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Macdonald AS, McConnachie A, Dickie DA, Bath PM, Forbes K, Quinn T, Broomfield NM, Dani K, Doney A, Muir KW, Struthers A, Walters M, Barber M, Bhalla A, Cameron A, Guyler P, Hassan A, Kearney M, Keegan B, Lakshmanan S, Macleod MJ, Randall M, Shaw L, Subramanian G, Werring D, Dawson J. Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST. J Hum Hypertens 2024; 38:307-313. [PMID: 38438602 PMCID: PMC11001576 DOI: 10.1038/s41371-024-00906-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/06/2024]
Abstract
Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV was lowered by allopurinol and whether it was related to neuroimaging markers of cerebral small vessel disease (CSVD) and cognition. We used data from a randomised, double-blind, placebo-controlled trial of two years allopurinol treatment after recent ischemic stroke or transient ischemic attack. Visit-to-visit BPV was assessed using brachial blood pressure (BP) recordings. Short-term BPV was assessed using ambulatory BP monitoring (ABPM) performed at 4 weeks and 2 years. Brain MRI was performed at baseline and 2 years. BPV measures were compared between the allopurinol and placebo groups, and with CSVD and cognition. 409 participants (205 allopurinol; 204 placebo) were included in the visit-to-visit BPV analyses. There were no significant differences found between placebo and allopurinol groups for any measure of visit-to-visit BPV. 196 participants were included in analyses of short-term BPV at week 4. Two measures were reduced by allopurinol: the standard deviation (SD) of systolic BP (by 1.30 mmHg (95% confidence interval (CI) 0.18-2.42, p = 0.023)); and the average real variability (ARV) of systolic BP (by 1.31 mmHg (95% CI 0.31-2.32, p = 0.011)). There were no differences in other measures at week 4 or in any measure at 2 years, and BPV was not associated with CSVD or cognition. Allopurinol treatment did not affect visit-to-visit BPV in people with recent ischemic stroke or TIA. Two BPV measures were reduced at week 4 by allopurinol but not at 2 years.
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Affiliation(s)
- Alexander S Macdonald
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Alex McConnachie
- Robertson Centre for Biostatistics, School of Health and Wellbeing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - David Alexander Dickie
- DD Analytics Cubed Ltd, 73 Union Street, Greenock, Scotland, PA16 8BG, UK
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary & Life Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK
| | - Philip M Bath
- Stroke Trials Unit, Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Kirsten Forbes
- Department of Neuroradiology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK
| | - Terence Quinn
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Niall M Broomfield
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Krishna Dani
- Department of Neurology, Institute of Neurological Sciences Glasgow, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, UK
| | - Alex Doney
- Medicine Monitoring Unit (MEMO), School of Medicine, University of Dundee. Ninewells Hospital, Dundee, DD1 9SY, UK
- Division of Imaging and Science Technology, School of Medicine, Ninewells Hospital, Dundee, DD1 9SY, UK
| | - Keith W Muir
- School of Psychology & Neuroscience, College of Medical, Veterinary & Life Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK
| | - Allan Struthers
- Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Matthew Walters
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Mark Barber
- University Department of Stroke Care, University Hospital Monklands, Airdrie, ML6 OJS, UK
| | - Ajay Bhalla
- Department of Stroke, Ageing and Health, Guy's and St Thomas NHS Foundation Trust, St Thomas' Hospital, Lambeth Palace Rd, London, SE1 7EH, UK
| | - Alan Cameron
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary & Life Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK
| | - Paul Guyler
- Department of Stroke Medicine, Mid and South Essex University Hospitals Group, Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 0RY, UK
| | - Ahamad Hassan
- Department of Neurology, Leeds General Infirmary, Leeds, UK
| | | | - Breffni Keegan
- Department of Medicine, Southwest Acute Hospital, Enniskillen, BT74 6DN, UK
| | - Sekaran Lakshmanan
- Department of Stroke Medicine, The Luton and Dunstable University Hospital, Bedfordshire, NHSFT, Lewsey Road, Luton, LU4 0DZ, UK
| | | | - Marc Randall
- Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Louise Shaw
- Department of Stroke Medicine, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK
| | - Ganesh Subramanian
- Department of Stroke Medicine, Nottingham University Hospitals, Nottingham, NG5 1PB, UK
| | - David Werring
- Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK
- Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, Queen Square, University College Hospitals NHS Foundation Trust, London, UK
| | - Jesse Dawson
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary & Life Sciences, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK.
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Pashtan IM, Kosak T, Shin KY, Molodowitch C, Killoran JH, Hancox C, Czerminska M, Bredfeldt JS, Cail DW, Kearney M, Tishler RB, Mak RH. An Automated, Dynamic Radiation Oncology Prescription Checking System. Pract Radiat Oncol 2023:S1879-8500(23)00345-4. [PMID: 38151183 DOI: 10.1016/j.prro.2023.12.002] [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: 08/19/2023] [Revised: 10/29/2023] [Accepted: 12/01/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE Despite serving as a critical communication tool, radiation oncology prescriptions are entered manually and prone to error. An automated prescription checking system was developed and implemented to help address this problem. METHODS AND MATERIALS Rules defining clinically appropriate prescriptions were generated, examining specific types of errors: (1) unapproved dose per fraction for a given disease site; (2) dose per fraction too large for nonstereotactic treatment technique; and (3) dose per fraction too low. With a goal of catching errors as upstream as possible to minimize their propagation, a report was created and ran every 30 minutes to check all newly written or approved prescriptions against the 3 rules. When a prescription violated these rules, an automated email was immediately sent to the prescriber alerting them of the potential error. System performance was continuously monitored and the criteria triggering an alert adjusted to balance error detection against false positives. Alerts leading to prescription amendment were considered true errors. RESULTS From June 2021 to November 2022, the system checked 24,047 prescriptions. A total of 241 email alerts were triggered, for an average alert rate of 1%. Of the 241 alerts, 198 (82.2%) were unapproved doses per fraction for the disease site, 14 (5.8%) were doses per fraction that were too low, and 29 (12%) were doses too large for nonstereotactic treatment technique. Thirty-one percent of alerts led to a change of prescription, suggesting they were true errors. The baseline rate of erroneous prescription entry was 0.3%. A regression model showed that trainee prescription entry and dose per fraction <150 cGy were significantly associated with true errors. CONCLUSIONS Given the significant consequences of erroneous prescription entry, which ranged from wasted resources and treatment delays to potentially serious misadministration, there is significant value in implementing automated prescription checking systems in radiation oncology clinics.
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Affiliation(s)
- I M Pashtan
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts.
| | - T Kosak
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
| | - K-Y Shin
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - C Molodowitch
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
| | - J H Killoran
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
| | - C Hancox
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
| | - M Czerminska
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
| | - J S Bredfeldt
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
| | - D W Cail
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
| | - M Kearney
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
| | - R B Tishler
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
| | - R H Mak
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
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Kosak TK, Mak RH, Tishler RB, Kearney M, Pashtan IM. Improving Radiation Oncology Staff Engagement with Quality Improvement and Safety through a QI Committee Visiting Staff Initiative. Int J Radiat Oncol Biol Phys 2023; 117:e426. [PMID: 37785395 DOI: 10.1016/j.ijrobp.2023.06.1586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) An interdisciplinary, team-based approach to safety and quality is a critical value of radiation oncology. Quality Improvement (QI) programs can be meaningful contributors. A visiting staff initiative to the monthly QI meeting was developed, with goals of broadening staff engagement with QI activities, providing transparency, encouraging a culture of reporting, and offering additional perspectives to the standing QI Committee (QIC). MATERIALS/METHODS From 5/2021 - 1/2023, 24 staff, including physicians (n = 11), radiation therapists (n = 6), dosimetrists (n = 4), and administrative staff (n = 3) from 4 community-based radiation oncology clinics rotated through the monthly QI meeting as visitors. The meeting was held virtually. Prior to the meeting, visitors were provided with a background on QI operations and encouraged to be active participants. The QIC has 30 standing members including physicians (n = 2), physicists (n = 8), dosimetrists (n = 2), nursing (n = 3), radiation therapists (n = 4), IT (n = 2), administrative staff (n = 4), and QIC support staff (n = 2), out of a total of 115 staff members. Visitors filled out pre- and post-attendance surveys. A survey of the QIC (n = 14) was conducted to assess the value of the program to the committee. Survey responses were on a Likert scale (1 = Strongly Disagree; 5 = Strongly Agree). A 2-tail t-test was used for statistical analysis. RESULTS Nearly all visitors stated that they learned something new through participation in the QI meeting (92%), and most said they were interested in future QI participation (63%). Most visitors were familiar with the process of submitting a safety report (75%), and nearly half submitted one in the past year (46%). After the first 10 visitors participated in QIC, the standing QIC was surveyed and agreed that visitors offered new perspective (4.3), and that the visitor program enhanced quality and safety in the department (4.2). CONCLUSION The QIC visiting staff initiative was significantly effective in educating interdisciplinary staff members, establishing a safety culture, increasing transparency around QI functions, and providing new perspectives. At baseline, there was appreciation for the role of QI and safety. Implementing a QI visiting staff initiative is feasible and beneficial and may be of even higher impact in less established QI programs.
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Affiliation(s)
- T K Kosak
- Department of Radiation Oncology, Dana-Farber Brigham Cancer Center, Boston, MA
| | - R H Mak
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - R B Tishler
- Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - M Kearney
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - I M Pashtan
- Department of Radiation Oncology, Dana-Farber Brigham Cancer Center, Boston, MA
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Quirk S, Mackin M, Killoran JH, Kosak TK, Murray A, Kearney M, Mak RH, Pashtan IM. Radiation Treatment Preparation Safety Risk Prediction. Int J Radiat Oncol Biol Phys 2023; 117:e429. [PMID: 37785401 DOI: 10.1016/j.ijrobp.2023.06.1593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To determine the effect of delays in radiation treatment preparation task timeliness on reported safety events. MATERIALS/METHODS For 2022, all patients treated at four community-based radiation oncology clinics were included for analysis. Safety reports which occurred during treatment preparation tasks (i.e., between CT simulation and the first treatment) were included for this analysis. Patients with a reported safety event were the report cohort and those without were the control cohort. Treatment preparation tasks are completed sequentially and included contouring, treatment planning, Radiation Oncologist review, Medical Physicist review, Therapist quality check. At baseline, each task was scheduled a standard interval for completion based on treatment technique. The time taken to complete each task was captured using ARIA v16.0 Care Path module (Varian Medical Systems, Palo Alto, CA) and extracted through database query. For each task, two metrics were quantified: Task (1) Completion Timeliness: the time (hours) to complete each task, relative to the time allocated to each task. A negative value indicated more time taken than scheduled. (2) Overall Timeliness: specific task timeliness (hours) relative to overall timeliness for the whole Care Path. A negative value indicated the tasks were behind schedule. A student's t-test with an alpha of 0.05 was used to indicate significance. RESULTS Over the study period, 66 courses had a reported treatment preparation safety event (report) and 2690 did not (control). Techniques include 54% and 56% 3DCRT, 35% and 35% IMRT, 3% and 3% SRS, and 6% and 8% SBRT, for the report and control groups, respectively. Disease sites include breast, GU, GI, head and neck, CNS, thoracic, skin, secondary, gynecological, sarcoma, and heme. Table 1 displays the timeliness for each of the five tasks. Of the courses with safety events, overall timeliness was significantly behind the control group from the in contouring, treatment planning, Radiation Oncologist review, and Medical Physicist review. Courses with safety events took significantly more time than scheduled early in treatment preparation with a significant increase at treatment planning and significantly less time towards the end with the therapist quality check. CONCLUSION Patient courses with reported safety events had significantly longer treatment planning times, and as a result inadequate time to perform each downstream pre-treatment activity. The implication of this analysis is that a flag could be created to indicate risk of a safety event early in the treatment preparation process.
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Affiliation(s)
- S Quirk
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - M Mackin
- Brigham & Women's Hospital, Boston, MA
| | - J H Killoran
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - T K Kosak
- Department of Radiation Oncology, Dana-Farber Brigham Cancer Center, Boston, MA
| | - A Murray
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - M Kearney
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - R H Mak
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - I M Pashtan
- Department of Radiation Oncology, Dana-Farber Brigham Cancer Center, Boston, MA
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Katusiime M, Guo S, Neer V, Patro S, Wu X, Horner A, Chahroudi A, Mavigner M, Kearney M. OP 3.4 – 00197 Infected naïve CD4+ T cells in children with HIV can proliferate and persist on ART. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Romerio F, Li R, Sklutuis R, Groebner J, Kearney M. PP 1.28 – 00156 The HIV-1 antisense RNA Ast promotes viral latency via epigenetic silencing of the proviral 5′LTR and is expressed in latently infected cells from ART-suppressed donors. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100132] [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: 12/24/2022] Open
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7
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Capoferri A, Wiegand A, Hong F, Shao W, Sobolewski M, Kearney M, Hoh R, Deeks S, Coffin J, Mellors J. OP 1.3 – 00017 The fraction of cells with unspliced HIV RNA is not associated with plasma viremia. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100098] [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: 12/24/2022] Open
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Kearney M, Schuck S, Fergusson J, Perry R. Effective practices during emergency school lockdowns: shared experiences of four Australian schools. Aust Educ Res 2022:1-21. [PMID: 36407673 PMCID: PMC9652584 DOI: 10.1007/s13384-022-00588-3] [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] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
This study investigates common features of a set of diverse schools' responses to the initial school lockdown period during the pandemic in 2020, with a focus on practices supporting learning, inclusion and wellbeing. It comprises a collective case study of four Australian schools that were selected based on their reputation for impactful support of students and teachers during the emergency remote teaching period. Methods included interviews and focus groups with school leaders, teachers and students. The schools had widely differing contexts, technology access and student needs. Despite these varied contexts, the findings provided important insights into common practices supporting effective remote teaching. Emerging principles of effective practice illuminate ways forward to mitigate the significant risks accompanying emergency remote teaching, and guide practices in a variety of school contexts.
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Affiliation(s)
- M. Kearney
- Faculty of Arts and Social Sciences, University of Technology Sydney (UTS), Ultimo, Australia
| | - S. Schuck
- Faculty of Arts and Social Sciences, University of Technology Sydney (UTS), Ultimo, Australia
| | - J. Fergusson
- Faculty of Arts and Social Sciences, University of Technology Sydney (UTS), Ultimo, Australia
| | - R. Perry
- The Association of Independent Schools of NSW, Sydney, Australia
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Patel M, Ali S, Robson J, Clements R, Theodoulou A, Wright P, Kearney M, Patel R, Sohaib A, Antoniou S. Pharmacist-led multidisciplinary approach in preventing strokes in people with atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Targets set by Public Health England (PHE) state that 90% of patients with atrial fibrillation (AF) are expected to receive anticoagulation by 2029. In 2019/2020, across three London boroughs serving a population of 770,000, the percentage of AF patients at high risk of stroke (CHA2DS2VASc>2) anticoagulated was below the target set by PHE. In addition, optimisation of risk factors can significantly reduce the risk of cardiovascular disease and associated mortality in these patients.
Purpose
To provide specialist input from a cardiovascular pharmacist to prevent AF-related strokes through improvement of anticoagulation rates and optimisation of cardiovascular risk factors in patients with AF across three London boroughs over one year, as well as minimising bleed risk in patients on dual antithrombotic therapy.
Methods
A specialist cardiovascular pharmacist was commissioned to identify high-risk AF patients (CHA2DS2VASc>2) by working with primary care clinicians. Utilising “proactive care frameworks” created by UCLPartners and Clinical Effectiveness Group Queen Mary University of London, patients were stratified and prioritised for review. Patients not on anticoagulation were deemed to be at highest risk, requiring an urgent review to assess suitability for anticoagulation. A virtual multidisciplinary team (MDT) would review any complex patients and agree an action plan. Patients on dual antithrombotic therapy were also assessed to determine if antiplatelet therapy was indicated to minimise risk of major bleeding. All AF patients were reviewed for suitability of statin initiation to optimise cardiovascular risk prevention.
Results
At baseline, 86% (7581/8582) of AF patients with a CHA2DS2VASc>2 across the three boroughs were anticoagulated. 1001 patients were reviewed by a specialist pharmacist, with 84% (841/1001) of patients having a CHA2DS2VASc between 2–5, and 28% (280/1001) on antiplatelet monotherapy. Analysis at 12 months following intervention reported that 95% (7888/8280) of AF patients with a CHA2DS2VASc>2 were suitably anticoagulated, an improvement of 9%. 6% (61/1001) of patients were switched from antiplatelets and 25% (246/1001) were newly initiated on anticoagulation. 13% (130/1001) of patients required specialist MDT input to determine appropriateness for anticoagulation initiation. There was also a reduction in dual anticoagulation and antiplatelet therapy from 429 to 252 patients (41% reduction). Lastly of those reviewed, 2609 patients received a recommendation to start a statin for either primary (n=1981) or secondary prevention (n=628).
Conclusion(s)
Provision of a specialist cardiovascular pharmacist supported a multidisciplinary workforce to significantly improve and optimise cardiovascular risk, and reduce the risk of stroke in this high-risk population for people with AF across all three boroughs. By extrapolating these results nationally, 3600 strokes could be averted over 18 months.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Patel
- Barts Heart Centre, Pharmacy , Greater London , United Kingdom
| | - S Ali
- NHS Redbridge Clinical Commissioning Group , London , United Kingdom
| | - J Robson
- Queen Mary University of London, Clinical Effectiveness Group , London , United Kingdom
| | - R Clements
- NHS North East London Clinical Commissioning Group , London , United Kingdom
| | - A Theodoulou
- Barts Health NHS Trust, Haematology , London , United Kingdom
| | - P Wright
- Barts Heart Centre, Pharmacy , Greater London , United Kingdom
| | - M Kearney
- UCLPartners , London , United Kingdom
| | - R Patel
- Barts Heart Centre, Cardiology , London , United Kingdom
| | - A Sohaib
- Barking Havering and Redbridge Hospitals NHS trust, Cardiology , London , United Kingdom
| | - S Antoniou
- Barts Heart Centre, Pharmacy , Greater London , United Kingdom
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Knott C, Kearney M, Mahmoudpour H, Verpillat P. 1750P Factors associated with the receipt of systemic treatment (tx) for metastatic urothelial carcinoma (mUC) in England. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1828] [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: 11/01/2022] Open
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11
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Wilke T, Zhang L, Hubscher E, Musat M, Harricharan S, Kearney M. 1765P Undertreatment rates, associated factors, and survival among patients with locally advanced or metastatic urothelial cancer (la/mUC): A systematic literature review. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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La Puente M, Berry M, Milloy N, Montgomery R, Bleasdale C, Kluth C, Kirker M, Kearney M, Costa N, Chang J. CN71 Evaluating real-world caregiver involvement from a survey of patients (pts) with metastatic urothelial cancer (mUC) receiving systemic anticancer treatment in France, Germany, Italy, Spain, and the UK (Eu5). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.394] [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] Open
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13
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Patel M, Ali S, Robson J, Clements R, Theodoulou A, Wright P, Kearney M, Patel R, Sohaib A, Antoniou S. Pharmacist-led multidisciplinary approach in preventing strokes in people with atrial fibrillation. Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.001] [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: None.
Background/Introduction
In England, 90% of patients with atrial fibrillation (AF) are expected to receive anticoagulation as part of targets set by Public Health England by 2029. In 2019/2020, across three London boroughs serving a population of 770,000, the percentage of AF patients at high risk of stroke (CHA2DS2VASc>2) anticoagulated was 87%, 83% and 84%. This placed two of the three localities in the bottom 10% compared to others in England. In addition, optimising cholesterol and lifestyle choices can significantly reduce the risk of cardiovascular disease and associated mortality in these patients.
Purpose
To prevent AF-related strokes by improving anticoagulation rates and optimising cardiovascular risk factors in patients with AF in all general practices across three London boroughs over one year, and to minimise risk of bleeding in patients on concurrent anticoagulation and antiplatelet therapy.
Methods
A specialist cardiovascular pharmacist was commissioned to systemically identify high-risk AF patients (CHA2DS2VASc>2) by working with primary care clinicians, including up-skilling of primary care pharmacists. Through utilisation of ‘proactive care frameworks’ created by the Clinical Effectiveness Group Queen Mary University of London and UCL Partners, patients were able to be stratified and prioritised for review. AF patients not on anticoagulation or on antiplatelet monotherapy were deemed to be at highest risk, and these patients were reviewed to assess suitability for anticoagulation. Subsequently, patients on concurrent anticoagulation and antiplatelets were assessed to determine if dual antithrombotic prescribing was still indicated to minimise risk of major bleeding. Lastly, to optimise cardiovascular risk prevention, all AF patients were reviewed for suitability of statin initiation for primary or secondary prevention. A virtual multidisciplinary team was convened for complex patients, which included a cardiologist, haematologist, general practitioner and pharmacist to review and agree an action plan.
Results
An interim analysis at 9 months reported that 94% (6745/7145) of patients with a CHA2DS2VASc>2 across the three boroughs were suitably anticoagulated, an improvement of 6% on the initial 88% (6585/7391). There was a reduction in concurrent anticoagulation and antiplatelet therapy from 381 to 262 patients (31.2% reduction) following specialist review. Lastly 2285 patients were reviewed with a recommendation to start a statin for either primary (n=1783) or secondary prevention (n=502).
Conclusion(s)
Provision of a specialist cardiovascular pharmacist supported a multidisciplinary workforce with significant improvement in anticoagulation rates across all three boroughs, reducing the risk of stroke in this high-risk population. In addition, we were able to reduce the risk of bleeding in this cohort of patients by stopping inappropriate antiplatelet therapy, and reduced the risk of cardiovascular disease through statin initiation.
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Affiliation(s)
- M Patel
- Barts Heart Centre, Pharmacy , Greater London , United Kingdom of Great Britain & Northern Ireland
| | - S Ali
- NHS Redbridge Clinical Commissioning Group , London , United Kingdom of Great Britain & Northern Ireland
| | - J Robson
- Queen Mary University of London, Clinical Effectiveness Group , London , United Kingdom of Great Britain & Northern Ireland
| | - R Clements
- NHS North East London Clinical Commissioning Group , London , United Kingdom of Great Britain & Northern Ireland
| | - A Theodoulou
- Barts Health NHS Trust, Haematology , London , United Kingdom of Great Britain & Northern Ireland
| | - P Wright
- Barts Heart Centre, Pharmacy , Greater London , United Kingdom of Great Britain & Northern Ireland
| | - M Kearney
- UCLPartners , London , United Kingdom of Great Britain & Northern Ireland
| | - R Patel
- Barts Heart Centre, Cardiology , London , United Kingdom of Great Britain & Northern Ireland
| | - A Sohaib
- Barking Havering and Redbridge Hospitals NHS trust, Cardiology , London , United Kingdom of Great Britain & Northern Ireland
| | - S Antoniou
- Barts Heart Centre, Pharmacy , Greater London , United Kingdom of Great Britain & Northern Ireland
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14
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Ajmera M, Chang J, Hitchens A, Kearney M, Esterberg E, Kim R, Cappelleri J, Devgan G, Costa N, Candrilli S. 706P Real-world study assessing physician rationale for initiating first-line (1L) immuno-oncology (IO) therapy for patients with advanced urothelial cancer (aUC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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15
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Da Ros S, Aliev AE, del Gaudio I, King R, Pokorska A, Kearney M, Curran K. Characterising plasticised cellulose acetate-based historic artefacts by NMR spectroscopy: A new approach for quantifying the degree of substitution and diethyl phthalate contents. Polym Degrad Stab 2021. [DOI: 10.1016/j.polymdegradstab.2020.109420] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Franco I, Adleman J, Arriaga A, Kearney M, Mak R, Weiler M, Buzurovic I, Cormak R, Devlin P, King M, Lee L. Evaluating Errors and Inefficiencies in Brachytherapy: An Approach Toward Process Redesign and Patient Safety. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1437] [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: 10/23/2022]
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17
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Sentell T, Kearney M, Hazen A, Dela Cruz MR, Yamauchi J, McHenry L, Rodericks B, Massey P. Do you Vape With Aloha?: How culture and place are used to spread misinformation on Instagram. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Forty-two percent of high school teens in Hawai'i have tried e-cigarettes, double the United States' national average. Native Hawaiians have higher use than other racial/ethnic groups. While Hawai'i state law prohibits tobacco sales to anyone under 21, many Hawai'i adolescents purchase e-cigarettes on the internet, often through social media.
Methods
We collected 717 public Instagram posts from April and December 2018 geotagged in Hawai'i that mentioned one or more hashtag search terms (e.g., #vape, #ecig). All relevant, working posts (n = 476) were manually coded for text and image characteristics.
Results
Over 80% of posts were from vape shops (n = 389 of 476;81.7%). Caption text commonly mentioned brand names (n = 409;85.9%), vape shop names (n = 379;79.6%), and flavors (n = 103;21.6%). The most frequent image elements were logos (n = 395;82.7%), e-cigarettes (n = 324;68.1%), and flavors (n = 110;23.1%). Less than one in 50 (n = 9;1.8%) included caption text warnings.
One in five posts (n = 94,19.7%%) featured content specific to Hawai'i including references to Native Hawaiian culture, flavors and foods, scenery, plants, animals, and language. For example, “Hawai'i Nei...Stay Blessed n Vape With Aloha” or “Ma'o Hau Hele” is the state flower of Hawaii, combined with a refreshing sweet raspberry it makes the perfect balance of flavor.” User engagement (i.e., likes) varied, with a median of 17 likes per post (range: 0-308). Posts with Hawaiian cultural elements received significantly more likes than other posts (median: 22 versus 16;p=0.0047).
Conclusions
Culture is a critical strength that can support positive health outcomes in many communities. Vape shops and product promoters explicitly misappropriated Native Hawaiian culture to sell e-cigarettes on Instagram, while downplaying known harms. Adolescents and young adults may be particularly vulnerable given social media's role as a powerful health behavior influence and an e-cigarette purchasing source.
Key messages
Health misinformation is contextualized within culture and place in a way that is compelling to users, may put youth at particular risk, and can perpetuate health disparities. Our study supports tailored health campaigns and interventions for local communities and cultures to combat such online misinformation.
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Affiliation(s)
- T Sentell
- University of Hawaii at Manoa, Honolulu, USA
| | - M Kearney
- Drexel University, Philadelphia, USA
| | - A Hazen
- Drexel University, Philadelphia, USA
| | | | - J Yamauchi
- Hawaii Public Health Institute, Honolulu, USA
| | - L McHenry
- University Laboratory School, Honolulu, USA
| | - B Rodericks
- University of Hawaii at Manoa, Honolulu, USA
| | - P Massey
- Drexel University, Philadelphia, USA
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18
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Kearney M, Townsend J, Parkin I, Hidalgo M, Curran K. Factors affecting the practicality of solid-phase microextraction VOC analysis of artworks featuring polymeric materials in open environments. Microchem J 2020. [DOI: 10.1016/j.microc.2020.104711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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19
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Paton MF, Gierula J, Lowry J, Byrom-Goulthorp R, Cubbon R, Kearney M, Witte K. REPROGRAMMING TO PREVENT PROGRESSIVE PACEMAKER-INDUCED REMODELLING. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)30941-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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Joseph K, Halvas E, Brandt L, Patro S, Rausch J, Kearney M, Coffin J, Mellors J. High-throughput sequencing of integrated HIV-1 reveals novel proviral structures. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30138-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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21
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Hasson J, Katusiime M, Smith S, Cotton M, Boritz E, Coffin J, Mellors J, Patro S, Van Zyl G, Kearney M. Proviral landscape in children parallels adults and enables reservoir reconstruction. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30136-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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22
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Patro S, Niyongabo A, Guo S, Wu X, Boritz E, Deeks S, Maldarelli F, Hughes S, Coffin J, Kearney M. HIV proviruses with identical sequences arise from cell expansion and infection by a common ancestor virus. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30140-0] [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: 11/28/2022] Open
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23
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Bale M, Katusiime M, Wells D, Wu X, Coffin J, Cotton M, Hughes S, Mellors J, Van Zyl G, Kearney M. Long-term persistence of HIV-infected cell clones in early treated children. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30146-1] [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: 10/23/2022] Open
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24
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Zanotti G, Kim R, Krulewicz S, Hall J, Leith A, Bailey A, Liu F, Kearney M. Treatment (TX) Patterns Of Patients with Advanced Renal Cell Carcinoma (aRCC) Receiving First-Line (1L) TX: Results from a Cross-Sectional Real-World Study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz450.008] [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: 11/14/2022] Open
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25
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Shao W, Shan J, Hu W, Halvas E, Mellors J, Coffin J, Kearney M. Updates on two public databases for studies of HIV persistence; the Retrovirus Integration Database (RID) and HIV Proviral Sequence Database (PSD). J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30103-5] [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] Open
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26
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Li J, Etemad B, Namazi G, Wen Y, Jilg N, Esmaeilzadeh E, Zhang X, Sharaf R, Brumme Z, Kearney M. HIV post-treatment control despite plasma viral evolution and dual infection. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30170-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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27
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Conteduca V, Ku SY, Wang Y, Fernandez L, Kearney M, Lee J, Jiles R, Rodriguez A, Nanus D, Tagawa S, Dittamore R, Beltran H. Circulating tumour cell (CTC) genomic landscape in neuroendocrine prostate cancer (NEPC) by single cell copy number analysis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.045] [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: 11/14/2022] Open
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28
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Koshy A, Gierula J, Paton M, Swoboda P, Toms A, Saunderson C, Shelley D, Plein D, Cubbon R, Kearney M, Witte K. P1236Revealing cardiac mechanics with CMR whilst CRT is active: the first step. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Cardiac resynchronisation therapy (CRT) is a routine treatment for heart failure with reduced ejection fraction and conduction delay to improve symptoms and prognosis. Technological advancements both in cardiac magnetic resonance (CMR) and devices (MRI-conditional modes) now enable investigation of the haemodynamic response to CRT over a range of heart rates.
Methods
Patients with a CRT-D device were enrolled from heart failure clinics at a single tertiary centre. A complete device system assessment and baseline device check was conducted to ensure MRI compatibility and suitability. Left ventricular (LV) volumes and systolic blood pressure were measured at baseline and heart rates of 75, 90, 100, 115, 125, and 140 bpm (randomised order) with CRT active and intrinsic conduction (AOO). MRI conditional mode parameters were replicated through standard parameter modification to ensure biventricular pacing during CRT active scans. All scans were conducted using a 3.0 T Siemens Prisma MRI scanner with analysis on commercially available software. Contractility was derived from the systolic blood pressure and left ventricular end systolic volume. A post scan device and lead assessment was conducted to assess for scanning safety.
Results
Scanning was conducted in 22 patients (safety cohort). Post scan battery voltage reduced by 2.9±1.0%. Mean change in atrial, right ventricular and left ventricular lead impedance was 0.5±0.06%, 3.0±0.04% and −1.7±0.05% respectively. Mean change in atrial, right ventricular and left ventricular pacing threshold was 0.0±0.3%, 8.3±0.3% and 5.6±0.3%. No patient experienced symptoms related to scanning or device failure.
Preliminary data for patients with CRT on and off have been analysed (paired analysis cohort, n=8, 6 men). Mean age was 71.1±8.2, aetiology was primarily ischaemic (62.5%) with the remainder dilated cardiomyopathy. The mean LV ejection fraction at baseline was 29.4±12.9%. Biventricular pacing led to acute improvements in ejection fraction (p=0.005), left ventricular cardiac output (p<0.0001) and contractility (p=0.05) over the entire range of heart rates studied. We also noted an improvement in the force frequency relationship during biventricular pacing with a higher peak contractility (p=0.05), a higher heart rate at which this occurred (HR=130) and a generally up sloping relationship when compared with intrinsic conduction.
Conclusion
We have demonstrated for the first time, the mechanistic improvements in cardiac contractility consequent to CRT using CMR and also that MRI scans of conditional devices can be safe with CRT active.
Acknowledgement/Funding
Dr A Koshy is conducting a PhD supported by grant from Medtronic. Dr Klaus Witte has received honoraria from Medtronic
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Affiliation(s)
- A Koshy
- University of Leeds, Leeds, United Kingdom
| | - J Gierula
- University of Leeds, Leeds, United Kingdom
| | - M Paton
- University of Leeds, Leeds, United Kingdom
| | - P Swoboda
- University of Leeds, Leeds, United Kingdom
| | - A Toms
- Leeds General Infirmary, Leeds, United Kingdom
| | | | - D Shelley
- Leeds General Infirmary, Leeds, United Kingdom
| | - D Plein
- University of Leeds, Leeds, United Kingdom
| | - R Cubbon
- University of Leeds, Leeds, United Kingdom
| | - M Kearney
- University of Leeds, Leeds, United Kingdom
| | - K Witte
- University of Leeds, Leeds, United Kingdom
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29
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Shyam-Sundar V, Swoboda P, Cubbon R, Greenwood J, Kearney M, Plein S, Witte K. 15 Improvement in diagnosis of ischaemic cardiomyopathy by cardiovascular magnetic resonance. Imaging 2019. [DOI: 10.1136/heartjnl-2019-bcs.14] [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: 11/04/2022] Open
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30
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Chabrier G, Hobson S, Yuldasheva N, Kearney M, Schurmans S, Pineda Torra I, Gage M. SUN-084 Aged Insulin Resistant Macrophages Reveal Dysregulated Cholesterol Biosynthesis, Pro-Inflammatory Gene Expression, and Reduced Foam Cell Formation. J Endocr Soc 2019. [PMCID: PMC6552898 DOI: 10.1210/js.2019-sun-084] [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: 12/04/2022] Open
Abstract
Insulin resistance is the central defining feature of type 2 diabetes and increases with age. People with type 2 diabetes are at a significantly increased risk of developing atherosclerosis. Macrophages are phagocytotic leukocytes which play a central role in the development of type 2 diabetes and atherosclerosis. Despite their relevance however, the effect of insulin and insulin resistance on macrophages regarding their inflammatory status and role in atherosclerosis remain unclear. Our aim was to determine the inflammatory gene expression profile in aged insulin resistant macrophages and how this may impact foam cell formation - a key step in the development of atherosclerosis. Genome-wide transcript array analysis was performed on bone marrow derived macrophages from aged insulin resistant mice (n=3) gained through chronic hyper-stimulation of the PI3K arm of the insulin signalling pathway via hematopoietic SHIP2 knock-down (h-SHIP2KD). The transcriptome of aged h-SHIP2KD insulin resistant macrophages become reprogrammed, differentially expressing more than 4000 genes (≥2fold, P=≤ 0.05. Pathway analysis revealed that the most significantly altered intracellular signalling pathways include upregulation of interferon signalling pathwyas, components of the inflammasome (for example increased mRNA expression Nlrp3: 1.75-fold, P=0.05, Casp4: 4.31-fold, P=0.05) and changes in cholesterol biosynthesis genes (for example Fdps: 2.56-fold, P=0.05, Idi1: 3.13-fold, P=0.05, Sqle: 3.87-fold, P=0.05, Cyp51: 4.47-fold, P=0.05, Dhcr: 4.72-fold, P=0.05). Exposure of these h-SHIP2KD macrophages to acetylated LDL revealed a decreased capacity to form foam cells compared to WT controls (Mean staining intensity 2818 vs 4730 units respectively, P=0.03, n=3). These data support the emerging role of insulin a modulator of inflammation and that insulin resistance in macrophages is protective against foam cell formation. Our transcriptome expression data revealed novel targets which may be exploited for new therapies.
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Affiliation(s)
| | - Sam Hobson
- University College London, London, , United Kingdom
| | | | - Mark Kearney
- Div of Cardiovascular Diabetes, University of Leeds, Leeds, , United Kingdom
| | | | | | - Matthew Gage
- University College London, London, , United Kingdom
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31
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Selvan P, Kearney M, Massey PM, Leader AE. Recruiting for an Online Survey through Social Media: Testing Variations in Messaging, Compensation, and Platform. Cancer Epidemiol Biomarkers Prev 2019. [DOI: 10.1158/1055-9965.epi-19-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
To test three recruitment strategies for parents on social media (Facebook and Twitter) to complete a brief survey about the human papillomavirus (HPV) vaccine. Methods: We created three campaigns with ads on Facebook and promoted tweets on Twitter that invited parents of children ages 9–15 to complete a brief survey about the HPV vaccine. Iterative, yet varied, campaigns were conducted to determine the ideal social media platform, compensation amount, and messaging. Ads depicted vaccine-eligible children (11–12 years of age) of various ethnicities. Ad messaging was adapted from social media toolkits at the CDC and the HPV Roundtable. Parents who clicked on our ad were first screened for eligibility. Those who were eligible then completed a 20-item survey via Qualtrics that included questions about HPV, the vaccine, and social media use. Survey compensation was either $5 or $10. At the end of the survey, we provided information about HPV and the vaccine. The campaign was available in English and Spanish. Results: The first campaign was launched on both Facebook and Twitter and offered $5 compensation. The Facebook component yielded 18,527 impressions; two adults were confirmed eligible by the screener and both completed the survey (100% screener to completion rate). Cost per survey was $349.45. The Twitter component received 143,661 impressions and yielded 18 completed surveys, with a screener to completion rate of 26% and a cost of $42.99 per survey. For the second campaign, we dropped Facebook and focused solely on Twitter, offering $10 compensation. We received 50,475 impressions that yielded 55 completed surveys (screener to completion rate = 71%) costing $4.78 each. The final campaign tested simpler messaging on Twitter with $10 compensation, and received 8,897 impressions, 38 survey completions (screener to completion rate = 88%), and cost $1.19 per survey. Conclusions: While Facebook is widely used among Americans, our findings may suggest that Twitter is more engaging and cost-effective. Recent Facebook policy changes may explain the differences seen in cost and survey completion. Understanding the reach and effectiveness of the different platforms will help ensure the success of an intervention using social media.
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32
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Straw S, Byrom R, Gierula J, Paton MF, Koshy A, Cubbon R, Drozd M, Kearney M, Witte KK. Predicting one-year mortality in heart failure using the 'Surprise Question': a prospective pilot study. Eur J Heart Fail 2018; 21:227-234. [PMID: 30548129 DOI: 10.1002/ejhf.1353] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 05/30/2018] [Revised: 08/19/2018] [Accepted: 10/05/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The Surprise Question: 'would you be surprised if this patient were to die within the next year?' has been shown to predict mortality in patients with chronic kidney disease and cancer. This prospective study aimed to determine whether the Surprise Question could identify heart failure patients with a prognosis of less than 1 year, and whether the Surprise Question can be used by different healthcare professionals. METHODS AND RESULTS Overall, 129 consecutive patients admitted with decompensated heart failure were included. Doctors and nurses were asked to provide a 'surprised' or 'not surprised' response to the Surprise Question for each patient. Patients were followed up until death or 1 year following study inclusion. The sensitivity, specificity, positive predictive value and negative predictive value of the Surprise Question were assessed. Cox regression was used to determine covariates significantly associated with survival. The Surprise Question showed excellent sensitivity (0.85) and negative predictive value (0.88) but only fair specificity (0.59) and positive predictive value (0.52) when asked of cardiologists. There were similar levels of accuracy between doctors and specialist nurses. The Surprise Question was significantly associated with all-cause mortality in multivariate regression analysis (hazard ratio 2.8, 95% confidence interval 1.0-7.9, P = 0.046). CONCLUSION This study demonstrates that the Surprise Question can identify heart failure patients within the last year of life. Despite over-classification of patients into the 'not surprised' category, the Surprise Question identified nearly all patients who were within the last year of life, whilst also accurately identifying those unlikely to die.
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Affiliation(s)
- Sam Straw
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Rowenna Byrom
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - John Gierula
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Maria F Paton
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Aaron Koshy
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Richard Cubbon
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Michael Drozd
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Mark Kearney
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Klaus K Witte
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
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33
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Morris M, Vogelzang N, Sartor O, Armour A, Messmann R, Groaning M, Robarts A, Tolcher A, Gordon M, Babiker H, Kuo P, Kearney M, Jendrisak A, Wang Y, Landers M, Petrylak D. CTC-based biomarkers & PSMA-targeted imaging in patients with metastatic castrate-resistant prostate cancer (mCRPC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.051] [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: 11/12/2022] Open
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34
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Affiliation(s)
- Mark Kearney
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds School of Medicine, Leeds, UK
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35
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Kearney M, Perron J, Marc I, Weisnagel SJ, Tchernof A, Robitaille J. Association of prenatal exposure to gestational diabetes with offspring body composition and regional body fat distribution. Clin Obes 2018; 8:81-87. [PMID: 29239129 DOI: 10.1111/cob.12237] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 11/14/2017] [Indexed: 12/21/2022]
Abstract
The aim of this cohort study was to compare body composition and regional body fat distribution between children exposed (GDM+) or unexposed (GDM-) in utero to gestational diabetes mellitus (GDM) and to investigate the association with the glycaemic and the insulin profile. Data from 56 GDM+ and 30 GDM- were analysed. Height, weight and waist circumference were measured. Total and regional body composition was measured by dual-energy X-ray absorptiometry. Insulin, glucose and HbA1c were obtained from a fasting plasma sample, and the HOMA-IR index was calculated. anova was performed to compare adiposity measures between GDM+ and GDM-. Associations between the glycaemic and insulin profile and adiposity measures were studied using partial Pearson correlations. Mean age was 6.6 ± 2.3 years. Waist circumference, fat mass percentage, android fat mass, android fat mass percentage and android-to-gynoid fat mass ratio were higher among GDM+, and lean mass percentage was lower (P < 0.05). Among GDM+ children, body mass index (BMI) z score, waist circumference, fat mass percentage, android fat mass percentage and android-to-gynoid fat mass ratio were all positively correlated with HbA1C (r = 0.32-0.43, P < 0.05). Prenatal exposure to GDM is associated with increased total and abdominal adiposity. This increased adiposity observed among GDM+ children is associated with an altered glycaemic profile. This study is registered in the Clinical Trials.gov registry (NCT01340924).
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Affiliation(s)
- M Kearney
- School of Nutrition, Laval University, Québec, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Canada
| | - J Perron
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Canada
| | - I Marc
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Québec, Canada
| | - S J Weisnagel
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Québec, Canada
- Diabetes Research Unit, Laval University Medical Research Center, Québec, Canada
| | - A Tchernof
- School of Nutrition, Laval University, Québec, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Canada
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Québec, Canada
| | - J Robitaille
- School of Nutrition, Laval University, Québec, Canada
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Canada
- Endocrinology and Nephrology Axis, CHU de Québec Research Center, Québec, Canada
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36
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McMurrough I, Lynch MV, Murray F, Kearney M, Nitzsche F. A Comparison of Alternative High-Performance Liquid Chromatographic Systems for Measuring Bitterness in Beer. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-45-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- I. McMurrough
- Research Centre, Arthur Guinness Son & Co. Ltd., St. James Gate, Dublin
| | - M. V. Lynch
- Research Centre, Arthur Guinness Son & Co. Ltd., St. James Gate, Dublin
| | - F. Murray
- Research Centre, Arthur Guinness Son & Co. Ltd., St. James Gate, Dublin
| | - M. Kearney
- Research Centre, Arthur Guinness Son & Co. Ltd., St. James Gate, Dublin
| | - F. Nitzsche
- Technische Universität, Weihenstephan, West Germany
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Ghasemi-Roudsari S, Al-Shimary A, Varcoe B, Byrom R, Kearney L, Kearney M. A portable prototype magnetometer to differentiate ischemic and non-ischemic heart disease in patients with chest pain. PLoS One 2018; 13:e0191241. [PMID: 29351337 PMCID: PMC5774725 DOI: 10.1371/journal.pone.0191241] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 12/11/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Magnetocardiography (MCG) is a non-invasive technique used to measure and map cardiac magnetic fields. We describe the predictive performance of a portable prototype magnetometer designed for use in acute and routine clinical settings. We assessed the predictive ability of the measurements derived from the magnetometer for the ruling-out of healthy subjects and patients whose chest pain has a non-ischemic origin from those with ischemic heart disease (IHD). METHODS MCG data were analyzed from a technical performance study, a pilot clinical study, and a young healthy reference group. Participants were grouped to enable differentiation of those with IHD versus non-IHD versus controls: Group A (70 IHD patients); Group B (69 controls); Group C (37 young healthy volunteers). Scans were recorded in an unshielded room. Between-group differences were explored using analysis of variance. The ability of 10 candidate MCG predictors to predict normal/abnormal cases was analyzed using logistic regression. Predictive performance was internally validated using repeated five-fold cross-validation. RESULTS Three MCG predictors showed a significant difference between patients and age-matched controls (P<0.001); eight predictors showed a significant difference between patients and young healthy volunteers (P<0.001). Logistic regression comparing patients with controls yielded a specificity of 35.0%, sensitivity of 95.4%, and negative predictive value for the ruling-out of IHD of 97.8% (area under the curve 0.78). CONCLUSION This analysis represents a preliminary indication that the portable magnetometer can help rule-out healthy subjects and patients whose chest pain has a non-ischemic origin from those with IHD.
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Affiliation(s)
| | - Abbas Al-Shimary
- Department of Physics and Astronomy, University of Leeds, Leeds, United Kingdom
- * E-mail:
| | - Benjamin Varcoe
- Department of Physics and Astronomy, University of Leeds, Leeds, United Kingdom
| | - Rowena Byrom
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Lorraine Kearney
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Mark Kearney
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
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Anderson E, Bell J, Kearney M, Coffin J, Maldarelli F. HIV viremia is the product of a small fraction of infected cells. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30608-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Tiernan E, Casey P, O'Boyle C, Birkbeck G, Mangan M, O'Siorain L, Kearney M. Relations between Desire for Early Death, Depressive Symptoms and Antidepressant Prescribing in Terminally Ill Patients with Cancer. J R Soc Med 2017; 95:386-90. [PMID: 12151487 PMCID: PMC1279962 DOI: 10.1177/014107680209500803] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Some patients with advanced cancer express the wish for an early death. This may be associated with depression. We examined the relations between depressive symptoms and desire for early death (natural or by euthanasia or physician-assisted suicide) in 142 terminally ill patients with cancer being cared for by a specialist palliative care team. They completed the Hospital Anxiety and Depression Scale questionnaire and answered four supplementary questions on desire for early death. Only 2 patients expressed a strong wish for death by some form of suicide or euthanasia. 120 denied that they ever wished for early release. The desire for early death correlated with depression scores. Depressive symptoms were common in the whole group but few were on antidepressant therapy. Better recognition and treatment of depression might improve the lives of people with terminal illness and so lessen desire for early death, whether natural or by suicide.
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Affiliation(s)
- E Tiernan
- Our Lady's Hospice, Harold's Cross, Dublin 6W, Ireland.
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Patel P, Watt N, Gage M, Yuldasheva N, Viswambharan H, Walker A, Ali N, Galloway S, Mughal R, Wheatcroft S, Schurmans S, Kearney M, Cubbon R. 232 Endothelial ship2 knockout causes nox2 nadph oxidase-dependent oxidative stress and endothelial dysfunction. Heart 2017. [DOI: 10.1136/heartjnl-2017-311726.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sfyri P, Y. Yuldasheva N, Tzimou A, Mougios V, Kearney M, Matsakas A. 226 The impact of nadph oxidase 2 inhibition on skeletal muscle pathophysiology of atherosclerotic mice. Heart 2017. [DOI: 10.1136/heartjnl-2017-311726.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Peterson G, Rapaka S, Koski N, Kearney M, Ortblad K, Tadlock L. A robust sebum, oil, and particulate pollution model for assessing cleansing efficacy of human skin. Int J Cosmet Sci 2017; 39:351-354. [DOI: 10.1111/ics.12378] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 10/25/2016] [Indexed: 12/19/2022]
Affiliation(s)
- G. Peterson
- L'Oreal Research and Innovation; 17275 NE 6th Ct. Redmond WA USA
| | - S. Rapaka
- L'Oreal Research and Innovation; 17275 NE 6th Ct. Redmond WA USA
| | - N. Koski
- L'Oreal Research and Innovation; 17275 NE 6th Ct. Redmond WA USA
| | - M. Kearney
- L'Oreal Research and Innovation; 17275 NE 6th Ct. Redmond WA USA
| | - K. Ortblad
- L'Oreal Research and Innovation; 17275 NE 6th Ct. Redmond WA USA
| | - L. Tadlock
- L'Oreal Research and Innovation; 17275 NE 6th Ct. Redmond WA USA
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Wahab A, Jamil H, Gierula J, Paton M, Byrom-Goulthorp R, Sunley E, Winsor S, Cubbon R, Kearney M, Witte K. 19 Time From Symptoms Onset to Diagnosis and Optimum Therapy; Does It Relate to Outcome in Heart Failure Patients? Heart 2016. [DOI: 10.1136/heartjnl-2016-309890.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Aldeyab M, Scott M, Conlon-Bingham G, Nagar A, Farren D, Kearney M. Are we measuring what we intend to measure? Implications for the management of healthcare-acquired infections. J Hosp Infect 2015; 92:206-8. [PMID: 26654471 DOI: 10.1016/j.jhin.2015.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022]
Affiliation(s)
- M Aldeyab
- Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, UK.
| | - M Scott
- Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, UK
| | - G Conlon-Bingham
- Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, UK; Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, Belfast, UK
| | - A Nagar
- Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, UK
| | - D Farren
- Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, UK
| | - M Kearney
- Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, UK
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Gatenby K, Wheatcroft S, Kearney M. The Heart and Blood Vessels. Clin Nutr 2015. [DOI: 10.1002/9781119211945.ch18] [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: 11/10/2022]
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Gilchrist E, Burks B, Espaillat K, Fortenberry T, Baggett S, Kearney M, Goggins B, He L, Mocco J, Froehler M. E-076 improvement of patient care, quality and research through an automated cerebrovascular data collection (acdc). J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.151] [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: 11/04/2022]
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47
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Jamil H, Gierula J, Byrom R, WInsor S, Sunley E, Kearney L, Houghton A, Bailey K, Cubbon R, Reynolds G, Pavitt S, David C, Julian B, Davis M, Sharples L, Kearney M, Witte K. 47 Using Natriuretic Peptide Levels to Diagnose Heart Failure in Primary Care: An Evaluation of the 2010 United Kingdom National Institute of Clinical Excellence Guidelines on the Diagnosis of Chronic Heart Failure. Heart 2015. [DOI: 10.1136/heartjnl-2015-308066.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Viswambharan H, Sukumar P, Sengupta A, Cubbon R, Imrie H, Gage M, Haywood N, Yuldasheva N, Skromna A, Gatenby K, Galloway S, Santos C, Shah A, Beech D, Wheatcroft S, Kearney M, Shah P. 184 Increasing Insulin Sensitivity in the Endothelium Leads to Reduced Nitric Oxide Bioavailability. Heart 2015. [DOI: 10.1136/heartjnl-2015-308066.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cronin M, O’Regan C, O’Donoghue O, Kearney M, Kenny R. O1.20: Physical, psychological & cognitive risk factors for fear of falling. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70103-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cronin M, O’Regan C, Kearney M, Kenny R. P281: Functional and economic associations of fear of falling. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70452-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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