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Donald F, Keshkamat A, Kumar S, May K, Williams L. Supervision of SAS anaesthetists who are not formally recognised as autonomous. Comment on Br J Anaesth 2024; 132: 867-76. Br J Anaesth 2024; 132:969-970. [PMID: 38531757 DOI: 10.1016/j.bja.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/28/2024] Open
Affiliation(s)
| | | | | | - Kirstin May
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Lucy Williams
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
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Xu W, Williams L, Sebaratnam G, Varghese C, Cedarwall C, Daker C, Keane C. Gastric Alimetry® Testing and Healthcare Economic Analysis in Nausea and Vomiting Syndromes. Dig Dis Sci 2024:10.1007/s10620-024-08455-0. [PMID: 38689198 DOI: 10.1007/s10620-024-08455-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Chronic nausea and vomiting syndromes (CNVS), gastroparesis and functional dyspepsia (FD) are complex disorders. Body Surface Gastric Mapping (BSGM), a new test of gastric function, using Gastric Alimetry® (Alimetry, New Zealand) may be useful for de-escalating healthcare utilisation. This study aimed to define healthcare costs and estimate health economic impacts of implementing this test in patients with chronic gastroduodenal symptoms. METHODS Consecutive patients at a tertiary referral centre evaluated with Gastric Alimetry were included. Frequency and cost data relating to medical investigations, hospital and outpatient presentations were evaluated. Costs of healthcare utilisation were calculated, and the potential cost savings of implementing Gastric Alimetry within a diagnostic decision-tree model were estimated. RESULTS Overall, 31 consecutive patients (mean age 36.1 years; 83.9% female; predominant symptoms: nausea [83.9%], pain [61.3%], vomiting [67.7%] and bloating [35.5%]) completed Gastric Alimetry testing. Repeat gastroscopy and abdominal CT rates were 29% (8/28) and 85% (11/13), respectively. Gastric Alimetry testing identified spectral abnormalities in 45.2% of patients, and symptom profiling classified a further 29.1% of patients. Median annualised cost difference after test introduction was NZ$-12,032. Estimated reductions in investigation-related costs when incorporating Gastric Alimetry into the diagnostic workflow model were approximately NZ$1,300 per patient. CONCLUSIONS Healthcare utilisation and confirmatory testing rates remain high in nausea and vomiting syndromes. This study presents real-world data, together with a decision-tree analysis, showing Gastric Alimetry can streamline clinical care pathways, resulting in reduced healthcare utilisation and cost.
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Affiliation(s)
- William Xu
- The University of Auckland, Auckland, New Zealand
- Te Tai Tokerau District, Te Whatu Ora, Whangarei, New Zealand
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | | | | | - Chris Varghese
- The University of Auckland, Auckland, New Zealand
- Counties Manukau District, Te Whatu Ora, Whangarei, New Zealand
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Chris Cedarwall
- Capital and Coast District, Te Whatu Ora, Whangarei, New Zealand
| | | | - Celia Keane
- Te Tai Tokerau District, Te Whatu Ora, Whangarei, New Zealand.
- Department of Surgery, University of Auckland, Auckland, New Zealand.
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John M, Williams L, Nolan G, Bonnett M, Castley A, Nolan D. Real-world use of long-acting cabotegravir and rilpivirine: 12-month results of the inJectable Antiretroviral therapy feasiBility Study (JABS). HIV Med 2024. [PMID: 38644518 DOI: 10.1111/hiv.13647] [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] [Received: 12/11/2023] [Accepted: 04/01/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES The inJectable Antiretroviral feasiBility Study (JABS) aimed to evaluate the implementation of long-acting regimens in a 'real world' Australian setting, with inclusion of participants with complex medical needs, social vulnerability and/or historical non-adherence. METHODS JABS was a 12-month, single-centre, single-arm, open-label phase IV study of long-acting cabotegravir 600 mg plus rilpivirine 900 mg administered intramuscularly every 2 months to adults with treated HIV-1 infection. The primary endpoint was the proportion of attendances and administration of injections within a 14-day dosing window over 12 months, out of the total prescribed doses. Secondary endpoints included proportions of missed appointments, use of oral bridging, discontinuations, virological failures, adverse events and participant-reported outcomes. A multidisciplinary adherence programme embedded in the clinical service known as REACH provided support to JABS participants. RESULTS Of 60 participants enrolled by May 2022, 60% had one or more complexity or vulnerability factors identified, including absence of social supports (50%), mental health issues, alcohol or drug use (30%) and financial hardship or instability (13%), among others. Twenty-seven per cent of participants had historical non-adherence to antiretroviral therapy. Out of 395 prescribed doses, 97.2% of injections were administered within correct dosing windows at clinic visits. Two courses of short-term oral bridging were required. The rate of injection site reactions was 29%, the majority being grade 1-2. There were no virological failures, no serious adverse events and only one injection-related study discontinuation. High baseline treatment satisfaction and acceptability of injections increased by month 12. Those with vulnerability factors had similar adherence to injections as those without such factors. Ninety-eight per cent of the participants who completed 12 months on the study have maintained long-acting therapy, virological suppression and retention in care. CONCLUSIONS Long-acting cabotegravir plus rilpivirine was associated with very high adherence, maintenance of virological suppression, safety and treatment satisfaction in a diverse Australian clinic population, comparable to results of phase III randomized clinical trials. Individuals with vulnerability factors can achieve adherence to injections with individualized support. Long-acting therapies in this group can increase the subsequent engagement in clinical care.
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Affiliation(s)
- M John
- Department of Clinical Immunology, Royal Perth Hospital, Perth, Western Australia, Australia
- Immunology, PathWest, Murdoch, Western Australia, Australia
- Medical Genomics IIID, Murdoch University, Murdoch, Western Australia, Australia
| | - L Williams
- Department of Clinical Immunology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - G Nolan
- Department of Clinical Immunology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - M Bonnett
- Department of Clinical Immunology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - A Castley
- Department of Clinical Immunology, Royal Perth Hospital, Perth, Western Australia, Australia
- Immunology, PathWest, Murdoch, Western Australia, Australia
| | - D Nolan
- Department of Clinical Immunology, Royal Perth Hospital, Perth, Western Australia, Australia
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Williams L, Waller SE, Bradley M, Lockhart A, Narayanan RK, Kumar KR, Morales Briceno H, Tchan M, Healy DG, Fung VSC. ATP1A3 related disease manifesting as rapid onset dystonia-parkinsonism with prominent myoclonus and exaggerated startle. Parkinsonism Relat Disord 2023; 117:105864. [PMID: 37827923 DOI: 10.1016/j.parkreldis.2023.105864] [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: 04/16/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/14/2023]
Abstract
We report ATP1A3-associated rapid-onset dystonia-parkinsonism with an atypical presentation including myoclonus and exaggerated startle in four patients. Their prominence over parkinsonism prompted consideration of a syndromic diagnosis of myoclonus dystonia. ATP1α3 dysfunction in GABAergic neurons could explain these examination findings. The spectrum of ATP1A3-associated movement disorders includes myoclonus-dystonia.
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Affiliation(s)
- L Williams
- Movement Disorders Unit, Neurology Department, Westmead Hospital, Westmead, NSW, 2145, Australia.
| | - S E Waller
- Movement Disorders Unit, Neurology Department, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - M Bradley
- Department of Neurology, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | - A Lockhart
- Department of Neurology, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | - R K Narayanan
- Northcott Neuroscience Laboratory, ANZAC Research Institute, Concord, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - K R Kumar
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Garvan Institute of Medical Research, Darlinghurst, NSW, Australia; Faculty of Medicine and Health, University of New South Wales, Australia; Molecular Medicine Laboratory and Neurology Department, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - H Morales Briceno
- Movement Disorders Unit, Neurology Department, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - M Tchan
- Department of Medical Genetics, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - D G Healy
- Department of Neurology, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | - V S C Fung
- Movement Disorders Unit, Neurology Department, Westmead Hospital, Westmead, NSW, 2145, Australia; Faculty of Medicine and Health, University of New South Wales, Australia
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Falconer Hall T, Williams LG, Williams L, Horne ST. Defence context for the UK's Defence Engagement (Health). BMJ Mil Health 2023:military-2023-002369. [PMID: 37192763 DOI: 10.1136/military-2023-002369] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/02/2023] [Indexed: 05/18/2023]
Abstract
Defence Engagement (DE) has been a core UK Defence task since 2015. DE (Health) is the use of military medical capabilities to achieve DE effects within the health sector to achieve security and defence objectives. DE (Health) practitioners must understand the underlying defence context that shapes these objectives. The strategic context is becoming more uncertain with the return of great power competition layered on enduring threats from non-state actors and transnational challenges. The UK response has been to develop the Integrated Review, outlining four national security and international policy objectives. UK Defence has responded by developing the integrated operating concept, differentiating military activity between operating and warfighting. Engage is one of the three functions of operate activity, which is complementary to the other operate functions of protect and constrain. DE (Health) can play a unique role in engagement, given its ability to develop new partnerships through health-related activity. DE (Health) may be an enabler for other engagements or to enable the protect and constrain functions. This will be dependent on delivering improvement in health outcomes. Therefore, the DE (Health) practitioner must be conversant with both the contemporary defence and global health contexts to deliver effective DE (Health) activities. This is an article commissioned for the DE special issue of BMJ Military Health.
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Affiliation(s)
- Thomas Falconer Hall
- AMS Support Unit, Army Medical Services, Camberley, UK
- DMS Centre for Defence Engagement, Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
| | - L G Williams
- AMS Support Unit, Army Medical Services, Camberley, UK
| | - L Williams
- 2 Armoured Medical Regiment, British Army, Tidworth, UK
| | - S T Horne
- DMS Centre for Defence Engagement, Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
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Schulte T, Panas MD, Han X, Williams L, Kedersha N, Fleck JS, Tan TJC, Dopico XC, Olsson A, Morro AM, Hanke L, Nilvebrant J, Giang KA, Nygren PÅ, Anderson P, Achour A, McInerney GM. Caprin-1 binding to the critical stress granule protein G3BP1 is influenced by pH. Open Biol 2023; 13:220369. [PMID: 37161291 PMCID: PMC10170197 DOI: 10.1098/rsob.220369] [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: 05/11/2023] Open
Abstract
G3BP is the central node within stress-induced protein-RNA interaction networks known as stress granules (SGs). The SG-associated proteins Caprin-1 and USP10 bind mutually exclusively to the NTF2 domain of G3BP1, promoting and inhibiting SG formation, respectively. Herein, we present the crystal structure of G3BP1-NTF2 in complex with a Caprin-1-derived short linear motif (SLiM). Caprin-1 interacts with His-31 and His-62 within a third NTF2-binding site outside those covered by USP10, as confirmed using biochemical and biophysical-binding assays. Nano-differential scanning fluorimetry revealed reduced thermal stability of G3BP1-NTF2 at acidic pH. This destabilization was counterbalanced significantly better by bound USP10 than Caprin-1. The G3BP1/USP10 complex immunoprecipated from human U2OS cells was more resistant to acidic buffer washes than G3BP1/Caprin-1. Acidification of cellular condensates by approximately 0.5 units relative to the cytosol was detected by ratiometric fluorescence analysis of pHluorin2 fused to G3BP1. Cells expressing a Caprin-1/FGDF chimera with higher G3BP1-binding affinity had reduced Caprin-1 levels and slightly reduced condensate sizes. This unexpected finding may suggest that binding of the USP10-derived SLiM to NTF2 reduces the propensity of G3BP1 to enter condensates.
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Affiliation(s)
- Tim Schulte
- Science for Life Laboratory, Department of Medicine Solna, Karolinska Institutet, and Division of Infectious Diseases, Karolinska University Hospital, Stockholm, 171 77, Sweden
| | - Marc D Panas
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Xiao Han
- Science for Life Laboratory, Department of Medicine Solna, Karolinska Institutet, and Division of Infectious Diseases, Karolinska University Hospital, Stockholm, 171 77, Sweden
| | - Lucy Williams
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Nancy Kedersha
- Division of Rheumatology, Immunity, and Inflammation, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Harvard Medical School Initiative for RNA Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Jonas Simon Fleck
- Science for Life Laboratory, Department of Medicine Solna, Karolinska Institutet, and Division of Infectious Diseases, Karolinska University Hospital, Stockholm, 171 77, Sweden
| | - Timothy J C Tan
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Xaquin Castro Dopico
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Anders Olsson
- Protein Expression and Characterization, AlbaNova University Center, Royal Institute of Technology, 114 21, Stockholm
| | - Ainhoa Moliner Morro
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Leo Hanke
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - Johan Nilvebrant
- Division of Protein Engineering, Department of Protein Science, School of Engineering Sciences in Chemistry, Biotechnology and Health, AlbaNova University Center, Royal Institute of Technology, 114 21, Stockholm
- Science for Life Laboratory, Tomtebodavägen 23A, 171 65, Sweden
| | - Kim Anh Giang
- Division of Protein Engineering, Department of Protein Science, School of Engineering Sciences in Chemistry, Biotechnology and Health, AlbaNova University Center, Royal Institute of Technology, 114 21, Stockholm
- Science for Life Laboratory, Tomtebodavägen 23A, 171 65, Sweden
| | - Per-Åke Nygren
- Division of Protein Engineering, Department of Protein Science, School of Engineering Sciences in Chemistry, Biotechnology and Health, AlbaNova University Center, Royal Institute of Technology, 114 21, Stockholm
- Science for Life Laboratory, Tomtebodavägen 23A, 171 65, Sweden
| | - Paul Anderson
- Division of Rheumatology, Immunity, and Inflammation, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Harvard Medical School Initiative for RNA Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Adnane Achour
- Science for Life Laboratory, Department of Medicine Solna, Karolinska Institutet, and Division of Infectious Diseases, Karolinska University Hospital, Stockholm, 171 77, Sweden
| | - Gerald M McInerney
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, 171 77, Sweden
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Hall EA, Kumar D, Prosser SL, Yeyati PL, Herranz-Pérez V, García-Verdugo JM, Rose L, McKie L, Dodd DO, Tennant PA, Megaw R, Murphy LC, Ferreira MF, Grimes G, Williams L, Quidwai T, Pelletier L, Reiter JF, Mill P. Centriolar satellites expedite mother centriole remodeling to promote ciliogenesis. eLife 2023; 12:e79299. [PMID: 36790165 PMCID: PMC9998092 DOI: 10.7554/elife.79299] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 02/14/2023] [Indexed: 02/16/2023] Open
Abstract
Centrosomes are orbited by centriolar satellites, dynamic multiprotein assemblies nucleated by Pericentriolar material 1 (PCM1). To study the requirement for centriolar satellites, we generated mice lacking PCM1, a crucial component of satellites. Pcm1-/- mice display partially penetrant perinatal lethality with survivors exhibiting hydrocephalus, oligospermia, and cerebellar hypoplasia, and variably expressive phenotypes such as hydronephrosis. As many of these phenotypes have been observed in human ciliopathies and satellites are implicated in cilia biology, we investigated whether cilia were affected. PCM1 was dispensable for ciliogenesis in many cell types, whereas Pcm1-/- multiciliated ependymal cells and human PCM1-/- retinal pigmented epithelial 1 (RPE1) cells showed reduced ciliogenesis. PCM1-/- RPE1 cells displayed reduced docking of the mother centriole to the ciliary vesicle and removal of CP110 and CEP97 from the distal mother centriole, indicating compromised early ciliogenesis. Similarly, Pcm1-/- ependymal cells exhibited reduced removal of CP110 from basal bodies in vivo. We propose that PCM1 and centriolar satellites facilitate efficient trafficking of proteins to and from centrioles, including the departure of CP110 and CEP97 to initiate ciliogenesis, and that the threshold to trigger ciliogenesis differs between cell types.
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Affiliation(s)
- Emma A Hall
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Dhivya Kumar
- Department of Biochemistry and Biophysics, Cardiovascular Research Institute, University of CaliforniaSan FranciscoUnited States
| | - Suzanna L Prosser
- Lunenfeld-Tanenbaum Research Institute, Sinai Health SystemTorontoCanada
| | - Patricia L Yeyati
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Vicente Herranz-Pérez
- Cavanilles Institute of Biodiversity and Evolutionary Biology, University of ValenciaValenciaSpain
- Predepartamental Unit of Medicine, Jaume I UniversityCastelló de la PlanaSpain
| | | | - Lorraine Rose
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Lisa McKie
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Daniel O Dodd
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Peter A Tennant
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Roly Megaw
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Laura C Murphy
- Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Marisa F Ferreira
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Graeme Grimes
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Lucy Williams
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Tooba Quidwai
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
| | - Laurence Pelletier
- Lunenfeld-Tanenbaum Research Institute, Sinai Health SystemTorontoCanada
- Department of Molecular Genetics, University of TorontoUniversity of TorontoCanada
| | - Jeremy F Reiter
- Department of Biochemistry and Biophysics, Cardiovascular Research Institute, University of CaliforniaSan FranciscoUnited States
- Chan Zuckerberg BiohubSan FranciscoUnited States
| | - Pleasantine Mill
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of EdinburghEdinburghUnited Kingdom
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Reeves AE, Mlynczak M, Jenkins M, Williams L, Sarkar S. Geauxhealth.org - A technological approach to addressing social determinants of health in New Orleans. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00553-0] [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: 01/28/2023]
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Wilson MP, Craig L, Peacock E, Williams L, Fields T, Roberts S, Sarpong D, Krousel-Wood M. Using diverse community feedback to inform inclusive community action: Insights from the Louisiana Community Engagement Alliance. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00551-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Houghton N, Williams L, Baptista A, Thakerar V, Dharmarajah A. Digital clinical placements: Student perspectives and preparedness for placements. Clin Teach 2023; 20:e13558. [PMID: 36599293 PMCID: PMC10108031 DOI: 10.1111/tct.13558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/30/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND In May 2020, first-year students at Imperial College School of Medicine attended a 'digital hospital placement'. Occurring in the early months of the COVID-19 pandemic, this replaced their first planned hospital placement. The authors analysed student experiences to understand how a digital hospital placement impacted self-perceived clinical and professional development and whether it improved preparedness for face-to-face hospital placements. METHODS Three hundred ten students participated in this week-long digital placement, which integrated clinical skills, communication and professional behaviour domains. It aimed to prepare students for safe participation in clinical environments. Resources included self-directed and peer learning, virtual simulations (Oxford Medical Simulation) and staff-led debriefing. Surveys were administered after the digital placement and after students' first face-to-face placement to collect quantitative and qualitative data. A reflexive thematic analysis was conducted. RESULTS Eighty-three and twenty-nine students completed the postdigital and post-face-to-face placement evaluation respectively. Quantitative results indicated a high self-rated achievement of learning objectives and enthusiasm for digital placements; 83% of respondents supported digital simulations as part of regular medical education. Qualitative analysis identified three superordinate themes: (1) domain integration in digital placements helped students feel better prepared; (2) digital experiential learning is ideally suited to early clinical learning; and (3) virtual placements are a compliment, not an alternative, to face-to-face placements. CONCLUSION Digital placements are a promising means of supporting the challenging transition from classroom learner to clinical learner. They provide a feasible and scalable option for building student confidence and improving preparedness.
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Affiliation(s)
- Natasha Houghton
- Centre for Engagement and Simulation Science, Imperial College London, London, UK
| | - Lucy Williams
- Faculty of Medicine, Imperial College London, London, UK
| | - Ana Baptista
- Medical Education Research Unit, Faculty of Medicine, Imperial College London, London, UK
| | - Viral Thakerar
- Faculty of Medicine, Imperial College London, London, UK
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Heckman S, Kushida C, Bennett C, Cortes M, Raio D, Heit T, Williams L, Griffin T. Biomimetic Oral Appliance Therapy (BOAT): Novel Oral Appliance Treatment for Obstructive Sleep Apnea Administered by Dentists. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.164] [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: 10/17/2022]
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12
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Williams L, Taylor K, Cameron D, Jack W, Bartlett J, Caldwell J, Kunkler I, Dunlop J. Randomised controlled trial of breast conserving therapy: 30 year analysis of the Scottish breast conservation trial. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01352-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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13
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Vale GL, Williams L, Neal Webb S, Schapiro SJ, Brosnan SF. Female squirrel monkeys' ( Saimiri boliviensis) responses to inequity in a group context; testing a link between cooperation and inequity responses. Anim Behav 2022; 193:51-62. [PMID: 36467329 PMCID: PMC9718534 DOI: 10.1016/j.anbehav.2022.08.005] [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] [Indexed: 11/24/2022]
Abstract
Primates of several species respond negatively to receiving less preferred rewards than a partner for completing the same task (inequity responses), either rejecting rewards or refusing to participate in the task when disadvantaged. This has been linked to cooperation, with species that cooperate frequently refusing to participate in inequity tasks (the 'cooperation hypothesis'). However, inequity is a social response, and previous research has involved dyads, precluding studying the effects of additional social partners. While dyads allow for tighter control in experimental settings, dyadic interactions in nature do not take place in a social vacuum, so understanding the role of the social context is needed to verify that the pattern of results supports the cooperation hypothesis. Here we focus on Bolivian squirrel monkeys, Saimiri boliviensis, a highly social species that does not generally cooperate and has not responded to inequity in previous dyadic research, although they do respond to receiving a lower reward than they expected. In the current study, we provide a more nuanced test by studying female Bolivian squirrel monkeys, the demographic most likely to cooperate in both field and laboratory contexts, in a more socially relevant group setting. For some reward values, females responded in both the inequity condition, rejecting less preferred rewards when they were disadvantaged relative to their social group, and a contrast condition, wherein all animals received a lower reward than they expected, making it difficult to disentangle contrast from inequity. As in capuchin monkeys, refusals increased when monkeys were to receive low-value rewards compared to medium-value rewards. These results suggest that the relationship between cooperation and inequity responses may be more nuanced than previously suggested, with demographic, social context and reward value potentially influencing outcomes even within species.
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Affiliation(s)
- G. L. Vale
- Lester E. Fisher Center for the Study and Conservation of Apes, Lincoln Park Zoo, Chicago, IL, U.S.A
- Department of Comparative Medicine, Michale E. Keeling Center for Comparative Medicine and Research, The University of Texas MD Anderson Cancer Center, Bastrop, TX, U.S.A
- Department of Psychology, Language Research Center, Neuroscience Institute and Center for Behavioral Neuroscience, Georgia State University, Atlanta, GA, U.S.A
| | - L. Williams
- Department of Comparative Medicine, Michale E. Keeling Center for Comparative Medicine and Research, The University of Texas MD Anderson Cancer Center, Bastrop, TX, U.S.A
| | - S. Neal Webb
- Department of Comparative Medicine, Michale E. Keeling Center for Comparative Medicine and Research, The University of Texas MD Anderson Cancer Center, Bastrop, TX, U.S.A
| | - S. J. Schapiro
- Department of Comparative Medicine, Michale E. Keeling Center for Comparative Medicine and Research, The University of Texas MD Anderson Cancer Center, Bastrop, TX, U.S.A
| | - S. F. Brosnan
- Department of Comparative Medicine, Michale E. Keeling Center for Comparative Medicine and Research, The University of Texas MD Anderson Cancer Center, Bastrop, TX, U.S.A
- Department of Psychology, Language Research Center, Neuroscience Institute and Center for Behavioral Neuroscience, Georgia State University, Atlanta, GA, U.S.A
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Proietti M, Romiti GF, Vitolo M, Harrison SL, Lane DA, Fauchier L, Marin F, Näbauer M, Potpara TS, Dan GA, Maggioni AP, Cesari M, Boriani G, Lip GYH, Ekmekçiu U, Paparisto V, Tase M, Gjergo H, Dragoti J, Goda A, Ciutea M, Ahadi N, el Husseini Z, Raepers M, Leroy J, Haushan P, Jourdan A, Lepiece C, Desteghe L, Vijgen J, Koopman P, Van Genechten G, Heidbuchel H, Boussy T, De Coninck M, Van Eeckhoutte H, Bouckaert N, Friart A, Boreux J, Arend C, Evrard P, Stefan L, Hoffer E, Herzet J, Massoz M, Celentano C, Sprynger M, Pierard L, Melon P, Van Hauwaert B, Kuppens C, Faes D, Van Lier D, Van Dorpe A, Gerardy A, Deceuninck O, Xhaet O, Dormal F, Ballant E, Blommaert D, Yakova D, Hristov M, Yncheva T, Stancheva N, Tisheva S, Tokmakova M, Nikolov F, Gencheva D, Shalganov T, Kunev B, Stoyanov M, Marchov D, Gelev V, Traykov V, Kisheva A, Tsvyatkov H, Shtereva R, Bakalska-Georgieva S, Slavcheva S, Yotov Y, Kubíčková M, Marni Joensen A, Gammelmark A, Hvilsted Rasmussen L, Dinesen P, Riahi S, Krogh Venø S, Sorensen B, Korsgaard A, Andersen K, Fragtrup Hellum C, Svenningsen A, Nyvad O, Wiggers P, May O, Aarup A, Graversen B, Jensen L, Andersen M, Svejgaard M, Vester S, Hansen S, Lynggaard V, Ciudad M, Vettus R, Muda P, Maestre A, Castaño S, Cheggour S, Poulard J, Mouquet V, Leparrée S, Bouet J, Taieb J, Doucy A, Duquenne H, Furber A, Dupuis J, Rautureau J, Font M, Damiano P, Lacrimini M, Abalea J, Boismal S, Menez T, Mansourati J, Range G, Gorka H, Laure C, Vassalière C, Elbaz N, Lellouche N, Djouadi K, Roubille F, Dietz D, Davy J, Granier M, Winum P, Leperchois-Jacquey C, Kassim H, Marijon E, Le Heuzey J, Fedida J, Maupain C, Himbert C, Gandjbakhch E, Hidden-Lucet F, Duthoit G, Badenco N, Chastre T, Waintraub X, Oudihat M, Lacoste J, Stephan C, Bader H, Delarche N, Giry L, Arnaud D, Lopez C, Boury F, Brunello I, Lefèvre M, Mingam R, Haissaguerre M, Le Bidan M, Pavin D, Le Moal V, Leclercq C, Piot O, Beitar T, Martel I, Schmid A, Sadki N, Romeyer-Bouchard C, Da Costa A, Arnault I, Boyer M, Piat C, Fauchier L, Lozance N, Nastevska S, Doneva A, Fortomaroska Milevska B, Sheshoski B, Petroska K, Taneska N, Bakrecheski N, Lazarovska K, Jovevska S, Ristovski V, Antovski A, Lazarova E, Kotlar I, Taleski J, Poposka L, Kedev S, Zlatanovik N, Jordanova S, Bajraktarova Proseva T, Doncovska S, Maisuradze D, Esakia A, Sagirashvili E, Lartsuliani K, Natelashvili N, Gumberidze N, Gvenetadze R, Etsadashvili K, Gotonelia N, Kuridze N, Papiashvili G, Menabde I, Glöggler S, Napp A, Lebherz C, Romero H, Schmitz K, Berger M, Zink M, Köster S, Sachse J, Vonderhagen E, Soiron G, Mischke K, Reith R, Schneider M, Rieker W, Boscher D, Taschareck A, Beer A, Oster D, Ritter O, Adamczewski J, Walter S, Frommhold A, Luckner E, Richter J, Schellner M, Landgraf S, Bartholome S, Naumann R, Schoeler J, Westermeier D, William F, Wilhelm K, Maerkl M, Oekinghaus R, Denart M, Kriete M, Tebbe U, Scheibner T, Gruber M, Gerlach A, Beckendorf C, Anneken L, Arnold M, Lengerer S, Bal Z, Uecker C, Förtsch H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, Holst Hansen C, Engset I, Atar D, Dyduch-Fejklowicz B, Koba E, Cichocka M, Sokal A, Kubicius A, Pruchniewicz E, Kowalik-Sztylc A, Czapla W, Mróz I, Kozlowski M, Pawlowski T, Tendera M, Winiarska-Filipek A, Fidyk A, Slowikowski A, Haberka M, Lachor-Broda M, Biedron M, Gasior Z, Kołodziej M, Janion M, Gorczyca-Michta I, Wozakowska-Kaplon B, Stasiak M, Jakubowski P, Ciurus T, Drozdz J, Simiera M, Zajac P, Wcislo T, Zycinski P, Kasprzak J, Olejnik A, Harc-Dyl E, Miarka J, Pasieka M, Ziemińska-Łuć M, Bujak W, Śliwiński A, Grech A, Morka J, Petrykowska K, Prasał M, Hordyński G, Feusette P, Lipski P, Wester A, Streb W, Romanek J, Woźniak P, Chlebuś M, Szafarz P, Stanik W, Zakrzewski M, Kaźmierczak J, Przybylska A, Skorek E, Błaszczyk H, Stępień M, Szabowski S, Krysiak W, Szymańska M, Karasiński J, Blicharz J, Skura M, Hałas K, Michalczyk L, Orski Z, Krzyżanowski K, Skrobowski A, Zieliński L, Tomaszewska-Kiecana M, Dłużniewski M, Kiliszek M, Peller M, Budnik M, Balsam P, Opolski G, Tymińska A, Ozierański K, Wancerz A, Borowiec A, Majos E, Dabrowski R, Szwed H, Musialik-Lydka A, Leopold-Jadczyk A, Jedrzejczyk-Patej E, Koziel M, Lenarczyk R, Mazurek M, Kalarus Z, Krzemien-Wolska K, Starosta P, Nowalany-Kozielska E, Orzechowska A, Szpot M, Staszel M, Almeida S, Pereira H, Brandão Alves L, Miranda R, Ribeiro L, Costa F, Morgado F, Carmo P, Galvao Santos P, Bernardo R, Adragão P, Ferreira da Silva G, Peres M, Alves M, Leal M, Cordeiro A, Magalhães P, Fontes P, Leão S, Delgado A, Costa A, Marmelo B, Rodrigues B, Moreira D, Santos J, Santos L, Terchet A, Darabantiu D, Mercea S, Turcin Halka V, Pop Moldovan A, Gabor A, Doka B, Catanescu G, Rus H, Oboroceanu L, Bobescu E, Popescu R, Dan A, Buzea A, Daha I, Dan G, Neuhoff I, Baluta M, Ploesteanu R, Dumitrache N, Vintila M, Daraban A, Japie C, Badila E, Tewelde H, Hostiuc M, Frunza S, Tintea E, Bartos D, Ciobanu A, Popescu I, Toma N, Gherghinescu C, Cretu D, Patrascu N, Stoicescu C, Udroiu C, Bicescu G, Vintila V, Vinereanu D, Cinteza M, Rimbas R, Grecu M, Cozma A, Boros F, Ille M, Tica O, Tor R, Corina A, Jeewooth A, Maria B, Georgiana C, Natalia C, Alin D, Dinu-Andrei D, Livia M, Daniela R, Larisa R, Umaar S, Tamara T, Ioachim Popescu M, Nistor D, Sus I, Coborosanu O, Alina-Ramona N, Dan R, Petrescu L, Ionescu G, Popescu I, Vacarescu C, Goanta E, Mangea M, Ionac A, Mornos C, Cozma D, Pescariu S, Solodovnicova E, Soldatova I, Shutova J, Tjuleneva L, Zubova T, Uskov V, Obukhov D, Rusanova G, Soldatova I, Isakova N, Odinsova S, Arhipova T, Kazakevich E, Serdechnaya E, Zavyalova O, Novikova T, Riabaia I, Zhigalov S, Drozdova E, Luchkina I, Monogarova Y, Hegya D, Rodionova L, Rodionova L, Nevzorova V, Soldatova I, Lusanova O, Arandjelovic A, Toncev D, Milanov M, Sekularac N, Zdravkovic M, Hinic S, Dimkovic S, Acimovic T, Saric J, Polovina M, Potpara T, Vujisic-Tesic B, Nedeljkovic M, Zlatar M, Asanin M, Vasic V, Popovic Z, Djikic D, Sipic M, Peric V, Dejanovic B, Milosevic N, Stevanovic A, Andric A, Pencic B, Pavlovic-Kleut M, Celic V, Pavlovic M, Petrovic M, Vuleta M, Petrovic N, Simovic S, Savovic Z, Milanov S, Davidovic G, Iric-Cupic V, Simonovic D, Stojanovic M, Stojanovic S, Mitic V, Ilic V, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Markovic S, Kovacevic S, García Fernandez A, Perez Cabeza A, Anguita M, Tercedor Sanchez L, Mau E, Loayssa J, Ayarra M, Carpintero M, Roldán Rabadan I, Leal M, Gil Ortega M, Tello Montoliu A, Orenes Piñero E, Manzano Fernández S, Marín F, Romero Aniorte A, Veliz Martínez A, Quintana Giner M, Ballesteros G, Palacio M, Alcalde O, García-Bolao I, Bertomeu Gonzalez V, Otero-Raviña F, García Seara J, Gonzalez Juanatey J, Dayal N, Maziarski P, Gentil-Baron P, Shah D, Koç M, Onrat E, Dural IE, Yilmaz K, Özin B, Tan Kurklu S, Atmaca Y, Canpolat U, Tokgozoglu L, Dolu AK, Demirtas B, Sahin D, Ozcan Celebi O, Diker E, Gagirci G, Turk UO, Ari H, Polat N, Toprak N, Sucu M, Akin Serdar O, Taha Alper A, Kepez A, Yuksel Y, Uzunselvi A, Yuksel S, Sahin M, Kayapinar O, Ozcan T, Kaya H, Yilmaz MB, Kutlu M, Demir M, Gibbs C, Kaminskiene S, Bryce M, Skinner A, Belcher G, Hunt J, Stancombe L, Holbrook B, Peters C, Tettersell S, Shantsila A, Lane D, Senoo K, Proietti M, Russell K, Domingos P, Hussain S, Partridge J, Haynes R, Bahadur S, Brown R, McMahon S, Y H Lip G, McDonald J, Balachandran K, Singh R, Garg S, Desai H, Davies K, Goddard W, Galasko G, Rahman I, Chua Y, Payne O, Preston S, Brennan O, Pedley L, Whiteside C, Dickinson C, Brown J, Jones K, Benham L, Brady R, Buchanan L, Ashton A, Crowther H, Fairlamb H, Thornthwaite S, Relph C, McSkeane A, Poultney U, Kelsall N, Rice P, Wilson T, Wrigley M, Kaba R, Patel T, Young E, Law J, Runnett C, Thomas H, McKie H, Fuller J, Pick S, Sharp A, Hunt A, Thorpe K, Hardman C, Cusack E, Adams L, Hough M, Keenan S, Bowring A, Watts J, Zaman J, Goffin K, Nutt H, Beerachee Y, Featherstone J, Mills C, Pearson J, Stephenson L, Grant S, Wilson A, Hawksworth C, Alam I, Robinson M, Ryan S, Egdell R, Gibson E, Holland M, Leonard D, Mishra B, Ahmad S, Randall H, Hill J, Reid L, George M, McKinley S, Brockway L, Milligan W, Sobolewska J, Muir J, Tuckis L, Winstanley L, Jacob P, Kaye S, Morby L, Jan A, Sewell T, Boos C, Wadams B, Cope C, Jefferey P, Andrews N, Getty A, Suttling A, Turner C, Hudson K, Austin R, Howe S, Iqbal R, Gandhi N, Brophy K, Mirza P, Willard E, Collins S, Ndlovu N, Subkovas E, Karthikeyan V, Waggett L, Wood A, Bolger A, Stockport J, Evans L, Harman E, Starling J, Williams L, Saul V, Sinha M, Bell L, Tudgay S, Kemp S, Brown J, Frost L, Ingram T, Loughlin A, Adams C, Adams M, Hurford F, Owen C, Miller C, Donaldson D, Tivenan H, Button H, Nasser A, Jhagra O, Stidolph B, Brown C, Livingstone C, Duffy M, Madgwick P, Roberts P, Greenwood E, Fletcher L, Beveridge M, Earles S, McKenzie D, Beacock D, Dayer M, Seddon M, Greenwell D, Luxton F, Venn F, Mills H, Rewbury J, James K, Roberts K, Tonks L, Felmeden D, Taggu W, Summerhayes A, Hughes D, Sutton J, Felmeden L, Khan M, Walker E, Norris L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Mead M, Bevilacqua M, Loiseaux C, Hallett S, Jude S, Emmanouilidis C, Harris J, Leinster P, Mutnuri S, Tran T, Williams L. Generalised network architectures for environmental sensing: Case studies for a digitally enabled environment. Array 2022. [DOI: 10.1016/j.array.2022.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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16
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Williams L, Hatton FL, Willcock H, Mele E. Electrospinning of Stimuli‐Responsive Polymers for Controlled Drug Delivery: pH‐ and Temperature‐Driven Release. Biotechnol Bioeng 2022; 119:1177-1188. [DOI: 10.1002/bit.28043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 12/21/2021] [Accepted: 01/17/2022] [Indexed: 11/08/2022]
Affiliation(s)
- L. Williams
- Department of Materials Loughborough University Epinal Way, Loughborough LE11 3TU UK
| | - F. L. Hatton
- Department of Materials Loughborough University Epinal Way, Loughborough LE11 3TU UK
| | - H. Willcock
- Department of Materials Loughborough University Epinal Way, Loughborough LE11 3TU UK
| | - E. Mele
- Department of Materials Loughborough University Epinal Way, Loughborough LE11 3TU UK
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17
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Williams L, Drennan VM. Evaluating the efficacy of rapid diagnostic tests for imported malaria in high income countries: A systematic review. Int Emerg Nurs 2021; 60:101110. [PMID: 34953438 DOI: 10.1016/j.ienj.2021.101110] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 10/15/2021] [Accepted: 10/27/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Malaria is a life-threatening disease. Prior to the pandemic, over a million people annually from non-endemic, high income countries such as Europe and North America visited countries with a risk of malaria transmission. Emergency care nurses in non-endemic countries frequently encounter returning travellers, presenting with symptoms suggestive of malaria. While rapid diagnostic tests are used in countries with endemic malaria, in countries such as the United Kingdom diagnosis is undertaken by microscopy and three negative tests are required to exclude. QUESTION Are rapid diagnostic tests effective for diagnosing imported malaria in non-endemic, high income countries? METHOD A systematic review of published research (January 2009 - November 2020) comparing rapid diagnostic tests with microscopy. RESULTS Fourteen studies were included, conducted in five countries with 14 different RDTs evaluated. Mean sensitivity and specificity for Plasmodium Falciparum was 91.8% and 97.7% and Plasmodium Vivax 81.6% and 99.2%. Higher sensitivities were related to higher parasite densities. CONCLUSIONS International travel will return post-pandemic and rapid, accurate and cost-efficient tests will be required. The rapid diagnostic tests in these studies showed significant variation and were not as accurate as microscopy. Consequently, it cannot be recommended that rapid diagnostic tests replace the gold standard of microscopy. Further research is required.
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Affiliation(s)
- Lucy Williams
- Joint Faculty of Kingston University & St. George's University of London, Cranmer Terrace, London SW17 ORE, UK.
| | - Vari M Drennan
- Joint Faculty of Kingston University & St. George's University of London, Cranmer Terrace, London SW17 ORE, UK.
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18
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Abstract
We examined relationships between various sociodemographic factors and attendance at the Glasgow Pain Management Programme (n = 2899 from 2011 to 2019). We tested for associations between gender, age and socioeconomic deprivation of patients who were invited to attend, and uptake to a programme when invited, attendance at screening assessment, eligibility, adherence and attendance at 3- and 6-month reviews. Uptake was significantly higher for patients from more affluent areas (95% confidence interval (CI) = 0.93–0.99, p = 0.002) and for older patients (95% CI = 0.98–0.99, p = 0.006), although effect sizes were very small. Patients were significantly more likely to be assessed as suitable if they were younger (95% CI = 0.98–0.99, p = 0.013) or female (95% CI = 0.55–0.84, p < 0.001). Attendance at sessions and at 3- and 6-month reviews was higher for patients from more affluent areas (95% CI = 1–1.09, p = 0.001, and 95% CI = 1–1.1, p = 0.044 respectively). We argue that there are multiple potential explanations for these findings and that future work should attempt to determine whether these patterns replicate in other populations and to determine any modifiable causes.
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Affiliation(s)
- F R Moore
- Phoenix Centre, Raigmore Hospital, Inverness, UK
| | | | - M Dunbar
- New Victoria Hospital, Glasgow, UK
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19
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Hollingworth J, Walsh L, Tran S, Ramage L, Patel-Brown S, Ambekar M, Weeks J, Williams L, Cohen PA. Does a multidisciplinary menopausal symptoms after cancer clinic reduce symptoms? Support Care Cancer 2021; 30:2245-2252. [PMID: 34714415 DOI: 10.1007/s00520-021-06637-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/16/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aimed to measure the prevalence of menopausal symptoms in patients attending a multidisciplinary model of care clinic at their initial clinic visit and their subsequent follow-up consultation using a validated patient-reported outcome measure to assess whether menopausal symptoms after cancer had improved. METHODS A retrospective review was conducted of patients attending the clinic in a 12-month period in 2017 (n = 189). Recorded variables included patient demographics, details of index cancer, previous treatments, and menopausal symptom management strategies. Severity of menopausal symptoms was evaluated using the Greene Climacteric Scale. The extent to which patients were bothered by symptoms was combined into two categories and dichotomized (present/absent). Differences in symptom prevalence between the initial consultation and first follow-up visit were examined using McNemar's test. RESULTS The majority of patients attending the clinic had a history of breast cancer (72%). Fifty-five percent of patients were prescribed a non-hormonal therapy at their initial visit, most commonly gabapentin. Significantly fewer patients reported being bothered by hot flushes, fatigue, sleep difficulties, and loss of interest in sex, anxiety, or troubles concentrating at the first follow-up visit compared to their initial consultation (p < 0.01). CONCLUSION In this study, there was an improvement in self-reported menopausal symptoms in a significant proportion of cancer survivors attending a multidisciplinary menopause clinic between their initial and first subsequent follow-up consultations.
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Affiliation(s)
| | - Lucy Walsh
- King Edward Memorial Hospital, Subiaco, WA, 6008, Australia
| | - Stephanie Tran
- University of Western Australia, Crawley, WA, 6009, Australia
| | - Lesley Ramage
- King Edward Memorial Hospital, Subiaco, WA, 6008, Australia
| | | | - Manju Ambekar
- King Edward Memorial Hospital, Subiaco, WA, 6008, Australia
| | - Jane Weeks
- King Edward Memorial Hospital, Subiaco, WA, 6008, Australia
| | - Lucy Williams
- King Edward Memorial Hospital, Subiaco, WA, 6008, Australia
| | - Paul A Cohen
- University of Western Australia, Crawley, WA, 6009, Australia.,St John of God Hospital, Subiaco, WA, 6008, Australia
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20
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Miller J, Williams L, Alhurani A, Saleh Z, Bailey A, Connell A, Hammash M, Chung M, Moser D. Race matters: cardiovascular disease risk in male US prisoners. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.060] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIH/National Institute of Nursing Research, 1RC2NR011948
Introduction
Approximately 10% of the 2.2 million prisoners in the US have a diagnosis of cardiovascular disease (CVD) and in 2016, 28% of all deaths in custody were attributable to CVD. Black race, inadequate health literacy, and poor perceived control are predictors of increased cardiovascular disease (CVD) risk, which are prevalent in prisoners. However, little is known about the relationships among race, health literacy, and perceived control in CVD risk for male prisoners.
Objective
The purpose of this study was to explore the relationships among race, health literacy, perceived control, and CVD risk while controlling for well-known risk factors (education, partner status, and body mass index) in male prisoners.
Methods
We used baseline data from 349 male prisoners in a biobehavioral CVD risk reduction intervention. Health literacy was measured using the Newest Vital Sign and perceived control by the Control Attitudes Scale- Revised. CVD risk was quantified with the Framingham Risk Score (FRS). Three indirect effects of race on CVD risk were examined using serial mediation model with two sequential mediators (i.e., health literacy and perceived control) and 95% confidence intervals from 5000 bootstrap samples.
Results
Of the participants (mean age = 36 + 10 years), 64.2% were white and 35.8% were black. Mean education level was 12 years and most (85.8%) were not married or partnered. Mean BMI was 28.3 + 5.0. Mean FRS was 6.63 + 4.90, indicating risk percentages of 2.3 to 13.3% over the next ten years. Black prisoners were younger (35 + 9 versus 37 + 10, p = .047) and had lower levels of health literacy (3.84 + 1.90 versus 4.69 + 1.63, p < .001) than white prisoners. No statistically significant differences in perceived control, education, partner status, or body mass index were noted between races. All three indirect effects of race on CVD were significant while the direct effect of race was not. Compared to white prisoners, black prisoners had higher levels of CVD risk through health literacy (a1b1 = .3571, 95% CI [.0948, .7162]) and lower levels of CVD risk through perceived control (a2b2 = -.1855, 95% CI [-.4388, -.0077]). Black prisoners had higher levels of CVD risk through health literacy influenced by perceived control (a1b2d21 = .0627, 95% CI [.0028, .1409]) indicating that despite the protective effect of higher levels of perceived control in black prisoners, CVD risk remained higher compared to their white counterparts.
Conclusion
Future CVD risk reduction interventions in prisoners of all races, but specifically black male prisoners, should include goals of improving health literacy and perceived control in addition to the traditional modifiable risk factors often included in biobehavioral interventions.
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Affiliation(s)
- J Miller
- University of Kentucky, College of Nursing, Lexington, United States of America
| | - L Williams
- University of Kentucky, College of Nursing, Lexington, United States of America
| | | | - Z Saleh
- University of Jordan, Amman, Jordan
| | - A Bailey
- Centennial Heart at Parkridge HCA Healthcare, Cardiology, Nashville, United States of America
| | - A Connell
- Eastern Kentucky University, Richmond, United States of America
| | - M Hammash
- University of Louisville, Louisville, United States of America
| | - M Chung
- University of Kentucky, College of Nursing, Lexington, United States of America
| | - D Moser
- University of Kentucky, College of Nursing, Lexington, United States of America
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21
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Imai N, Hogan AB, Williams L, Cori A, Mangal TD, Winskill P, Whittles LK, Watson OJ, Knock ES, Baguelin M, Perez-Guzman PN, Gaythorpe KA, Sonabend R, Ghani AC, Ferguson NM. Interpreting estimates of coronavirus disease 2019 (COVID-19) vaccine efficacy and effectiveness to inform simulation studies of vaccine impact: a systematic review. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16992.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: The multiple efficacious vaccines authorised for emergency use worldwide represent the first preventative intervention against coronavirus disease 2019 (COVID-19) that does not rely on social distancing measures. The speed at which data are emerging and the heterogeneities in study design, target populations, and implementation make it challenging to interpret and assess the likely impact of vaccine campaigns on local epidemics. We reviewed available vaccine efficacy and effectiveness studies to generate working estimates that can be used to parameterise simulation studies of vaccine impact. Methods: We searched MEDLINE, the World Health Organization’s Institutional Repository for Information Sharing, medRxiv, and vaccine manufacturer websites for studies that evaluated the emerging data on COVID-19 vaccine efficacy and effectiveness. Studies providing an estimate of the efficacy or effectiveness of a COVID-19 vaccine using disaggregated data against SARS-CoV-2 infection, symptomatic disease, severe disease, death, or transmission were included. We extracted information on study population, variants of concern (VOC), vaccine platform, dose schedule, study endpoints, and measures of impact. We applied an evidence synthesis approach to capture a range of plausible and consistent parameters for vaccine efficacy and effectiveness that can be used to inform and explore a variety of vaccination strategies as the COVID-19 pandemic evolves. Results: Of the 602 articles and reports identified, 53 were included in the analysis. The availability of vaccine efficacy and effectiveness estimates varied by vaccine and were limited for VOCs. Estimates for non-primary endpoints such as effectiveness against infection and onward transmission were sparse. Synthesised estimates were relatively consistent for the same vaccine platform for wild-type, but was more variable for VOCs. Conclusions: Assessment of efficacy and effectiveness of COVID-19 vaccines is complex. Simulation studies must acknowledge and capture the uncertainty in vaccine effectiveness to robustly explore and inform vaccination policies and policy around the lifting of non-pharmaceutical interventions.
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22
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Verrill L, Boyer M, Williams L, Otto J, Lando A, Dawood N, Liggans G. Hand Washing Observations in Fast-Food and Full-Service Restaurants: Results from the 2014 U.S. Food and Drug Administration Retail Food Risk Factors Study. J Food Prot 2021; 84:1016-1022. [PMID: 33465242 DOI: 10.4315/jfp-20-412] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/06/2021] [Indexed: 11/11/2022]
Abstract
ABSTRACT Properly executed hand washing by food service employees can greatly minimize the risk of transmitting foodborne pathogens to food and food contact surfaces in restaurants. However, food service employee hand washing is often not done correctly or does not occur as often as it should. The purpose of this study was to assess the relative impact of (i) the convenience and accessibility of hand washing facilities; (ii) the maintenance of hand washing supplies, (iii) multiunit status, (iv) having a certified food protection manager, and (v) having a food safety management system for compliance with proper hand washing. Results revealed marked differences in hand washing behaviors between fast-food and full-service restaurants; 45% of 425 fast-food restaurants and 57% of 396 full-service restaurants were out of compliance for washing hands correctly, and 57% of fast-food restaurants and 78% of full-service restaurants were out of compliance for employee hands being washed when required. Logistic regression results indicated the benefits of accessibility and maintenance of the hand washing sink and of a food safety management system for increasing the likelihood of employees washing hands when they are supposed to and washing them correctly when they do. HIGHLIGHTS
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Affiliation(s)
- L Verrill
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - M Boyer
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - L Williams
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - J Otto
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - A Lando
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - N Dawood
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
| | - G Liggans
- U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 5001 Campus Drive, Room 2C-095, College Park, Maryland 20740, USA
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23
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Williams L, Butler JS, O'Riordan S, Skeehan S, Collins C, Hutchinson M. Response to "isolated head tremor: A DAT SPECT and somatosensory temporal discrimination study.". Parkinsonism Relat Disord 2021; 87:166-167. [PMID: 34090789 DOI: 10.1016/j.parkreldis.2021.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/23/2021] [Indexed: 10/21/2022]
Abstract
In response to Ferrazano and colleagues' observation of normal DAT binding in patients with isolated head tremor but with abnormal STDT, we report normal 123-IBZM SPECT in a cohort of patients with adult-onset idiopathic focal dystonia with cervical dystonia and their unaffected first-degree relatives both with normal and abnormal TDTs. We discuss molecular imaging findings in dystonia.
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Affiliation(s)
- L Williams
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland.
| | - J S Butler
- School of Mathematical Sciences, Technological Universtiy Dublin, Dublin, Ireland
| | - S O'Riordan
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland
| | - S Skeehan
- Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland
| | - C Collins
- Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland
| | - M Hutchinson
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland
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24
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Davey C, Liu P, Kamranvand F, Williams L, Jiang Y, Parker A, Tyrrel S, McAdam E. Membrane distillation for concentrated blackwater: Influence of configuration (air gap, direct contact, vacuum) on selectivity and water productivity. Sep Purif Technol 2021; 263:118390. [PMID: 34002109 PMCID: PMC7965860 DOI: 10.1016/j.seppur.2021.118390] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/15/2020] [Accepted: 01/23/2021] [Indexed: 12/23/2022]
Abstract
Water recovery from concentrated blackwater has been studied using air gap (AGMD), direct contact (DCMD) and vacuum membrane distillation (VMD) to deliver decentralised sanitation. Whilst good water quality was achieved with each configuration, differences in the rejection of volatile compounds was observed. VMD exhibited the highest rejection of volatiles, specifically ammoniacal nitrogen, of all the configurations but fouling inhibited total flux. DCMD exhibited a temperature dependent volatile rejection which resulted in poor rejection at lower feed temperatures (≤40 °C). AGMD was identified as the most promising configuration for application within decentralised sanitation, since the rejection of volatiles was consistent over a range of operating temperatures with ammonia rejection directly related to solution pH. An increase in organic colloids and particles due to faecal contamination reduced COD removal due to the induction of wetting, but was shown to be offset by adoption of a smaller pore size (0.1 μm), and when complemented with upstream solid-liquid separation within a fully integrated system, will provide a robust sanitation solution. Importantly, this work has shown that AGMD can recover water from concentrated blackwater close to international discharge and reuse regulations in a single stage process; this is significant as blackwater consists of only urine and faeces, and is thus 40 times more concentrated than municipal sewage. It is proposed that the water quality produced reflects a step change to delivering safe sanitation, and is complemented by a simple method for heat recovery integration this is similarly advantageous for resource constrained environments common to decentralised sanitation solutions.
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Affiliation(s)
- C.J. Davey
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
| | - P. Liu
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
- GreenTech Environmental Co. Ltd., Wangjing, Chaoyang District, 100102 Beijing, China
| | - F. Kamranvand
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
| | - L. Williams
- Centre for Creative and Competitive Design, Cranfield University, Bedfordshire MK43 0AL, UK
| | - Y. Jiang
- Centre for Thermal Energy Systems and Materials, Cranfield University, Bedfordshire MK43 0AL, UK
| | - A. Parker
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
| | - S. Tyrrel
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
| | - E.J. McAdam
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
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25
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Bampton TJ, Holmes-Walker DJ, Drogemuller CJ, Radford T, Anderson P, Etherton C, Russell CH, Khurana S, Torpy DJ, Couper JJ, Couper RLT, Macintyre P, Neo EL, Benitez-Aguirre P, Thomas G, Loudovaris T, Thomas HE, Palmer LJ, Wu D, Rogers NM, Williams L, Hawthorne WJ, O'Connell PJ, Kay TW, Pleass H, Chen JW, Coates PT. Australian experience with total pancreatectomy with islet autotransplantation to treat chronic pancreatitis. ANZ J Surg 2021; 91:2663-2668. [PMID: 33956377 DOI: 10.1111/ans.16853] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND This study aimed to describe the clinical outcomes of total pancreatectomy with islet autotransplantation (TP-IAT) in Australia. METHODS Individuals selected for TP-IAT surgery according to the Minnesota Criteria (Appendix) without evidence of diabetes were evaluated including time to transplantation from pancreatectomy, islet numbers infused and post-transplantation HbA1c, C-peptide, total daily insulin and analgesic requirement. RESULTS Sixteen individuals underwent TP-IAT from Australia and New Zealand between 2010 and 2020. Two recipients are deceased. The median islet equivalents/kg infused was 4244 (interquartile range (IQR) 2290-7300). The median C-peptide 1 month post-TP-IAT was 384 (IQR 210-579) pmol/L and at median 29.5 (IQR 14.5-46.5) months from transplant was 395 (IQR 139-862) pmol/L. Insulin independence was achieved in eight of 15 (53.3%) surviving recipients. A higher islet equivalents transplanted was most strongly associated with the likelihood of insulin independence (P < 0.05). Of the 15 surviving recipients, 14 demonstrated substantial reduction in analgesic requirement. CONCLUSION The TP-IAT programme in Australia has been a successful new therapy for the management of individuals with chronic pancreatitis including hereditary forms refractory to medical treatment to improve pain management with 50% insulin independence rates.
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Affiliation(s)
- Tristan J Bampton
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - D Jane Holmes-Walker
- Department of Endocrinology, Westmead Hospital, Sydney, New South Wales, Australia.,Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Chris J Drogemuller
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Toni Radford
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Patricia Anderson
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - C Etherton
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - C H Russell
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - S Khurana
- Department of Gastroenterology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - David J Torpy
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - J J Couper
- Department of Gastroenterology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - R L T Couper
- Department of Gastroenterology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Pamela Macintyre
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - E L Neo
- Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Paul Benitez-Aguirre
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - G Thomas
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Westmead Children's Hospital, Sydney, New South Wales, Australia
| | - T Loudovaris
- Islet biology, St Vincent's Institute, Melbourne, Victoria, Australia
| | - H E Thomas
- Islet biology, St Vincent's Institute, Melbourne, Victoria, Australia
| | - Lyle J Palmer
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Denghao Wu
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Natasha M Rogers
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia
| | - L Williams
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - W J Hawthorne
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.,Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - P J O'Connell
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia
| | - Tom W Kay
- Islet biology, St Vincent's Institute, Melbourne, Victoria, Australia
| | - Henry Pleass
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia.,Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - John W Chen
- The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Department of Gastroenterology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - P Toby Coates
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,The Central and Northern Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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26
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Winarski A, Williams L, Ingoe H. 816 The Effect Of COVID-19 And Service Delivery Changes On 30-Day Mortality in Fractured Neck of Femur Patients: A Case-Control Study. Br J Surg 2021. [PMCID: PMC8135818 DOI: 10.1093/bjs/znab134.089] [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: 11/24/2022]
Abstract
Introduction The majority of neck of femur (NOF) fractures occur within the home, therefore admissions were not expected to change during the COVID-19 pandemic(1) . This study investigates the effect of coronavirus and our department’s response on 30-day mortality for patients admitted with NOF fractures. Method Data from 65 fractured NOF admissions (22nd March - 24th May 2020) was compared with 62 patients from the same period in 2019. Binary logistic regression was used to explore 30-day mortality; accounting for differences in ASA, anaesthetic type, anticoagulation status, surgery type, age, time to surgery and year of admission. Results The odds of 30-day mortality was statistically significantly higher in patients who were suspected/confirmed COVID-19 positive (n = 10),(OR 2.39, 95%CI (1.60-74.13)). In COVID-19 negative patients (n = 55), the odds of 30-day mortality was lower in 2020, and approached statistical significance (0.232, 95%CI (0.053-1.02)), compared to the same period in 2019. Median length of stay (LOS) in patients who survived was 11 days in 2020 and 15.5 days in 2019 (p = 0.003). Conclusions The results suggest that a COVID-19 diagnosis significantly increases the 30-day mortality in patients with a fractured NOF. The changes implemented in service delivery have shortened LOS and appeared to improve 30-day mortality for those without COVID-19.
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Affiliation(s)
- A Winarski
- Royal Victoria Infirmary, Newcastle, United Kingdom
| | - L Williams
- Royal Victoria Infirmary, Newcastle, United Kingdom
| | - H Ingoe
- Royal Victoria Infirmary, Newcastle, United Kingdom
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Leow HW, Koscielniak M, Williams L, Saunders PTK, Daniels J, Doust AM, Jones MC, Ferguson GD, Bagger Y, Horne AW, Whitaker LHR. Dichloroacetate as a possible treatment for endometriosis-associated pain: a single-arm open-label exploratory clinical trial (EPiC). Pilot Feasibility Stud 2021; 7:67. [PMID: 33712086 PMCID: PMC7953373 DOI: 10.1186/s40814-021-00797-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 02/15/2021] [Indexed: 01/31/2023] Open
Abstract
Background Endometriosis (where endometrial-like tissue is found outside the uterus) affects ~ 176 million women worldwide and can lead to debilitating pelvic pain. There is an unmet need for new medical treatment options for endometriosis. Pelvic peritoneal mesothelial cells of women with endometriosis exhibit detrimental metabolic reprogramming that creates an environment favouring the formation and survival of endometriosis lesions. We have generated powerful preclinical proof-of-concept data to show that it is possible to correct this metabolic phenotype using dichloroacetate (DCA), a non-hormonal compound previously used to treat rare metabolic disorders in children. We plan a single-arm, open-label, single site exploratory clinical trial to inform the design of a future randomised controlled trial (RCT) to determine the efficacy of DCA for the treatment of endometriosis-associated pain. Methods We will recruit 30 women with endometriosis-associated pain over a 6-month period. All participants will receive approximately 6.25 mg/kg oral DCA capsules twice daily for 6 weeks, with a dose increase to approximately 12.5 mg/kg twice daily for a further 6 weeks if their pain has not been adequately controlled on this dose regime and side-effects are acceptable. If pain is adequately controlled with minimal side-effects, the lower dose will be continued for a further 6 weeks. The primary objective is to determine whether it is possible to achieve acceptable recruitment and retention rates within the defined exclusion and inclusion criteria. Secondary objectives are to determine the acceptability of the trial to participants, including the proposed methods of recruitment, treatment, follow-up frequency and number of questionnaires. The recruitment rate will be determined by the proportion of patients recruited from the pool of eligible women. The retention rate will be determined by the proportion of participants who attended the final trial visit. Discussion This is a feasibility study to explore effectiveness and acceptability of the proposed field methodology (recruitment, retention, study processes and compliance with treatment). The results will be used to inform the design of a future RCT. Trial registration ClinicalTrials.gov, NCT04046081 Registered 6 August 2019
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Affiliation(s)
- H W Leow
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - M Koscielniak
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - L Williams
- Usher Institute, NINE Edinburgh BioQuarter, 9 Little France Road, Edinburgh, EH16 4UX, UK
| | - P T K Saunders
- Centre for Inflammation Research, Queen's Medical Research Institue, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - J Daniels
- Clinical Trials Unit, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - A M Doust
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - M-C Jones
- Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - G D Ferguson
- Reproductive Medicine and Maternal Health, Ferring Research Institute, San Diego, CA, 92121, USA
| | - Y Bagger
- Reproductive Medicine and Maternal Health, Ferring Research Institute, San Diego, CA, 92121, USA
| | - A W Horne
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK.
| | - L H R Whitaker
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
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Frost C, Williams L, Naidoo R, Tesar P. P52 PEARS During Pregnancy: First Reported Case. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kamranvand F, Davey CJ, Williams L, Parker A, Jiang Y, Tyrrel S, McAdam EJ. Ultrafiltration pretreatment enhances membrane distillation flux, resilience and permeate quality during water recovery from concentrated blackwater (urine/faeces). Sep Purif Technol 2020; 253:117547. [PMID: 33335447 PMCID: PMC7511602 DOI: 10.1016/j.seppur.2020.117547] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
UF is used as a pre-treatment to reduce membrane distillation fouling. UF removes particles and colloids from blackwater but low MW fraction increases. Whilst UF treated blackwater high in organics, flux and water quality is stable. Without UF pre-treatment, severe fouling reduces flux, which reduces quickly. With UF pre-treatment, permeate quality consistently meets treatment quality.
In this study, the pretreatment of concentrated blackwater using ultrafiltration (UF) was shown to improve the permeability, selectivity and robustness of membrane distillation (MD) for application to wastewater treatment. Concentrated blackwater comprises urine and faeces, with minimal flushwater added. The faecal contribution increased the soluble organic fraction and introduced coarse and colloidal particles into the urine, which increased resistance to filtration during dead-end UF. Ultrafiltration removed the particulate and colloidal fractions (MW > 500 kDa) from the blackwater, which permitted similar permeability and robustness for MD to that observed with urine (29.9 vs 25.9 kg m−2 h−1), which comprises a lower colloidal organic concentration. Without UF pretreatment, a higher density organic layer formed on the MD surface (197 vs 70 gCOD m−2) which reduced mass transfer, and transformed the contact angle from hydrophobic to hydrophilic (144.9° to 49.8°), leading to pore wetting and a dissipation in product water quality due to breakthrough. In comparison, with UF pretreatment, MD delivered permeate water quality to standards satisfactory for discharge or reuse. This is particularly timely as the ISO standard for non-sewered sanitation has been adopted by several countries at a national level, and to date there are relatively few technologies to achieve the treatment standard. Membrane distillation provides a robust means for concentrated blackwater treatment, and since the energy required for separation is primarily heat, this advanced treatment can be delivered into areas with more fragile power networks.
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Affiliation(s)
- F Kamranvand
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire MK43 0AL, UK
| | - C J Davey
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire MK43 0AL, UK
| | - L Williams
- Centre for Creative and Competitive Design, Cranfield University, Bedfordshire MK43 0AL, UK
| | - A Parker
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire MK43 0AL, UK
| | - Y Jiang
- Centre for Thermal Energy Systems and Materials, Cranfield University, Bedfordshire MK43 0AL, UK
| | - S Tyrrel
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire MK43 0AL, UK
| | - E J McAdam
- Cranfield Water Science Institute, Vincent Building, Cranfield University, Bedfordshire MK43 0AL, UK
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Hulme A, Davey C, Parker A, Williams L, Tyrrel S, Jiang Y, Pidou M, McAdam E. Managing power dissipation in closed-loop reverse electrodialysis to maximise energy recovery during thermal-to-electric conversion. Desalination 2020; 496:114711. [PMID: 33335330 PMCID: PMC7695618 DOI: 10.1016/j.desal.2020.114711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/20/2020] [Accepted: 08/17/2020] [Indexed: 05/26/2023]
Abstract
Whilst the efficiency of reverse electrodialysis (RED) for thermal-to-electrical conversion has been theoretically demonstrated for low-grade waste heat, the specific configuration and salinity required to manage power generation has been less well described. This study demonstrates that operating RED by recycling feed solutions provides the most suitable configuration for energy recovery from a fixed solution volume, providing a minimum unitary cost for energy production. For a fixed membrane area, recycling feeds achieves energy efficiency seven times higher than single pass (conventional operation), and with an improved power density. However, ionic transport, water flux and concentration polarisation introduce complex temporal effects when concentrated brines are recirculated, that are not ordinarily encountered in single pass systems. Regeneration of the concentration gradient at around 80% energy dissipation was deemed most economically pragmatic, due to the increased resistance to mass transport beyond this threshold. However, this leads to significant exergy destruction that could be improved by interventions to better control ionic build up in the dilute feed. Further improvements to energy efficiency were fostered through optimising current density for each brine concentration independently. Whilst energy efficiency was greatest at lower brine concentrations, the work produced from a fixed volume of feed solution was greatest at higher saline concentrations. Since the thermal-to-electrical conversion proposed is governed by volumetric heat utilisation (distillation to reset the concentration gradient), higher brine concentrations are therefore recommended to improve total system efficiency. Importantly, this study provides new evidence for the configuration and boundary conditions required to realise RED as a practical solution for application to sources of low-grade waste heat in industry.
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Affiliation(s)
- A.M. Hulme
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
| | - C.J. Davey
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
| | - A. Parker
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
| | - L. Williams
- Centre for Creative and Competitive Design, Cranfield University, Bedfordshire MK43 0AL, UK
| | - S. Tyrrel
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
| | - Y. Jiang
- Centre for Thermal Energy Systems and Materials, Cranfield University, Bedfordshire MK43 0AL, UK
| | - M. Pidou
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
| | - E.J. McAdam
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
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Sigmon JS, Blanchard MW, Baric RS, Bell TA, Brennan J, Brockmann GA, Burks AW, Calabrese JM, Caron KM, Cheney RE, Ciavatta D, Conlon F, Darr DB, Faber J, Franklin C, Gershon TR, Gralinski L, Gu B, Gaines CH, Hagan RS, Heimsath EG, Heise MT, Hock P, Ideraabdullah F, Jennette JC, Kafri T, Kashfeen A, Kulis M, Kumar V, Linnertz C, Livraghi-Butrico A, Lloyd KCK, Lutz C, Lynch RM, Magnuson T, Matsushima GK, McMullan R, Miller DR, Mohlke KL, Moy SS, Murphy CEY, Najarian M, O'Brien L, Palmer AA, Philpot BD, Randell SH, Reinholdt L, Ren Y, Rockwood S, Rogala AR, Saraswatula A, Sassetti CM, Schisler JC, Schoenrock SA, Shaw GD, Shorter JR, Smith CM, St Pierre CL, Tarantino LM, Threadgill DW, Valdar W, Vilen BJ, Wardwell K, Whitmire JK, Williams L, Zylka MJ, Ferris MT, McMillan L, Manuel de Villena FP. Content and Performance of the MiniMUGA Genotyping Array: A New Tool To Improve Rigor and Reproducibility in Mouse Research. Genetics 2020; 216:905-930. [PMID: 33067325 PMCID: PMC7768238 DOI: 10.1534/genetics.120.303596] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [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: 08/11/2020] [Accepted: 10/06/2020] [Indexed: 12/14/2022] Open
Abstract
The laboratory mouse is the most widely used animal model for biomedical research, due in part to its well-annotated genome, wealth of genetic resources, and the ability to precisely manipulate its genome. Despite the importance of genetics for mouse research, genetic quality control (QC) is not standardized, in part due to the lack of cost-effective, informative, and robust platforms. Genotyping arrays are standard tools for mouse research and remain an attractive alternative even in the era of high-throughput whole-genome sequencing. Here, we describe the content and performance of a new iteration of the Mouse Universal Genotyping Array (MUGA), MiniMUGA, an array-based genetic QC platform with over 11,000 probes. In addition to robust discrimination between most classical and wild-derived laboratory strains, MiniMUGA was designed to contain features not available in other platforms: (1) chromosomal sex determination, (2) discrimination between substrains from multiple commercial vendors, (3) diagnostic SNPs for popular laboratory strains, (4) detection of constructs used in genetically engineered mice, and (5) an easy-to-interpret report summarizing these results. In-depth annotation of all probes should facilitate custom analyses by individual researchers. To determine the performance of MiniMUGA, we genotyped 6899 samples from a wide variety of genetic backgrounds. The performance of MiniMUGA compares favorably with three previous iterations of the MUGA family of arrays, both in discrimination capabilities and robustness. We have generated publicly available consensus genotypes for 241 inbred strains including classical, wild-derived, and recombinant inbred lines. Here, we also report the detection of a substantial number of XO and XXY individuals across a variety of sample types, new markers that expand the utility of reduced complexity crosses to genetic backgrounds other than C57BL/6, and the robust detection of 17 genetic constructs. We provide preliminary evidence that the array can be used to identify both partial sex chromosome duplication and mosaicism, and that diagnostic SNPs can be used to determine how long inbred mice have been bred independently from the relevant main stock. We conclude that MiniMUGA is a valuable platform for genetic QC, and an important new tool to increase the rigor and reproducibility of mouse research.
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Affiliation(s)
- John Sebastian Sigmon
- Department of Computer Science, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Matthew W Blanchard
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
- Mutant Mouse Resource and Research Center, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Ralph S Baric
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Timothy A Bell
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Jennifer Brennan
- Mutant Mouse Resource and Research Center, University of North Carolina, Chapel Hill, North Carolina 27599
| | | | - A Wesley Burks
- Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - J Mauro Calabrese
- Department of Pharmacology, University of North Carolina, Chapel Hill, North Carolina 27599
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Kathleen M Caron
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Richard E Cheney
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Dominic Ciavatta
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Frank Conlon
- Department of Biology, University of North Carolina, Chapel Hill, North Carolina 27599
| | - David B Darr
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina 27599
| | - James Faber
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Craig Franklin
- Department of Veterinary Pathobiology, University of Missouri, Columbia, Missouri 65211
| | - Timothy R Gershon
- Department of Neurology, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Lisa Gralinski
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Bin Gu
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Christiann H Gaines
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Robert S Hagan
- Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Ernest G Heimsath
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina 27599
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Mark T Heise
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Pablo Hock
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Folami Ideraabdullah
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina 27599
- Department of Nutrition, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27599
| | - J Charles Jennette
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Tal Kafri
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, North Carolina 27599
- Gene Therapy Center, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Anwica Kashfeen
- Department of Computer Science, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Mike Kulis
- Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Vivek Kumar
- The Jackson Laboratory, Bar Harbor, Maine 04609
| | - Colton Linnertz
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Alessandra Livraghi-Butrico
- Marsico Lung Institute/UNC Cystic Fibrosis Center, University of North Carolina, Chapel Hill, North Carolina 27599
| | - K C Kent Lloyd
- Department of Surgery, University of California Davis, Davis, California 95616
- School of Medicine, University of California Davis, California 95616
- Mouse Biology Program, University of California Davis, California 95616
| | | | - Rachel M Lynch
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Terry Magnuson
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
- Mutant Mouse Resource and Research Center, University of North Carolina, Chapel Hill, North Carolina 27599
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Glenn K Matsushima
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, North Carolina 27599
- UNC Neuroscience Center, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Rachel McMullan
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Darla R Miller
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Karen L Mohlke
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Sheryl S Moy
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina 27599
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Caroline E Y Murphy
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Maya Najarian
- Department of Computer Science, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Lori O'Brien
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina 27599
| | | | - Benjamin D Philpot
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina 27599
- Marsico Lung Institute/UNC Cystic Fibrosis Center, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Scott H Randell
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina 27599
| | | | - Yuyu Ren
- University of California San Diego, La Jolla, California 92093
| | | | - Allison R Rogala
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina 27599
- Division of Comparative Medicine, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Avani Saraswatula
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Christopher M Sassetti
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Jonathan C Schisler
- Department of Pharmacology, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Sarah A Schoenrock
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Ginger D Shaw
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - John R Shorter
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Clare M Smith
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | | | - Lisa M Tarantino
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
- Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina 27599
| | - David W Threadgill
- University of California San Diego, La Jolla, California 92093
- Department of Biochemistry and Biophysics, Texas A&M University, Texas 77843
| | - William Valdar
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Barbara J Vilen
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, North Carolina 27599
| | | | - Jason K Whitmire
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Lucy Williams
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Mark J Zylka
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Martin T Ferris
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Leonard McMillan
- Department of Computer Science, University of North Carolina, Chapel Hill, North Carolina 27599
| | - Fernando Pardo Manuel de Villena
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina 27599
- Mutant Mouse Resource and Research Center, University of North Carolina, Chapel Hill, North Carolina 27599
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina 27599
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Gujral D, Nazir S, Hunter B, McNaught P, Williams L, Porter S, Coughlan S, Cleator S. PO-0930: Wide tangents versus volumetric arc therapy to treat the internal mammary chain using breath hold. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00947-6] [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: 10/22/2022]
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Ciarka A, Page A, Messer S, Pavlushkov E, Tsui S, Parameshwar J, Williams L, Aggraval B, Large S. Donation after circulatory death hearts recipients compared to donation after brain death heart recipients have comparable systolic left ventricular function and better myocardial strain at 1 year. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1108] [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
Purpose
Cardiac transplantation from donation after circulatory death (DCD) has been implemented at our hospital since February 2015. Despite encouraging results some concerns may be raised about the impact of the warm ischemia and reperfusion injury on the myocardium status at longer follow-up. Therefore, we aimed to analyse systolic performance of the left ventricle at 1 year follow in DCD and donation after brain death (DBD) cardiac recipients, as assessed by echocardiography with myocardial deformation imaging.
Methods
We identified 46 consecutive DCD cardiac recipients who were transplanted from February 2015 to August 2018 and we matched them with 46 DBD cardiac recipients. Six and 7 patients from DCD and DBD group, respectively, died in the first-year post transplant. In the remaining patients we have compared the classical echocardiographic measurements as well as global longitudinal strain (GLS) and global circumferential strain (GCS) at 1-year follow-up.
Results
DCD and DBD patients did not present with differences in terms of classical echocardiographic parameters of left ventricular (LV) structure and systolic function at one-year follow-up. LVEDV was similar in DCD and DBD patients (101±24 vs. 95±32 ml, p=0.4 respectively), as well as LVESV (42±13 vs. 42±16 ml, p=0.9, respectively), LV ejection fraction (58±6 vs. 56±8%, p=0.22) and LV mass (156±39 vs. 163±38 gr, p=0.2, respectively). In contrast, myocardial deformation parameters, such as GLS and GCS, were better in DCD than in DBD (16.1 vs. −14.5%, p<0.01; and −25.2 vs. 22.3%, p<0.05, respectively). The diastolic LV function parameters were similar in DCD and DBD group, as evidenced by E wave velocity, A wave velocity and deceleration time of mitral inflow, however E over E prime was lower in DCD than in DBD recipients (7.7±8.7, p<0.05). Fractional area change of the right ventricle was higher in DCD in comparison with DBD (46±7 vs. 40±7%, p<0.01) while right atrial volume index was lower in DCD than in DBD (25±8 vs. 29±9 ml/m2, p<0.01). Other parameters of RV function (systolic excursion of the tricuspid annulus, TAPSE) were similar in both groups.
Conclusion
DCD and DBD heart recipients present with similar systolic LV function at 1-year follow, as assessed by classical echocardiographic parameters. DCD cardiac recipients have better myocardial deformation parameters as assessed by the speckle tracking, better systolic right ventricular function and lower filling pressures of the left ventricle.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Ciarka
- Gasthuisberg University Hospital, Leuven, Belgium
| | - A Page
- Royal Papworth Hospital NHS Foundation Trust, Cardiac Surgery, Cambridge, United Kingdom
| | - S Messer
- Royal Papworth Hospital NHS Foundation Trust, Cardiac Surgery, Cambridge, United Kingdom
| | - E Pavlushkov
- Royal Papworth Hospital NHS Foundation Trust, Cardiac Surgery, Cambridge, United Kingdom
| | - S Tsui
- Royal Papworth Hospital NHS Foundation Trust, Cardiac Surgery, Cambridge, United Kingdom
| | - J Parameshwar
- Royal Papworth Hospital NHS Foundation Trust, Cardiac Surgery, Cambridge, United Kingdom
| | - L Williams
- Royal Papworth Hospital NHS Foundation Trust, Cardiac Surgery, Cambridge, United Kingdom
| | - B Aggraval
- Royal Papworth Hospital NHS Foundation Trust, Cardiac Surgery, Cambridge, United Kingdom
| | - S Large
- Royal Papworth Hospital NHS Foundation Trust, Cardiac Surgery, Cambridge, United Kingdom
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Simon J, Clayton A, Kingsberg S, Portman D, Jordan R, Lucas J, Williams L, Krop J. 038 Effect Size of Bremelanotide Treatment in the Phase 3 RECONNECT Studies. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kingsberg S, Portman D, Clayton A, Revicki D, Jordan R, Sadiq A, Williams L, Krop J. 011 Correlation Between Validated Instruments Used in the RECONNECT Studies. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kingsberg S, Clayton A, Portman D, Jordan R, Revicki D, Williams L, Krop J. 012 Bremelanotide Treatment Provided Clinically Meaningful Benefits in Premenopausal Women With Hypoactive Sexual Desire Disorder. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.248] [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]
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Afrin N, Honkanen R, Koivumaa-Honkanen H, Sund R, Rikkonen T, Williams L, Kröger H. Depression, falls, and fractures. Osteoporos Int 2020; 31:1173-1174. [PMID: 32088732 DOI: 10.1007/s00198-020-05348-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 10/24/2022]
Affiliation(s)
- N Afrin
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211, Kuopio, Finland.
| | - R Honkanen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211, Kuopio, Finland
- Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
| | - H Koivumaa-Honkanen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211, Kuopio, Finland
- Institute of Clinical Medicine (Psychiatry), University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
- South-Savonia Hospital District, Mikkeli, Finland
- North Karelia Central Hospital, Joensuu, Finland
- SOTE, Iisalmi, Finland
- Oulu University Hospital, Oulu, Finland
| | - R Sund
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211, Kuopio, Finland
| | - T Rikkonen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211, Kuopio, Finland
| | - L Williams
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia
| | - H Kröger
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211, Kuopio, Finland
- Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
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Afrin N, Sund R, Honkanen R, Koivumaa-Honkanen H, Rikkonen T, Williams L, Kröger H. A fall in the previous 12 months predicts fracture in the subsequent 5 years in postmenopausal women. Osteoporos Int 2020; 31:839-847. [PMID: 31858171 PMCID: PMC7170829 DOI: 10.1007/s00198-019-05255-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 12/02/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to evaluate if a history of falls predicts future postmenopausal fractures and if this prediction variesaccording to frequency, mechanism, and severity of falls and site of fractures. METHODS This study used data from OSTPRE prospective cohort. Total study population consisted of 8744 postmenopausal women (mean age 62.2 years) who responded to postal enquiry in 1999 (baseline) and in 2004 (follow-up). RESULTS Women were classified by frequency (non/occasional/frequent fallers), mechanism (slip/nonslip), and severity (injurious/ non-injurious) of falls and fractures by site (major osteoporotic/other). A total of 1693 (19.4%) women reported a fall during the preceding 12 months in 1999; 812 a slip fall, 654 a nonslip, 379 an injurious fall, and 1308 a non-injurious fall. A total of 811 women (9.3%) sustained a fracture during the 5-year follow-up period (1999-2004); 431 major osteoporotic fractures and 380 other fractures. Compared with non-fallers, earlier falls predicted subsequent fractures with an OR of 1.41 (95% CI 1.19-1.67, p ≤ 0.001), 1.43 (95% CI 1.14-1.80, p = 0.002) for earlier slip falls, and 1.35 (95% CI 1.04-1.74, p = 0.02) for earlier nonslip falls. Earlier injurious falls predicted future fractures (OR = 1.64, 95% CI 1.21-2.23, p ≤ 0.01), especially other fractures (OR = 1.86, 95% CI 1.24-2.80, p ≤ 0.01), but not major osteoporotic fractures (OR = 1.37, 95% CI 0.89-2.10, p = 0.151). Fracture risk predictions for earlier non-injurious falls was OR = 1.36, 95% CI 1.12-1.64, p = 0.002. These risk patterns remain same after adjustments. CONCLUSION History of falls (especially injurious falls) predicts subsequent fractures (mainly other fractures compared with major osteoporotic fractures) inpostmenopausal women. We aimed to investigate if history of falls (frequency, mechanism, and severity) is a predictor of future fractures in postmenopausal women. Our results indicate that history of falls (especially injurious falls) appeared to be an indicator for subsequent fracture overall. Earlier injurious falls were stronger predictors for future other fractures than for typical major osteoporotic fractures.
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Affiliation(s)
- N. Afrin
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211 Kuopio, Finland
| | - R. Sund
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211 Kuopio, Finland
| | - R. Honkanen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211 Kuopio, Finland
- Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
| | - H. Koivumaa-Honkanen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211 Kuopio, Finland
- Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
- Institute of Clinical Medicine (Psychiatry), University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, South-Savonia Hospital District, Mikkeli, Finland
- Department of Psychiatry, North Karelia Central Hospital, Joensuu, Finland
- Department of Psychiatry, SOTE, Iisalmi, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - T. Rikkonen
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211 Kuopio, Finland
| | - L. Williams
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia
| | - H. Kröger
- Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland (UEF), P.O. Box 1627, 70211 Kuopio, Finland
- Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
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Fadle AA, Campbell BC, Willett JF, Williams L, Conti SF, Miller MC. A simple foot pedal device in a horizontal bore imaging facility replicates weightbearing outcomes for Hallux Valgus patients. Foot Ankle Surg 2020; 26:320-324. [PMID: 31079958 DOI: 10.1016/j.fas.2019.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 03/08/2019] [Accepted: 04/09/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Weightbearing images are important to the diagnosis of foot pathologies as are the three dimensional views available from CT and MRI. Standard three-dimensional imaging hardware, however, does not have a simple tool to obtain weightbearing images. The current research aimed to design, build and test a simple device to apply load in a horizontal bore imaging facility. METHODS With the immediate need in hallux valgus studies, hallux valgus subjects were imaged using the new loading device, which could be easily transported and had no additional electronics. RESULTS Testing showed that the usual angular measures of the foot (intermetatarsal and hallux valgus) replicated the results from the standard of care standing plain film results. With application of load, HV angle changed from 29.9° non-weightbearing to 32.2° weightbearing, while IM angle changed from nonweightbearing 15.8° to weightbearing 16.5°. CONCLUSION The pedal-like device can provide weightbearing images in a horizontal bore MRI facility.
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Affiliation(s)
- Amr A Fadle
- Assiut University, Orthpaedic Department, Assiut, Egypt
| | - B C Campbell
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA; Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - J F Willett
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - L Williams
- Department of Radiology, Passavant Hospital, Pittsburgh PA, USA
| | - S F Conti
- Orthopedic Partners, Pittsburgh PA, USA
| | - M C Miller
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Orthopaedic Biomechanics Laboratory, Allegheny General Hospital, Pittsburgh, PA, USA.
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Simon J, Clayton A, Kingsberg S, Portman D, Jordan R, Williams L, Krop J. 194 Effect Size of Bremelanotide Treatment in the Phase 3 RECONNECT Studies. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sepehripour S, Dawood O, Hatter S, Williams L, Zahd Z, Liebmann R, Dheansa B. An assessment of histological margins and recurrence of completely excised cutaneous SCC. J Plast Reconstr Aesthet Surg 2019; 73:899-903. [PMID: 32184053 DOI: 10.1016/j.bjps.2019.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 08/26/2019] [Accepted: 09/21/2019] [Indexed: 10/25/2022]
Abstract
There is a paucity of data relating to histological margins of cutaneous squamous cell carcinoma (cSCC) and local recurrence. Retrospective data were collected for 721 patients with cSCC treated at Queen Victoria Hospital, UK, and followed up for five years. The local recurrence rate was 6.1%, the mean time to recurrence was 12.61 months and 93% of recurrences occurred within two years. Sixty-six per cent of recurrences had a deep margin of 2.5 mm or less (p 0.041). The Pearson's correlation coefficient showed a strong correlation with tumour grade (r=0.82, p, 0.05), lymphovascular invasion (r=0.73. p<0.05), medium correlation with deep histological margin(r= -0.55, p<0.05), a weak correlation with male sex (r= 0.31, p<0.05) and the anatomical site of head and neck (r=0.31, p<0.05).The multiple regression analysis model using the 5 variables generated an r value of 0.71 and adjusted r square of 0.7. In conclusion, our findings are consistent with previously mentioned prognostic indicators and also demonstrate that deep histological margin is a significant predictor of local recurrence of cSCC. We recommend larger multi-institutional studies to confirm the above results to subsequently guide the specialist skin multidisciplinary teams' recommendations.
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Affiliation(s)
| | - O Dawood
- Queen Victoria Hospital, East Grinstead
| | - S Hatter
- Queen Victoria Hospital, East Grinstead
| | | | - Z Zahd
- Queen Victoria Hospital, East Grinstead
| | | | - B Dheansa
- Queen Victoria Hospital, East Grinstead
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Somorin T, Fidalgo B, Hassan S, Sowale A, Kolios A, Parker A, Williams L, Collins M, McAdam EJ, Tyrrel S. Non-isothermal drying kinetics of human feces. Dry Technol 2019; 38:1819-1827. [PMID: 33767602 PMCID: PMC7932498 DOI: 10.1080/07373937.2019.1670205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 05/24/2023]
Abstract
The non-isothermal drying behavior and kinetics of human feces (HF) were investigated by means of thermogravimetric analysis to provide data for designing a drying unit operation. The effect of heating rate and blending with woody biomass were also evaluated on drying pattern and kinetics. At low heating rate (1 K/min), there is effective transport of moisture, but a higher heating rate would be necessary at low moisture levels to reduce drying time. Blending with wood biomass improves drying characteristics of HF. The results presented in this study are relevant for designing non-sewered sanitary systems with in-situ thermal treatment.
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Affiliation(s)
- T. Somorin
- Department of Chemical & Process Engineering, University of Strathclyde, Glasgow, UK
| | - B. Fidalgo
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - S. Hassan
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - A. Sowale
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - A. Kolios
- Naval Architecture, Ocean & Marine Engineering, University of Strathclyde, Glasgow, UK
| | - A. Parker
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - L. Williams
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - M. Collins
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - E. J. McAdam
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
| | - S. Tyrrel
- School of Water, Energy and Environment, Cranfield University, Cranfield, UK
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Shi Q, Williams L, El Ferjani B, Hirschmann M, Ponce D, Dibaj S, Chandwani S, Roarty E, Rinsurongkawong W, Lewis J, Burke T, Cleeland C, Lee J, Roth J, Swisher S, Heymach J, Zhang J, Simon G. P1.16-31 Body Mass Index Relating to Patient-Reported Symptoms in First-Line Treatment of Metastatic Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brown CJ, Hochman D, Raval MJ, Moloo H, Phang PT, Bouchard A, Williams L, Drolet S, Boushey R. A multi-centre randomized controlled trial of open vs closed management of the rectal defect after transanal endoscopic microsurgery. Colorectal Dis 2019; 21:1025-1031. [PMID: 31081281 DOI: 10.1111/codi.14689] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 04/12/2019] [Indexed: 01/17/2023]
Abstract
AIM Transanal endoscopic microsurgery (TEM) is a technically challenging strategy that allows expanded indications for local excision of rectal lesions. Transluminal suturing is difficult, so open management of the resultant defect is appealing. Expert opinion suggests there is more pain when the defect is left open. The aim of this study was to determine if closure of the defect created during full thickness excision of rectal lesions with TEM leads to less postoperative pain compared to leaving the defect open. METHOD At the time of surgery, patients undergoing a full thickness TEM were randomized to sutured (TEM-S) or open (TEM-O) management of the rectal defect. At five Canadian academic colorectal surgery centres, experienced TEM surgeons enrolled patients ≥ 18 years treated by full thickness TEM. The primary outcome was postoperative pain measured by the visual analogue scale. Secondary outcomes included postoperative pain medication use and 30-day postoperative complications, including bleeding, infection and hospital readmission. RESULTS Between March 2012 and October 2013, 50 patients were enrolled and randomized to sutured (TEM-S, n = 28) or open (TEM-O, n = 22) management of the rectal defect. There was no difference between the two study groups in postoperative pain on postoperative day 1 (2.8 vs 2.6, P = 0.76), day 3 (2.8 vs 2.1, P = 0.23) and day 7 (2.8 vs 1.7, P = 0.10). CONCLUSION In this multicentre randomized controlled trial, there was no difference in postoperative pain between sutured or open defect management in patients having a full thickness excision with TEM.
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Affiliation(s)
- C J Brown
- Department of Surgery, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - D Hochman
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - M J Raval
- Department of Surgery, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - H Moloo
- Department of Surgery, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - P T Phang
- Department of Surgery, University of British Columbia and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - A Bouchard
- Department of Surgery, CHU de Québec - Université Laval, Quebec City, Quebec, Canada
| | - L Williams
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - S Drolet
- Department of Surgery, CHU de Québec - Université Laval, Quebec City, Quebec, Canada
| | - R Boushey
- Department of Surgery, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Mercer E, Davey C, Azzini D, Eusebi A, Tierney R, Williams L, Jiang Y, Parker A, Kolios A, Tyrrel S, Cartmell E, Pidou M, McAdam E. Hybrid membrane distillation reverse electrodialysis configuration for water and energy recovery from human urine: An opportunity for off-grid decentralised sanitation. J Memb Sci 2019; 584:343-352. [PMID: 31423048 PMCID: PMC6558964 DOI: 10.1016/j.memsci.2019.05.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 03/25/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 11/30/2022]
Abstract
The integration of membrane distillation with reverse electrodialysis has been investigated as a sustainable sanitation solution to provide clean water and electrical power from urine and waste heat. Reverse electrodialysis was integrated to provide the partial remixing of the concentrate (urine) and diluate (permeate) produced from the membrane distillation of urine. Broadly comparable power densities to those of a model salt solution (sodium chloride) were determined during evaluation of the individual and combined contribution of the various monovalent and multivalent inorganic and organic salt constituents in urine. Power densities were improved through raising feed-side temperature and increasing concentration in the concentrate, without observation of limiting behaviour imposed by non-ideal salt and water transport. A further unique contribution of this application is the limited volume of salt concentrate available, which demanded brine recycling to maximise energy recovery analogous to a battery, operating in a 'state of charge'. During recycle, around 47% of the Gibbs free energy was recoverable with up to 80% of the energy extractable before the concentration difference between the two solutions was halfway towards equilibrium which implies that energy recovery can be optimised with limited effect on permeate quality. This study has provided the first successful demonstration of an integrated MD-RED system for energy recovery from a limited resource, and evidences that the recovered power is sufficient to operate a range of low current fluid pumping technologies that could help deliver off-grid sanitation and clean water recovery at single household scale.
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Affiliation(s)
- E. Mercer
- School of Water, Energy and Environment, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - C.J. Davey
- School of Water, Energy and Environment, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - D. Azzini
- Department of Materials, Environmental Sciences and Urban Planning, Università Politecnica delle Marche, Piazza Roma, Ancona, Italy
| | - A.L. Eusebi
- Department of Materials, Environmental Sciences and Urban Planning, Università Politecnica delle Marche, Piazza Roma, Ancona, Italy
| | - R. Tierney
- School of Water, Energy and Environment, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - L. Williams
- School of Water, Energy and Environment, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - Y. Jiang
- School of Water, Energy and Environment, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - A. Parker
- School of Water, Energy and Environment, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - A. Kolios
- Naval Architecture, Ocean and Marine Engineering, University of Strathclyde, Glasgow, UK
| | - S. Tyrrel
- School of Water, Energy and Environment, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - E. Cartmell
- Scottish Water, Castle House, Carnegie Campus, Dunfermline, UK
| | - M. Pidou
- School of Water, Energy and Environment, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - E.J. McAdam
- School of Water, Energy and Environment, Cranfield University, Bedfordshire, MK43 0AL, UK
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Meyer L, Shi Q, Schneider A, Lin H, Molina E, Williams L, Savelieva K, Soliman P, Westin S, Wang X, Sun C. Symptom trajectory in women with recurrent ovarian cancer: How does symptom burden change near the end of life? Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Williams L, Poynton S, Graham L, Wilkie M, Williamson E, Smith L, Rybacka A, Smith N, Zhang X, Meenan J, Lei J, Clouet J. Performance of first trimester maternal screening biomarkers pregnancy-associated plasma protein a (PAPP-A) and free beta human chorionic gonadotropin (FBHCG) on the Atellica® IM Analyzer. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Clayton A, Simon J, Kingsberg S, Jordan R, Lucas J, Williams L, Krop J. 029 Bremelanotide for Hypoactive Sexual Desire Disorders in the RECONNECT Studies: Analysis of Baseline Free Testosterone Level Quartile Subgroups. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hutton N, Callender J, Hutton D, Williams L, Wong S, Wong H, Syndikus I. EP-2180 The effect of Rectal size and shape on Bladder deformation in Urinary Bladder Radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32600-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kaye M, Arredondo F, Anderson A, Williams L, Mak W. A study to compare the birth outcomes of infants conceived by intravaginal culture using the invocellTM device and conventional in vitro fertilization in traditional incubators. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.02.115] [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: 10/27/2022]
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