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Hahnemann L, Krämer A, Fink C, Jungk C, Thomas M, Christopoulos P, Lischalk J, Meis J, Hörner-Rieber J, Eichkorn T, Deng M, Lang K, Paul A, Meixner E, Weykamp F, Debus J, König L. Fractionated stereotactic radiotherapy of intracranial postoperative cavities after resection of brain metastases - Clinical outcome and prognostic factors. Clin Transl Radiat Oncol 2024; 46:100782. [PMID: 38694237 PMCID: PMC11061678 DOI: 10.1016/j.ctro.2024.100782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 04/17/2024] [Accepted: 04/20/2024] [Indexed: 05/04/2024] Open
Abstract
Background and Purpose After surgical resection of brain metastases (BM), radiotherapy (RT) is indicated. Postoperative stereotactic radiosurgery (SRS) reduces the risk of local progression and neurocognitive decline compared to whole brain radiotherapy (WBRT). Aside from the optimal dose and fractionation, little is known about the combination of systemic therapy and postoperative fractionated stereotactic radiotherapy (fSRT), especially regarding tumour control and toxicity. Methods In this study, 105 patients receiving postoperative fSRT with 35 Gy in 7 fractions performed with Cyberknife were retrospectively reviewed. Overall survival (OS), local control (LC) and total intracranial brain control (TIBC) were analysed via Kaplan-Meier method. Cox proportional hazards models were used to identify prognostic factors. Results Median follow-up was 20.8 months. One-year TIBC was 61.6% and one-year LC was 98.6%. Median OS was 28.7 (95%-CI: 16.9-40.5) months. In total, local progression (median time not reached) occurred in 2.0% and in 20.4% radiation-induced contrast enhancements (RICE) of the cavity (after median of 14.3 months) were diagnosed. Absence of extracranial metastases was identified as an independent prognostic factor for superior OS (p = <0.001) in multivariate analyses, while a higher Karnofsky performance score (KPS) was predictive for longer OS in univariate analysis (p = 0.041). Leptomeningeal disease (LMD) developed in 13% of patients. Conclusion FSRT after surgical resection of BM is an effective and safe treatment approach with excellent local control and acceptable toxicity. Further prospective randomized trials are needed to establish standardized therapeutic guidelines.
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Affiliation(s)
- L. Hahnemann
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - A. Krämer
- Department of Radiation Oncology, University Hospital of Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - C. Fink
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - C. Jungk
- Department of Neurosurgery, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - M. Thomas
- Department of Thoracic Oncology, Thoraxklinik and National Center for Tumor Diseases at Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Germany
| | - P. Christopoulos
- Department of Thoracic Oncology, Thoraxklinik and National Center for Tumor Diseases at Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Germany
| | - J.W. Lischalk
- Department of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Health at Long Island, New York, NY, USA
| | - J. Meis
- Institute of Medical Biometry, University of Heidelberg, Im Neuenheimer Feld 130, 69120 Heidelberg, Germany
| | - J. Hörner-Rieber
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - T. Eichkorn
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - M. Deng
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - K. Lang
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - A. Paul
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - E. Meixner
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - F. Weykamp
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - J. Debus
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- Heavy Ion Therapy Center (HIT), Heidelberg University Hospital, Im Neuenheimer Feld 450, 69120 Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology (E050), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - L. König
- Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Thomas M, Scheer M, Rampp S, Strauss C, Schönfeld R, Leplow B. Psychological factors and long-term tinnitus handicap in vestibular schwannoma patients after retrosigmoid microsurgery - a cross-sectional study. Int J Audiol 2024:1-8. [PMID: 38613519 DOI: 10.1080/14992027.2024.2339351] [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: 10/03/2023] [Accepted: 04/01/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE This study aimed to investigate the connection between psychological factors and postoperative tinnitus in vestibular schwannoma (VS) patients following retrosigmoid microsurgery. DESIGN Cross-sectional study. STUDY SAMPLE Ninety-three VS patients participated, completing questionnaires on demographics, tinnitus severity (THI-12), personality traits (TIPI-G), dizziness impact (DHI), perceived health benefits (GBI), somatisation tendencies (SOMS-2), and psychological distress (HADS-D). Our analysis involved Mann-Whitney U-tests, Spearman's rank-order correlations, and false discovery rate correction. RESULTS Most participants reported postoperative tinnitus (77/93), with 41 experiencing it preoperatively. Emotional stability correlated negatively with tinnitus presence, while tinnitus severity was associated with emotional distress. Preoperative somatisation tendencies were also positively linked to tinnitus severity. Postoperative Tinnitus was further linked to reduced perceived health benefits and increased anxiety and depression levels. Notably, age and gender showed no significant associations. CONCLUSION This study uncovers the interplay between postoperative tinnitus and psychological factors in VS patients, highlighting emotional and cognitive dimensions. Tailored psychological interventions addressing tinnitus's psychosomatic impact may enhance patients quality of life.
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Affiliation(s)
- M Thomas
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Scheer
- Department of Neurosurgery, University Hospital Halle, Halle, Germany
| | - S Rampp
- Department of Neurosurgery, University Hospital Halle, Halle, Germany
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - C Strauss
- Department of Neurosurgery, University Hospital Halle, Halle, Germany
| | - R Schönfeld
- Department of Psychology, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - B Leplow
- Department of Psychology, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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Thomas M, Hayes K, White P, Ramesh A, Culliford L, Ackland G, Pickering A. Early Intravenous Beta-Blockade with Esmolol in Adults with Severe Traumatic Brain Injury (EBB-TBI): Protocol for a Phase 2a Intervention Design Study. Neurocrit Care 2024; 40:795-806. [PMID: 37308729 PMCID: PMC10959800 DOI: 10.1007/s12028-023-01755-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/10/2023] [Indexed: 06/14/2023]
Abstract
Traumatic brain injury is a leading cause of death and disability worldwide. Interventions that mitigate secondary brain injury have the potential to improve outcomes for patients and reduce the impact on communities and society. Increased circulating catecholamines are associated with worse outcomes and there are supportive animal data and indications in human studies of benefit from beta-blockade after severe traumatic brain injury. Here, we present the protocol for a dose-finding study using esmolol in adults commenced within 24 h of severe traumatic brain injury. Esmolol has practical advantages and theoretical benefits as a neuroprotective agent in this setting, but these must be balanced against the known risk of secondary injury from hypotension. The aim of this study is to determine a dose schedule for esmolol, using the continual reassessment method, that combines a clinically significant reduction in heart rate as a surrogate for catecholamine drive with maintenance of cerebral perfusion pressure. The maximum tolerated dosing schedule for esmolol can then be tested for patient benefit in subsequent randomized controlled trials.Trial registration ISRCTN, ISRCTN11038397, registered retrospectively 07/01/2021 https://www.isrctn.com/ISRCTN11038397.
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Affiliation(s)
- Matt Thomas
- Intensive Care Unit, North Bristol NHS Trust, Bristol, UK.
| | - Kati Hayes
- Intensive Care Unit, North Bristol NHS Trust, Bristol, UK
| | - Paul White
- School of Data Science and Mathematics, University of the West of England, Bristol, UK
| | - Aravind Ramesh
- GW4 Clinical Academic Training Programme for Health Professionals, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Lucy Culliford
- Bristol Trials Centre, Bristol Medical School (PHS), University of Bristol, Bristol, UK
| | - Gareth Ackland
- Translational Medicine and Therapeutics, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Anthony Pickering
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
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Rollman JE, Thomas M, Mercer Kollar LM, Ports KA, Clelland C, Satter DE, David-Ferdon C. American Indian and Alaska Native violence prevention efforts: a systematic review, 1980 to 2018. Inj Epidemiol 2024; 8:72. [PMID: 38504377 PMCID: PMC10949553 DOI: 10.1186/s40621-024-00488-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Violence is a serious public health concern disproportionately experienced by American Indian and Alaska Native (AIAN) people. While the burden and impact of violence may be explained by the presence of risk factors among this group, AIAN communities benefit from unique protective factors and universal strategies which may be tailored with tribal adaptations. We sought to identify and explore violence prevention strategies specific to AIAN populations. METHODS A review was conducted to systematically identify violence prevention programs, policies, and practices implemented in AIAN communities. We searched nine electronic databases and relevant gray literature released between January 1980 and June 2018. We included intervention-focused records targeting at least one violence topic area (child abuse/neglect, elder abuse, intimate partner violence, sexual violence, youth violence, and suicide) in a majority (> 50%) AIAN population. RESULTS A total of 5220 non-duplicate records were screened, yielding 318 full-text records. After applying exclusion criteria, 57 records describing 60 program, policy, or practice implementations of 43 unique interventions were identified. All six violence types were represented, although more than half (58%; n = 25/43) focused on suicide prevention. Among suicide prevention programs, the most common strategies were identifying and supporting people at risk (80%; n = 20), teaching coping and problem-solving skills (56%; n = 14), and promoting connectedness (48%; n = 12). Two-thirds of the implementations (67%; n = 40/60) were in fully (100%) AIAN communities. Programs were implemented across many settings, though schools were the most common (35%, n = 21/60) setting. Of the 60 total implementations, a majority (80%; n = 48) were new approaches developed by and for AIAN communities, while the remainder were AIAN adaptations of programs previously created for non-AIAN populations. Most implementations (60%; n = 36/60) provided some evaluation data although less than half (45%; n = 27/60) reported evaluation results. CONCLUSIONS This review identified many violence prevention strategies specific to AIAN populations. While programs developed in one tribe may not be completely generalizable to others, shared tribal risk and protective factors suggest programs could be successful across diverse communities. Findings indicate there is a need to develop and evaluate violence prevention programs, policies and practices for AIAN populations.
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Affiliation(s)
- Jeffrey E Rollman
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - M Thomas
- Independent Researcher, Gulf Breeze, FL, 32563, USA
| | - Laura M Mercer Kollar
- Division of Violence Prevention, Centers for Disease Control and Prevention, National Center for Injury Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA.
| | - Katie A Ports
- American Institutes for Research, 10 South Riverside Plaza, 6th Floor, Chicago, IL, 60606, USA
| | - Carmen Clelland
- Indian Health Service, 5600 Fishers Lane, Rockville, MD, 20857, USA
- Centers for Disease Control and Prevention, National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, 1825 Century Boulevard, Atlanta, GA, 30345, USA
| | - Delight E Satter
- Centers for Disease Control and Prevention, National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, 1825 Century Boulevard, Atlanta, GA, 30345, USA
| | - Corinne David-Ferdon
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 4770 Buford Highway, Atlanta, GA, 30341, USA
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Thomas M, Cleverley A, Beanland R. Parameterized absorptive electron scattering factors. Acta Crystallogr A Found Adv 2024; 80:146-150. [PMID: 38270202 PMCID: PMC10913675 DOI: 10.1107/s2053273323010963] [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: 09/23/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
In electron diffraction, thermal atomic motion produces incoherent scattering over a relatively wide angular range, which appears as a diffuse background that is usually subtracted from measurements of Bragg spot intensities in structure solution methods. The transfer of electron flux from Bragg spots to diffuse scatter is modelled using complex scattering factors f + if' in the Bloch wave methodology. In a two-beam Einstein model the imaginary `absorptive' scattering factor f' can be obtained by the evaluation of an integral containing f over all possible scattering angles. While more sophisticated models of diffuse scatter are widely used in the electron microscopy community, it is argued in this paper that this simple model is appropriate for current structure solution and refinement methods. The two-beam model is a straightforward numerical calculation, but even this simplistic approach can become time consuming for simulations of materials with large numbers of atoms in the unit cell and/or many incident beam orientations. Here, a parameterized form of f' is provided for 103 elements as neutral, spherical atoms that reduces calculation time considerably.
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Affiliation(s)
- M. Thomas
- Department of Physics, University of Warwick, Coventry CV4 7AL, UK
| | - A. Cleverley
- Department of Chemistry, University of Warwick, Coventry CV4 7AL, UK
| | - R. Beanland
- Department of Physics, University of Warwick, Coventry CV4 7AL, UK
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6
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Taccone FS, Dankiewicz J, Cariou A, Lilja G, Asfar P, Belohlavek J, Boulain T, Colin G, Cronberg T, Frat JP, Friberg H, Grejs AM, Grillet G, Girardie P, Haenggi M, Hovdenes J, Jakobsen JC, Levin H, Merdji H, Njimi H, Pelosi P, Rylander C, Saxena M, Thomas M, Young PJ, Wise MP, Nielsen N, Lascarrou JB. Hypothermia vs Normothermia in Patients With Cardiac Arrest and Nonshockable Rhythm: A Meta-Analysis. JAMA Neurol 2024; 81:126-133. [PMID: 38109117 PMCID: PMC10728804 DOI: 10.1001/jamaneurol.2023.4820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/06/2023] [Indexed: 12/19/2023]
Abstract
Importance International guidelines recommend body temperature control below 37.8 °C in unconscious patients with out-of-hospital cardiac arrest (OHCA); however, a target temperature of 33 °C might lead to better outcomes when the initial rhythm is nonshockable. Objective To assess whether hypothermia at 33 °C increases survival and improves function when compared with controlled normothermia in unconscious adults resuscitated from OHCA with initial nonshockable rhythm. Data Sources Individual patient data meta-analysis of 2 multicenter, randomized clinical trials (Targeted Normothermia after Out-of-Hospital Cardiac Arrest [TTM2; NCT02908308] and HYPERION [NCT01994772]) with blinded outcome assessors. Unconscious patients with OHCA and an initial nonshockable rhythm were eligible for the final analysis. Study Selection The study cohorts had similar inclusion and exclusion criteria. Patients were randomized to hypothermia (target temperature 33 °C) or normothermia (target temperature 36.5 to 37.7 °C), according to different study protocols, for at least 24 hours. Additional analyses of mortality and unfavorable functional outcome were performed according to age, sex, initial rhythm, presence or absence of shock on admission, time to return of spontaneous circulation, lactate levels on admission, and the cardiac arrest hospital prognosis score. Data Extraction and Synthesis Only patients who experienced OHCA and had a nonshockable rhythm with all causes of cardiac arrest were included. Variables from the 2 studies were available from the original data sets and pooled into a unique database and analyzed. Clinical outcomes were harmonized into a single file, which was checked for accuracy of numbers, distributions, and categories. The last day of follow-up from arrest was recorded for each patient. Adjustment for primary outcome and functional outcome was performed using age, gender, time to return of spontaneous circulation, and bystander cardiopulmonary resuscitation. Main Outcomes and Measures The primary outcome was mortality at 3 months; secondary outcomes included unfavorable functional outcome at 3 to 6 months, defined as a Cerebral Performance Category score of 3 to 5. Results A total of 912 patients were included, 490 from the TTM2 trial and 422 from the HYPERION trial. Of those, 442 had been assigned to hypothermia (48.4%; mean age, 65.5 years; 287 males [64.9%]) and 470 to normothermia (51.6%; mean age, 65.6 years; 327 males [69.6%]); 571 patients had a first monitored rhythm of asystole (62.6%) and 503 a presumed noncardiac cause of arrest (55.2%). At 3 months, 354 of 442 patients in the hypothermia group (80.1%) and 386 of 470 patients in the normothermia group (82.1%) had died (relative risk [RR] with hypothermia, 1.04; 95% CI, 0.89-1.20; P = .63). On the last day of follow-up, 386 of 429 in the hypothermia group (90.0%) and 413 of 463 in the normothermia group (89.2%) had an unfavorable functional outcome (RR with hypothermia, 0.99; 95% CI, 0.87-1.15; P = .97). The association of hypothermia with death and functional outcome was consistent across the prespecified subgroups. Conclusions and Relevance In this individual patient data meta-analysis, including unconscious survivors from OHCA with an initial nonshockable rhythm, hypothermia at 33 °C did not significantly improve survival or functional outcome.
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Affiliation(s)
- Fabio Silvio Taccone
- Department of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
- After ROSC Network
| | - Josef Dankiewicz
- Cardiology Department, Lund University, Skåne University Hospital Lund, Lund, Sweden
| | - Alain Cariou
- After ROSC Network
- Department of Intensive Care, Paris Cité University, Cochin Hospital (APHP), Paris, France
| | - Gisela Lilja
- Neurology Department of Clinical Sciences, Lund University, Lund, Sweden
- Neurology Department, Skåne University Hospital, Lund, Sweden
| | - Pierre Asfar
- Département de Médecine Intensive Réanimation, CHU Angers, Angers, France
| | - Jan Belohlavek
- 2nd Department of Medicine, Cardiovascular Medicine, 1st Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - Thierry Boulain
- Medical Intensive Care Unit, Centre Hospitalier Régional, d’Orléans, Hôpital de la Source, Orléans, France
| | - Gwenhael Colin
- District Hospital Center, Medical-Surgical Intensive Care Unit, La Roche-sur-Yon, France
| | - Tobias Cronberg
- Neurology Department of Clinical Sciences, Lund University, Lund, Sweden
- Neurology Department, Skåne University Hospital, Lund, Sweden
| | - Jean-Pierre Frat
- INSERM CIC 1402, groupe IS-ALIVE, Université de Poitiers, Poitiers, France
| | - Hans Friberg
- Department of Clinical Sciences, Anesthesiology and Intensive Care, Lund University, Lund, Sweden
- Skåne University Hospital, Intensive and Perioperative Care, Malmö, Sweden
| | - Anders M. Grejs
- Department of Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Guillaume Grillet
- Medical-Surgical Intensive Care Unit, District Hospital Center, Lorient, France
| | - Patrick Girardie
- Médecine Intensive Réanimation, CHU Lille, Université de Lille, Faculté de Médicine, Lille, France
| | - Matthias Haenggi
- Department of Intensive Care Medicine, Bern University Hospital (Inselspital), University of Bern, Bern, Switzerland
| | - Jan Hovdenes
- Department of Anesthesia and Intensive Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Janus Christian Jakobsen
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Helena Levin
- Department of Research & Education, Lund University and Skåne University Hospital, Lund, Sweden
| | - Hamid Merdji
- Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, Hôpitaux universitaires de Strasbourg, Strasbourg, France
- INSERM, UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg (UNISTRA), Strasbourg, France
| | - Hassane Njimi
- Department of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Paolo Pelosi
- Department of Anesthesiology and Critical Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Christian Rylander
- Anaesthesia and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Manoj Saxena
- Critical Care and Trauma Division, George Institute for Global Health, Sydney, New South Wales, Australia
- Department of Intensive Care Medicine, St George Hospital, Kogarah, New South Wales, Australia
| | - Matt Thomas
- Department of Anaesthesia, Southmead Hospital, Bristol, United Kingdom
| | - Paul J. Young
- Department of Intensive Care, Wellington Regional Hospital, Capital and Coast District Health Board, Wellington, New Zealand
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - Matt P. Wise
- Adult Critical Care, University Hospital of Wales, Cardiff, United Kingdom
| | - Niklas Nielsen
- INSERM CIC 1402, groupe IS-ALIVE, Université de Poitiers, Poitiers, France
| | - Jean-Baptiste Lascarrou
- After ROSC Network
- Medecine Intensive Reanimation, CHU Nantes, Nantes, France
- Université Paris Cité, INSERM, PARCC, 75015 Paris, France
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Thomas M, Escudero MM, Howard V, Jones-Caballero M. Perianal and Scrotal Porokeratosis Ptychotropica. Case Report of an Unusual Condition, and Review of the Literature. Actas Dermosifiliogr 2024; 115:T196-T197. [PMID: 38048959 DOI: 10.1016/j.ad.2023.11.005] [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] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/12/2022] [Indexed: 12/06/2023] Open
Affiliation(s)
- M Thomas
- Dermatology Department, Westmead Hospital, Sídney, Australia.
| | - M M Escudero
- Dermatology Department, Westmead Hospital, Sídney, Australia
| | - V Howard
- Douglas Hanly Moir Pathology, Sídney, Australia
| | - M Jones-Caballero
- Dermatology Department, Westmead Hospital, Sídney, Australia; Sydney Medical School, The University of Sydney, Sídney, Australia
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Bourdon M, Maget AS, Jeljeli M, Doridot L, Marcellin L, Thomas M, Chêne C, Chouzenoux S, Batteux F, Chapron C, Santullli P. Reduced fertility in an adenomyosis mouse model is associated with an altered immune profile in the uterus during the implantation period. Hum Reprod 2024; 39:119-129. [PMID: 38011900 DOI: 10.1093/humrep/dead246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 11/03/2023] [Indexed: 11/29/2023] Open
Abstract
STUDY QUESTION Does a reduction in fertility and/or systemic immune cell change occur during the early implantation period in a mouse model of adenomyosis? SUMMARY ANSWER A reduction in fertility was observed in mice with adenomyosis, coinciding with local and systemic immune changes observed during the implantation period. WHAT IS KNOWN ALREADY Adenomyosis is a pathology responsible for impaired fertility in humans, with a still unclear pathophysiology. One hypothesis is that changes in immune cells observed in adenomyosis-affected uteri may alter fertility, notably the physiological immune environment necessary for successful implantation and a healthy pregnancy. STUDY DESIGN, SIZE, DURATION Randomly selected CD-1 female neonatal pups were orally dosed by administration of tamoxifen to induce adenomyosis (TAM group), while others received solvent only (control group). From 6 weeks of life, CD-1 mice of both groups were mated to study impaired fertility and related local and/or systemic immune cell changes during the early implantation period. PARTICIPANTS/MATERIALS, SETTINGS, METHODS To evaluate fertility and pregnancy outcomes, ultrasound imaging was performed at E (embryonic day) 7.5 and E11.5 to count the number of gestational sacs and the number of resorptions in eight mice of the TAM group and 16 mice of the control group. The mice were sacrificed at E18.5, and morphometric, functional (quantitative reverse transcription PCR; RT-qPCR), and histological analyses were performed on the placentas. To identify local and/or systemic immune changes during the early implantation period, 8 mice of the TAM group and 12 mice of the control group were sacrificed at E4.5. Uterine horns and spleens were collected for flow cytometry and RT-qPCR analyses to study the immune cell populations. To investigate the profile of the cytokines secreted during the early implantation period at the systemic level, supernatants from stimulated spleen cells were analyzed by multiplex immunoassay analysis. MAIN RESULTS AND THE ROLE OF CHANCE By ultrasound imaging, we observed a lower number of implantation sites (P < 0.005) and a higher number of resorptions (P < 0.001) in the TAM group, leading to smaller litters (average number of fetuses per litter: 1.00 [0.00; 5.25] in the TAM group versus 12.00 [9.50; 13.75] in the control group (P < 0.001). Histological and morphometric analyses of the placentas at E18.5 showed a higher junctional/labyrinthine area ratio in the TAM group (P = 0.005). The expression levels of genes that play a role in vascularization and placental growth (Vegf (P < 0.001), Plgf (P < 0.005), Pecam (P < 0.0001), and Igf2 (P = 0.002)) were reduced in the TAM group. In the TAM group, the percentages of macrophages, natural killer (NK) cells, and dendritic cells (DC) were significantly decreased in the uterus around the implantation period. However, the number of M1 macrophages was increased. Both macrophages and DC had an increased activation profile (higher expression of MCHII, P = 0.012; CD80, P = 0.015; CCR7, P = 0.043 for macrophages, and higher expression of CD206, P = 0.018; CXCR4, P = 0.010; CCR7, P = 0.006, MCHII, P = 0.010; and CD80, P = 0.012 for DC). In spleen, an increase in the activation of macrophages (CCR7, P = 0.002; MCHII, P = 0.001; and CD80, P = 0.034) and DC was observed in the TAM group (CCR7, P = 0.001; MCHII, P = 0.001; Ly6C, P = 0.015). In the uteri and the spleen, we observed increased percentages of CD4+ T lymphocytes (P = 0.0237 and P = 0.0136, respectively) in the TAM group and, in the uteri, an increased number of regulatory T cells (P = 0.036) compared with the controls. LARGE SCALE DATA Not applicable. LIMITATIONS, REASONS FOR CAUTION This study is limited by the use of an animal model and the lack of intervention. WIDER IMPLICATIONS OF THE FINDINGS These data support involvement of innate and adaptive immune cells in the implantation failure and the increased rate of resorption observed in the mouse model of adenomyosis. This substantiates the need for additional research in this domain, with the goal of addressing fertility challenges in women affected by this condition. STUDY FUNDING/COMPETING INTEREST(S) None.
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Affiliation(s)
- M Bourdon
- Department of Gynaecology Obstetrics and Reproductive Medicine, Assistance Publique-Hopitaux de Paris (AP-HP), Centre Hospitalier Universitaire (CHU), Université Paris Cité, Paris, France
- Institut Cochin, INSERM, CNRS, Paris, France
| | - A S Maget
- Department of Gynaecology Obstetrics and Reproductive Medicine, Assistance Publique-Hopitaux de Paris (AP-HP), Centre Hospitalier Universitaire (CHU), Université Paris Cité, Paris, France
- Institut Cochin, INSERM, CNRS, Paris, France
| | - M Jeljeli
- Institut Cochin, INSERM, CNRS, Paris, France
- Department of Immunology, Assistance Publique-Hopitaux de Paris (AP-HP), Centre Hospitalier Universitaire (CHU), Université Paris Cité, Paris, France
| | - L Doridot
- Institut Cochin, INSERM, CNRS, Paris, France
| | - L Marcellin
- Department of Gynaecology Obstetrics and Reproductive Medicine, Assistance Publique-Hopitaux de Paris (AP-HP), Centre Hospitalier Universitaire (CHU), Université Paris Cité, Paris, France
- Institut Cochin, INSERM, CNRS, Paris, France
| | - M Thomas
- Institut Cochin, INSERM, CNRS, Paris, France
| | - C Chêne
- Institut Cochin, INSERM, CNRS, Paris, France
| | | | - F Batteux
- Institut Cochin, INSERM, CNRS, Paris, France
- Department of Immunology, Assistance Publique-Hopitaux de Paris (AP-HP), Centre Hospitalier Universitaire (CHU), Université Paris Cité, Paris, France
| | - C Chapron
- Department of Gynaecology Obstetrics and Reproductive Medicine, Assistance Publique-Hopitaux de Paris (AP-HP), Centre Hospitalier Universitaire (CHU), Université Paris Cité, Paris, France
- Institut Cochin, INSERM, CNRS, Paris, France
| | - P Santullli
- Department of Gynaecology Obstetrics and Reproductive Medicine, Assistance Publique-Hopitaux de Paris (AP-HP), Centre Hospitalier Universitaire (CHU), Université Paris Cité, Paris, France
- Institut Cochin, INSERM, CNRS, Paris, France
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9
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Al-Monajjed R, Radtke JP, Thomas M, Boschheidgen M, Drewes LR, Ullrich T, Rau T, Esposito I, Antoch G, Albers P, Lopez-Cotarelo C, Schimmöller L. Multiparametric MRI characteristics of prostatitis and atrophy in the peripheral zone in men without prostate cancer. Eur J Radiol 2023; 169:111151. [PMID: 37866192 DOI: 10.1016/j.ejrad.2023.111151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE To analyse multiparametric magnetic resonance imaging (mpMRI) characteristics and appearance of histopathologically proven non-cancerous intraprostatic findings focussing on quantity of prostatitis and atrophy in the peripheral zone. METHOD In this retrospective analysis consecutive patients with mpMRI followed by MRI/TRUS-fusion biopsy comprising targeted (TB) and systematic biopsy (SB) cores without prostate cancer (PC) at histopathology were included. Subgroup analysis was performed in younger men (≤50 years). The proportions of prostatitis and atrophy were quantified for each biopsy core based on histopathology. MRI findings in the peripheral zone (PZ) and index lesions (IL, most suspicious/representative lesion) were characterized regarding changes in T2w, ADC value, and enhancement of dynamic contrast enhancement (DCE) and correlated with quantity of prostatitis and atrophy. RESULTS Seventy-two patients were analysed. The median baseline characteristics were PSA 5.4 ng/ml (4.0-7.9), PI-RADS classification 3 (2-4), prostate volume 43 ml (33-57), and PSA density 0.13 ng/ml2 (0.10-0.19). Prostatitis was found in 44 % (n = 32) and atrophy in 65 % (n = 47) of cases. The quantity of atrophy demonstrated a significant correlation to T2w changes, ADC increase and DCE enhancement (p = 0.05, p = 0.05, p = 0.01), whereas quantity of prostatitis did not show any significant correlation to the MRI changes (p = 0.68, p = 0.58, p = 0.95). Quantity of prostatitis and atrophy increased with PI-RADS classification. Younger men had lower PSA (4.4 vs. 7.8 ml/ng; p < 0.001), smaller prostate volume (40 vs. 59 ml; p = 0.001), and lower PI-RADS classification (2-3 vs. 3-4; p = 0.005) and prostatitis and atrophy were less frequently observed (p ≤ 0.01, p = 0.03). CONCLUSIONS Quantity of atrophy and prostatitis had different influence on MRI characteristics and increased within higher PI-RADS classification. Younger men had diffuse hypointense changes at T2w images, but less quantity of prostatitis and atrophy.
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Affiliation(s)
- R Al-Monajjed
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany
| | - J P Radtke
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany.
| | - M Thomas
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany; Cantonal Hospital Aarau, Department of Urology, CH-5000 Aarau, Switzerland
| | - M Boschheidgen
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - L R Drewes
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - T Ullrich
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - T Rau
- University Dusseldorf, Medical Faculty, Department of Pathology, D-40225 Dusseldorf, Germany
| | - I Esposito
- University Dusseldorf, Medical Faculty, Department of Pathology, D-40225 Dusseldorf, Germany
| | - G Antoch
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - P Albers
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany
| | - C Lopez-Cotarelo
- University Dusseldorf, Medical Faculty, Department of Pathology, D-40225 Dusseldorf, Germany; Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - L Schimmöller
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany; Department of Diagnostic, Interventional Radiology and Nuclear Medicine, Marien Hospital Herne, University Hospital of the Ruhr-University Bochum, Herne, Germany.
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10
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Thomas M. "A nice cup of tea": Caffeine in the intensive care unit. J Intensive Care Soc 2023; 24:29. [PMID: 37928084 PMCID: PMC10621512 DOI: 10.1177/1751143720958406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
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11
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Thomas M, Pike C, Humphreys I, Bragg T, Ghattaura A. Impact and outcomes after lymphaticovenous anastomosis for 150 cases of lymphoedema followed up over 24 months. J Plast Reconstr Aesthet Surg 2023; 85:104-113. [PMID: 37473641 DOI: 10.1016/j.bjps.2023.06.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Lymphoedema is a chronic condition affecting daily activities of life, causing significant alterations and adjustments. Since 2015, lymphaticovenous anastomosis (LVA) has been available on the National Health Service for people with lymphoedema in Wales, United Kingdom. This study aimed to explore the impact and outcomes after LVA over a 24-month follow-up. METHODS Data were prospectively captured before and after LVA surgery on 150 patients with unilateral upper or lower limb lymphoedema. The same team (three lymphoedema specialists and two plastic surgeons) assessed/operated on all patients. Data captured included a quality of life tool (EQ5D5L), circumferential measurements (tape measure/perometer), compression garment usage, occurrence of cellulitis and a range of patient-reported outcome measures. RESULTS People who underwent LVA surgery had predominantly cancer-related lymphoedema (n = 118). Reviewing baseline data and 24-months after LVA, quality of life statistically improved (p = <0.005), as well as pain, heaviness, anxiety, impact on hobbies, work, purchasing clothes and intimacy/desirability. Mean perometer and circumferential measurements did not reduce over the 24 months. Number of days per week and hours that the patient wore compression garments did lessen and was statistically significant (p = <0.001). The quantity of cellulitis episodes captured from two years before and two years after LVA decreased from 4.22 to 0.10 (p = <0.001). Significant results (p = <0.001) were also found in a reduction in patients taking days off work due to cellulitis (5.81 to 0.16). CONCLUSION LVA resulted in significant improvements in patient-reported outcome measures, cellulitis episodes and reduced need for compression garments. Limb circumference via tape measure/perometer did not alter, yet the patient's quality of life considerably improved.
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Affiliation(s)
- M Thomas
- Swansea Bay UHB - Lymphoedema Wales Clinical Network, United Kingdom.
| | - C Pike
- Swansea Bay UHB - Lymphoedema Wales Clinical Network, United Kingdom
| | - I Humphreys
- School of Health and Social Care, Swansea University, United Kingdom
| | - T Bragg
- Swansea Bay UHB - Plastic and Reconstructive Department, United Kingdom
| | - A Ghattaura
- Swansea Bay UHB - Plastic and Reconstructive Department, United Kingdom
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12
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Gott CA, Thomas M, Allan J, Kennedy J, Black Y, Dark F, Lappin JM. Cognitive remediation therapy - implementation and translation into clinical practice in rural and metropolitan New South Wales mental health services. Australas Psychiatry 2023; 31:584-586. [PMID: 37365838 DOI: 10.1177/10398562231186125] [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] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Cognitive Remediation Therapy (CRT) is an effective intervention in managing the significant cognitive deficits experienced by those living with psychosis. Given its strong evidence base CRT is recommended in Australian and international guidelines for rehabilitation of people with psychosis, however, access to CRT remains limited. In this commentary, we describe recent efforts to implement CRT programs within NSW mental health services. Development of CRT delivery has been successfully achieved in both rural and metropolitan settings, utilising both face-to-face and telehealth methods. CONCLUSIONS The delivery of CRT in public mental health services is feasible and adaptable to diverse settings. We strongly advocate for sustainable implementation of CRT into routine clinical practice. This will require policy and practice change to enable resources for CRT training and delivery to become embedded in the roles of the clinical workforce.
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Affiliation(s)
- Chloe A Gott
- The Tertiary Referral Service for Psychosis, South Eastern Sydney Local Health District, Sydney, NSW, Australia; and
- Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney, NSW, Australia
| | - Matt Thomas
- Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney, NSW, Australia
- School of Psychology, Charles Sturt University, Bathurst, NSW, Australia; and
- Marathon Health, Bathurst, NSW, Australia
| | - Julaine Allan
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
| | - Jessica Kennedy
- Dubbo and Region, Mental Health, Drug & Alcohol Services, Western New South Wales Local Health District, NSW, Australia
| | - Yvette Black
- Bloomfield Hospital, Western New South Wales Local Health District, Orange, NSW, Australia
| | - Frances Dark
- Metro South Addiction and Mental Health Services, Brisbane, Queensland, Australia
| | - Julia M Lappin
- The Tertiary Referral Service for Psychosis, South Eastern Sydney Local Health District, Sydney, NSW, Australia; and
- Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney, NSW, Australia
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13
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Ghosh D, Thomas M. Surgical care delivery in India during the COVID pandemic. J Postgrad Med 2023; 69:190-191. [PMID: 37787264 PMCID: PMC10846803 DOI: 10.4103/jpgm.jpgm_568_23] [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] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/29/2023] [Accepted: 09/02/2023] [Indexed: 10/04/2023] Open
Affiliation(s)
- D Ghosh
- Department of Pediatric Surgery, NIHR Global Health Research Unit on Global Surgery, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - M Thomas
- Department of Pediatric Surgery, NIHR Global Health Research Unit on Global Surgery, Christian Medical College and Hospital, Ludhiana, Punjab, India
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Cowen J, Harrison S, Thom L, Thomas M, Sedano J, Stephens P, Lip GYH, Craig S. Use of historical remote monitoring data to determine predictors of CPAP non-compliance in patients with OSA. Sleep Breath 2023; 27:1899-1908. [PMID: 36917443 DOI: 10.1007/s11325-023-02806-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE Continuous positive airway pressure (CPAP) is the gold standard treatment for obstructive sleep apnoea. This study aimed to use complete usage data collected remotely from modern CPAP devices to identify compliance trends and clinical predictors of CPAP usage. METHODS Group usage data were analysed for a large cohort at a single tertiary sleep-centre before a detailed review of a 90-day reporting window for each patient was conducted. Individual data were collected for a smaller cohort of patients including demographics, past medical history and diagnostic sleep study results. A zero-inflated negative binomial regression model was used to determine associations between patient characteristics and usage days. RESULTS Of 6450 patients who were prescribed CPAP and included in the initial service analysis, 476 patients were included in the sub-group. Complete usage data revealed that 46% of patients were fully compliant with CPAP therapy. Compliance fell from 55 to 46% by day 90 and remained at this rate going forward. Significant predictors of CPAP non-compliance included being in the lowest quartile of Index of Multiple Deprivation scores (most deprived) compared with the highest quartile (least deprived) (p = .005), and less severe oxygen desaturation index (ODI) on diagnosis (p = .03). CONCLUSIONS Complete usage data show that compliance at day 90 appears to be a good indicator of future CPAP usage. Predictors of CPAP non-compliance may include lower socioeconomic status, and lower ODI.
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Affiliation(s)
- Jake Cowen
- Department of Respiratory Medicine, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L9 7AL, UK.
| | - Stephanie Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Lydia Thom
- Department of Respiratory Medicine, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L9 7AL, UK
| | - Matt Thomas
- Department of Respiratory Medicine, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L9 7AL, UK
| | - Joanna Sedano
- Department of Respiratory Medicine, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L9 7AL, UK
| | - Phil Stephens
- Resmed UK, Quad 1, First Floor, Becquerel Ave, Harwell Campus, Didcot, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Sonya Craig
- Department of Respiratory Medicine, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L9 7AL, UK
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15
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Daubney K, Suata Z, Marriott Haresign I, Thomas M, Kushnerenko E, Wass SV. The development of the relationship between auditory and visual neural sensitivity and autonomic arousal from 6 m to 12 m. Dev Cogn Neurosci 2023; 63:101289. [PMID: 37597447 PMCID: PMC10458697 DOI: 10.1016/j.dcn.2023.101289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023] Open
Abstract
The differential sensitivity hypothesis argues that environmental sensitivity has the bivalent effect of predisposing individuals to both the risk-inducing and development-enhancing influences of early social environments. However, the hypothesis requires that this variation in environmental sensitivity be general across domains. In this study, we focused on neural sensitivity and autonomic arousal to test domain generality. Neural sensitivity can be assessed by correlating measures of perceptual sensitivity, as indexed by event-related potentials (ERP) in electrophysiology. The sensitivity of autonomic arousal can be tested via heart rate changes. Domain generality was tested by comparing associations in perceptual sensitivity across auditory and visual domains, and associations between sensitivity in sensory domains and heart rate. We contrasted ERP components in auditory (P3) and visual (P1, N290 and P4) detection-of-difference tasks for N = 68 infants longitudinally at 6 and 12 months of age. Domain generality should produce correlated individual differences in sensitivity across the two modalities, with higher levels of autonomic arousal associating with increased perceptual sensitivity. Having controlled for multiple comparisons, at 6 months of age, the difference in amplitude of the P3 component evoked in response to standard and deviant tones correlated with the difference in amplitude of the P1 N290 and P4 face-sensitive components evoked in response to fearful and neutral faces. However, this correlation was not found at 12 months of age. Similarly, autonomic arousal correlated with neural sensitivity at 6 months but not at 12 months. The results suggest bottom-up neural perceptual sensitivity is domain-general across auditory and visual domains and is related to autonomic arousal at 6 months but not at 12 months of age. We interpret the development of the association of these markers of ES within a neuroconstructivist framework and with respect to the concept of interactive specialisation. By 12 months of age, more experience of visual processing may have led to top-down endogenous attention mechanisms that process visual information in a way that no longer associates with automatic auditory perceptual sensitivity.
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Affiliation(s)
- K Daubney
- BabyDevLab, University of East London, UK.
| | | | | | - M Thomas
- Centre for Educational Neuroscience, BirkBeck University of London, UK
| | | | - S V Wass
- BabyDevLab, University of East London, UK
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Ashtari Esfahani A, Böser S, Buzinsky N, Carmona-Benitez MC, Claessens C, de Viveiros L, Doe PJ, Fertl M, Formaggio JA, Gaison JK, Gladstone L, Grando M, Guigue M, Hartse J, Heeger KM, Huyan X, Johnston J, Jones AM, Kazkaz K, LaRoque BH, Li M, Lindman A, Machado E, Marsteller A, Matthé C, Mohiuddin R, Monreal B, Mueller R, Nikkel JA, Novitski E, Oblath NS, Peña JI, Pettus W, Reimann R, Robertson RGH, Rosa De Jesús D, Rybka G, Saldaña L, Schram M, Slocum PL, Stachurska J, Sun YH, Surukuchi PT, Tedeschi JR, Telles AB, Thomas F, Thomas M, Thorne LA, Thümmler T, Tvrznikova L, Van De Pontseele W, VanDevender BA, Weintroub J, Weiss TE, Wendler T, Young A, Zayas E, Ziegler A. Tritium Beta Spectrum Measurement and Neutrino Mass Limit from Cyclotron Radiation Emission Spectroscopy. Phys Rev Lett 2023; 131:102502. [PMID: 37739382 DOI: 10.1103/physrevlett.131.102502] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/26/2023] [Accepted: 07/17/2023] [Indexed: 09/24/2023]
Abstract
The absolute scale of the neutrino mass plays a critical role in physics at every scale, from the subatomic to the cosmological. Measurements of the tritium end-point spectrum have provided the most precise direct limit on the neutrino mass scale. In this Letter, we present advances by Project 8 to the cyclotron radiation emission spectroscopy (CRES) technique culminating in the first frequency-based neutrino mass limit. With only a cm^{3}-scale physical detection volume, a limit of m_{β}<155 eV/c^{2} (152 eV/c^{2}) is extracted from the background-free measurement of the continuous tritium beta spectrum in a Bayesian (frequentist) analysis. Using ^{83m}Kr calibration data, a resolution of 1.66±0.19 eV (FWHM) is measured, the detector response model is validated, and the efficiency is characterized over the multi-keV tritium analysis window. These measurements establish the potential of CRES for a high-sensitivity next-generation direct neutrino mass experiment featuring low background and high resolution.
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Affiliation(s)
- A Ashtari Esfahani
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - S Böser
- Institute for Physics, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | - N Buzinsky
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - M C Carmona-Benitez
- Department of Physics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - C Claessens
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
- Institute for Physics, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | - L de Viveiros
- Department of Physics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - P J Doe
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - M Fertl
- Institute for Physics, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | - J A Formaggio
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J K Gaison
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - L Gladstone
- Department of Physics, Case Western Reserve University, Cleveland, Ohio 44106, USA
| | - M Grando
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - M Guigue
- Laboratoire de Physique Nucléaire et de Hautes Énergies, Sorbonne Université, Université Paris Cité, CNRS/IN2P3, 75005 Paris, France
| | - J Hartse
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - K M Heeger
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - X Huyan
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - J Johnston
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A M Jones
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - K Kazkaz
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B H LaRoque
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - M Li
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Lindman
- Institute for Physics, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | - E Machado
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - A Marsteller
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - C Matthé
- Institute for Physics, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | - R Mohiuddin
- Department of Physics, Case Western Reserve University, Cleveland, Ohio 44106, USA
| | - B Monreal
- Department of Physics, Case Western Reserve University, Cleveland, Ohio 44106, USA
| | - R Mueller
- Department of Physics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - J A Nikkel
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - E Novitski
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - N S Oblath
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - J I Peña
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - W Pettus
- Center for Exploration of Energy and Matter and Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - R Reimann
- Institute for Physics, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | - R G H Robertson
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - D Rosa De Jesús
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - G Rybka
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - L Saldaña
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - M Schram
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - P L Slocum
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J Stachurska
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Y-H Sun
- Department of Physics, Case Western Reserve University, Cleveland, Ohio 44106, USA
| | - P T Surukuchi
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J R Tedeschi
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - A B Telles
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - F Thomas
- Institute for Physics, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | - M Thomas
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - L A Thorne
- Institute for Physics, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | - T Thümmler
- Institute of Astroparticle Physics, Karlsruhe Institute of Technology, 76021 Karlsruhe, Germany
| | - L Tvrznikova
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - W Van De Pontseele
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - B A VanDevender
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
- Pacific Northwest National Laboratory, Richland, Washington 99354, USA
| | - J Weintroub
- Center for Astrophysics, Harvard & Smithsonian, Cambridge, Massachusetts 02138, USA
| | - T E Weiss
- Wright Laboratory and Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - T Wendler
- Department of Physics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - A Young
- Center for Astrophysics, Harvard & Smithsonian, Cambridge, Massachusetts 02138, USA
| | - E Zayas
- Laboratory for Nuclear Science, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Ziegler
- Department of Physics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
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Barnes K, Ashlee A, Mukankusi A, Pacitto J, Rabi A, Thomas M, Ullah N, Zazai R, Zhao A. Education in times of restriction: an examination of refugee girls' and young women's access to learning during COVID-19 school closures in Pakistan. Educ Res Policy Pract 2023; 23:115-133. [PMID: 38318494 PMCID: PMC10840450 DOI: 10.1007/s10671-023-09353-4] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 05/07/2023] [Indexed: 02/07/2024]
Abstract
This paper examines the extent to which refugee girls and young women were able to access learning during COVID-19 education closures in Pakistan, and the role that EdTech played in their learning access. It is based on findings from a survey with 403 Afghan refugee students, along with in-depth interviews with six young female refugees. The research shows that, while the majority of female refugee students were able to continue accessing education in some form during school closures, learning access was nevertheless limited, and a sizable minority were not engaged in any learning during this time. Teacher and institutional support was either absent or inadequate for many students, and infrastructure and devices that serve to support remote learning were not always reliable or accessible. Although male respondents were less likely than females to engage in independent study during the closures, refugee girls and young women were significantly less likely than their male counterparts to own the devices they needed for learning. The findings demonstrate how targeted investment in specific types of EdTech and teacher professional development, as well as supporting educational institutions in the establishment of remote learning opportunities, could help sustain learning during future periods of educational restriction.
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Affiliation(s)
| | | | | | | | - Asma Rabi
- Jigsaw, London, UK
- EdTech Hub, London, UK
| | | | - Noor Ullah
- Jigsaw, London, UK
- EdTech Hub, London, UK
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18
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Monnery D, Tredgett K, Hooper D, Barringer G, Munton A, Thomas M, Vijeratnam N, Godfrey N, Summerfield L, Hawkes K, Staley P, Holyhead K, Liu Y, Lockhart J, Bass S, Tavabie S, White N, Stewart E, Droney J, Minton O. Delivery Models and Health Economics of Supportive Care Services in England: A Multicentre Analysis. Clin Oncol (R Coll Radiol) 2023; 35:e395-e403. [PMID: 36997458 DOI: 10.1016/j.clon.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/16/2023] [Accepted: 03/02/2023] [Indexed: 03/30/2023]
Abstract
AIMS Improvements in cancer treatment have led to more people living with and beyond cancer. These patients have symptom and support needs unmet by current services. The development of enhanced supportive care (ESC) services may meet the longitudinal care needs of these patients, including at the end of life. This study aimed to determine the impact and health economic benefits of ESC for patients living with treatable but not curable cancer. MATERIALS AND METHODS A prospective observational evaluation was undertaken over 12 months across eight cancer centres in England. ESC service design and costs were recorded. Data relating to patients' symptom burden were collected using the Integrated Palliative Care Outcome Scale (IPOS). For patients in the last year of life, secondary care use was compared against an NHS England published benchmark. RESULTS In total, 4594 patients were seen by ESC services, of whom 1061 died during follow-up. Mean IPOS scores improved across all tumour groups. In total, £1,676,044 was spent delivering ESC across the eight centres. Reductions in secondary care usage for the 1061 patients who died saved a total of £8,490,581. CONCLUSIONS People living with cancer suffer with complex and unmet needs. ESC services appear to be effective at supporting these vulnerable people and significantly reduce the costs of their care.
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Affiliation(s)
- D Monnery
- The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK.
| | - K Tredgett
- Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | - D Hooper
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - G Barringer
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - A Munton
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - M Thomas
- Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - N Vijeratnam
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - N Godfrey
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - L Summerfield
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - K Hawkes
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - P Staley
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - K Holyhead
- Somerset NHS Foundation Trust, Taunton, UK
| | - Y Liu
- NHS England Specialised Services Improving Value Team, UK
| | - J Lockhart
- NHS England Specialised Services Improving Value Team, UK
| | - S Bass
- University Hospitals Sussex NHS Foundation Trust, Worthing, UK
| | - S Tavabie
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - N White
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - E Stewart
- University Hospitals Sussex NHS Foundation Trust, Worthing, UK
| | - J Droney
- The Royal Marsden NHS Foundation Trust, London, UK
| | - O Minton
- University Hospitals Sussex NHS Foundation Trust, Worthing, UK
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19
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Thomas M, Serrenho RC, Puga SO, Torres JM, Puga SO, Stangaferro M. Effect of feeding a Saccharomyces cerevisiae fermentation product to Holstein cows exposed to high temperature and humidity conditions on milk production performance and efficiency-A pen-level trial. J Dairy Sci 2023:S0022-0302(23)00289-8. [PMID: 37268565 DOI: 10.3168/jds.2022-22516] [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: 07/12/2022] [Accepted: 01/31/2023] [Indexed: 06/04/2023]
Abstract
The objective of this study was to evaluate the effect of feeding a Saccharomyces cerevisiae fermentation product (SCFP) on milk production efficiency of Holstein cows naturally exposed to high temperature and humidity conditions. The study was conducted in 2 commercial farms in Mexico from July to October 2020 and included 1 wk covariate period, 3 wk adaptation, and 12 wk data collection. Cows [n = 1,843; ≥21 d in milk (DIM) and <100 d carried calf] were enrolled and assigned to the study pens (n = 10) balanced for parity, milk yield, and DIM. Pens were fed a total mixed ration diet either without (CTRL) or with SCFP (19 g/d, NutriTek, Diamond V). Milk yield, energy-corrected milk (ECM), milk components, linear somatic cell score, dry matter intake (DMI), feed efficiency (FE; Milk/DMI and ECM/DMI), body condition score, and the incidence of clinical mastitis, pneumonia, and culling were monitored. Statistical analyses included mixed linear and logistic models accounting for repeated measures (when applicable; multiple measurements per cow within treated pens) with pen as the experimental unit and treatment, time (week of study), parity (1 vs. 2+), and their interactions as fixed and pen nested within farm and treatment as random effect. Parity 2+ cows within pens fed SCFP produced more milk than cows within CTRL pens (42.1 vs. 41.2 kg/d); there were no production differences between groups of primiparous groups. Cows within SCFP pens had lower DMI (25.2 vs. 26.0 kg/d) and greater FE (1.59 vs. 1.53) and ECM FE (1.73 vs. 1.68) than cows within CTRL pens. Milk components, linear somatic cell score, health events, and culling were not different between groups. At the end of the study (245 ± 54 DIM), SCFP cows had greater body condition score than CTRL (3.33 vs. 3.23 in the first parity; 3.11 vs. 3.04 in 2+ parity cows). Feeding Saccharomyces cerevisiae fermentation products to lactating cows exposed to high temperature and humidity conditions improved FE.
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Affiliation(s)
- M Thomas
- Dairy Health and Management Services, Lowville, NY 13367
| | | | | | | | | | - M Stangaferro
- Dairy Health and Management Services, Lowville, NY 13367.
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20
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Darnell R, Newell C, Edwards J, Gendall E, Harrison D, Sprinckmoller S, Mouncey P, Gould D, Thomas M. Critical illness related cardiac arrest: Protocol for an investigation of the incidence and outcome of cardiac arrest within intensive care units in the United Kingdom. J Intensive Care Soc 2023; 24:222-223. [PMID: 37260435 PMCID: PMC10227896 DOI: 10.1177/17511437221086890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Affiliation(s)
- Robert Darnell
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | | | - Julia Edwards
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | - Emma Gendall
- Clinical Research Centre, Southmead Hospital, Bristol, UK
| | - David Harrison
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | - Stefan Sprinckmoller
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | - Paul Mouncey
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | - Doug Gould
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | - Matt Thomas
- Department of Anaesthesia, Southmead Hospital, Bristol, UK
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21
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Pham T, Heunks L, Bellani G, Madotto F, Aragao I, Beduneau G, Goligher EC, Grasselli G, Laake JH, Mancebo J, Peñuelas O, Piquilloud L, Pesenti A, Wunsch H, van Haren F, Brochard L, Laffey JG, Acharya SP, Amin P, Arabi Y, Aragao I, Bauer P, Beduneau G, Beitler J, Berkius J, Bugedo G, Camporota L, Cerny V, Cho YJ, Clarkson K, Estenssoro E, Goligher E, Grasselli G, Gritsan A, Hashemian SM, Hermans G, Heunks LM, Jovanovic B, Kurahashi K, Laake JH, Matamis D, Moerer O, Molnar Z, Ozyilmaz E, Panka B, Papali A, Peñuelas Ó, Perbet S, Piquilloud L, Qiu H, Razek AA, Rittayamai N, Roldan R, Serpa Neto A, Szuldrzynski K, Talmor D, Tomescu D, Van Haren F, Villagomez A, Zeggwagh AA, Abe T, Aboshady A, Acampo-de Jong M, Acharya S, Adderley J, Adiguzel N, Agrawal VK, Aguilar G, Aguirre G, Aguirre-Bermeo H, Ahlström B, Akbas T, Akker M, Al Sadeh G, Alamri S, Algaba A, Ali M, Aliberti A, Allegue JM, Alvarez D, Amador J, Andersen FH, Ansari S, Apichatbutr Y, Apostolopoulou O, Arabi Y, Arellano D, Arica M, Arikan H, Arinaga K, Arnal JM, Asano K, Asín-Corrochano M, Avalos Cabrera JM, Avila Fuentes S, Aydemir S, Aygencel G, Azevedo L, Bacakoglu F, Badie J, Baedorf Kassis E, Bai G, Balaraj G, Ballico B, Banner-Goodspeed V, Banwarie P, Barbieri R, Baronia A, Barrett J, Barrot L, Barrueco-Francioni JE, Barry J, Bauer P, Bawangade H, Beavis S, Beck E, Beehre N, Belenguer Muncharaz A, Bellani G, Belliato M, Bellissima A, Beltramelli R, Ben Souissi A, Benitez-Cano A, Benlamin M, Benslama A, Bento L, Benvenuti D, Berkius J, Bernabe L, Bersten A, Berta G, Bertini P, Bertram-Ralph E, Besbes M, Bettini LR, Beuret P, Bewley J, Bezzi M, Bhakhtiani L, Bhandary R, Bhowmick K, Bihari S, Bissett B, Blythe D, Bocher S, Boedjawan N, Bojanowski CM, Boni E, Boraso S, Borelli M, Borello S, Borislavova M, Bosma KJ, Bottiroli M, Boyd O, Bozbay S, Briva A, Brochard L, Bruel C, Bruni A, Buehner U, Bugedo G, Bulpa P, Burt K, Buscot M, Buttera S, Cabrera J, Caccese R, Caironi P, Canchos Gutierrez I, Canedo N, Cani A, Cappellini I, Carazo J, Cardonnet LP, Carpio D, Carriedo D, Carrillo R, Carvalho J, Caser E, Castelli A, Castillo Quintero M, Castro H, Catorze N, Cengiz M, Cereijo E, Ceunen H, Chaintoutis C, Chang Y, Chaparro G, Chapman C, Chau S, Chavez CE, Chelazzi C, Chelly J, Chemouni F, Chen K, Chena A, Chiarandini P, Chilton P, Chiumello D, Cho YJ, Chou-Lie Y, Chudeau N, Cinel I, Cinnella G, Clark M, Clark T, Clarkson K, Clementi S, Coaguila L, Codecido AJ, Collins A, Colombo R, Conde J, Consales G, Cook T, Coppadoro A, Cornejo R, Cortegiani A, Coxo C, Cracchiolo AN, Crespo Ramirez M, Crova P, Cruz J, Cubattoli L, Çukurova Z, Curto F, Czempik P, D'Andrea R, da Silva Ramos F, Dangers L, Danguy des Déserts M, Danin PE, Dantas F, Daubin C, Dawei W, de Haro C, de Jesus Montelongo F, De Mendoza D, de Pablo R, De Pascale G, De Rosa S, Decavèle M, Declercq PL, Deicas A, del Carmen Campos Moreno M, Dellamonica J, Delmas B, Demirkiran O, Demirkiran H, Dendane T, di Mussi R, Diakaki C, Diaz A, Diaz W, Dikmen Y, Dimoula A, Doble P, Doha N, Domingos G, Dres M, Dries D, Duggal A, Duke G, Dunts P, Dybwik K, Dykyy M, Eckert P, Efe S, Elatrous S, Elay G, Elmaryul AS, Elsaadany M, Elsayed H, Elsayed S, Emery M, Ena S, Eng K, Englert JA, Erdogan E, Ergin Ozcan P, Eroglu E, Escobar M, Esen F, Esen Tekeli A, Esquivel A, Esquivel Gallegos H, Ezzouine H, Facchini A, Faheem M, Fanelli V, Farina MF, Fartoukh M, Fehrle L, Feng F, Feng Y, Fernandez I, Fernandez B, Fernandez-Rodriguez ML, Ferrando C, Ferreira da Silva MJ, Ferreruela M, Ferrier J, Flamm Zamorano MJ, Flood L, Floris L, Fluckiger M, Forteza C, Fortunato A, Frans E, Frattari A, Fredes S, Frenzel T, Fumagalli R, Furche MA, Fusari M, Fysh E, Galeas-Lopez JL, Galerneau LM, Garcia A, Garcia MF, Garcia E, Garcia Olivares P, Garlicki J, Garnero A, Garofalo E, Gautam P, Gazenkampf A, Gelinotte S, Gelormini D, Ghrenassia E, Giacomucci A, Giannoni R, Gigante A, Glober N, Gnesin P, Gollo Y, Gomaa D, Gomero Paredes R, Gomes R, Gomez RA, Gomez O, Gomez A, Gondim L, Gonzalez M, Gonzalez I, Gonzalez-Castro A, Gordillo Romero O, Gordo F, Gouin P, Graf Santos J, Grainne R, Grando M, Granov Grabovica S, Grasselli G, Grasso S, Grasso R, Grimmer L, Grissom C, Gritsan A, Gu Q, Guan XD, Guarracino F, Guasch N, Guatteri L, Gueret R, Guérin C, Guerot E, Guitard PG, Gül F, Gumus A, Gurjar M, Gutierrez P, Hachimi A, Hadzibegovic A, Hagan S, Hammel C, Han Song J, Hanlon G, Hashemian SM, Heines S, Henriksson J, Herbrecht JE, Heredia Orbegoso GO, Hermans G, Hermon A, Hernandez R, Hernandez C, Herrera L, Herrera-Gutierrez M, Heunks L, Hidalgo J, Hill D, Holmquist D, Homez M, Hongtao X, Hormis A, Horner D, Hornos MC, Hou M, House S, Housni B, Hugill K, Humphreys S, Humbert L, Hunter S, Hwa Young L, Iezzi N, Ilutovich S, Inal V, Innes R, Ioannides P, Iotti GA, Ippolito M, Irie H, Iriyama H, Itagaki T, Izura J, Izza S, Jabeen R, Jamaati H, Jamadarkhana S, Jamoussi A, Jankowski M, Jaramillo LA, Jeon K, Jeong Lee S, Jeswani D, Jha S, Jiang L, Jing C, Jochmans S, Johnstad BA, Jongmin L, Joret A, Jovanovic B, Junhasavasdikul D, Jurado MT, Kam E, Kamohara H, Kane C, Kara I, Karakurt S, Karnjanarachata C, Kataoka J, Katayama S, Kaushik S, Kelebek Girgin N, Kerr K, Kerslake I, Khairnar P, Khalid A, Khan A, Khanna AK, Khorasanee R, Kienhorst D, Kirakli C, Knafelj R, Kol MK, Kongpolprom N, Kopitko C, Korkmaz Ekren P, Kubisz-Pudelko A, Kulcsar Z, Kumasawa J, Kurahashi K, Kuriyama A, Kutchak F, Laake JH, Labarca E, Labat F, Laborda C, Laca Barrera MA, Lagache L, Landaverde Lopez A, Lanspa M, Lascari V, Le Meur M, Lee SH, Lee YJ, Lee J, Lee WY, Lee J, Legernaes T, Leiner T, Lemiale V, Leonor T, Lepper PM, Li D, Li H, Li O, Lima AR, Lind D, Litton E, Liu N, Liu L, Liu J, Llitjos JF, Llorente B, Lopez R, Lopez CE, Lopez Nava C, Lovazzano P, Lu M, Lucchese F, Lugano M, Lugo Goytia G, Luo H, Lynch C, Macheda S, Madrigal Robles VH, Maggiore SM, Magret Iglesias M, Malaga P, Mallapura Maheswarappa H, Malpartida G, Malyarchikov A, Mansson H, Manzano A, Marey I, Marin N, Marin MDC, Markman E, Martin F, Martin A, Martin Dal Gesso C, Martinez F, Martínez-Fidalgo C, Martin-Loeches I, Mas A, Masaaki S, Maseda E, Massa E, Mattsson A, Maugeri J, McCredie V, McCullough J, McGuinness S, McKown A, Medve L, Mei C, Mellado Artigas R, Mendes V, Mervat MKE, Michaux I, Mikhaeil M, Milagros O, Milet I, Millan MT, Minwei Z, Mirabella L, Mishra S, Mistraletti G, Mochizuki K, Moerer O, Moghal A, Mojoli F, Molin A, Molnar Z, Montiel R, Montini L, Monza G, Mora Aznar M, Morakul S, Morales M, Moreno Torres D, Morocho Tutillo DR, Motherway C, Mouhssine D, Mouloudi E, Muñoz T, Munoz de Cabo C, Mustafa M, Muthuchellappan R, Muthukrishnan M, Muttini S, Nagata I, Nahar D, Nakanishi M, Nakayama I, Namendys-Silva SA, Nanchal R, Nandakumar S, Nasi A, Nasir K, Navalesi P, Naz Aslam T, Nga Phan T, Nichol A, Niiyama S, Nikolakopoulou S, Nikolic E, Nitta K, Noc M, Nonas S, Nseir S, Nur Soyturk A, Obata Y, Oeckler R, Oguchi M, Ohshimo S, Oikonomou M, Ojados A, Oliveira MT, Oliveira Filho W, Oliveri C, Olmos A, Omura K, Orlandi MC, Orsenigo F, Ortiz-Ruiz De Gordoa L, Ota K, Ovalle Olmos R, Öveges N, Oziemski P, Ozkan Kuscu O, Özyilmaz E, Pachas Alvarado F, Pagella G, Palaniswamy V, Palazon Sanchez EL, Palmese S, Pan G, Pan W, Panka B, Papanikolaou M, Papavasilopoulou T, Parekh A, Parke R, Parrilla FJ, Parrilla D, Pasha T, Pasin L, Patão L, Patel M, Patel G, Pati BK, Patil J, Pattnaik S, Paul D, Pavesi M, Pavlotsky VA, Paz G, Paz E, Pecci E, Pellegrini C, Peña Padilla AG, Perchiazzi G, Pereira T, Pereira V, Perez M, Perez Calvo C, Perez Cheng M, Perez Maita R, Pérez-Araos R, Perez-Teran P, Perez-Torres D, Perkins G, Persona P, Petnak T, Petrova M, Pham T, Philippart F, Picetti E, Pierucci E, Piervincenzi E, Pinciroli R, Pintado MC, Piquilloud L, Piraino T, Piras S, Piras C, Pirompanich P, Pisani L, Platas E, Plotnikow G, Porras W, Porta V, Portilla M, Portugal J, Povoa P, Prat G, Pratto R, Preda G, Prieto I, Prol-Silva E, Pugh R, Qi Y, Qian C, Qin T, Qiu H, Qu H, Quintana T, Quispe Sierra R, Quispe Soto R, Rabbani R, Rabee M, Rabie A, Rahe Pereira MA, Rai A, Raj Ashok S, Rajab M, Ramdhani N, Ramey E, Ranieri M, Rathod D, Ray B, Redwanul Huq SM, Regli A, Reina R, Resano Sarmiento N, Reynaud F, Rialp G, Ricart P, Rice T, Richardson A, Rieder M, Rinket M, Rios F, Rios F, Risso Vazquez A, Rittayamai N, Riva I, Rivette M, Roca O, Roche-Campo F, Rodriguez C, Rodriguez G, Rodriguez Gonzalez D, Rodriguez Tucto XY, Rogers A, Romano ME, Rørtveit L, Rose A, Roux D, Rouze A, Rubatto Birri PN, Ruilan W, Ruiz Robledo A, Ruiz-Aguilar AL, Sadahiro T, Saez I, Sagardia J, Saha R, Saha R, Saiphoklang N, Saito S, Salem M, Sales G, Salgado P, Samavedam S, Sami Mebazaa M, Samuelsson L, San Juan Roman N, Sanchez P, Sanchez-Ballesteros J, Sandoval Y, Sani E, Santos M, Santos C, Sanui M, Saravanabavan L, Sari S, Sarkany A, Sauneuf B, Savioli M, Sazak H, Scano R, Schneider F, Schortgen F, Schultz MJ, Schwarz GL, Seçkin Yücesoy F, Seely A, Seiler F, Seker Tekdos Y, Seok Chan K, Serano L, Serednicki W, Serpa Neto A, Setten M, Shah A, Shah B, Shang Y, Shanmugasundaram P, Shapovalov K, Shebl E, Shiga T, Shime N, Shin P, Short J, Shuhua C, Siddiqui S, Silesky Jimenez JI, Silva D, Silva Sales B, Simons K, Sjøbø BÅ, Slessor D, Smiechowicz J, Smischney N, Smith P, Smith T, Smith M, Snape S, Snyman L, Soetens F, Sook Hong K, Sosa Medellin MÁ, Soto G, Souloy X, Sousa E, Sovatzis S, Sozutek D, Spadaro S, Spagnoli M, Spångfors M, Spittle N, Spivey M, Stapleton A, Stefanovic B, Stephenson L, Stevenson E, Strand K, Strano MT, Straus S, Sun C, Sun R, Sundaram V, SunPark T, Surlemont E, Sutherasan Y, Szabo Z, Szuldrzynski K, Tainter C, Takaba A, Tallott M, Tamasato T, Tang Z, Tangsujaritvijit V, Taniguchi L, Taniguchi D, Tarantino F, Teerapuncharoen K, Temprano S, Terragni P, Terzi N, Thakur A, Theerawit P, Thille AW, Thomas M, Thungtitigul P, Thyrault M, Tilouch N, Timenetsky K, Tirapu J, Todeschini M, Tomas R, Tomaszewski C, Tonetti T, Tonnelier A, Trinder J, Trongtrakul K, Truwit J, Tsuei B, Tulaimat A, Turan S, Turkoglu M, Tyagi S, Ubeda A, Vagginelli F, Valenti MF, Vallverdu I, Van Axel A, van den Hul I, van der Hoeven H, Van Der Meer N, Van Haren F, Vanhoof M, Vargas-Ordoñez M, Vaschetto R, Vascotto E, Vatsik M, Vaz A, Vazquez-Sanchez A, Ventura S, Vermeijden JW, Vidal A, Vieira J, Vilela Costa Pinto B, Villagomez A, Villagra A, Villegas Succar C, Vinorum OG, Vitale G, Vj R, Vochin A, Voiriot G, Volta CA, von Seth M, Wajdi M, Walsh D, Wang S, Wardi G, Ween-Velken NC, Wei BL, Weller D, Welsh D, Welters I, Wert M, Whiteley S, Wilby E, Williams E, Williams K, Wilson A, Wojtas J, Won Huh J, Wrathall D, Wright C, Wu JF, Xi G, Xing ZJ, Xu H, Yamamoto K, Yan J, Yáñez J, Yang X, Yates E, Yazicioglu Mocin O, Ye Z, Yildirim F, Yoshida N, Yoshido HHL, Young Lee B, Yu R, Yu G, Yu T, Yuan B, Yuangtrakul N, Yumoto T, Yun X, Zakalik G, Zaki A, Zalba-Etayo B, Zambon M, Zang B, Zani G, Zarka J, Zerbi SM, Zerman A, Zetterquist H, Zhang J, Zhang H, Zhang W, Zhang G, Zhang W, Zhao H, Zheng J, Zhu B, Zumaran R. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study. Lancet Respir Med 2023; 11:465-476. [PMID: 36693401 DOI: 10.1016/s2213-2600(22)00449-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 01/23/2023]
Abstract
BACKGROUND Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. METHODS WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. FINDINGS Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. INTERPRETATION In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. FUNDING European Society of Intensive Care Medicine, European Respiratory Society.
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Affiliation(s)
- Tài Pham
- Service de Médecine Intensive-Réanimation, AP-HP, Hôpital de Bicêtre, DMU CORREVE, FHU SEPSIS, Groupe de Recherche CARMAS, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France; Université Paris-Saclay, UVSQ, Université Paris-Sud, Inserm U1018, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, 94807, Villejuif, France
| | - Leo Heunks
- Department of Intensive Care Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Giacomo Bellani
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; Department of Emergency and Intensive Care, University Hospital San Gerardo, Monza, Italy
| | - Fabiana Madotto
- Department of Anaesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Irene Aragao
- Department of Intensive Care Medicine, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Gaëtan Beduneau
- Normandie University, UNIROUEN, UR 3830, CHU Rouen, Department of Medical Intensive Care, F-76000 Rouen, France
| | - Ewan C Goligher
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Department of Medicine, Division of Respirology, Toronto General Hospital Research Institute University Health Network, Toronto, Canada
| | - Giacomo Grasselli
- Department of Anaesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Jon Henrik Laake
- Department of Anaesthesiology and Department of Research and Development, Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Jordi Mancebo
- Department of Intensive Care Medicine, Hospital Universitari Sant Pau, Barcelona, Spain
| | - Oscar Peñuelas
- Intensive Care Unit, Hospital Universitario de Getafe, Madrid, Spain; Centro de Investigación Biomédica en Red, CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain
| | - Lise Piquilloud
- Adult Intensive Care Unit, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Antonio Pesenti
- Department of Anaesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Hannah Wunsch
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Frank van Haren
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia; Intensive Care Unit, St George Hospital, Sydney, NSW, Australia
| | - Laurent Brochard
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - John G Laffey
- Anaesthesia and Intensive Care Medicine, School of Medicine, Clinical Sciences Institute, Galway University Hospitals, Galway, Ireland; School of Medicine, Regenerative Medicine Institute (REMEDI) at CÚRAM Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.
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Giron M, Thomas M, Bornes S, Dardevet D, Chassard C, Savary-Auzeloux I. A Promising Probiotic Capable To Reduce The Impact Of Undernutrition On The Development Of Sarcopenia. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Griesinger F, Garassino M, Felip E, Sakai H, Le X, Veillon R, Smit E, Raskin J, Thomas M, Ahn MJ, Vlassak S, Bruns R, Johne A, Paik P. 34P Treatment sequencing in the VISION study of tepotinib in patients with MET exon 14 (METex14) skipping NSCLC. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00288-5] [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: 04/03/2023]
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Balasubramanian P, Thomas M, Makey I, Alvarez F, Narula T, Pham S, Landolfo K, Ahmed MES, Jacob S, Shah S, Mallea J. Remote vs Local Ex-Vivo Lung Perfusion, a Single Center Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Daniello L, Elshiaty M, Lusky F, Blasi M, Schneider M, Bozorgmehr F, Shah R, Kazdal D, Angeles A, Liersch S, Eichhorn F, Allgäuer M, Janke F, Bischoff H, Thomas M, Sültmann H, Stenzinger A, Christopoulos P. 67P Blood cell gene expression and clinical characteristics in advanced non-small cell lung cancer with immune-related adverse events. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00321-0] [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: 04/04/2023]
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Thomas M, Baltatzis M, Price A, Fox J, Pearce L, Vilches-Moraga A. The influence of frailty on outcomes for older adults admitted to hospital with benign biliary disease: a single-centre, observational cohort study. Ann R Coll Surg Engl 2023; 105:231-240. [PMID: 35616268 PMCID: PMC9974336 DOI: 10.1308/rcsann.2021.0331] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The prevalence and complications of biliary disease increase with age. Frailty has been associated with adverse outcomes in the hospital setting. We describe the prevalence of frailty in older patients hospitalised with benign biliary disease and its association with duration of hospital stay, and 90-day and 1-year mortality. METHODS We performed a retrospective cohort study of patients aged 75 years and over admitted with acute biliary disease between 17 September 2014 and 20 March 2017. Clinical Frailty Scale (CFS) score was recorded on admission. RESULTS We included 200 patients with a median age of 82 (75-99) years, 60% were female; 154 (77%) were independent for personal activities of daily living (ADLs) and 99 (49.5%) for instrumental ADLs. Cholecystitis was the most common diagnosis (43%) followed by cholangitis (36%) and pancreatitis (21%). Ninety-nine patients were non frail (NF; CFS 1-4) and 101 were frail (F; CFS 5-9). Some 104 patients received medical treatment only. Surgery was more common in NF patients (11% vs F 2%), percutaneous drainage more frequently performed in F patients (15% vs NF 5%) and endoscopic cholangiopancreatography was similar in both groups (F 32% vs NF 31%). Frailty was associated with worse clinical outcomes in F vs NF: functional deconditioning (34% vs 11%), increased care level (19% vs 3%), length of stay (12 vs 7 days), 90-day mortality (8% vs 3%) and 1-year mortality (48% vs 24%). CONCLUSIONS Half of patients in our cohort were frail and spent longer in hospital, were less likely to undergo surgery and were less likely to remain alive at 1 year after discharge.
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Affiliation(s)
- M Thomas
- Salford Royal NHS Foundation Trust, Northern Care Alliance, UK
| | - M Baltatzis
- Salford Royal NHS Foundation Trust, Northern Care Alliance, UK
| | - A Price
- Salford Royal NHS Foundation Trust, Northern Care Alliance, UK
| | - J Fox
- Salford Royal NHS Foundation Trust, Northern Care Alliance, UK
| | - L Pearce
- Salford Royal NHS Foundation Trust, Northern Care Alliance, UK
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Saqib R, Madhavan A, Thornber E, Siripurapu R, Choi C, Holsgrove D, Bailey K, Thomas M, Hilditch CA. The value of performing cerebrovascular CT angiography in major trauma patients: a 5-year retrospective review. Clin Radiol 2023; 78:e190-e196. [PMID: 36646530 DOI: 10.1016/j.crad.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/07/2022] [Accepted: 10/17/2022] [Indexed: 01/15/2023]
Abstract
AIM To assess whether routine cerebrovascular imaging is required in all major trauma (MT) patients. MATERIALS AND METHODS All MT patients with cerebrovascular imaging between January 2015 and December 2020 were included in the study. Data were collated regarding the type of indication for computed tomography (CT) angiography imaging, time interval from the initial trauma, relevant trauma diagnoses on initial trauma imaging, and CT angiography. Findings, such as aneurysms, vascular malformations, luminal thrombus, venous sinus thrombosis, or vascular injury, were collated. Subsequent treatment with anti-coagulants/anti-platelets or surgical/radiological intervention was noted. Follow-up imaging was assessed for residual injury or complications. RESULTS Two hundred and fifty of the 6,251 MT patients underwent dedicated cerebrovascular imaging and were included in the study. Of these 41 (16.4%) had cervical artery or venous sinus injury. Further positive vascular findings were identified in 25/250 patients who presented with an incidental stroke or a vascular abnormality and were mislabelled as MT patients at presentation. One patient with a carotid injury subsequently died following a large infarction. Another patient with vertebral artery injury suffered a non-lethal stroke. No patients underwent surgery or intervention. CONCLUSION The present study showed that the overall incidence of detected blunt cerebrovascular injuries was very low (0.6%) and even lower for symptomatic vascular injury (0.03%). Routine cerebrovascular imaging is not recommended in all MT trauma patients, but instead, a continued case-by-case basis should be considered.
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Affiliation(s)
- R Saqib
- Department of Neuroradiology, Salford Royal Hospital-Northern Care Alliance NHS Foundation Trust, Salford, UK.
| | - A Madhavan
- Department of Neuroradiology, Salford Royal Hospital-Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - E Thornber
- Department of Neuroradiology, Salford Royal Hospital-Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - R Siripurapu
- Department of Neuroradiology, Salford Royal Hospital-Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - C Choi
- Department of Neuroradiology, Salford Royal Hospital-Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - D Holsgrove
- Department of Neurosurgery, Salford Royal Hospital-Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - K Bailey
- Department of Anaesthetics and Critical Care, Salford Royal Hospital-Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - M Thomas
- Department of Emergency Medicine, Salford Royal Hospital-Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - C A Hilditch
- Department of Neuroradiology, Salford Royal Hospital-Northern Care Alliance NHS Foundation Trust, Salford, UK
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Bousquet J, Melén E, Haahtela T, Koppelman GH, Togias A, Valenta R, Akdis CA, Czarlewski W, Rothenberg M, Valiulis A, Wickmann M, Aguilar D, Akdis M, Ansotegui IJ, Barbara C, Bedbrook A, Bindslev Jensen C, Bosnic-Anticevich S, Boulet LP, Brightling CE, Brussino L, Burte E, Bustamante M, Canonica GW, Cecchi L, Celedon JC, Chaves-Loureiro C, Costa E, Cruz AA, Erhola M, Gemicioglu B, Fokkens WJ, Garcia Aymerich J, Guerra S, Heinrich J, Ivancevich JC, Keil T, Klimek L, Kuna P, Kupczyk M, Kvedariene V, Larenas-Linnemann DE, Lemonnier N, Lodrup Carlsen KC, Louis R, Makris M, Maurer M, Momas I, Morais-Almeida M, Mullol J, Naclerio RN, Nadeau K, Nadif R, Niedoszytko M, Okamoto Y, Ollert M, Papadopoulos NG, Passalacqua G, Patella V, Pawankar R, Pham-Thi N, Pfaar O, Regateiro FS, Ring J, Rouadi PW, Samolinski B, Sastre J, Savouré M, Scichilone N, Shamji MH, Sheikh A, Siroux V, Sousa-Pinto B, Standl M, Sunyer J, Taborda-Barata L, Toppila-Salmi S, Torres MJ, Tsiligianni I, Valovirta E, Vandenplas O, Ventura MT, Weiss S, Yorgancioglu A, Zhang L, Abdul Latiff AH, Aberer W, Agache I, Al-Ahmad M, Alobid I, Arshad HS, Asayag E, Baharudin A, Battur L, Bennoor KS, Berghea EC, Bergmann KC, Bernstein D, Bewick M, Blain H, Bonini M, Braido F, Buhl R, Bumbacea R, Bush A, Calderon M, Calvo G, Camargos P, Caraballo L, Cardona V, Carr W, Carreiro-Martins P, Casale T, Cepeda Sarabia AM, Chandrasekharan R, Charpin D, Chen YZ, Cherrez-Ojeda I, Chivato T, Chkhartishvili E, Christoff G, Chu DK, Cingi C, Correia da Sousa J, Corrigan C, Custovic A, D'Amato G, Del Giacco S, De Blay F, Devillier P, Didier A, do Ceu Teixeira M, Dokic D, Douagui H, Doulaptsi M, Durham S, Dykewicz M, Eiwegger T, El-Sayed ZA, Emuzyte R, Emuzyte R, Fiocchi A, Fyhrquist N, Gomez RM, Gotua M, Guzman MA, Hagemann J, Hamamah S, Halken S, Halpin DMG, Hofmann M, Hossny E, Hrubiško M, Irani C, Ispayeva Z, Jares E, Jartti T, Jassem E, Julge K, Just J, Jutel M, Kaidashev I, Kalayci O, Kalyoncu O, Kardas P, Kirenga B, Kraxner H, Kull I, Kulus M, La Gruta S, Lau S, Le Tuyet Thi L, Levin M, Lipworth B, Lourenço O, Mahboub B, Mäkelä MJ, Martinez-Infante E, Matricardi P, Miculinic N, Migueres N, Mihaltan F, Mohamad Y, Moniusko M, Montefort S, Neffen H, Nekam K, Nunes E, Nyembue Tshipukane D, O'Hehir RE, Ogulur I, Ohta K, Okubo K, Ouedraogo S, Olze H, Pali-Schöll I, Palomares O, Palosuo K, Panaitescu C, Panzner P, Park HS, Pitsios C, Plavec D, Popov TA, Puggioni F, Quirce S, Recto M, Repka-Ramirez R, Roballo-Cordeiro C, Roche N, Rodriguez-Gonzales M, Romantowski J, Rosario Filho N, Rottem M, Sagara H, Sarquis-Serpa F, Sayah Z, Scheire S, Schmid-Grendelmeier P, Sisul JC, Sole D, Soto-Martinez M, Sova M, Sperl A, Spranger O, Stelmach R, Suppli Ulrik C, Thomas M, To T, Todo-Bom A, Tomazic PV, Urrutia-Pereira M, Valentin-Rostan M, van Ganse E, Van Hage M, Vasankari T, Vichyanond P, Viegi G, Wallace D, Wang DY, Williams S, Worm M, Yiallouros P, Yiallouros P, Yusuf O, Zaitoun F, Zernotti M, Zidarn M, Zuberbier J, Fonseca JA, Zuberbier T, Anto JM. Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis. Allergy 2023; 78:1169-1203. [PMID: 36799120 DOI: 10.1111/all.15679] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 02/18/2023]
Abstract
Asthma, rhinitis and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of "one-airway-one-disease", coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitisation and multimorbidity, (iii) advances in mHealth for novel phenotype definition, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut and neuropsychiatric multimorbidities, is the "Epithelial Barrier Hypothesis". This review determined that the "one-airway-one-disease" concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme "allergic" (asthma) phenotype combining asthma, rhinitis and conjunctivitis. Rhinitis alone and rhinitis and asthma multimorbidity represent two distinct diseases with the following differences: (i) genomic and transcriptomic background (Toll-Like Receptors and IL-17 for rhinitis alone as a local disease; IL-33 and IL-5 for allergic and non-allergic multimorbidity as a systemic disease), (ii) allergen sensitisation patterns (mono- or pauci-sensitisation versus polysensitisation), (iii) severity of symptoms and (iv) treatment response. In conclusion, rhinitis alone (local disease) and rhinitis with asthma multimorbidity (systemic disease) should be considered as two distinct diseases, possibly modulated by the microbiome, and may be a model for understanding the epidemics of chronic and auto-immune diseases.
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Affiliation(s)
- J Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.,University Hospital Montpellier, Montpellier, France.,Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France
| | - E Melén
- Sach´s Children and Youth Hospital, Södersjukhuset, and Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - G H Koppelman
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, GRIAC Research Institute, Groningen, the Netherlands
| | - A Togias
- Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, USA
| | - R Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - W Czarlewski
- Medical Consulting Czarlewski, Levallois, France.,MASK-air, Montpellier, France
| | - M Rothenberg
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - A Valiulis
- Institute of Clinical Medicine and Institute of Health Sciences, Vilnius, Lithuania.,Medical Faculty of Vilnius University, Vilnius, Lithuania
| | - M Wickmann
- Institute of Environmental medicine, Karolinska Institutet, Stockholm, Sweden
| | - D Aguilar
- Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBEREHD), Barcelona, Spain
| | - M Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - I J Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
| | - C Barbara
- Portuguese Nacional Programme for Respiratory Diseases, Direção -Geral da Saúde, Faculdade de Medicina de Lisboa, Instituto de Saúde Ambiental, Lisbon, Portugal
| | | | - C Bindslev Jensen
- Odense Research Center for Anaphylaxis (ORCA), and Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Finland
| | - S Bosnic-Anticevich
- Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, The University of Sydney, NSW, Australia.,Sydney Local Health District, Sydney, NSW, Australia
| | - L P Boulet
- Quebec Heart and Lung Institute, Laval University, Québec City, Quebec, Canada
| | - C E Brightling
- Institute of Lung Health, NIHR Biomedical Research Centre, Department of Respiratory and Infection Sciences, University of Leicester, Leicester, UK
| | - L Brussino
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino, Torino, Italy.,Mauriziano Hospital, Torino, Italy
| | - E Burte
- Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France.,Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France
| | - M Bustamante
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.,ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - G W Canonica
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - L Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - J C Celedon
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - C Chaves-Loureiro
- Pneumology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - E Costa
- UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
| | - A A Cruz
- Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil
| | - M Erhola
- Pirkanmaa Welfare district, Tampere, Finland
| | - B Gemicioglu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - W J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | - J Garcia Aymerich
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.,ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - S Guerra
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - J Heinrich
- Ludwig Maximilians University Munich, University Hospital Munich - Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Munich
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany.,State Institute of Health, Bavarian Health and Food Safety Authority, Erlangen, Germany
| | - L Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Germany.,Center for Rhinology and Allergology, Wiesbaden, Germany
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Poland
| | - M Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Poland
| | - V Kvedariene
- Institute of Clinical medicine, Clinic of Chest diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - D E Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - N Lemonnier
- Institute for Advanced Biosciences, UGA - INSERM U1209 - CNRS UMR5309, Site Santé, Allée des Alpes, La Tronche, France
| | | | - R Louis
- Department of Pulmonary Medicine, CHU, Liege, Liège, Belgium.,GIGA I3 research group, University of Liege, Belgium
| | - M Makris
- Allergy Unit "D Kalogeromitros", 2nd Dpt of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Greece
| | - M Maurer
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - I Momas
- Department of Public health and health products, Paris Descartes University-Sorbonne Paris Cité, EA 4064 and Paris Municipal Department of social action, childhood, and health, Paris, France
| | | | - J Mullol
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain.,Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Spain
| | - R N Naclerio
- Department of Otolaryngology - Head and Neck Surgery - Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - K Nadeau
- Stanford University School of Medicine, Sean N. Parker Center for Allergy and Asthma Research, Stanford, USA
| | - R Nadif
- Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France.,Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France
| | - M Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - Y Okamoto
- Chiba University Hospital, Chiba, Japan.,Chiba Rosai Hospital, Chiba, Japan
| | - M Ollert
- Odense Research Center for Anaphylaxis (ORCA), and Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Finland.,Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - N G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Italy
| | - V Patella
- Division of Allergy and Clinical Immunology, Department of Medicine, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy.,Agency of Health ASL, Salerno, Italy
| | - R Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - N Pham-Thi
- Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France
| | - O Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - F S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (ICBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - J Ring
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany.,Christine Kühne Center for Allergy Research and Education (CK-Care), Davos, Switzerland
| | - P W Rouadi
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon.,Department of Otorhinolaryngology-Head and Neck Surgery, Dar Al Shifa Hospital, Salmiya, Kuwait
| | - B Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Poland
| | - J Sastre
- Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain
| | - M Savouré
- Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France.,Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Villejuif, France
| | - N Scichilone
- PROMISE Department, University of Palermo, Palermo, Italy
| | - M H Shamji
- National Heart and Lung Institute, Imperial College, and NIHR Imperial Biomedical Research Centre, London, UK
| | - A Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - V Siroux
- INSERM, Université Grenoble Alpes, IAB, U 1209, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Université Joseph Fourier, Grenoble, France
| | - B Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research; University of Porto, Porto, Portugal.,RISE - Health Research Network; University of Porto, Porto, Portugal
| | - M Standl
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - J Sunyer
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.,ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - L Taborda-Barata
- Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal.,UBIAir - Clinical & Experimental Lung Centre and CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - S Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - M J Torres
- Allergy Unit, Málaga Regional University Hospital-IBIMA, Málaga, Spain
| | - I Tsiligianni
- International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland.,Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Greece
| | - E Valovirta
- Department of Lung Diseases and Clinical Immunology, University of Turku, Turku, Finland.,Terveystalo Allergy Clinic, Turku, Finland
| | - O Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL, Namur, and Université Catholique de Louvain, Yvoir, Belgium
| | - M T Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - S Weiss
- Harvard Medical School and Channing Division of Network Medicine, Boston, USA
| | - A Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - L Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China
| | - A H Abdul Latiff
- Allergy & Immunology Centre, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - W Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - I Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - M Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - I Alobid
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro Médico Teknon, Barcelona, Spain
| | - H S Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton.,David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - E Asayag
- Argentine Society of Allergy and Immunopathology, Buenos Ayres, Argentian
| | - A Baharudin
- Department of Otorhinolaryngology, Head and Neck, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - L Battur
- Mongolian Association of Hospital Managers, Ulaanbaatar, Mongolia
| | - K S Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - E C Berghea
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - K C Bergmann
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - D Bernstein
- Division of Immunology, Allergy and Rheumatology, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - M Bewick
- University of Central Lancashire Medical School, Preston, UK
| | - H Blain
- Department of Geriatrics, Montpellier University hospital, MUSE, Montpellier, France
| | - M Bonini
- Department of Clinical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy and National Heart and Lung Institute, Royal Brompton Hospital & Imperial College London, UK
| | - F Braido
- University of Genoa, Department of Internal Medicine (DiMI), and IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - R Buhl
- Dept of Pulmonary Medicine, Mainz University Hospital, Mainz, Germany
| | - R Bumbacea
- Department of Allergy, "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania
| | - A Bush
- Imperial College and Royal Brompton Hospital, London, UK
| | - M Calderon
- Imperial College and National Heart and Lung Institute, London, UK
| | - G Calvo
- Pediatrics Department, Universidad Austral de Chile, Valvidia, Chile
| | - P Camargos
- Federal University of Minas Gerais, Medical School, Department of Pediatrics, Belo Horizonte, Brazil
| | - L Caraballo
- Institute for Immunological Research, University of Cartagena, Campus de Zaragocilla, Edificio Biblioteca Primer piso, Cartagena, Colombia
| | - V Cardona
- Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Spain.,ARADyAL research network, Barcelona, Spain
| | - W Carr
- Allergy & Asthma Associates of Southern California, A Medical Group , Southern California Research, Mission Viejo, CA, USA
| | - P Carreiro-Martins
- NOVA Medical School/Comprehensive Health Research Centre (CHRC), Lisbon, Portugal.,Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - T Casale
- Division of Allergy/immunology, University of South Florida, Tampa, FLA, USA
| | - A M Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia and SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Branquilla, Columbia
| | - R Chandrasekharan
- Department of ENT, Badr al Samaa Hospital, Salalah, Sultanate of Oman
| | - D Charpin
- Clinique des bronches, allergie et sommeil, Hôpital Nord, Marseille, France
| | - Y Z Chen
- The capital institute of pediatrics, Beijing, China
| | - I Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab Research Group, Guayaquil, Guayas, Ecuador
| | - T Chivato
- School of Medicine, University CEU San Pablo, Madrid, Spain
| | - E Chkhartishvili
- David Tatishvili Medical Center; David Tvildiani Medical University-AIETI Medical School, Tbilisi, Georgia
| | - G Christoff
- Medical University - Sofia, Faculty of Public Health, Sofia, Bulgaria
| | - D K Chu
- Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - C Cingi
- skisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir, Turkey
| | - J Correia da Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - C Corrigan
- Division of Asthma, Allergy & Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK
| | - A Custovic
- National Heart and Lung Institute, Imperial College London, UK
| | - G D'Amato
- Division of Respiratory and Allergic Diseases,Hospital 'A Cardarelli', University of Naples Federico II, Naples, Italy
| | - S Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy
| | - F De Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, and Federation of translational medicine, University of Strasbourg, Strasbourg, France
| | - P Devillier
- VIM Suresnes, UMR 0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | - A Didier
- Department of Respiratory Diseases, Larrey Hospital, Toulouse University Hospital, Toulouse, France
| | - M do Ceu Teixeira
- Hospital Dr Agostinho Neto,Praia, Faculdade de Medicina de Cabo Verde
| | - D Dokic
- University Clinic of Pulmology and Allergy, Medical Faculty Skopje, Republic of Macedonia
| | - H Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algiers, Algeria
| | - M Doulaptsi
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital of Crete, Heraklion, Crete
| | - S Durham
- Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College London, London, UK
| | - M Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - T Eiwegger
- The Hospital for Sick Children, Department of Paediatrics, Division of Clinical Immunology and Allergy, Food allergy and Anaphylaxis Program, The University of Toronto, Toronto, Ontario, Canada
| | - Z A El-Sayed
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - R Emuzyte
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - R Emuzyte
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - A Fiocchi
- Allergy, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - N Fyhrquist
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - R M Gomez
- School of Health Sciences, Catholic University of Salta, Salta, Argentina
| | - M Gotua
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Center of Allergy and Immunology, David Tvildiani Medical University, Tbilisi, Georgia
| | - M A Guzman
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - J Hagemann
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Germany
| | - S Hamamah
- Biology of reproduction department, INSERM 1203, University hospital, Montpellier, France
| | - S Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - D M G Halpin
- University of Exeter, Medical School, College of Medicine and Health, University of Exeter, Exeter, Devon, UK
| | - M Hofmann
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - E Hossny
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - M Hrubiško
- Department of Clinical Immunology and Allergy, Oncology Institute of St Elisabeth, Bratislava, Slovakia
| | - C Irani
- Department of Internal Medicine and Infectious Diseases, St Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Z Ispayeva
- President of Kazakhstan Association of Allergology and Clinical Immunology, Department of Allergology and clinical immunology of the Kazakh National Medical University, Almaty, Kazakhstan
| | - E Jares
- Servicio de Alergia, Consultorios Médicos Privados, Buenos Aires, Argentina
| | - T Jartti
- EDEGO Research Unit, University of Oulu, Oulu, Finland
| | - E Jassem
- Medical University of Gdańsk, Department of Pneumology, Gdansk, Poland
| | - K Julge
- Tartu University Institute of Clinical Medicine, Children's Clinic, Tartu, Estonia
| | - J Just
- Sorbonne université, Hôpital américain de Paris, Neuilly, France
| | - M Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland.,ALL-MED Medical Research Institute, Wroclaw, Poland
| | | | - O Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - O Kalyoncu
- Hacettepe University, School of Medicine, Department of Chest Diseases, Immunology and Allergy Division, Ankara, Turkey
| | - P Kardas
- Department of Family Medicine, Medical University of Lodz, Poland
| | - B Kirenga
- Makerere University Lung Institute, Kampala, Uganda
| | - H Kraxner
- Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - I Kull
- Sach´s Children and Youth Hospital, Södersjukhuset, and Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - M Kulus
- Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Poland
| | - S La Gruta
- Institute of Translational Pharmacology, National Research Council, Palermo, Italy
| | - S Lau
- Department of Paediatric Respiratory Medicine, Immunology and Crital Care Medicine, Charité Universitätsmedizin, Berlin, Germany
| | - L Le Tuyet Thi
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - M Levin
- Division Paediatric Allergology, University of Cape Town, Cape Town, South Africa
| | - B Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, UK
| | - O Lourenço
- Faculty of Health Sciences and CICS - UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - B Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - M J Mäkelä
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - P Matricardi
- Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - N Migueres
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, and Federation of translational medicine, University of Strasbourg, Strasbourg, France
| | - F Mihaltan
- National Institute of Pneumology M Nasta, Bucharest, Romania
| | - Y Mohamad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia and Syrian Private University-, Damascus, Syria
| | - M Moniusko
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystock, Poland
| | - S Montefort
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, MSD, Malta
| | - H Neffen
- Director of Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina
| | - K Nekam
- Hungarian Allergy Association, Budapest, Hungary
| | - E Nunes
- Eduardo Mondlane University · Faculty of Medicine, Maputo, Mozambique
| | | | - R E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - I Ogulur
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - K Ohta
- National Hospital Organization Tokyo National Hospital, and JATA Fukujuji Hospital, Tokyo, Japan
| | - K Okubo
- Dept of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - S Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - H Olze
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, and Berlin Institute of Health, Berlin, Germany
| | - I Pali-Schöll
- Dept of Comparative Medicine; Messerli Research Institute of the University of Veterinary Medicine, Medical University, and University of Vienna, Vienna, Austria
| | - O Palomares
- Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain
| | - K Palosuo
- Department of Dermatology, University of Helsinki and Hospital for Skin and Allergic Diseases, Helsinki, Finland
| | - C Panaitescu
- OncoGen Center, County Clinical Emergency Hospital "Pius Branzeu," and University of Medicine and Pharmacy V Babes, Timisoara, Romania
| | - P Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - H S Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - C Pitsios
- Medical School, University of Cyprus, Nicosia, Cyprus
| | - D Plavec
- Srebrnjak Children's Hospital, Zagreb; Medical Faculty, University JJ Strossmayer of Osijek, Croatia
| | - T A Popov
- Clinic of Occupational Diseases, University Hospital Sveti Ivan Rilski, Sofia, Bulgaria
| | - F Puggioni
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - S Quirce
- QDepartment of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - M Recto
- Asian Hospital And Medical Center, Manilla, Philippines
| | - R Repka-Ramirez
- Division of Allergy, Asthma and Immunology, Clinics Hospital, San Lorenzo, Paraguay
| | | | - N Roche
- Pneumologie, AP-HP, Centre Université de Paris Cité, Hôpital Cochin, Paris, France.,UMR 1016, Institut Cochin, Paris, France
| | - M Rodriguez-Gonzales
- Pediatric Allergy and Clinical Immunology, Hospital Espanol de Mexico, Mexico City, Mexico
| | - J Romantowski
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - N Rosario Filho
- Department of Pediatrics, Federal University of Parana, Curitiba, Brazil
| | - M Rottem
- Division of Allergy, Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - H Sagara
- Showa University School of Medicine, Tokyo, Japan
| | - F Sarquis-Serpa
- Asthma Reference Center - School of Medicine of Santa Casa de Misericórdia of Vitória, Espírito Santo, Brazil
| | - Z Sayah
- SMAIC Société Marocaine d' Allergologie et Immunologie Clinique, Rabat, Morocco
| | - S Scheire
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zürich, Switzerland
| | - J C Sisul
- Allergy & Asthma, Medical Director, CLINICA SISUL, FACAAI, SPAAI, Asuncion, Paraguay
| | - D Sole
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - M Soto-Martinez
- Division of Respiratory Medicine, Department of Pediatrics, Hospital Nacional de Niños, Universidad de Costa Rica, San Jose, Costa Rica
| | - M Sova
- Department of Respiratory Medicine and Tuberculosis, University Hospital, Brno, Czech Republic
| | - A Sperl
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Germany
| | - O Spranger
- Global Allergy and Asthma Platform GAAPP, Vienna, Austria
| | - R Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - C Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, and Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - M Thomas
- University of Southampton, Southampton, UK
| | - T To
- The Hospital for Sick Children, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - A Todo-Bom
- Imunoalergologia, Centro Hospitalar Universitário de Coimbra, Faculty of Medicine, University of Coimbra, Portugal
| | - P V Tomazic
- Dept of General ORL, H&NS, Medical University of Graz, ENT-University Hospital Graz, Austria
| | | | | | - E van Ganse
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon1, Lyon, France
| | - M Van Hage
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - T Vasankari
- Fihla, Finnish Lung Association, Helsinki, Finland.,University of Turku, Turku, Finland
| | - P Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University Faculty of Medicine, Bangkok, Thailand
| | - G Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa
| | - D Wallace
- Nova Southeastern University, Florida, USA
| | - D Y Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - S Williams
- International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland
| | - M Worm
- Division of Allergy and Immunology Department of Dermatology, Allergy and Venerology Charité Universitätsmedizin Berlin Berlin, Germany
| | - P Yiallouros
- Medical School, University of Cyprus, Nicosia, Cyprus
| | - P Yiallouros
- Medical School, University of Cyprus, Nicosia, Cyprus
| | - O Yusuf
- The Allergy and Asthma Institute, Islamabad, Pakistan
| | - F Zaitoun
- Lebanese-American University, Clemenceau Medical Center DHCC, Dubai, UAE
| | - M Zernotti
- Universidad Católica de Córdoba, Universidad Nacional de Villa Maria, Argentina
| | - M Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.,University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - J Zuberbier
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, and Berlin Institute of Health, Berlin, Germany
| | - J A Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research; University of Porto, Porto, Portugal.,RISE - Health Research Network; University of Porto, Porto, Portugal
| | - T Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - J M Anto
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.,ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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29
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Lloyd M, Sugden N, Thomas M, McGrath A, Skilbeck C. The structure of the Hospital Anxiety and Depression Scale: Theoretical and methodological considerations. Br J Psychol 2023; 114:457-475. [PMID: 36745685 DOI: 10.1111/bjop.12637] [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: 06/06/2022] [Revised: 01/16/2023] [Accepted: 01/22/2023] [Indexed: 02/07/2023]
Abstract
The Hospital Anxiety and Depression Scale (HADS; Zigmond - Snaith, 1983) is widely used; however, its factor structure is unclear, with studies reporting differing unidimensional, two-factor and three-factor models. We aimed to address some key theoretical and methodological issues contributing to inconsistencies in HADS structures across samples. We reviewed existing HADS models and compared their fit using confirmatory factor analysis (CFA). We also investigated methodological effects by comparing factor structures derived from Rasch and Principal Components Analysis (PCA) methods, as well as effects of a negative wording factor. An Australian community-dwelling sample consisting of 189 females and 158 males aged 17-86 (M = 35.73, SD = 17.41) completed the 14-item HADS. The Rasch Analysis, PCA and CFA all supported the original two-factor structure. Although some three-factor models had good fit, they had unacceptable reliability. In the CFA, a hierarchical bifactor model with a general distress factor and uncorrelated depression and anxiety subscales produced the best fit, but the general factor was not unidimensional. The addition of a negative wording factor improved model fit. These findings highlight the effects of differing methodologies in producing inconsistent HADS factor structures across studies. Further replication of model fit across samples and refinement of the HADS items is warranted.
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Affiliation(s)
- Maddison Lloyd
- School of Psychology, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Nicole Sugden
- School of Psychology, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Matt Thomas
- School of Psychology, Charles Sturt University, Bathurst, New South Wales, Australia.,Western New South Wales Local Health District, Bathurst, New South Wales, Australia.,Marathon Health, Bathurst, New South Wales, Australia
| | - Andrew McGrath
- School of Psychology, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Clive Skilbeck
- School of Psychology, University of Tasmania, Sandy Bay, Tasmania, Australia
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30
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Hamilton FW, Thomas M, Arnold D, Palmer T, Moran E, Mentzer AJ, Maskell N, Baillie K, Summers C, Hingorani A, MacGowan A, Khandaker GM, Mitchell R, Davey Smith G, Ghazal P, Timpson NJ. Therapeutic potential of IL6R blockade for the treatment of sepsis and sepsis-related death: A Mendelian randomisation study. PLoS Med 2023; 20:e1004174. [PMID: 36716318 PMCID: PMC9925069 DOI: 10.1371/journal.pmed.1004174] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 02/13/2023] [Accepted: 01/13/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Sepsis is characterised by dysregulated, life-threatening immune responses, which are thought to be driven by cytokines such as interleukin 6 (IL-6). Genetic variants in IL6R known to down-regulate IL-6 signalling are associated with improved Coronavirus Disease 2019 (COVID-19) outcomes, a finding later confirmed in randomised trials of IL-6 receptor antagonists (IL6RAs). We hypothesised that blockade of IL6R could also improve outcomes in sepsis. METHODS AND FINDINGS We performed a Mendelian randomisation (MR) analysis using single nucleotide polymorphisms (SNPs) in and near IL6R to evaluate the likely causal effects of IL6R blockade on sepsis (primary outcome), sepsis severity, other infections, and COVID-19 (secondary outcomes). We weighted SNPs by their effect on CRP and combined results across them in inverse variance weighted meta-analysis, proxying the effect of IL6RA. Our outcomes were measured in UK Biobank, FinnGen, the COVID-19 Host Genetics Initiative (HGI), and the GenOSept and GainS consortium. We performed several sensitivity analyses to test assumptions of our methods, including utilising variants around CRP and gp130 in a similar analysis. In the UK Biobank cohort (N = 486,484, including 11,643 with sepsis), IL6R blockade was associated with a decreased risk of our primary outcome, sepsis (odds ratio (OR) = 0.80; 95% confidence interval (CI) 0.66 to 0.96, per unit of natural log-transformed CRP decrease). The size of this effect increased with severity, with larger effects on 28-day sepsis mortality (OR = 0.74; 95% CI 0.47 to 1.15); critical care admission with sepsis (OR = 0.48, 95% CI 0.30 to 0.78) and critical care death with sepsis (OR = 0.37, 95% CI 0.14 to 0.98). Similar associations were seen with severe respiratory infection: OR for pneumonia in critical care 0.69 (95% CI 0.49 to 0.97) and for sepsis survival in critical care (OR = 0.22; 95% CI 0.04 to 1.31) in the GainS and GenOSept consortium, although this result had a large degree of imprecision. We also confirm the previously reported protective effect of IL6R blockade on severe COVID-19 (OR = 0.69, 95% CI 0.57 to 0.84) in the COVID-19 HGI, which was of similar magnitude to that seen in sepsis. Sensitivity analyses did not alter our primary results. These results are subject to the limitations and assumptions of MR, which in this case reflects interpretation of these SNP effects as causally acting through blockade of IL6R, and reflect lifetime exposure to IL6R blockade, rather than the effect of therapeutic IL6R blockade. CONCLUSIONS IL6R blockade is causally associated with reduced incidence of sepsis. Similar but imprecisely estimated results supported a causal effect also on sepsis related mortality and critical care admission with sepsis. These effects are comparable in size to the effect seen in severe COVID-19, where IL-6 receptor antagonists were shown to improve survival. These data suggest that a randomised trial of IL-6 receptor antagonists in sepsis should be considered.
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Affiliation(s)
- Fergus W. Hamilton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Infection Science, North Bristol NHS Trust, Bristol, United Kingdom
| | - Matt Thomas
- Intensive Care Unit, North Bristol NHS Trust, Bristol, United Kingdom
| | - David Arnold
- Academic Respiratory Unit, University of Bristol, Bristol, United Kingdom
| | - Tom Palmer
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Ed Moran
- Infection Science, North Bristol NHS Trust, Bristol, United Kingdom
| | - Alexander J. Mentzer
- Wellcome Centre For Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Nick Maskell
- Academic Respiratory Unit, University of Bristol, Bristol, United Kingdom
| | - Kenneth Baillie
- Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Charlotte Summers
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Aroon Hingorani
- UCL Institute for Cardiovascular Science, University College London, London, United Kingdom
- UCL BHF Research Accelerator, University College London, London, United Kingdom
- Health Data Research UK, London, United Kingdom
| | | | - Golam M. Khandaker
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Ruth Mitchell
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Peter Ghazal
- Project Sepsis, Cardiff University, Cardiff, United Kingdom
| | - Nicholas J. Timpson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
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31
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Davino S, Callegari D, Pasini D, Thomas M, Nicotera I, Bonizzoni S, Mustarelli P, Quartarone E. Cross-Linked Gel Electrolytes with Self-Healing Functionalities for Smart Lithium Batteries. ACS Appl Mater Interfaces 2022; 14:51941-51953. [PMID: 36355595 PMCID: PMC9706498 DOI: 10.1021/acsami.2c15011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/31/2022] [Indexed: 06/01/2023]
Abstract
Next-generation Li-ion batteries must guarantee improved durability, quality, reliability, and safety to satisfy the stringent technical requirements of crucial sectors such as e-mobility. One breakthrough strategy to overcome the degradation phenomena affecting the battery performance is the development of advanced materials integrating smart functionalities, such as self-healing units. Herein, we propose a gel electrolyte based on a uniform and highly cross-linked network, hosting a high amount of liquid electrolyte, with multiple advantages: (i) autonomous, fast self-healing, and a promising PF5-scavenging role; (ii) solid-like mechanical stability despite the large fraction of entrapped liquid; and (iii) good Li+ transport. It is shown that such a gel electrolyte has very good conductivity (>1.0 mS cm-1 at 40 °C) with low activation energy (0.25 eV) for the ion transport. The transport properties are easily restored in the case of physical damages, thanks to the outstanding capability of the polymer to intrinsically repair severe cracks or fractures. The good elastic modulus of the cross-linked network, combined with the high fraction of anions immobilized within the polymer backbone, guarantees stable Li electrodeposition, disfavoring the formation of mossy dendrites with the Li metal anode. We demonstrate the electrolyte performance in a full-cell configuration with a LiNi0.8Mn0.1Co0.1O2 (NMC811) cathode, obtaining good cycling performance and stability.
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Affiliation(s)
- S. Davino
- Department
of Chemistry, University of Pavia, Via Taramelli 16, Pavia27100, Italy
| | - D. Callegari
- Department
of Chemistry, University of Pavia, Via Taramelli 16, Pavia27100, Italy
- GISEL—Centro
di Riferimento Nazionale per i Sistemi di Accumulo Elettrochimico
di Energia, INSTM, via G. Giusti 9, Firenze50121, Italy
| | - D. Pasini
- Department
of Chemistry, University of Pavia, Via Taramelli 16, Pavia27100, Italy
| | - M. Thomas
- Department
of Chemistry and Chemical Technology, University
of Calabria, Via P. Bucci, Rende, Cosenza87036, Italy
| | - I. Nicotera
- Department
of Chemistry and Chemical Technology, University
of Calabria, Via P. Bucci, Rende, Cosenza87036, Italy
- GISEL—Centro
di Riferimento Nazionale per i Sistemi di Accumulo Elettrochimico
di Energia, INSTM, via G. Giusti 9, Firenze50121, Italy
| | - S. Bonizzoni
- Department
of Materials Science, University of Milano
Bicocca, Via Cozzi 55, Milano20126, Italy
| | - P. Mustarelli
- Department
of Materials Science, University of Milano
Bicocca, Via Cozzi 55, Milano20126, Italy
- GISEL—Centro
di Riferimento Nazionale per i Sistemi di Accumulo Elettrochimico
di Energia, INSTM, via G. Giusti 9, Firenze50121, Italy
| | - E. Quartarone
- Department
of Chemistry, University of Pavia, Via Taramelli 16, Pavia27100, Italy
- GISEL—Centro
di Riferimento Nazionale per i Sistemi di Accumulo Elettrochimico
di Energia, INSTM, via G. Giusti 9, Firenze50121, Italy
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32
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Bastiaansen T, Benders R, Dijksman J, Thomas M, Hendriks W, de Vries S, Bosch G. Changes in thermomechanical properties of feed in relation to composition and their effect on pellet manufacturing. Anim Feed Sci Technol 2022. [DOI: 10.1016/j.anifeedsci.2022.115540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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33
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Salome P, Walz D, Sforazzini F, Kudak A, Dostal M, Regnery S, Schlamp K, Thomas M, Herth F, Jäkel O, Heußel C, Hoerner-Rieber J, Debus J, Knoll M, Abdollahi A. Multi-Omics Classifier of Tumor Recurrence vs. Radiation-Induced Lung Fibrosis in NSCLC Patients Treated with SBRT. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1542] [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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34
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Darnell R, Newell C, Edwards J, Gendall E, Harrison D, Sprinckmoller S, Mouncey P, Gould D, Thomas M. Critical illness-related cardiac arrest: Protocol for an investigation of the incidence and outcome of cardiac arrest within intensive care units in the United Kingdom. J Intensive Care Soc 2022; 23:493-497. [PMID: 36751345 PMCID: PMC9679899 DOI: 10.1177/17511437211055899] [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: 11/17/2022] Open
Abstract
Critical illness-related cardiac arrest (CIRCA) as a distinct entity is not well described epidemiologically. There is currently a knowledge gap regarding how many occur in the UK or the impact on patient outcome. The CIRCA study is a prospective multi-centre observational cohort study of patients in the United Kingdom experiencing a cardiac arrest while in a Critical Care Unit embedded in the Case Mix Programme and National Cardiac Arrest Audit. The duration of data collection is 12 months, with surviving patients and family members receiving questionnaire follow-up at 90 days, 180 days and 12 months. This paper describes the protocol for the CIRCA study which received favourable ethical opinion from South Central - Berkshire Research Ethics Committee and approval from the Health Research Authority. Study registration is on clinicaltrials.gov (NCT04219384).
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Affiliation(s)
- Robert Darnell
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | | | - Julia Edwards
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | - Emma Gendall
- Clinical Research Centre, Southmead Hospital, Bristol, UK
| | - David Harrison
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | - Stefan Sprinckmoller
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | - Paul Mouncey
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | - Doug Gould
- Clinical Trials Unit, Intensive Care National Audit & Research
Centre (ICNARC), London, UK
| | - Matt Thomas
- Department of Anaesthesia, Southmead Hospital, Bristol, UK,Matt Thomas, Department of Anaesthesia, Southmead
Hospital, Bristol BS10 5NB, UK.
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35
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Stuschke M, Eberhardt W, Passlick B, Groeschel A, Christopoulos P, Reck M, Grah C, Hoffknecht P, Ludwig P, Hipper A, Chiabudini M, Spring L, Jaenicke M, Andres-Pons A, Christoph D, Bernhardt C, Reiser M, Nusch A, Sebastian M, Griesinger F, Thomas M. EP05.01-030 CRISP: First Real-World Evidence of NSCLC Stage I, II and III in Germany - AIO-TRK-0315. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.477] [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: 10/14/2022]
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36
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Thomas M, Garassino M, Felip E, Sakai H, Le X, Veillon R, Smit E, Mazieres J, Cortot A, Raskin J, Viteri S, Yang JH, Ahn MJ, Wu YL, Ma R, Zhao J, O'Brate A, Berghoff K, Bruns R, Otto G, Paik P. OA03.05 Tepotinib in Patients with MET Exon 14 (METex14) Skipping NSCLC: Primary Analysis of the Confirmatory VISION Cohort C. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.024] [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: 10/14/2022]
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Smit E, Garassino M, Felip E, Sakai H, Le X, Veillon R, Mazieres J, Cortot A, Raskin J, Thomas M, Viteri Ramirez S, Berghoff K, Bruns R, Otto G, Paik P. 985P Tepotinib outcomes according to prior therapies in patients with MET exon 14 (METex14) skipping NSCLC. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1112] [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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Besse B, Griesinger F, Curigliano G, Thomas M, Subbiah V, Baik C, Tan D, Lee D, Garralda E, Kim DW, Van Der Wekken A, Gainor J, Paz-Ares L, Liu S, Bowles D, Zalutskaya A, Ruf T, Rahman A, Chen G, Mazieres J. 1170P Updated efficacy and safety data from the phase I/II ARROW study of pralsetinib in patients (pts) with advanced RET fusion+ non-small cell lung cancer (NSCLC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1293] [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: 11/17/2022] Open
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Kamarajah S, Evans R, Nepogodiev D, Hodson J, Bundred J, Gockel I, Gossage J, Isik A, Kidane B, Mahendran H, Negoi I, Okonta K, Sayyed R, van Hillegersberg R, Vohra R, Wijnhoven B, Singh P, Griffiths E, Kamarajah S, Hodson J, Griffiths E, Alderson D, Bundred J, Evans R, Gossage J, Griffiths E, Jefferies B, Kamarajah S, McKay S, Mohamed I, Nepogodiev D, Siaw-Acheampong K, Singh P, van Hillegersberg R, Vohra R, Wanigasooriya K, Whitehouse T, Gjata A, Moreno J, Takeda F, Kidane B, Guevara Castro R, Harustiak T, Bekele A, Kechagias A, Gockel I, Kennedy A, Da Roit A, Bagajevas A, Azagra J, Mahendran H, Mejía-Fernández L, Wijnhoven B, El Kafsi J, Sayyed R, Sousa M, Sampaio A, Negoi I, Blanco R, Wallner B, Schneider P, Hsu P, Isik A, Gananadha S, Wills V, Devadas M, Duong C, Talbot M, Hii M, Jacobs R, Andreollo N, Johnston B, Darling G, Isaza-Restrepo A, Rosero G, Arias-Amézquita F, Raptis D, Gaedcke J, Reim D, Izbicki J, Egberts J, Dikinis S, Kjaer D, Larsen M, Achiam M, Saarnio J, Theodorou D, Liakakos T, Korkolis D, Robb W, Collins C, Murphy T, Reynolds J, Tonini V, Migliore M, Bonavina L, Valmasoni M, Bardini R, Weindelmayer J, Terashima M, White R, Alghunaim E, Elhadi M, Leon-Takahashi A, Medina-Franco H, Lau P, Okonta K, Heisterkamp J, Rosman C, van Hillegersberg R, Beban G, Babor R, Gordon A, Rossaak J, Pal K, Qureshi A, Naqi S, Syed A, Barbosa J, Vicente C, Leite J, Freire J, Casaca R, Costa R, Scurtu R, Mogoanta S, Bolca C, Constantinoiu S, Sekhniaidze D, Bjelović M, So J, Gačevski G, Loureiro C, Pera M, Bianchi A, Moreno Gijón M, Martín Fernández J, Trugeda Carrera M, Vallve-Bernal M, Cítores Pascual M, Elmahi S, Halldestam I, Hedberg J, Mönig S, Gutknecht S, Tez M, Guner A, Tirnaksiz M, Colak E, Sevinç B, Hindmarsh A, Khan I, Khoo D, Byrom R, Gokhale J, Wilkerson P, Jain P, Chan D, Robertson K, Iftikhar S, Skipworth R, Forshaw M, Higgs S, Gossage J, Nijjar R, Viswanath Y, Turner P, Dexter S, Boddy A, Allum W, Oglesby S, Cheong E, Beardsmore D, Vohra R, Maynard N, Berrisford R, Mercer S, Puig S, Melhado R, Kelty C, Underwood T, Dawas K, Lewis W, Al-Bahrani A, Bryce G, Thomas M, Arndt A, Palazzo F, Meguid R, Fergusson J, Beenen E, Mosse C, Salim J, Cheah S, Wright T, Cerdeira M, McQuillan P, Richardson M, Liem H, Spillane J, Yacob M, Albadawi F, Thorpe T, Dingle A, Cabalag C, Loi K, Fisher O, Ward S, Read M, Johnson M, Bassari R, Bui H, Cecconello I, Sallum R, da Rocha J, Lopes L, Tercioti V, Coelho J, Ferrer J, Buduhan G, Tan L, Srinathan S, Shea P, Yeung J, Allison F, Carroll P, Vargas-Barato F, Gonzalez F, Ortega J, Nino-Torres L, Beltrán-García T, Castilla L, Pineda M, Bastidas A, Gómez-Mayorga J, Cortés N, Cetares C, Caceres S, Duarte S, Pazdro A, Snajdauf M, Faltova H, Sevcikova M, Mortensen P, Katballe N, Ingemann T, Morten B, Kruhlikava I, Ainswort A, Stilling N, Eckardt J, Holm J, Thorsteinsson M, Siemsen M, Brandt B, Nega B, Teferra E, Tizazu A, Kauppila J, Koivukangas V, Meriläinen S, Gruetzmann R, Krautz C, Weber G, Golcher H, Emons G, Azizian A, Ebeling M, Niebisch S, Kreuser N, Albanese G, Hesse J, Volovnik L, Boecher U, Reeh M, Triantafyllou S, Schizas D, Michalinos A, Balli E, Mpoura M, Charalabopoulos A, Manatakis D, Balalis D, Bolger J, Baban C, Mastrosimone A, McAnena O, Quinn A, Ó Súilleabháin C, Hennessy M, Ivanovski I, Khizer H, Ravi N, Donlon N, Cervellera M, Vaccari S, Bianchini S, Sartarelli L, Asti E, Bernardi D, Merigliano S, Provenzano L, Scarpa M, Saadeh L, Salmaso B, De Manzoni G, Giacopuzzi S, La Mendola R, De Pasqual C, Tsubosa Y, Niihara M, Irino T, Makuuchi R, Ishii K, Mwachiro M, Fekadu A, Odera A, Mwachiro E, AlShehab D, Ahmed H, Shebani A, Elhadi A, Elnagar F, Elnagar H, Makkai-Popa S, Wong L, Tan Y, Thannimalai S, Ho C, Pang W, Tan J, Basave H, Cortés-González R, Lagarde S, van Lanschot J, Cords C, Jansen W, Martijnse I, Matthijsen R, Bouwense S, Klarenbeek B, Verstegen M, van Workum F, Ruurda J, van der Sluis P, de Maat M, Evenett N, Johnston P, Patel R, MacCormick A, Young M, Smith B, Ekwunife C, Memon A, Shaikh K, Wajid A, Khalil N, Haris M, Mirza Z, Qudus S, Sarwar M, Shehzadi A, Raza A, Jhanzaib M, Farmanali J, Zakir Z, Shakeel O, Nasir I, Khattak S, Baig M, MA N, Ahmed H, Naeem A, Pinho A, da Silva R, Bernardes A, Campos J, Matos H, Braga T, Monteiro C, Ramos P, Cabral F, Gomes M, Martins P, Correia A, Videira J, Ciuce C, Drasovean R, Apostu R, Ciuce C, Paitici S, Racu A, Obleaga C, Beuran M, Stoica B, Ciubotaru C, Negoita V, Cordos I, Birla R, Predescu D, Hoara P, Tomsa R, Shneider V, Agasiev M, Ganjara I, Gunjić D, Veselinović M, Babič T, Chin T, Shabbir A, Kim G, Crnjac A, Samo H, Díez del Val I, Leturio S, Ramón J, Dal Cero M, Rifá S, Rico M, Pagan Pomar A, Martinez Corcoles J, Rodicio Miravalles J, Pais S, Turienzo S, Alvarez L, Campos P, Rendo A, García S, Santos E, Martínez E, Fernández Díaz M, Magadán Álvarez C, Concepción Martín V, Díaz López C, Rosat Rodrigo A, Pérez Sánchez L, Bailón Cuadrado M, Tinoco Carrasco C, Choolani Bhojwani E, Sánchez D, Ahmed M, Dzhendov T, Lindberg F, Rutegård M, Sundbom M, Mickael C, Colucci N, Schnider A, Er S, Kurnaz E, Turkyilmaz S, Turkyilmaz A, Yildirim R, Baki B, Akkapulu N, Karahan O, Damburaci N, Hardwick R, Safranek P, Sujendran V, Bennett J, Afzal Z, Shrotri M, Chan B, Exarchou K, Gilbert T, Amalesh T, Mukherjee D, Mukherjee S, Wiggins T, Kennedy R, McCain S, Harris A, Dobson G, Davies N, Wilson I, Mayo D, Bennett D, Young R, Manby P, Blencowe N, Schiller M, Byrne B, Mitton D, Wong V, Elshaer A, Cowen M, Menon V, Tan L, McLaughlin E, Koshy R, Sharp C, Brewer H, Das N, Cox M, Al Khyatt W, Worku D, Iqbal R, Walls L, McGregor R, Fullarton G, Macdonald A, MacKay C, Craig C, Dwerryhouse S, Hornby S, Jaunoo S, Wadley M, Baker C, Saad M, Kelly M, Davies A, Di Maggio F, McKay S, Mistry P, Singhal R, Tucker O, Kapoulas S, Powell-Brett S, Davis P, Bromley G, Watson L, Verma R, Ward J, Shetty V, Ball C, Pursnani K, Sarela A, Sue Ling H, Mehta S, Hayden J, To N, Palser T, Hunter D, Supramaniam K, Butt Z, Ahmed A, Kumar S, Chaudry A, Moussa O, Kordzadeh A, Lorenzi B, Wilson M, Patil P, Noaman I, Willem J, Bouras G, Evans R, Singh M, Warrilow H, Ahmad A, Tewari N, Yanni F, Couch J, Theophilidou E, Reilly J, Singh P, van Boxel Gijs, Akbari K, Zanotti D, Sgromo B, Sanders G, Wheatley T, Ariyarathenam A, Reece-Smith A, Humphreys L, Choh C, Carter N, Knight B, Pucher P, Athanasiou A, Mohamed I, Tan B, Abdulrahman M, Vickers J, Akhtar K, Chaparala R, Brown R, Alasmar M, Ackroyd R, Patel K, Tamhankar A, Wyman A, Walker R, Grace B, Abbassi N, Slim N, Ioannidi L, Blackshaw G, Havard T, Escofet X, Powell A, Owera A, Rashid F, Jambulingam P, Padickakudi J, Ben-Younes H, Mccormack K, Makey I, Karush M, Seder C, Liptay M, Chmielewski G, Rosato E, Berger A, Zheng R, Okolo E, Singh A, Scott C, Weyant M, Mitchell J. The influence of anastomotic techniques on postoperative anastomotic complications: Results of the Oesophago-Gastric Anastomosis Audit. J Thorac Cardiovasc Surg 2022; 164:674-684.e5. [PMID: 35249756 DOI: 10.1016/j.jtcvs.2022.01.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/22/2021] [Accepted: 01/18/2022] [Indexed: 12/08/2022]
Abstract
BACKGROUND The optimal anastomotic techniques in esophagectomy to minimize rates of anastomotic leakage and conduit necrosis are not known. The aim of this study was to assess whether the anastomotic technique was associated with anastomotic failure after esophagectomy in the international Oesophago-Gastric Anastomosis Audit cohort. METHODS This prospective observational multicenter cohort study included patients undergoing esophagectomy for esophageal cancer over 9 months during 2018. The primary exposure was the anastomotic technique, classified as handsewn, linear stapled, or circular stapled. The primary outcome was anastomotic failure, namely a composite of anastomotic leakage and conduit necrosis, as defined by the Esophageal Complications Consensus Group. Multivariable logistic regression modeling was used to identify the association between anastomotic techniques and anastomotic failure, after adjustment for confounders. RESULTS Of the 2238 esophagectomies, the anastomosis was handsewn in 27.1%, linear stapled in 21.0%, and circular stapled in 51.9%. Anastomotic techniques differed significantly by the anastomosis sites (P < .001), with the majority of neck anastomoses being handsewn (69.9%), whereas most chest anastomoses were stapled (66.3% circular stapled and 19.3% linear stapled). Rates of anastomotic failure differed significantly among the anastomotic techniques (P < .001), from 19.3% in handsewn anastomoses, to 14.0% in linear stapled anastomoses, and 12.1% in circular stapled anastomoses. This effect remained significant after adjustment for confounding factors on multivariable analysis, with an odds ratio of 0.63 (95% CI, 0.46-0.86; P = .004) for circular stapled versus handsewn anastomosis. However, subgroup analysis by anastomosis site suggested that this effect was predominantly present in neck anastomoses, with anastomotic failure rates of 23.2% versus 14.6% versus 5.9% for handsewn versus linear stapled anastomoses versus circular stapled neck anastomoses, compared with 13.7% versus 13.8% versus 12.2% for chest anastomoses. CONCLUSIONS Handsewn anastomoses appear to be independently associated with higher rates of anastomotic failure compared with stapled anastomoses. However, this effect seems to be largely confined to neck anastomoses, with minimal differences between techniques observed for chest anastomoses. Further research into standardization of anastomotic approach and techniques may further improve outcomes.
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Lusky F, Schindler H, Elshiaty M, Gaissmaier L, Daniello L, Bozorgmehr F, Kuon J, Shah R, Schneider M, Eichhorn F, Trudzinski F, Angeles A, Janke F, Kirchner M, Kazdal D, Stenzinger A, Sültmann H, Thomas M, Christopoulos P. EP08.01-031 Blood Gene Expression Changes in Metastatic Lung Cancer under second-line Immunotherapy according to Clinical Response. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.603] [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: 10/14/2022]
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Garon E, Lu S, Goto Y, De Marchi P, Paz-Ares L, Spigel D, Thomas M, Yang JH, Ardizzoni A, Barlesi F, Khanna S, Bossen C, Carbini M, Yovine A, Cho B. LBA49 CANOPY-A: Phase III study of canakinumab (CAN) as adjuvant therapy in patients (pts) with completely resected non-small cell lung cancer (NSCLC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.049] [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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N’Dow J, Smith E, Polychronopoulos K, Cannon A, Roobol M, Auweter S, Thomas M, Kremer A, De Meulder B, Dellamonica D, Alhambra D, Asiimwe A, Bussmann M, Ji X, Torremante P, Keller S, Kube F, Krueger H. 917P OPTIMA: Improve care for patients with prostate, breast, and lung cancer through artificial intelligence. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1042] [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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Besse B, Awad M, Forde P, Thomas M, Goss G, Aronson B, Hobson R, Dean E, Peters J, Iyer S, Conway J, Barrett J, Cosaert J, Dressman M, Barry S, Heymach J. OA15.05 HUDSON: An Open-Label, Multi-Drug, Biomarker-Directed Phase 2 Study in NSCLC Patients Who Progressed on Anti-PD-(L)1 Therapy. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.074] [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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Lyu F, Hendriks W, van der Poel A, Thomas M. Breaking behaviour and interactions in maize and soybean meal while grinding of a hammer mill. ADV POWDER TECHNOL 2022. [DOI: 10.1016/j.apt.2022.103726] [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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Sebastian M, Griesinger F, von der Heyde E, Dörfel S, Wiegand J, Schiefer C, Losem C, Jänicke M, Fleitz A, Zacharias S, Hipper A, Dietel C, Bleckmann A, Benkelmann R, Boesche M, Grah C, Müller A, Eberhardt W, Thomas M. 1164P Patient-reported outcomes in patients with advanced NSCLC before and during the COVID-19 pandemic in the German prospective CRISP Registry real-world cohort (AIO-TRK-0315). Ann Oncol 2022. [PMCID: PMC9472486 DOI: 10.1016/j.annonc.2022.07.1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Eberhardt W, Passlick B, Stuschke M, Groeschel A, Christopoulos P, Reck M, Ludwig P, Hipper A, Chiabudini M, Spring L, Jänicke M, Andres-Pons A, Christoph D, Bernhardt C, Reiser M, Sebastian M, Griesinger F, Thomas M. 963P Clinical research platform Into molecular testing, treatment and outcome of non-Small cell lung carcinoma Patients (CRISP): Real-world evidence of NSCLC patients treated with radiochemotherapy in Germany – AIO-TRK-0315. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1089] [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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Christopoulos P, Iams W, Oksen D, Mahmoudpour S, Thia T, Otto G, Thomas M. EP08.02-126 The MOMENT Disease Registry of Patients with Advanced Non-Small Cell Lung Cancer Harboring MET Exon 14 Skipping. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.809] [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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Long R, Dutta A, Thomas M, Vianna ME. Case complexity of root canal treatments accepted for training in a secondary care setting assessed by three complexity grading systems: a service evaluation. Int Endod J 2022; 55:1190-1201. [PMID: 35976108 DOI: 10.1111/iej.13815] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 11/28/2022]
Affiliation(s)
- R Long
- School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff, United Kingdom
| | - A Dutta
- School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff, United Kingdom
| | - M Thomas
- School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff, United Kingdom
| | - M E Vianna
- School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff, United Kingdom
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Cherian L, Varghese L, Rupa V, Bright R, Abraham L, Panicker R, R. N, Peter J, Nayak A, Shyam A, Varghese G, Manesh A, Karuppusami R, George K, George T, Lenin A, Hansdak S, I. R, Michael J, Ninan M, Thomas M, Kurian R, Mammen S, Kurien R. Rhino-orbito-cerebral mucormycosis: patient characteristics in pre-COVID-19 and COVID-19 period. Rhinology 2022; 60:427-434. [DOI: 10.4193/rhin22.099] [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: 11/08/2022]
Abstract
Background: Rhino-orbito-cerebral-mucormycosis (ROCM), a rare and potentially fatal disease was seen in increasing numbers during the COVID-19 pandemic. This study describes and compares the patient characteristics and outcomes in COVID-19 associated mucormycosis (CAM) and non-COVID-19 mucormycosis (non-CAM). Methodology: CAM patients (24 cases) were recruited from the COVID-19 period and non-CAM (24 controls) from the pre-COVID-19 period. Clinical data of the CAM group was collected retrospectively with 3 month outcomes prospectively. The non-CAM group data was collected retrospectively. Patient characteristics were compared and risk factors for mortality in ROCM were assessed. Results: Orbital symptoms [altered vision, restricted eye movements, ptosis] and intracranial involvement were higher in CAM patients on presentation. Similarly, the radiological involvement of orbit (orbital apex, superior orbital fissure) and intracranial cavity (intracranial thrombosis, cavernous sinus) was also higher in CAM patients. Newly detected diabetes was found only in CAM patients (29.2%). Although univariate analysis suggested an increased mortality risk in ROCM patients with orbital involvement, the multivariate analysis showed no increased risk with any of the parameters assessed, including COVID-19 positivity. Conclusions: Compared to the non-CAM, the disease presentation was severe in CAM with higher frequency of orbital and intracranial involvement. However, with early detection and treatment, the short term survival was comparable in both groups.
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Abbott R, Abe H, Acernese F, Ackley K, Adhikari N, Adhikari R, Adkins V, Adya V, Affeldt C, Agarwal D, Agathos M, Agatsuma K, Aggarwal N, Aguiar O, Aiello L, Ain A, Ajith P, Akutsu T, Albanesi S, Alfaidi R, Allocca A, Altin P, Amato A, Anand C, Anand S, Ananyeva A, Anderson S, Anderson W, Ando M, Andrade T, Andres N, Andrés-Carcasona M, Andrić T, Angelova S, Ansoldi S, Antelis J, Antier S, Apostolatos T, Appavuravther E, Appert S, Apple S, Arai K, Araya A, Araya M, Areeda J, Arène M, Aritomi N, Arnaud N, Arogeti M, Aronson S, Arun K, Asada H, Asali Y, Ashton G, Aso Y, Assiduo M, Melo SADS, Aston S, Astone P, Aubin F, AultONeal K, Austin C, Babak S, Badaracco F, Bader M, Badger C, Bae S, Bae Y, Baer A, Bagnasco S, Bai Y, Baird J, Bajpai R, Baka T, Ball M, Ballardin G, Ballmer S, Balsamo A, Baltus G, Banagiri S, Banerjee B, Bankar D, Barayoga J, Barbieri C, Barish B, Barker D, Barneo P, Barone F, Barr B, Barsotti L, Barsuglia M, Barta D, Bartlett J, Barton M, Bartos I, Basak S, Bassiri R, Basti A, Bawaj M, Bayley J, Mills J, Milotti E, Minenkov Y, Mio N, Mir L, Miravet-Tenés M, Mishkin A, Mishra C, Mishra T, Mistry T, Bazzan M, Mitra S, Mitrofanov V, Mitselmakher G, Mittleman R, Miyakawa O, Miyo K, Miyoki S, Mo G, Modafferi L, Moguel E, Becher B, Mogushi K, Mohapatra S, Mohite S, Molina I, Molina-Ruiz M, Mondin M, Montani M, Moore C, Moragues J, Moraru D, Bécsy B, Morawski F, More A, Moreno C, Moreno G, Mori Y, Morisaki S, Morisue N, Moriwaki Y, Mours B, Mow-Lowry C, Bedakihale V, Mozzon S, Muciaccia F, Mukherjee A, Mukherjee D, Mukherjee S, Mukherjee S, Mukherjee S, Mukund N, Mullavey A, Munch J, Beirnaert F, Muñiz E, Murray P, Musenich R, Muusse S, Nadji S, Nagano K, Nagar A, Nakamura K, Nakano H, Nakano M, Bejger M, Nakayama Y, Napolano V, Nardecchia I, Narikawa T, Narola H, Naticchioni L, Nayak B, Nayak R, Neil B, Neilson J, Belahcene I, Nelson A, Nelson T, Nery M, Neubauer P, Neunzert A, Ng K, Ng S, Nguyen C, Nguyen P, Nguyen T, Benedetto V, Quynh LN, Ni J, Ni WT, Nichols S, Nishimoto T, Nishizawa A, Nissanke S, Nitoglia E, Nocera F, Norman M, Beniwal D, North C, Nozaki S, Nurbek G, Nuttall L, Obayashi Y, Oberling J, O’Brien B, O’Dell J, Oelker E, Ogaki W, Benjamin M, Oganesyan G, Oh J, Oh K, Oh S, Ohashi M, Ohashi T, Ohkawa M, Ohme F, Ohta H, Okada M, Bennett T, Okutani Y, Olivetto C, Oohara K, Oram R, O’Reilly B, Ormiston R, Ormsby N, O’Shaughnessy R, O’Shea E, Oshino S, Bentley J, Ossokine S, Osthelder C, Otabe S, Ottaway D, Overmier H, Pace A, Pagano G, Pagano R, Page M, Pagliaroli G, BenYaala M, Pai A, Pai S, Pal S, Palamos J, Palashov O, Palomba C, Pan H, Pan KC, Panda P, Pang P, Bera S, Pankow C, Pannarale F, Pant B, Panther F, Paoletti F, Paoli A, Paolone A, Pappas G, Parisi A, Park H, Berbel M, Park J, Parker W, Pascucci D, Pasqualetti A, Passaquieti R, Passuello D, Patel M, Pathak M, Patricelli B, Patron A, Bergamin F, Paul S, Payne E, Pedraza M, Pedurand R, Pegoraro M, Pele A, Arellano FP, Penano S, Penn S, Perego A, Berger B, 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Search for continuous gravitational wave emission from the Milky Way center in O3 LIGO-Virgo data. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.042003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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