cohort 2. Cohort 2 will be recruited from the workforce as a whole and include nurses and other health professionals involved in routine hospital falls screening and prevention. The investigation will be framed on Keller's Model of Motivational Design and Kirkpatrick's evaluation framework. It will involve a mixed methods pre and post-test questionnaire design inclusive of semi-structured telephone interviews, to triangulate the data from multiple approaches. DISCUSSION This study will quantify the outcomes of a high-quality clinician education program to increase knowledge of evidence-based practice for falls prevention. It is predicted that positive behavioural changes will occur in health professionals, leading to organisational change and improved patient outcomes. Furthermore, the findings from the study will inform the future refinement of educational delivery to health professionals across hospital sites. TRIAL REGISTRATION The study has also been approved by the Australian New Zealand Clinical Trials Registry: Preventing Hospital Falls: Optimal Screening UTN U1111-1225-8450. Universal Trial Number (UTN): U1111-1228-0041 (obtained 5/2/19). Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000200189 (obtained 12/2/19).
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Affiliation(s)
- L Shaw
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, Moorabbin, Vic, 3189, Australia.
| | - D Kiegaldie
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, Moorabbin, Vic, 3189, Australia
| | - M E Morris
- School of Allied Health, La Trobe Centre for Sport and Exercises Medicine Research, La Trobe University, Melbourne, Victoria, 3086, Australia.,Healthscope, North Eastern Rehabilitation Centre, Ivanhoe, Victoria, 3086, Australia
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Heuer HW, Wang P, Rascovsky K, Wolf A, Appleby B, Bove J, Bordelon Y, Brannelly P, Brushaber DE, Caso C, Coppola G, Dickerson B, Dickinson S, Domoto-Reilly K, Faber K, Ferrall J, Fields J, Fishman A, Fong J, Foroud T, Forsberg LK, Gearhart D, Ghazanfari B, Ghoshal N, Goldman J, Graff-Radford J, Graff-Radford N, Grant I, Grossman M, Haley D, Hsiung GY, Huey E, Irwin D, Jones D, Kantarci K, Karydas A, Kaufer D, Kerwin D, Knopman D, Kornak J, Kramer JH, Kraft R, Kremers WK, Kukull W, Litvan I, Ljubenkov P, Mackenzie IR, Maldonado M, Manoochehri M, McGinnis S, McKinley E, Mendez MF, Miller BL, Onyike C, Pantelyat A, Pearlman R, Petrucelli L, Potter M, Rademakers R, Ramos EM, Rankin KP, Roberson ED, Rogalski E, Sengdy P, Shaw L, Syrjanen J, Tartaglia MC, Tatton N, Taylor J, Toga A, Trojanowski J, Weintraub S, Wong B, Wszolek Z, Boeve BF, Rosen HJ, Boxer AL. Comparison of sporadic and familial behavioral variant frontotemporal dementia (FTD) in a North American cohort. Alzheimers Dement 2020; 16:60-70. [PMID: 31914226 PMCID: PMC7192555 DOI: 10.1002/alz.12046] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Behavioral variant frontotemporal dementia (bvFTD) may present sporadically or due to an autosomal dominant mutation. Characterization of both forms will improve understanding of the generalizability of assessments and treatments. METHODS A total of 135 sporadic (s-bvFTD; mean age 63.3 years; 34% female) and 99 familial (f-bvFTD; mean age 59.9; 48% female) bvFTD participants were identified. f-bvFTD cases included 43 with known or presumed chromosome 9 open reading frame 72 (C9orf72) gene expansions, 28 with known or presumed microtubule-associated protein tau (MAPT) mutations, 14 with known progranulin (GRN) mutations, and 14 with a strong family history of FTD but no identified mutation. RESULTS Participants with f-bvFTD were younger and had earlier age at onset. s-bvFTD had higher total Neuropsychiatric Inventory Questionnaire (NPI-Q) scores due to more frequent endorsement of depression and irritability. DISCUSSION f-bvFTD and s-bvFTD cases are clinically similar, suggesting the generalizability of novel biomarkers, therapies, and clinical tools developed in either form to the other.
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Affiliation(s)
- Hilary W Heuer
- University of California, San Francisco, San Francisco, California
| | - P Wang
- University of California, San Francisco, San Francisco, California
| | - K Rascovsky
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - A Wolf
- University of California, San Francisco, San Francisco, California
| | - B Appleby
- Case Western Reserve University, Cleveland, Ohio
| | - J Bove
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - Y Bordelon
- University of California, Los Angeles, Los Angeles, California
| | - P Brannelly
- Tau Consortium, Rainwater Charitable Foundation, Fort Worth, Texas
| | | | - C Caso
- U Washington, Seattle, Washington
| | - G Coppola
- University of California, Los Angeles, Los Angeles, California
| | - B Dickerson
- Harvard University/MGH, Boston, Massachusetts
| | - S Dickinson
- Association for Frontotemporal Degeneration, Radnor, Pennsylvania
| | | | - K Faber
- National Centralized Repository for Alzheimer's Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, Indiana
| | - J Ferrall
- University of North Carolina, Chapel Hill, North Carolina
| | - J Fields
- Mayo Clinic, Rochester, Minnesota
| | - A Fishman
- Johns Hopkins University, Baltimore, Maryland
| | - J Fong
- University of California, San Francisco, San Francisco, California
| | - T Foroud
- National Centralized Repository for Alzheimer's Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, Indiana
| | | | | | | | - N Ghoshal
- Washington University, St. Louis, Missouri
| | - J Goldman
- Columbia University, New York, New York
| | | | | | - I Grant
- Northwestern University, Chicago, Illinois
| | - M Grossman
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - D Haley
- Mayo Clinic, Jacksonville, Florida
| | - G-Y Hsiung
- University of British Columbia, Vancouver, British Columbia, Canada
| | - E Huey
- Columbia University, New York, New York
| | - D Irwin
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - D Jones
- Mayo Clinic, Rochester, Minnesota
| | | | - A Karydas
- University of California, San Francisco, San Francisco, California
| | - D Kaufer
- University of North Carolina, Chapel Hill, North Carolina
| | - D Kerwin
- The University of Texas, Southwestern Medical Center at Dallas, Dallas, Texas
| | | | - J Kornak
- University of California, San Francisco, San Francisco, California
| | - J H Kramer
- University of California, San Francisco, San Francisco, California
| | - R Kraft
- Mayo Clinic, Rochester, Minnesota
| | | | - W Kukull
- National Alzheimer Coordinating Center (NACC), University of Washington, Seattle, Washington
| | - I Litvan
- University of California, San Diego, San Diego, California
| | - P Ljubenkov
- University of California, San Francisco, San Francisco, California
| | - I R Mackenzie
- University of British Columbia, Vancouver, British Columbia, Canada
| | - M Maldonado
- University of California, Los Angeles, Los Angeles, California
| | | | - S McGinnis
- Harvard University/MGH, Boston, Massachusetts
| | - E McKinley
- University of Alabama at Birmingham, Birmingham, Alabama
| | - M F Mendez
- University of California, Los Angeles, Los Angeles, California
| | - B L Miller
- University of California, San Francisco, San Francisco, California
| | - C Onyike
- Johns Hopkins University, Baltimore, Maryland
| | - A Pantelyat
- Johns Hopkins University, Baltimore, Maryland
| | - R Pearlman
- Bluefield Project, San Francisco, California
| | | | - M Potter
- National Centralized Repository for Alzheimer's Disease and Related Disorders (NCRAD), Indiana University, Indianapolis, Indiana
| | | | - E M Ramos
- University of California, Los Angeles, Los Angeles, California
| | - K P Rankin
- University of California, San Francisco, San Francisco, California
| | - E D Roberson
- University of Alabama at Birmingham, Birmingham, Alabama
| | - E Rogalski
- Northwestern University, Chicago, Illinois
| | - P Sengdy
- University of British Columbia, Vancouver, British Columbia, Canada
| | - L Shaw
- University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | - N Tatton
- Association for Frontotemporal Degeneration, Radnor, Pennsylvania
| | - J Taylor
- University of California, San Francisco, San Francisco, California
| | - A Toga
- Laboratory of Neuroimaging (LONI), USC, Los Angeles, California
| | | | | | - B Wong
- Harvard University/MGH, Boston, Massachusetts
| | | | | | - H J Rosen
- University of California, San Francisco, San Francisco, California
| | - A L Boxer
- University of California, San Francisco, San Francisco, California
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Shaw L, Wang L, Cui Z, Rich AJ, Armstrong HL, Lachowsky NJ, Sereda P, Card KG, Olarewaju G, Moore D, Hogg R, Roth EA. Longitudinal Event-Level Analysis of Gay and Bisexual Men's Anal Sex Versatility: Behavior, Roles, and Substance Use. J Sex Res 2019; 56:1136-1146. [PMID: 31461383 PMCID: PMC6791743 DOI: 10.1080/00224499.2019.1652238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Gay and bisexual Men Who Have Sex with Men (GBM) are sexually unique in that they can practice penile-anal sex versatility, i.e. engage in insertive and receptive anal sex. Individual-level versatility is extensively researched both as a sexual behavior linked to HIV/STI transmission, and as a GBM identity that can change over time. However, there is a dearth of research on event-level versatility (ELV), defined as taking the receptive and insertive role in the same sexual encounter. We analyzed event-level data from 644 GBM in the Momentum Health Study from February 2012-February 2017 to identify factors associated with ELV prevalence, the relationship between ELV and anal sex role preference, and sero-adaptive and sexualized drug use strategies. Univariate analysis revealed ELV prevalence rates between 15% and 20%. A multivariate generalized linear mixed model indicated ELV significantly (p < .05) associated with versatile role preference and condomless sex. However, the majority of ELV came from GBM reporting insertive or receptive role preferences, and there was significantly higher condom use among sero-discordant partners, indicating sero-adaptation. Multivariate log-linear modeling identified multiple polysubstance combinations significantly associated with ELV. Results provide insights into GBM sexual behavior and constitute empirical data useful for future HIV/STI transmission pattern modeling.
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Affiliation(s)
- Lindsay Shaw
- Canadian Institute for Substance Use Research, University of Victoria
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS
| | - Zishan Cui
- British Columbia Centre for Excellence in HIV/AIDS
| | - Ashleigh J Rich
- British Columbia Centre for Excellence in HIV/AIDS
- Faculty of Medicine, University of British Columbia
| | - Heather L Armstrong
- British Columbia Centre for Excellence in HIV/AIDS
- Faculty of Medicine, University of British Columbia
| | - Nathan J Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS
- School of Public Health and Social Policy, University of Victoria
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS
| | | | | | - David Moore
- British Columbia Centre for Excellence in HIV/AIDS
- Faculty of Medicine, University of British Columbia
| | - Robert Hogg
- British Columbia Centre for Excellence in HIV/AIDS
- Faculty of Health Sciences, Simon Fraser University
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Solman L, Glover M, Beattie PE, Buckley H, Clark S, Gach JE, Giardini A, Helbling I, Hewitt RJ, Laguda B, Langan SM, Martinez AE, Murphy R, Proudfoot L, Ravenscroft J, Shahidullah H, Shaw L, Syed SB, Wells L, Flohr C. Oral propranolol in the treatment of proliferating infantile haemangiomas: British Society for Paediatric Dermatology consensus guidelines. Br J Dermatol 2019; 179:582-589. [PMID: 29774538 DOI: 10.1111/bjd.16779] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Infantile haemangiomas (IH) are the most common vascular tumours of infancy. Despite their frequency and potential complications, there are currently no unified U.K. guidelines for the treatment of IH with propranolol. There are still uncertainties and diverse opinions regarding indications, pretreatment investigations, its use in PHACES (posterior fossa malformations-haemangiomas-arterial anomalies-cardiac defects-eye abnormalities-sternal cleft and supraumbilical raphe) syndrome and cessation of treatment. OBJECTIVES To provide unified guidelines for the treatment of IH with propranolol. METHODS This study used a modified Delphi technique, which involved an international treatment survey, a systematic evidence review of the literature, a face-to-face multidisciplinary panel meeting and anonymous voting. RESULTS The expert panel achieved consensus on 47 statements in eight categories, including indications and contraindications for starting propranolol, pretreatment investigations, starting and target dose, monitoring of adverse effects, the use of propranolol in PHACES syndrome and how to stop treatment. CONCLUSIONS These consensus guidelines will help to standardize and simplify the treatment of IH with oral propranolol across the U.K. and assist in clinical decision-making.
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Affiliation(s)
- L Solman
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, U.K
| | - M Glover
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, U.K
| | | | - H Buckley
- Queen Alexandra Hospital, Portsmouth, U.K
| | - S Clark
- Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, U.K
| | - J E Gach
- Birmingham Children's Hospital, Birmingham, U.K
| | - A Giardini
- Paediatric Cardiology Division, Great Ormond Street Hospital for Children, London, U.K
| | - I Helbling
- Leicester Royal Infirmary, Leicester, U.K
| | - R J Hewitt
- Department of Paediatric Otolaryngology, Great Ormond Street Hospital for Children, London, U.K
| | - B Laguda
- Chelsea and Westminster Hospital, London, U.K
| | - S M Langan
- London School of Hygiene and Tropical Medicine, London, U.K
| | - A E Martinez
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, U.K
| | - R Murphy
- Sheffield Teaching Hospitals, Sheffield, U.K
| | | | | | | | - L Shaw
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, U.K
| | - S B Syed
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, U.K
| | - L Wells
- Nottingham Children's Hospital, London, U.K
| | - C Flohr
- Unit of Population-Based Dermatology Research and Department of Paediatric Dermatology, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
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Webber L, Cummins M, Mann R, Shaw L, Ghinai R, Mahon C. Panniculitis in a 3-year-old child with Fanconi anemia-associated bone marrow hypoplasia heralds transformation to acute myeloid leukemia. Pediatr Dermatol 2019; 36:725-727. [PMID: 31318095 DOI: 10.1111/pde.13872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Indexed: 11/28/2022]
Abstract
Fanconi anemia is a rare, autosomal recessive genomic instability disorder characterized by congenital limb anomalies, panmyelopathy and a high risk of malignancy, principally acute myeloid leukemia. Hematologic malignancy presenting with acute febrile neutrophilic dermatosis (Sweet syndrome), both deep and superficial forms, is well described in Fanconi anemia patients but is a rare phenomenon in otherwise healthy children. We present a case of panniculitis (presumptive subcutaneous Sweet syndrome) heralding transformation to acute myeloid leukemia in a 3-year-old boy with a severe Fanconi anemia phenotype.
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Affiliation(s)
- Lucy Webber
- Department of Paediatric Dermatology, Bristol Children's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Michelle Cummins
- Department of Paediatric Haematology & Oncology, Bristol Children's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Rebecca Mann
- Department of Paediatrics, Musgrove Park Hospital, Taunton & Somerset NHS Foundation Trust, Taunton, UK
| | - Lindsay Shaw
- Department of Paediatric Dermatology, Bristol Children's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Rosanna Ghinai
- Department of Paediatric Haematology & Oncology, Bristol Children's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Caroline Mahon
- Department of Paediatric Dermatology, Starship Child Health, Auckland, New Zealand.,Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
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Nunns M, Shaw L, Briscoe S, Thompson-Coon J, Hemsley A, McGrath JS, Lovegrove CJ, Thomas D, Anderson R. 88REDUCING LENGTH OF HOSPITAL STAY FOR OLDER ELECTIVE SURGICAL INPATIENTS: FINDINGS OF A SYSTEMATIC REVIEW. Age Ageing 2019. [DOI: 10.1093/ageing/afz061.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Nunns
- Exeter HS&DR Evidence Synthesis Centre, University of Exeter
| | - L Shaw
- Exeter HS&DR Evidence Synthesis Centre, University of Exeter
| | - S Briscoe
- Exeter HS&DR Evidence Synthesis Centre, University of Exeter
| | - J Thompson-Coon
- Exeter HS&DR Evidence Synthesis Centre, University of Exeter
| | - A Hemsley
- Royal Devon & Exeter NHS Foundation Trust, Exeter
| | - J S McGrath
- Royal Devon & Exeter NHS Foundation Trust, Exeter
- College of Medicine & Health, University of Exeter
| | - C J Lovegrove
- Royal Devon & Exeter NHS Foundation Trust, Exeter
- Faculty of Health & Human Sciences, Plymouth
| | - D Thomas
- Royal Devon & Exeter NHS Foundation Trust, Exeter
| | - R Anderson
- Exeter HS&DR Evidence Synthesis Centre, University of Exeter
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Mahon C, Webber L, Bisson N, Droop E, Angus J, Shaw L, Wlodek C. Aerosolised deodorant-induced bullous dermatitis artefacta: A clinicopathological correlation. Australas J Dermatol 2019; 60:331-333. [PMID: 31158918 DOI: 10.1111/ajd.13083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Caroline Mahon
- Department of Paediatric Dermatology, Starship Child Health, Auckland, New Zealand.,Department of Paediatrics and Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Lucy Webber
- Department of Paediatric Dermatology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Nicholas Bisson
- Department of Paediatric Dermatology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Elizabeth Droop
- Department of Pathology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Janet Angus
- Department of Paediatric Dermatology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Lindsay Shaw
- Department of Paediatric Dermatology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Christina Wlodek
- Department of Dermatology, Waikato Hospital, Hamilton, New Zealand
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Smith HL, Stevens A, Minogue B, Sneddon S, Shaw L, Wood L, Adeniyi T, Xiao H, Lio P, Kimber SJ, Brison DR. Systems based analysis of human embryos and gene networks involved in cell lineage allocation. BMC Genomics 2019; 20:171. [PMID: 30836937 PMCID: PMC6399968 DOI: 10.1186/s12864-019-5558-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/22/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Little is understood of the molecular mechanisms involved in the earliest cell fate decision in human development, leading to the establishment of the trophectoderm (TE) and inner cell mass (ICM) stem cell population. Notably, there is a lack of understanding of how transcriptional networks arise during reorganisation of the embryonic genome post-fertilisation. RESULTS We identified a hierarchical structure of preimplantation gene network modules around the time of embryonic genome activation (EGA). Using network models along with eukaryotic initiation factor (EIF) and epigenetic-associated gene expression we defined two sets of blastomeres that exhibited diverging tendencies towards ICM or TE. Analysis of the developmental networks demonstrated stage specific EIF expression and revealed that histone modifications may be an important epigenetic regulatory mechanism in preimplantation human embryos. Comparison to published RNAseq data confirmed that during EGA the individual 8-cell blastomeres are transcriptionally primed for the first lineage decision in development towards ICM or TE. CONCLUSIONS Using multiple systems biology approaches to compare developmental stages in the early human embryo with single cell transcript data from blastomeres, we have shown that blastomeres considered to be totipotent are not transcriptionally equivalent. Furthermore we have linked the developmental interactome to individual blastomeres and to later cell lineage. This has clinical implications for understanding the impact of fertility treatments and developmental programming of long term health.
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Affiliation(s)
- H. L. Smith
- Maternal and Fetal Health Research Centre, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
| | - A. Stevens
- Division of Developmental Biology & Medicine, School of Medical Sciences, University of Manchester, Manchester Academic Health Sciences Centre, 5th Floor Research, Royal Manchester Children’s Hospital, Oxford Road, Manchester, M13 9WL UK
| | - B. Minogue
- Maternal and Fetal Health Research Centre, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
| | - S. Sneddon
- Maternal and Fetal Health Research Centre, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
| | - L. Shaw
- Maternal and Fetal Health Research Centre, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
| | - L. Wood
- Department of Reproductive Medicine, Saint Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
| | - T. Adeniyi
- Department of Reproductive Medicine, Saint Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
| | - H. Xiao
- Computer Laboratory, William Gates Building, University of Cambridge, Cambridge, UK
| | - P. Lio
- Computer Laboratory, William Gates Building, University of Cambridge, Cambridge, UK
| | - S. J. Kimber
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
| | - D. R. Brison
- Maternal and Fetal Health Research Centre, University of Manchester, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
- Department of Reproductive Medicine, Saint Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Oxford Road, Manchester, M13 9WL UK
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Rodgers H, Shaw L, Bhattarai N, Cant R, Drummond A, Ford GA, Forster A, Francis R, Hills K, Howel D, Laverty AM, McKevitt C, McMeekin P, Price C, Stamp E, Stevens E, Vale L. 137A trial to evaluate an eXTended RehAbilitation service for Stroke patients (EXTRAS): main patient results. Age Ageing 2019. [DOI: 10.1093/ageing/afz001.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H Rodgers
- Newcastle University
- Northumbria Healthcare NHS Foundation Trust
- Newcastle upon Tyne Hospitals NHS Foundation Trust
| | | | | | | | | | | | | | | | | | | | | | | | | | - C Price
- Newcastle University
- Northumbria Healthcare NHS Foundation Trust
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Russell S, Shaw L, McParland P, Guha K. An unusual cause of chest pain: the importance of acute aortic syndromes. Br J Hosp Med (Lond) 2019; 80:54-55. [PMID: 30592672 DOI: 10.12968/hmed.2019.80.1.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S Russell
- Specialty Doctor, Department of Cardiology, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth
| | - L Shaw
- Specialty Doctor, Department of Cardiology, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth
| | - P McParland
- Consultant Radiologist, Department of Radiology, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth
| | - K Guha
- Consultant Cardiologist, Department of Cardiology, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth PO6 3LY
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Solman L, Glover M, Beattie P, Buckley H, Clark S, Gach J, Giardini A, Helbling I, Hewitt R, Laguda B, Langan S, Martinez A, Murphy R, Proudfoot L, Ravenscroft J, Shahidullah H, Shaw L, Syed S, Wells L, Flohr C. BSPD guidelines for treatment of IH with propranolol. Br J Dermatol 2018. [DOI: 10.1111/bjd.17053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Solman L, Glover M, Beattie P, Buckley H, Clark S, Gach J, Giardini A, Helbling I, Hewitt R, Laguda B, Langan S, Martinez A, Murphy R, Proudfoot L, Ravenscroft J, Shahidullah H, Shaw L, Syed S, Wells L, Flohr C. 使用普萘洛尔治疗IH的BSPD指南. Br J Dermatol 2018. [DOI: 10.1111/bjd.17069] [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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44
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Ridd MJ, Gaunt DM, Guy RH, Redmond NM, Garfield K, Hollinghurst S, Ball N, Shaw L, Purdy S, Metcalfe C. Comparison of patient (POEM), observer (EASI, SASSAD, TIS) and corneometry measures of emollient effectiveness in children with eczema: findings from the COMET feasibility trial. Br J Dermatol 2018; 179:362-370. [PMID: 29476542 DOI: 10.1111/bjd.16475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Eczema affects around 20% of children, but multiple different outcome measures have hampered research into the effectiveness of different treatments. OBJECTIVES To compare the change in scores and correlations within and between five measures of eczema severity: Patient-Orientated Eczema Measure (POEM), Eczema Area and Severity Index (EASI), Six Area, Six Sign Atopic Dermatitis (SASSAD), Three Item Severity (TIS) and skin hydration (corneometry). METHODS Data from a feasibility trial that randomized young children with eczema to one of four emollients were used. Participants were followed for 3 months (84 days). Descriptive statistics (by emollient over time) and Spearman's correlation coefficients comparing scores at each time point and absolute change (between adjacent time points) for each outcome measure were calculated. RESULTS In total, 197 children, mean ± SD age 21·7 ± 12·8 months, were randomized. POEM and TIS appeared to capture a range of eczema severity at baseline, but only POEM had close approximation to normal distribution. Mean POEM, EASI, SASSAD and TIS scores improved month by month, with POEM showing the greatest sensitivity (effect size 0·42). Correlations within POEM, EASI, SASSAD and TIS were moderate to good, decreasing over time. Correlations between measures were strongest for EASI, SASSAD and TIS. By contrast, corneometry scores were more variable, correlated less well over time and were poorly correlated with the other measures. CONCLUSIONS Except for corneometry, all measures appear to change in relation to emollient use over time and correlate well with themselves. POEM demonstrated the greatest range of scores at baseline and change in eczema severity over the first 28 days.
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Affiliation(s)
- M J Ridd
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, U.K
| | - D M Gaunt
- Bristol Randomised Trials Collaboration, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, U.K
| | - R H Guy
- Department of Pharmacy & Pharmacology, University of Bath, Claverton Down, Bath, BA2 7AY, U.K
| | - N M Redmond
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, U.K.,NIHR CLAHRC West, University Hospitals Bristol NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, U.K
| | - K Garfield
- Bristol Randomised Trials Collaboration, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, U.K
| | - S Hollinghurst
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, U.K
| | - N Ball
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, U.K
| | - L Shaw
- Department of Dermatology, University Hospitals Bristol NHS Foundation Trust, Marlborough Street, Bristol, BS1 3NU, U.K
| | - S Purdy
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, U.K
| | - C Metcalfe
- Bristol Randomised Trials Collaboration, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, U.K
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Harjunmaa U, Doyle R, Järnstedt J, Kamiza S, Jorgensen JM, Stewart CP, Shaw L, Hallamaa L, Ashorn U, Klein N, Dewey KG, Maleta K, Ashorn P. Periapical infection may affect birth outcomes via systemic inflammation. Oral Dis 2018; 24:847-855. [PMID: 29230915 DOI: 10.1111/odi.12817] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 11/26/2017] [Accepted: 12/03/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Maternal dental periapical infections are associated with preterm birth and intrauterine growth restriction. This study investigates whether the association is mediated through bacterial spread from periapical lesions to placenta (direct pathway) or systemic inflammatory reaction (indirect pathway). MATERIALS AND METHODS We compared birth outcomes in Malawian mothers with and without periapical infection. As markers of a direct pathway, we identified placental bacteria using a 16S rDNA approach and assessed histological evidence of inflammation in the placenta and amniotic membranes. We measured C-reactive protein, alpha-1-acid glycoprotein, and salivary cortisol as markers of an indirect pathway. We used regression models to associate the predictor variables with duration of pregnancy and newborn size. RESULTS Of 1,024 women, 23.5% had periapical infection. There was no association of periapical infection with either bacterial DNA or histological inflammation in placenta or membranes. Periapical infection was associated with C-reactive protein, alpha-1-acid glycoprotein, and cortisol concentrations in a dose-dependent manner at 36 weeks. Addition of alpha-1-acid glycoprotein or cortisol concentration into regression models attenuated the association between periapical infection and pregnancy outcomes. CONCLUSION There was no evidence of direct spread of periapical bacteria to the placenta. Periapical infections and adverse pregnancy outcomes are in part mediated through systemic inflammation.
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Affiliation(s)
- U Harjunmaa
- Center for Child Health Research, University of Tampere Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
| | - R Doyle
- Microbiology, Virology & Infection Control, Great Ormond Street Hospital NHS Foundation Trust, London, UK.,Institute of Child Health, University College London, London, UK
| | - J Järnstedt
- Department of Radiology, Medical Imaging Center, Tampere University Hospital, Tampere, Finland
| | - S Kamiza
- Department of Pathology, University of Malawi College of Medicine, Blantyre, Malawi
| | - J M Jorgensen
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - C P Stewart
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - L Shaw
- Institute of Child Health, University College London, London, UK
| | - L Hallamaa
- Center for Child Health Research, University of Tampere Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
| | - U Ashorn
- Center for Child Health Research, University of Tampere Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
| | - N Klein
- Institute of Child Health, University College London, London, UK
| | - K G Dewey
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - K Maleta
- Department of Community Health, University of Malawi College of Medicine, Blantyre, Malawi
| | - P Ashorn
- Center for Child Health Research, University of Tampere Faculty of Medicine and Life Sciences and Tampere University Hospital, Tampere, Finland
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Gnanenthiran S, Naoum C, Achenbach S, Al-Mallah M, Andrieni D, Bax J, Berman D, Budoff M, Cademartiri F, Callister T, Chang H, Chinnaiyan K, Chow B, Cury R, DeLago A, Feuchtner G, Hadamitzky M, Hausleiter J, Kaufman P, Maffei Y, Marques H, Pontone G, Raff G, Rubenshtein R, Shaw L, Villines T, Gransar H, Jones E, Pena J, Lin F, Leipsic J, Kritharides L, Min J. Atherosclerotic Plaque Burden Determined by Computed Tomography Coronary Angiography is Predictive of Long-Term Major Adverse Cardiovascular Events in Older Populations. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.398] [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: 10/28/2022]
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Affiliation(s)
- C. Wlodek
- Department of Paediatric Dermatology; Bristol Royal Hospital for Children; Bristol UK
| | - J. Clinch
- Department of Paediatric Rheumatology; Bristol Royal Hospital for Children; Bristol UK
| | - S. Planas
- Department of Histopathology; Southmead Hospital; Bristol UK
| | - L. Shaw
- Department of Paediatric Dermatology; Bristol Royal Hospital for Children; Bristol UK
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48
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Bouty A, Faure A, Shaw L, Ah Toy J, Dobremez E, O'Brien M, Heloury Y. Is peritoneal dialysis feasible after laparotomy in children? A case-control series to compare outcomes. J Pediatr Urol 2017; 13:612.e1-612.e7. [PMID: 28571995 DOI: 10.1016/j.jpurol.2017.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 04/06/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Peritoneal dialysis (PD) is the modality of choice for children with end-stage renal disease (ESRD) awaiting renal transplant; however, this option is sometimes avoided for those with previous laparotomy. The goal of this study was to compare the outcomes of PD in patients with and without previous laparotomy. PATIENTS AND METHODS Twenty-four patients who had been started on peritoneal dialysis were retrospectively analysed. Group LAP consisted of six patients with previous laparotomy, and Group NO-LAP of 18 controls with either retroperitoneal or no abdominal surgery. The percentage of theoretical maximum volume of infusion, time to reach it, complications (infection and drainage difficulties), and number of catheters needed to finish therapy were analysed. RESULTS The characteristics of patients and technique of insertion are presented in Table. The percentage of maximum theoretical volume of infusion was similar in both groups. Median of catheter survival was similar in both groups. Complications were divided into malfunction (slow drainage, obstruction or leak) and infection. Incidence of complications per catheter and per month of dialysis was ten times lower in Group NO-LAP. Peritoneal dialysis failed in one patient with recurrent intraperitoneal adhesions after adhesiolysis in Group LAP. CONCLUSION Despite a higher incidence of complications (malfunction and infections), PD remains an acceptable option after laparotomy. In this series, it was sufficient in achieving adequate filtration in five patients.
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Affiliation(s)
- A Bouty
- Department of Urology, Royal Children's Hospital, Parkville, Australia.
| | - A Faure
- Department of Paediatric Surgery, Hôpital Marseille Nord, Marseille, France
| | - L Shaw
- Department of Nephrology, Royal Children's Hospital, Parkville, Australia
| | - J Ah Toy
- Department of Urology, Royal Children's Hospital, Parkville, Australia
| | - E Dobremez
- Department of Paediatric Surgery, Hôpital Pellegrin enfants, Bordeaux, France
| | - M O'Brien
- Department of Urology, Royal Children's Hospital, Parkville, Australia
| | - Y Heloury
- Department of Urology, Royal Children's Hospital, Parkville, Australia
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Wolff J, Shaw L. The influence of personal assistance on employment outcomes for young adults with neuromuscular disease. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.144] [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: 10/18/2022]
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50
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Kelly A, Shaw L. 034. Channelling pain - Reducing anxiety reduces pain in a particularly severe case primary erythromelalgia. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex356.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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