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Gladman DD, Chandran V, Rosen CF, Rohekar S, Boyd T, Eder L, Rahman P, Dutz J, Chan J, Haydey RP, Barac S, Laliberté MC, Girard T, Fournier PA, Sutton M, Pereira D, Chim T, Coupal L, Choquette D. Residual Disease Activity In Canadian Patients With Psoriatic Arthritis (PsA) Treated With Advanced Therapies: Results From A Multi-Registry Analysis (UNISON-PsA). J Rheumatol 2024:jrheum.2023-0716. [PMID: 38359937 DOI: 10.3899/jrheum.2023-0716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE Although patient outcomes in psoriatic arthritis (PsA) have improved with the advent of advanced therapies, there remains a high unmet need to treat residual disease activity. The objective of the current study was to quantify residual disease activity and burden of disease in Canadian patients with PsA. METHODS This was a multi-region, observational, retrospective analysis of patient data extracted from the Rhumadata™ and the International Psoriasis and Arthritis Research Team (IPART) registries, analyzing de-identified data from patients who had initiated advanced therapy for the treatment of PsA between January 2010 and December 2019. The primary endpoint was the proportion of patients failing to achieve minimal disease activity (MDA) within 6 months; secondary endpoints included clinical and patient-reported burden of disease. Descriptive statistics included summaries by region, treatment class, and number of prior advanced therapies. RESULTS 1,596 patients were included. The proportion of patients who failed to achieve MDA within 6 months of an advanced therapy was 64.8% in Ontario, 68.3% in Western Canada, 74.8% in Québec and 75.0% in the Atlantic/East region. Failure to achieve MDA was higher amongst patients receiving an IL-17i compared with a TNFi in all regions except Atlantic/East. Between 73.2 to 78.6% of patients reported pain at 6 months, and continuing functional impairment varied from 24.0% in the West to 83.3% in the Atlantic/East. CONCLUSION There is substantial burden and unmet need for improved therapies for Canadians living with PsA. There is a wide regional variation in outcomes that requires further assessment.
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Affiliation(s)
- Dafna D Gladman
- Dafna D. Gladman, University of Toronto, Department of Medicine, Division of Rheumatology, Toronto, ON, Canada; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Vinod Chandran
- Vinod Chandran, University of Toronto, Department of Medicine, Division of Rheumatology, Toronto, ON, Canada; Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Cheryl F Rosen
- Cheryl F. Rosen, Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Dermatology, Toronto Western Hospital, Toronto, ON, Canada
| | - Sherry Rohekar
- Sherry Rohekar, Division of Rheumatology, Western University, London, Ontario, Canada
| | - Tristan Boyd
- Tristan Boyd, Division of Rheumatology, Western University, London, ON, Canada; Division of Rheumatology, St. Joseph's Hospital, London, ON, Canada
| | - Lihi Eder
- Lihi Eder, Division of Rheumatology, Women's College Hospital, Toronto, ON M5S 1B2, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Proton Rahman
- Proton Rahman, Department of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Jan Dutz
- Jan Dutz, Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Jonathan Chan
- Jonathan Chan, Department of Medicine, Division of Rheumatology, University of British Columbia, and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | | | - Snezana Barac
- Snezana Barac, Winnipeg Clinic, Winnipeg, MB, Canada
| | | | - Tanya Girard
- Tanya Girard, AbbVie Corporation, St. Laurent, Québec, Canada
| | | | - Mitchell Sutton
- Mitchell Sutton, Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Disease Program, Toronto Western Hospital, University Health Network
| | - Daniel Pereira
- Daniel Pereira, Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Disease Program, Toronto Western Hospital, University Health Network
| | - Tina Chim
- Tina Chim, Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Disease Program, Toronto Western Hospital, University Health Network
| | - Louis Coupal
- Louis Coupal, Institut de Rhumatologie de Montréal, CHUM, University of Montréal, Montréal, QC Canada
| | - Denis Choquette
- Denis Choquette, Institut de Rhumatologie de Montréal, CHUM, University of Montréal, Montréal, QC Canada
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Pirouzmand N, Pereira D, Sutton M, Mathew AJ, Chandran V, Gladman DD. Psoriatic Arthritis and COVID-19: Patient Perspectives in a Large Psoriatic Arthritis Cohort. J Rheumatol 2023:jrheum.2022-1265. [PMID: 37657794 DOI: 10.3899/jrheum.2022-1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
OBJECTIVE To estimate the prevalence of coronavirus disease 2019 (COVID-19) infection among patients with psoriatic arthritis (PsA), understand patients' perspectives regarding their risk of COVID-19 infection, and evaluate the standard of virtual care offered during the early phases of the pandemic. METHODS An online survey was conducted between June 2021 and September 2021 in patients with PsA who had consented to email contact. The survey was completed by 152/193 (79%) patients who had consented to the study. RESULTS There were 86 (56.6%) men and 66 (43.4%) women with a mean age of 58 years and mean disease duration of 19 years. During the pandemic, the mean patient-reported symptom severity was 4.10, 3.24, and 3.72 for joint, skin, and overall symptom severity, respectively. Seventy-four percent of respondents would accept the effect of their PsA over the past month for the next few months. Of 79 patients who were tested for severe acute respiratory syndrome coronavirus 2, 4 tested positive. All 4 were admitted to hospital; 2 required oxygen. One hundred fifty-one patients (99%) had received at least 1 vaccine dose. Fifty-nine (38.8%) participants believed their PsA medications increased their COVID-19 infection risk. Of the 130 patients who had a telemedicine assessment, 83.1% were happy with their virtual consultations. Most were happy to continue with virtual consultations until the pandemic resolved. The average satisfaction level regarding pandemic care was 7.87 on a sliding 10-point scale. CONCLUSION COVID-19 prevalence was low among our patients. Patients were satisfied with their care during the pandemic. Most patients would happily continue with virtual care for the duration of the pandemic.
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Affiliation(s)
- Neda Pirouzmand
- N. Pirouzmand, BSc, medical student, Temerty Faculty of Medicine, University of Toronto
| | - Daniel Pereira
- D. Pereira, BSc, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital
| | - Mitchell Sutton
- M. Sutton, MSc, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital
| | - Ashish J Mathew
- A.J. Mathew, DNB, DM, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, and University of Toronto
| | - Vinod Chandran
- V. Chandran, DM, PhD, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, and University of Toronto, and Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Dafna D Gladman
- D.D. Gladman, MD, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, and University of Toronto, and Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
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Mollayeva T, Tran A, Colantonio A, Chan V, Sutton M, Escobar M. Data-Driven Analysis for Detecting Transitions in Health Status in Traumatic Brain Injury: Implications For Prevention. Arch Phys Med Rehabil 2022. [DOI: 10.1016/j.apmr.2022.08.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Kwok TSH, Sutton M, Cook RJ, Pereira D, Chandran V, Gladman DD. Musculoskeletal Surgery in Psoriatic Arthritis: Prevalence and Risk Factors. J Rheumatol 2022; 50:497-503. [PMID: 36379576 DOI: 10.3899/jrheum.220908] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Despite medical therapy, damage occurs in patients with psoriatic arthritis (PsA) requiring musculoskeletal (MSK) surgery. We aimed to describe MSK surgery in patients with PsA and identify risk factors for undergoing first MSK surgery attributable to PsA. METHODS A single-center cohort identified patients with PsA fulfilling Classification Criteria for Psoriatic Arthritis who had MSK surgery between January 1978 and December 2019 inclusive. Charts were reviewed to confirm surgeries were MSK-related and attributable to PsA. Descriptive statistics determined MSK surgery prevalence and types. Cox proportional hazards models evaluated clinical variables for undergoing first MSK surgery using time-dependent covariates. Using a dataset with 1-to-1 matching on markers of PsA disease severity, a Cox proportional hazards model evaluated the effect of targeted therapies, namely biologics on time to first MSK surgery. RESULTS Of 1574 patients, 185 patients had 379 MSK surgeries related to PsA. The total number of damaged joints (hazard ratio [HR] 1.03, P < 0.001), tender/swollen joints (HR 1.04, P = 0.01), presence of nail lesions (HR 2.08, P < 0.01), higher Health Assessment Questionnaire scores (HR 2.01, P < 0.001), elevated erythrocyte sedimentation rate (HR 2.37, P = 0.02), and HLA-B27 positivity (HR 2.22, P = 0.048) were associated with increased risk of surgery, whereas higher Psoriasis Area Severity Index (HR 0.88, P < 0.002) conferred a protective effect in a multivariate model. The effect of biologics did not reach statistical significance. CONCLUSION MSK surgery attributable to PsA is not rare, affecting 11.8% of patients. Markers of cumulative disease activity and damage are associated with a greater risk of requiring surgery.
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Affiliation(s)
- Timothy S H Kwok
- T.S.H. Kwok, MD, Division of Rheumatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto
| | - Mitchell Sutton
- M. Sutton, MSc, Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto
| | - Richard J Cook
- R.J. Cook, PhD, Department of Statistics and Actuarial Sciences, University of Waterloo, Waterloo
| | - Daniel Pereira
- D. Pereira, BSc, Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto
| | - Vinod Chandran
- V. Chandran, MBBS, MD, DM, PhD, Division of Rheumatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, and Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Dafna D Gladman
- D.D. Gladman, MD, Division of Rheumatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, and Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, and Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, and Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
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Chatzi G, Whittaker W, Chandola T, Mason T, Soiland-Reyes C, Sutton M, Bower P. Diabetes Prevention Programme and socioeconomic inequalities in Type 2 Diabetes in England. Eur J Public Health 2022; 32:ckac129.159. [PMCID: PMC9831347 DOI: 10.1093/eurpub/ckac129.159] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Abstract
The National Diabetes Prevention Programme (DPP) in England is a behavioural intervention for preventing Type 2 Diabetes Mellitus (T2DM) among people with non-diabetic hyperglycaemia (NDH, HbA1c 42-47 mmol/mol or 6.0-6.4%). How this programme affects inequalities by age, gender, disability, ethnicity, or deprivation is not known. We used multinomial logistic regression models to compare population characteristics at three stages along the prevention programme pathway: prevalence of NDH [using survey data from UK Household Longitudinal Study (N = 794) and Health Survey for England (N = 1,383)]; identification in primary care and offer of the programme [using administrative data from the National Diabetes Audit (N = 1,267,350)]; and programme participation [using programme provider records (N = 98,024)]). Younger adults (aged under 40) [4% of the NDH population (95% CIs 2%-6%)] and older adults (aged 80 and above) [12% (95%CIs 10%-14%] were both underrepresented amongst DPP participants [2% of DPP participants (95%CIs 1.8%-2.2%) and 8% (95%CIs 7.7%-8.3%) respectively]. People with disabilities were underrepresented in the DPP [15% (95%CIs 14.9%-15.1%) vs 60% (95%CIs 58%-62%)] compared to the general population. People living in more deprived areas were under-represented [14% (95% CIs 13.7%-14.3%) vs 20% (95%CIs 16%-24%) in the general population]. Ethnic minorities were overrepresented [36% (95%CIs 35.8%-36.2%) vs 13% (95%CIs 9%-17%) in the general population] among DPP referrals, though the proportion dropped at programme completion stage [19% (95%CI 18.5%-19.5%)]. The DPP has the potential to reduce ethnic inequalities but may widen socioeconomic, age, and disability-related inequalities in T2DM. Whilst ethnic minority groups are overrepresented at identification and offer stage, efforts are required to support the completion of the programme. Programme providers should target underrepresented groups to ensure equitable access and narrow inequalities in T2DM. Key messages • The DPP intervention may result in a widening of socioeconomic and disability related inequalities amongst people with NDH as the programme had fewer adults in deprived areas and with a disability. • The programme has the potential to reduce ethnic inequalities, but efforts are required to support the completion of the programme by minority ethnic groups.
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Affiliation(s)
- G Chatzi
- Social Statistics, University of Manchester, Manchester, UK
| | - W Whittaker
- Division of Population Health, University of Manchester, Manchester, UK
| | - T Chandola
- Social Statistics, University of Manchester, Manchester, UK
- Sociology, University of Hong Kong, Hong Kong
| | - T Mason
- Division of Population Health, University of Manchester, Manchester, UK
| | - C Soiland-Reyes
- Research and Innovation, Northern Care Alliance NHS Group, Salford, UK
| | - M Sutton
- Centre for Primary Care and Health Services, University of Manchester, Manchester, UK
| | - P Bower
- Centre for Primary Care and Health Services, University of Manchester, Manchester, UK
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Jana S, Sutton M, Mollayeva T, Chan V, Colantonio A, Escobar MD. Application of multiple testing procedures for identifying relevant comorbidities, from a large set, in traumatic brain injury for research applications utilizing big health-administrative data. Front Big Data 2022; 5:793606. [PMID: 36247970 PMCID: PMC9563390 DOI: 10.3389/fdata.2022.793606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Multiple testing procedures (MTP) are gaining increasing popularity in various fields of biostatistics, especially in statistical genetics. However, in injury surveillance research utilizing the growing amount and complexity of health-administrative data encoded in the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10), few studies involve MTP and discuss their applications and challenges. Objective We aimed to apply MTP in the population-wide context of comorbidity preceding traumatic brain injury (TBI), one of the most disabling injuries, to find a subset of comorbidity that can be targeted in primary injury prevention. Methods In total, 2,600 ICD-10 codes were used to assess the associations between TBI and comorbidity, with 235,003 TBI patients, on a matched data set of patients without TBI. McNemar tests were conducted on each 2,600 ICD-10 code, and appropriate multiple testing adjustments were applied using the Benjamini-Yekutieli procedure. To study the magnitude and direction of associations, odds ratios with 95% confidence intervals were constructed. Results Benjamini-Yekutieli procedure captured 684 ICD-10 codes, out of 2,600, as codes positively associated with a TBI event, reducing the effective number of codes for subsequent analysis and comprehension. Conclusion Our results illustrate the utility of MTP for data mining and dimension reduction in TBI research utilizing big health-administrative data to support injury surveillance research and generate ideas for injury prevention.
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Affiliation(s)
- Sayantee Jana
- Department of Mathematics, Indian Institute of Technology, Hyderabad, India
- *Correspondence: Sayantee Jana
| | | | - Tatyana Mollayeva
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- KITE Research Institute Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Global Brain Health Institute, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Vincy Chan
- KITE Research Institute Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Angela Colantonio
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- KITE Research Institute Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
- ICES (fomerly Institute for Clinical Evaluative Sciences), Toronto, ON, Canada
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Kwok TSH, Sutton M, Pereira D, Cook RJ, Chandran V, Haroon N, Inman RD, Gladman DD. Isolated axial disease in psoriatic arthritis and ankylosing spondylitis with psoriasis. Ann Rheum Dis 2022; 81:1678-1684. [PMID: 35973805 DOI: 10.1136/ard-2022-222537] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/23/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare isolated axial psoriatic arthritis (PsA), axial PsA with peripheral involvement and isolated axial ankylosing spondylitis (AS) with psoriasis. To evaluate predictors for developing peripheral disease from isolated axial PsA over time. METHODS Two PsA and AS cohorts identified patients with PsA with axial disease and isolated axial patients with AS with psoriasis. Logistic regression compared isolated axial PsA to axial PsA with peripheral involvement and isolated axial AS with psoriasis. Cox proportional hazards model evaluated predictors for developing peripheral disease from isolated axial PsA. RESULTS Of 1576 patients with PsA, 2.03% had isolated axial disease and 29.38% had axial and peripheral disease. human leucocyte antigen HLA-B*27 positivity (OR 25.00, 95% CI 3.03 to 206.11) and lower Health Assessment Questionnaire scores (OR 0.004, 95% CI 0.00 to 0.28) were associated with isolated axial disease. HLA-B*27 also predicted peripheral disease development over time (HR 7.54, 95% CI 1.79 to 31.77). Of 1688 patients with AS, 4.86% had isolated axial disease with psoriasis. Isolated axial patients with PsA were older at diagnosis (OR 1.06, 95% CI 1.01 to 1.13), more likely to have nail lesions (OR 12.37, 95% CI 2.22 to 69.07) and less likely to have inflammatory back pain (OR 0.12, 95% CI 0.02 to 0.61) compared with patients with isolated axial AS with psoriasis. CONCLUSIONS Isolated axial PsA and AS with psoriasis are uncommon. HLA-B*27 positivity is associated with isolated axial PsA and may identify those who develop peripheral disease over time. Isolated axial PsA is associated with better functional status. Isolated axial PsA appears clinically distinct from isolated axial AS with psoriasis.
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Affiliation(s)
- Timothy S H Kwok
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mitchell Sutton
- Centre for Prognosis Studies in the Rheumatic Diseases, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
| | - Daniel Pereira
- Centre for Prognosis Studies in the Rheumatic Diseases, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
| | - Richard J Cook
- Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Vinod Chandran
- Centre for Prognosis Studies in the Rheumatic Diseases, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada.,Termerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nigil Haroon
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Schroeder Arthritis Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Robert D Inman
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Schroeder Arthritis Institute, Toronto Western Hospital, Spondylitis Program, University Health Network, Toronto, Ontario, Canada
| | - Dafna D Gladman
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada .,Centre for Prognosis Studies in the Rheumatic Diseases, Schroeder Arthritis Institute, University Health Network, Toronto, Ontario, Canada
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Dayam RM, Law JC, Goetgebuer RL, Chao GY, Abe KT, Sutton M, Finkelstein N, Stempak JM, Pereira D, Croitoru D, Acheampong L, Rizwan S, Rymaszewski K, Milgrom R, Ganatra D, Batista NV, Girard M, Lau I, Law R, Cheung MW, Rathod B, Kitaygorodsky J, Samson R, Hu Q, Hardy WR, Haroon N, Inman RD, Piguet V, Chandran V, Silverberg MS, Gingras AC, Watts TH. Accelerated waning of immunity to SARS-CoV-2 mRNA vaccines in patients with immune-mediated inflammatory diseases. JCI Insight 2022; 7:e159721. [PMID: 35471956 PMCID: PMC9220925 DOI: 10.1172/jci.insight.159721] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/22/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUNDLimited information is available on the impact of immunosuppressants on COVID-19 vaccination in patients with immune-mediated inflammatory diseases (IMID).METHODSThis observational cohort study examined the immunogenicity of SARS-CoV-2 mRNA vaccines in adult patients with inflammatory bowel disease, rheumatoid arthritis, ankylosing spondylitis, or psoriatic disease, with or without maintenance immunosuppressive therapies. Ab and T cell responses to SARS-CoV-2, including neutralization against SARS-CoV-2 variants, were determined before and after 1 and 2 vaccine doses.RESULTSWe prospectively followed 150 subjects, 26 healthy controls, 9 patients with IMID on no treatment, 44 on anti-TNF, 16 on anti-TNF with methotrexate/azathioprine (MTX/AZA), 10 on anti-IL-23, 28 on anti-IL-12/23, 9 on anti-IL-17, and 8 on MTX/AZA. Ab and T cell responses to SARS-CoV-2 were detected in all participants, increasing from dose 1 to dose 2 and declining 3 months later, with greater attrition in patients with IMID compared with healthy controls. Ab levels and neutralization efficacy against variants of concern were substantially lower in anti-TNF-treated patients than in healthy controls and were undetectable against Omicron by 3 months after dose 2.CONCLUSIONSOur findings support the need for a third dose of the mRNA vaccine and for continued monitoring of immunity in these patient groups.FUNDINGFunded by a donation from Juan and Stefania Speck and by Canadian Institutes of Health (CIHR)/COVID-Immunity Task Force (CITF) grants VR-1 172711 and VS1-175545 (to THW and ACG), CIHR FDN-143250 (to THW), GA2-177716 (to VC, ACG, and THW), and GA1-177703 (to ACG) and the CIHR rapid response network to SARS-CoV-2 variants, CoVaRR-Net (to ACG).
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Affiliation(s)
- Roya M. Dayam
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Jaclyn C. Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Rogier L. Goetgebuer
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Gary Y.C. Chao
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Kento T. Abe
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Mitchell Sutton
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Naomi Finkelstein
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Joanne M. Stempak
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Daniel Pereira
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lily Acheampong
- Division of Dermatology, Department of Medicine, Women’s College Hospital, Toronto, Ontario, Canada
| | - Saima Rizwan
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Klaudia Rymaszewski
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Raquel Milgrom
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Darshini Ganatra
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | | | - Melanie Girard
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Irene Lau
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Ryan Law
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Michelle W. Cheung
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
| | - Bhavisha Rathod
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Julia Kitaygorodsky
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Reuben Samson
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Queenie Hu
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - W. Rod Hardy
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Nigil Haroon
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Robert D. Inman
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, Women’s College Hospital, Toronto, Ontario, Canada
| | - Vinod Chandran
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Division of Rheumatology, Department of Medicine, and
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Mark S. Silverberg
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, Sinai Health
| | - Anne-Claude Gingras
- Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Molecular Genetics
| | - Tania H. Watts
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
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Mathew AJ, Sutton M, Pereira D, Gladman DD, Chandran V. POS1093 EFFECT OF DISEASE MODIFYING ANTI-RHEUMATIC DRUGS ON DEPRESSION IN PATIENTS WITH PSORIATIC ARTHRITIS IN A LONGITUDINAL COHORT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3826] [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: 11/04/2022]
Abstract
BackgroundDepression, and its improvement with disease modifying anti-rheumatic drugs (DMARDs) is understudied in psoriatic arthritis (PsA).ObjectivesTo determine the effectiveness of DMARDs on depression in PsA patients.MethodsPatients enrolled from January 2000 to May 2020 in a large PsA cohort were included. Depression was defined as medical outcomes study short form-36 (SF-36) mental component summary score (MCS) ≤ 40 or mental health (MH) subscale score ≤ 56. Primary outcome was resolution of depression within 1 year of DMARDs, defined by two definitions: 1) MCS > 40 and/or MH subscale score of > 56; 2) Increase in MCS by 2.5 and MH subscale score by 5, the minimal clinically important difference (MCID). Baseline medications [non-steroidal anti-inflammatory drugs (NSAIDs) and/or conventional or targeted (c/t) DMARDs] were recorded for all patients and stratified into 3 mutually exclusive ordinal categories: I-No treatment/NSAIDs; II-cDMARDs±NSAIDs without tDMARDs; III-tDMARDs±cDMARDs/NSAIDs. Univariable and multivariable logistic regression models were created to determine the association between medications and resolution of depression, after controlling for age, sex, disease duration and baseline MCS/MH subscale score.ResultsBased on the MCS and MH subscale score definitions, 608 (48%) and 655 (52%) of the 1270 patients, respectively were depressed at baseline. 374 (50.8% males) and 399 (52.4% males) patients were followed up in the groups defined by MCS and MH subscales, respectively for 1 year. Patients in both groups had comparable body mass indices, baseline psoriasis area and severity index and active joint count. Mean MCS and MH subscale scores (standard deviation) were 33.2 (5.2) and 46.0 (10.2). A mean of 11.9 and 11.7 months was noted for resolution of depression in the MCS based analysis and MH subscale-based analysis groups, respectively. More patients achieved resolution of depression based on definition 2 (MCS, 64.7%; MH, 62.2%) as compared to definition 1 (MCS, 54.5%; MH, 53.9). The proportion of patients on each category of medications in both models is shown in the Figure 1. Table 1 depicts the univariate and multivariable regression results by both the definitions of primary outcome in the MH subscales model. The global p-value for medication categories showed a trend towards significance in both models using definition 2. There was a trend towards higher likelihood of response when comparing patients in treatment category III vs category I. A significant response was noted when comparing patients in category III with category II as reference (OR 1.71; 95% CI 1.05-2.76; p 0.03). No significant effect of treatment category on depression was noted using definition 1.Table 1.Association between treatment and resolution of depression in the MH Subscale model (n = 399)VariableResolution by MCIDResolution by MH subscale reductionUnivariable modelMultivariable modelUnivariate modelMultivariate modelOR (95% CI)p valueOR (95% CI)p valueOR (95% CI)p valueOR (95% CI)p valueMale vs. Female0.81 (0.54–1.22)0.310.83 (0.5–1.26)0.391.02 (0.68–1.51)0.940.94 (0.63 –1.42)0.79Baseline age1.01 (1.00 –1.03)0.091.01 (1.00 –1.03)0.161.02 (1.00–1.03)0.051.01 (0.99 –1.03)0.30Baseline PsA duration1.02 (1.00 –1.04)0.121.01 (0.99 –1.03)0.371.02 (1.00– 1.04)0.071.01 (0.99 –1.03)0.22Baseline MH subscale score0.98 (0.96 –1.00)0.030.98 (0.95 –1.00)0.021.04 (1.02– 1.06)<0.00011.04 (1.02 –1.06)<0.0001Medication category0.07*0.09*0.20*0.20* IReference II0.81 (0.48 –1.36)0.420.83 (0.48 –1.41)0.481.09 (0.65– 1.82)0.751.12 (0.66 –1.91)0.67 III1.40 (0.84 –2.36)0.201.41 (0.83 –2.38)0.201.51 (0.92– 2.49)0.101.55 (0.92 –2.59)0.10*global p valueFigure 1.Patients in each drug category.ConclusionIn an observational setting, resolution of depression occurs in majority of patients with PsA within 1 year. Patients on t-DMARDs may experience better improvement in depression compared to other treatments. Future effectiveness studies warrant better definitions of depression and treatment response.AcknowledgementsAJM was supported by the National Psoriasis Foundation Fellowship grant.Disclosure of InterestsAshish Jacob Mathew Speakers bureau: Novartis, IPCA Laboratories, Grant/research support from: Novartis, IPCA Laboratories, Mitchell Sutton: None declared, Daniel Pereira: None declared, Dafna D Gladman Consultant of: AstraZeneca, Grant/research support from: AbbVie, Vinod Chandran Consultant of: AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Grant/research support from: AbbVie, Amgen and Eli-Lilly
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Mathew AJ, Sutton M, Pereira D, Gladman DD, Chandran V. Effectiveness of Disease Modifying Anti-Rheumatic Drugs for Enthesitis in a Prospective Longitudinal Psoriatic Arthritis Cohort. J Rheumatol 2022; 49:1020-1025. [PMID: 35649547 DOI: 10.3899/jrheum.211231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Our objective was to assess the effectiveness of conventional and targeted disease modifying anti-rheumatic drugs (cDMARDs and tDMARDs, respectively) in treating enthesitis in PsA. METHODS Patients with active enthesitis, defined as ≥1 tender entheses (of 29 sites included in the spondyloarthritis research consortium of Canada enthesitis index, the Leeds enthesitis index, and the Maastricht ankylosing spondylitis enthesitis score), enrolled in a large PsA cohort were included. Medications at baseline were classified into 3 mutually exclusive categories: 1.'no treatment/non-steroidal anti-inflammatory drugs (NSAIDs)', 2. 'cDMARDs±NSAIDs' and 3.'tDMARDs±cDMARDs/NSAIDs'. Complete resolution of enthesitis (no tender entheseal site) at 12 months was the primary outcome. Logistic regression models were developed to determine the association between medication category and enthesitis resolution. RESULTS Of the 1270 patients studied, 628(49.44%) had enthesitis; 526 patients (51.71% males; mean age (standard deviation, s.d.) - 49.02(13.12) years; mean enthesitis score (s.d.) 2.13(2.16) with adequate follow-up were analysed. Complete resolution of enthesitis was noted in 453(86%) patients, within a mean period of 8.73 months from baseline. In the regression analysis, though not significant, DMARDs (Categories 2 and 3) had higher odds ratio compared to category 1 for resolution of enthesitis. Enthesitis resolution was associated with lower joint activity (OR 0.97; 95% CI 0.95 - 0.99; p = 0.01) and male sex (OR 1.66; 95% CI 0.97 - 2.84; p = 0.06). CONCLUSION Resolution of enthesitis was observed in 86% of patients in an observational setting regardless of the medication used. Future effectiveness studies may warrant evaluation of enthesitis using advanced imaging.
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Affiliation(s)
- Ashish Jacob Mathew
- AJ Mathew DNB, DM Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. The Copenhagen Center for Arthritis and Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India. M Sutton MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. D Pereira MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. DD Gladman MD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. V Chandran DM, PhD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Potential conflicts of interest: None. Address for correspondence: Dr. Vinod Chandran, 1E416, Toronto Western Hospital, 399 Bathurst Street, Toronto Ontario, Canada, M5T2S8.
| | - Mitchell Sutton
- AJ Mathew DNB, DM Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. The Copenhagen Center for Arthritis and Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India. M Sutton MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. D Pereira MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. DD Gladman MD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. V Chandran DM, PhD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Potential conflicts of interest: None. Address for correspondence: Dr. Vinod Chandran, 1E416, Toronto Western Hospital, 399 Bathurst Street, Toronto Ontario, Canada, M5T2S8.
| | - Daniel Pereira
- AJ Mathew DNB, DM Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. The Copenhagen Center for Arthritis and Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India. M Sutton MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. D Pereira MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. DD Gladman MD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. V Chandran DM, PhD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Potential conflicts of interest: None. Address for correspondence: Dr. Vinod Chandran, 1E416, Toronto Western Hospital, 399 Bathurst Street, Toronto Ontario, Canada, M5T2S8.
| | - Dafna D Gladman
- AJ Mathew DNB, DM Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. The Copenhagen Center for Arthritis and Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India. M Sutton MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. D Pereira MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. DD Gladman MD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. V Chandran DM, PhD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Potential conflicts of interest: None. Address for correspondence: Dr. Vinod Chandran, 1E416, Toronto Western Hospital, 399 Bathurst Street, Toronto Ontario, Canada, M5T2S8.
| | - Vinod Chandran
- AJ Mathew DNB, DM Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. The Copenhagen Center for Arthritis and Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopedics, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India. M Sutton MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. D Pereira MSc Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. DD Gladman MD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. V Chandran DM, PhD, FRCPC Centre for Prognosis Studies in the Rheumatic Diseases, Psoriatic Arthritis Program, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto Ontario, Canada. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. Potential conflicts of interest: None. Address for correspondence: Dr. Vinod Chandran, 1E416, Toronto Western Hospital, 399 Bathurst Street, Toronto Ontario, Canada, M5T2S8.
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Aldabie G, Sutton M, Gladman DD. AB0929 Is there a correlation between skin severity and joint activity in Psoriatic Arthritis (PsA)? Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1650] [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: 11/04/2022]
Abstract
BackgroundThe majority if patients with PsA present with skin manifestations first. Few studies have examined the relationship between severity of skin and joint manifestations, but the results have been variable.ObjectivesTo assess the correlation between the extent and severity of skin psoriasis and musculoskeletal manifestations of PsA over time.MethodsThis study is a retrospective analysis of prospectively collected data at a single center cohort study of patients who enrolled within 12 months of PsA diagnosis from 2000-2020. Patients are assessed according to a standard protocol which includes demographics, clinical assessment including skin and joint assessments, laboratory evaluation at 6–12-month intervals and radiographs every 2 years. Skin severity is measured by the PASI score, joint disease severity is measured by the number of tender and swollen joints. Axial disease was defined by the presence of bilateral grade sacroiliitis or unilateral grade 3 or 4. The Bath Ankylosing Spondylitis Metrology Index (BASMI) was also measured. Spearman correlations were calculated between PASI scores and joint counts and BASMI (in patients with axial disease). Multivariable analysis was done using negative binomial model for the joint counts and a linear regression for BASMI. This preliminary analysis includes only the baseline information.Results397 patients were included. Characteristics are shown in the Table 1. There was a correlation significant correlation between PASI score and the active joint count (AJC) (ρ 0.14, p=0.0095), swollen joint count (ρ 0.15, p=0.0071). Among the patients with axial disease there was a strong correlation between the PASI and BASMI scores ((ρ 0.58, p=0.0001).Table 1.Baseline characteristics of 397 patientsVariableMean (SD)*, Number (%)** N=397Age (years)44.97 (13.01)*PsA duration (years)0.43 (0.66)*Psoriasis duration (years)14.64 (13.65)*Married236 (60.5)**Smoker ever193 (48.7)**Alcohol intake246 (62.3)**Employed309 (78.4)**Post secondary education277 (71.0)**BMI29.21 (8.85)*PASI6.11 (9.03)*Nail238 (61.2)**Active joint count (tender ± swollen)7.3 (13/15)*Swollen joint count2.96 (4.93)*Axial disease53 (17.8%)**Treatment level None/NSAIDS only272 (68.2)** DMARDS ± NSAIDs98 (24.7)** Biologics ± DMARDs27 (6.80)**Multivariable analysis for AJC revealed traditional DMARDs (0.85 p=0.000). PASI score when patients were on no therapy (0.02 p=0.01) and those on biologics 0.04 p<0.05) were associated with higher AJC. Similarly for swollen joints the use of traditional DMARDs (0.85 P0.00), and the PASI score in those taking biologic DMARDs (0.07 p=0.003) were associated with higher swollen joint count.In patients with axial disease Age (0/05, p=0.004), PASI score in patients on no treatment (0.06 p=0.000) or those taking biologics (0.28 p=0.000) were associated with higher BASMI scores.ConclusionIn patients presenting within 12 months of diagnosis of PsA, there is a correlation between the severity of skin and joint disease. Further studies will assess whether this correlation persists over time.AcknowledgementsThe Toronto Psoriatic Arthritis Research Program is supported by a grant from the Krembil Foundation.Disclosure of InterestsGhaydaa Aldabie: None declared, Mitchell Sutton: None declared, Dafna D Gladman Consultant of: AstraZeneca
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Finkelstein N, Dayam RM, Law J, Goetgebuer R, Chao G, Abe KT, Sutton M, Stempak JM, Pereira D, Croitoru D, Acheampong L, Rizwan S, Rymaszewski K, Milgrom R, Ganatra D, Batista NV, Girard M, Lau I, Law R, Cheung M, Rathod B, Kitaygorodsky J, Samson R, Hu Q, Haroon N, Inman R, Piguet V, Silverberg M, Grigras AC, Watts TH, Chandran V. POS1217 ANTI-TNF THERAPY FOR IMMUNE MEDIATED INFLAMMATORY DISEASES MAY BE ASSOCIATED WITH LOWER ANTIBODY LEVELS AND VIRUS NEUTRALIZATION EFFICACY FOLLOWING SARS-CoV-2 mRNA VACCINATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1667] [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: 11/03/2022]
Abstract
BackgroundThe impact of immunosuppressants on COVID-19 vaccination response and durability in patients with immune-mediated inflammatory diseases (IMID) is yet to be fully characterized. Humoral response may be attenuated in these patients especially those on B cell depleting therapy and higher doses of corticosteroids, but data regarding other immunosuppressants are scarce.ObjectivesWe aimed to investigate antibody and T cell responses and durability to SARS-CoV-2 mRNA vaccines (BNT162b and/or mRNA 1273) in IMID patients on immunomodulatory maintenance therapy other than B-cell depleting therapy and corticosteroids.MethodsThis prospective observational cohort study examined the immunogenicity of SARS-CoV-2 mRNA vaccines in adult patients with IMIDs (psoriatic arthritis, psoriasis, inflammatory bowel disease and rheumatoid arthritis) with or without maintenance immunosuppressive therapies (anti-TNF, methotrexate/azathioprine [MTX/AZA], anti-TNF + MTX/AZA, anti IL12/23, anti-IL-17, anti-IL23) compared to healthy controls. Automated ELISA for IgGs to spike trimer, spike receptor binding domain (RBD) and the nucleocapsid (NP) and T-cell release of 9 cytokines (IFNg, IL2, IL4, IL17A, TNF) and cytotoxic molecules (sFasL, GzmA, GzmB, Perforinin) in cell culture supernatants following stimulation with spike or NP peptide arrays were conducted at 4 time points: T1=pre vaccination, T2=median 26 days after dose 1, T3=median 16 days after dose 2 and T4=median 106 days after dose 2. Neutralization assays against four SARS-CoV-2 variants (wild type, delta, beta and gamma) were conducted at T3.ResultsWe followed 150 subjects: 26 healthy controls and 124 IMID patients: 9 untreated, 44 on anti-TNF, 16 on anti-TNF with MTX/AZA, 10 on anti-IL23, 28 on anti-IL12/23, 9 on anti-IL17, 8 on MTX/AZA (Table 1). Most patients mounted antibody and T cell responses with increases from dose 1 to dose 2 (100% seroconversion at T3) and some decline by T4, with variability within groups. Antibody levels and neutralization efficacy was lower in anti-TNFgroups (anti-TNF, anti-TNF + MTX/AZA) compared to controls and waned by T4 (Figure 1). T cell responses were not consistently different between groups. Pooled data showed a higher antibody response to mRNA-1273 compared to BNT162b.Table 1.Baseline characteristics of study participantsControluntreated IMIDAnti- TNFAnti- TNF +MTX/AZAAnti-IL-23Anti -IL-12/23Anti -IL-17MTX/AZAn=26n=9n=44n=16n=10n=28n=9n=8p-valueIMID*N/A IBD9301002704 Psoriasis1318122 PA0732172 AS0830010 RA1100011Age median years [IQR]36 [26-46]33 [27-41]38 [30-51]53 [44-59]48 [45-61]34 [28-47]49 [46-61]42 [31-55]<0.001^Sex male (%)16 (62)5 (56)18 (41)8 (50)5 (50)13 (46)6 (67)4 (50)0.772~BMImedian kg/m2 [IQR]25 [23-28]26 [22-27]22 [24-26]26 [24-28]27 [24-35]22 [21-24]32 [26-34]26[25-33]0.001^Vaccine interval median days [IQR]74 [35-84]54 [31-64]60 [45-69]64 [50-72]74 [35-84]62 [49-69]65 [52-75]58 [21-97]0.372^*multiple IMIDs per patient possibleFigure 1.Antibody responses (A) Anti spike and anti RBD IgG levels at indicated time points. Blue line represents median ratio in convalescent patients. The red line is the seropositivity threshold: the median antibody level of those that pass both a 1% false positive rate and show ≥3SD from the log means of the negative controls. (B) Relative ratio of RBD, spike and NP across time. Black and gray lines indicate median and mean values, respectively. *p≤0.05, **p≤0.01, ***p≤0.001, ****p≤0.0001ConclusionFollowing 2 doses of mRNA vaccination there is 100% seroconversion in IMID patients on maintenance therapy. Antibody levels and neutralization efficacy in anti-TNF group are lower than controls, and wane substantially by 3 months after dose 2. These findings highlight the need for third dose in patients undergoing treatment with anti-TNF therapy and continued monitoring of immunity in these patient groups, taking into consideration newer variants and additional vaccine doses.AcknowledgementsThis work was funded by a donation from Juan and Stefania Speck and by grants VR-1 172711, VS1-175545, FDN-143250, GA1- 177703 and GA2- 177716, from Canadian Institutes of Health Research and COVID Immunity task force and by Sinai Health FoundationDisclosure of InterestsNaomi Finkelstein: None declared, Roya M. Dayam: None declared, Jaclyn Law: None declared, Rogier Goetgebuer: None declared, Gary Chao: None declared, Kento T. Abe: None declared, Mitchell Sutton: None declared, Joanne M. Stempak: None declared, Daniel Pereira: None declared, David Croitoru: None declared, Lily Acheampong: None declared, Saima Rizwan: None declared, Klaudia Rymaszewski: None declared, Raquel Milgrom: None declared, Darshini Ganatra: None declared, Nathalia V. Batista: None declared, Melanie Girard: None declared, Irene Lau: None declared, Ryan Law: None declared, Michelle Cheung: None declared, Bhavisha Rathod: None declared, Julia Kitaygorodsky: None declared, Reuben Samson: None declared, Queenie Hu: None declared, Nigil Haroon: None declared, Robert Inman Consultant of: AbbVie, Janssen, Lilly, Novartis., Grant/research support from: AbbVie, Novartis, Vincent Piguet Consultant of: AbbVie, Almirall, Celgene, Janssen, Kyowa Kirin Co. Ltd, LEO Pharma,Novartis, Pfizer, Sanofi, UCB, and Union Therapeutic, Grant/research support from: Unrestricted educational grants from AbbVie, Bausch Health, Celgene, Janssen, LEO Pharma, Lilly, L’Oréal, NAOS, Novartis, Pfizer, Pierre-Fabre, Sandoz, and Sanofi, Mark Silverberg Speakers bureau: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Consultant of: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Grant/research support from: AbbVie, Janssen, Takeda, Pfizer, Gilead and Amgen, Anne-Claude Grigras: None declared, Tania H. Watts: None declared, Vinod Chandran Consultant of: AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, Pfizer and UCB, Grant/research support from: AbbVie, Amgen, Eli-Lilly.
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Choquette D, Chandran V, Laliberté MC, Fournier PA, Girard T, Sutton M, Gladman DD. AB0895 Residual burden and disease activity of Canadian PsA patients treated with advanced therapies: preliminary results from a multiple registry analysis (UNISON-PsA). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1606] [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: 11/04/2022]
Abstract
BackgroundGiven the availability of advanced therapies in PsA with different modes of action, it is of interest to characterize their impact on overall clinical outcomes.ObjectivesTo describe residual disease activity in Canadians with PsA treated with advanced therapies.MethodsMulti-region, observational, retrospective analysis of data from Rhumadata (Quebec) and International Psoriasis and Arthritis Research Team (IPART) Canadian registries was performed. Data from each registry and region were analyzed separately using a common statistical analysis plan to generate descriptive statistics. Patients included in the registries were eligible if they were adults at the time of PsA diagnosis and were treated with an advanced therapy for ≥6 months initiated between January 2010 and December 2019. Residual disease activity was defined as failing to achieve MDA (defined as achieving ≥5 of: TJC ≤1; SJC ≤1; PASI ≤1 or BSA ≤3%; patient pain VAS score of ≤15 mm; patient global disease activity VAS score of ≤20 mm; HAQ score ≤0.5; and tender entheseal points ≤1) (primary endpoint), or DAPSA score ≥14 (secondary endpoint) within 6 months of initiation of an advanced therapy (TNFi, IL-12/23i, IL-17i, PDE4i, CTLA4i or JAKi).Results1,866 subjects (Atlantic [IPART; Newfoundland]: N=83; Quebec [Rhumadata]: N=687; Ontario [IPART]: N=966; West [IPART; British Columbia, Manitoba]: N=130) were included in this preliminary analysis. Baseline characteristics are presented in Table 1. Overall, 899 were receiving their 1st advanced therapy, 464 were receiving their 2nd, and 264 had received ≥3. The most common therapy class was TNFi, followed by IL-17i. 18/21 (85.7%) subjects in the Atlantic region with an assessment, 184/246 (74.8%) in Quebec, 391/571 (68.1%) in Ontario, and 30/43 (69.8%) in Western Canada failed to achieve MDA within 6 months following advanced therapy initiation. Failure to achieve MDA within the allotted period was higher among patients receiving an IL-17i compared with a TNFi. There was no appreciable effect of lines of therapy. Also, 74 of 110 (67.3%) patients with an assessment in Quebec, 201/365 (55.1%) in Ontario and 3/3 (100%) in the West failed to achieve at least low disease activity (LDA; DAPSA ≤14) within 6 months following initiation of an advanced therapy. Data were not available for the Atlantic region. The proportion of patients not achieving LDA by advanced therapy was similar for those receiving a TNFi and IL-17i but increased with line of therapy.Table 1.Patient demographic and baseline characteristics, and response to treatmentAtlantic (N=83)Quebec (N=687)Ontario (N=966)West (N=130)Age (years, mean [SD])50.3 (11.1)50.7 (12.1)49.1 (12.9)46.7 (12.1)Female (n [%])44/83 (53.0)346/687 (50.4)427/966 (44.2)81/128 (62.3)BMI (kg/m2, n, mean [SD])15, 30.8 (3.6)553, 29.6 (6.6)579, 30.6 (6.9)45, 32.8 (10.6)Time since diagnosis (years, N, mean [SD])83, 8.7 (8.7)687, 7.1 (7.9)895, 11.7 (11.1)74, 11.7 (8.9)HLA-B27 positive (n/N [%])N/A58/335 (17.3)86/648 (13.3)N/APresence of EAMs (n/N [%])4/44 (9.1)27/687 (3.9)65/693 (9.4)2/33 (6.1%)Fulfillment of CASPAR (n/N [%])N/A391/687 (56.9)100/100 (100)N/ATherapy class (n [%]):*TNFi66 (79.5)478 (69.6)651 (67.3)104 (80.0)IL-17i11 (13.3)106 (15.4)191 (19.9)21 (16.2)IL-12/23i6 (7.2)33 (4.8)124 (12.9)5 (3.9)PDE4i48 (7.0)Other22 (3.2)Failure to achieve MDA within 6 months of starting therapy (n/N [%])**18/21 (87.5)184/246 (74.8)391/571 (68.1)30/43 (69.8)Failure to achieve DAPSA ≤14 within 6 months of starting therapy (n/N [%])**N/A74/110 (67.3)201/365 (55.1)3/3 (100.0)*Patients may be taking >1 advanced therapy, **Not all patients had assessments of disease activity.ConclusionPreliminary data show approximately three quarters of Canadians with PsA failed to achieve MDA or LDA within 6 months of initiating an advanced therapy. Disease duration is a possible explanation for not achieving MDA or LDA; better therapeutic approaches are needed to achieve these outcomes in patients with PsA.AcknowledgementsThe authors wish to thank Dr. Steve Ramkissoon, for supporting the statistical analysis of the IPART registry. Medical writing and statistical support (funded by Abbvie) were provided by John Howell and Hong Chen, respectively, from McDougall Scientific. Financial support for the study was provided by AbbVie. AbbVie participated in the design of the study, interpretation of data, review, and approval of this publication. All authors contributed to the development of the publication and maintained control over the final content.Disclosure of InterestsDenis Choquette Speakers bureau: Amgen, Abbvie, CIHR, Novartis, Pfizer, Fresenius-Kabi, Eli Lilly, Sandoz, Tevapharm, Consultant of: Amgen, Abbvie, CIHR, Novartis, Pfizer, Fresenius-Kabi, Eli Lilly, Sandoz, Tevapharm, Grant/research support from: Rhumadata is supported through grants and research contracts from Amgen, Abbvie, CIHR, Novartis, Pfizer, Fresenius-Kabi, Eli Lilly, Sandoz, Tevapharm., Vinod Chandran Consultant of: AbbVie, Amgen, BMS, Eli Lilly, Janssen, Novartis, UCB, Pfizer, Employee of: Spouse is an employee of AstraZeneca, Marie-Claude Laliberté Shareholder of: AbbVie Corp., Employee of: AbbVie Corp., Pierre-André Fournier Shareholder of: AbbVie Corp., Employee of: AbbVie Corp., Tanya Girard Shareholder of: AbbVie Corp., Employee of: AbbVie Corp., Mitchell Sutton: None declared, Dafna D Gladman Consultant of: AbbVie, Amgen, BMS, Galapagos, Gilead, Eli Lilly, Janssen Novartis, Pfizer, UCB, Grant/research support from: AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, UCB
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Mollayeva T, Tran A, Chan V, Colantonio A, Sutton M, Escobar MD. Decoding health status transitions of over 200 000 patients with traumatic brain injury from preceding injury to the injury event. Sci Rep 2022; 12:5584. [PMID: 35379824 PMCID: PMC8980052 DOI: 10.1038/s41598-022-08782-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 02/28/2022] [Indexed: 11/17/2022] Open
Abstract
For centuries, the study of traumatic brain injury (TBI) has been centred on historical observation and analyses of personal, social, and environmental processes, which have been examined separately. Today, computation implementation and vast patient data repositories can enable a concurrent analysis of personal, social, and environmental processes, providing insight into changes in health status transitions over time. We applied computational and data visualization techniques to categorize decade-long health records of 235,003 patients with TBI in Canada, from preceding injury to the injury event itself. Our results highlighted that health status transition patterns in TBI emerged along with the projection of comorbidity where many disorders, social and environmental adversities preceding injury are reflected in external causes of injury and injury severity. The strongest associations between health status preceding TBI and health status at the injury event were between multiple body system pathology and advanced age-related brain pathology networks. The interwoven aspects of health status on a time continuum can influence post-injury trajectories and should be considered in TBI risk analysis to improve prevention, diagnosis, and care.
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Wilding A, Munford LA, Sutton M. Predictors of social participation: evidence from repeated cross-sectional population surveys in England. J Public Health (Oxf) 2022:6550292. [PMID: 35301537 DOI: 10.1093/pubmed/fdac029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/25/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social participation is linked to better health and well-being. However, there is limited research on the individual and area-level predictors of participation. This study aims to determine the characteristics associated with participation, particularly the impact of community asset availability. METHODS We used data from 34 582 adult respondents to the nationally representative Community Life Survey from 2013 to 2018. We measured social participation by reported participation in 15 types of groups. We used probit and negative binomial regression models and included a wide range of individual, household and area characteristics, and availability of 14 types of community assets. RESULTS The following characteristics were associated with higher levels of participation: being female (+3.0 percentage points (p.p.) (95% CI 1.8 to 4.1p.p.), Black, Asian or Minority Ethnicity (+3.7p.p. (1.9 to 5.5p.p.)), homeownership (+4.1 p.p. (2.7 to 5.6p.p.)) and living in a rural area (+2.1p.p. (0.5 to 3.6p.p)). Respondents from the most deprived areas were less likely to participate than those in average deprivation areas (-3.9p.p. (-5.9 to -1.99p.p.)). Higher availability of community assets was associated with increased participation in groups. The effect of availability on participation varied by type of asset. CONCLUSION Improving community assets infrastructure in high deprivation and urban areas would encourage more social participation in these areas.
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Affiliation(s)
- A Wilding
- Health Organisation, Policy and Economics, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
| | - L A Munford
- Health Organisation, Policy and Economics, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK
| | - M Sutton
- Health Organisation, Policy and Economics, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK.,Melbourne Institute: Applied Economic and Social Research, University of Melbourne, Melbourne, VIC 3010, Australia
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Taylor JH, Deo M, Sutton M, Chandran V, Shanmugarajah S, Pereira D, Gladman DD, Rosen CF. Assessment of the Toronto Psoriatic Arthritis Screen 2 as a Screening Tool for Psoriasis. J Cutan Med Surg 2021; 26:237-242. [PMID: 34841919 DOI: 10.1177/12034754211061085] [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: 11/15/2022]
Abstract
BACKGROUND Psoriasis is a chronic inflammatory disease affecting multiple organ systems and resulting in reduced quality of life for many patients. A screening tool would be useful, particularly in underserviced or research settings with limited access to dermatologists. The Toronto Psoriatic Arthritis Screen, version 2 (ToPAS 2) is a validated screening tool for psoriatic arthritis containing questions specific for psoriasis. OBJECTIVES To evaluate the performance of skin-specific questions from ToPAS 2 for the diagnosis of psoriasis. METHODS Participants aged >18 were recruited from Dermatology and Family Medicine clinics and completed the ToPAS 2 questionnaire prior to being examined by a dermatologist for psoriasis. Two scoring indexes were derived from the ToPAS 2 skin-related questions using backward selection regression models. Statistical analysis was performed using receiver operating characteristic (ROC) curves to measure their performances. RESULTS Two hundred and fifty eight participants were recruited. 32 (12%) were diagnosed with psoriasis by dermatologist assessment. Index 1 includes all 5 skin-related questions from ToPAS 2, while Index 2 includes three of the five questions. Both indexes demonstrate high specificity (82% to 92%), sensitivity (69% to 84%), and excellent negative predictive value (NPV) (>95%) for a diagnosis of psoriasis. The overall discriminatory power of these models is 0.823 (Index 1) and 0.875 (Index 2). CONCLUSIONS Skin-related questions from ToPAS 2 have discriminatory value in detecting psoriasis, specifically questions relating to a family history, a prior physician diagnosis of psoriasis or a rash consistent with images of plaque psoriasis. This study is a valuable step in developing a screening tool for psoriasis.
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Affiliation(s)
- Jennifer H Taylor
- 26625 Division of Dermatology, Department of Medicine, Toronto Western Hospital, ON, Canada
| | - Maneka Deo
- 26625 Division of Dermatology, Department of Medicine, Toronto Western Hospital, ON, Canada
| | - Mitchell Sutton
- 574808 Department of Rheumatology, Toronto Western Hospital, ON, Canada
| | - Vinod Chandran
- 574808 Department of Rheumatology, Toronto Western Hospital, ON, Canada
| | | | - Daniel Pereira
- 574808 Department of Rheumatology, Toronto Western Hospital, ON, Canada
| | - Dafna D Gladman
- 574808 Department of Rheumatology, Toronto Western Hospital, ON, Canada
| | - Cheryl F Rosen
- 26625 Division of Dermatology, Department of Medicine, Toronto Western Hospital, ON, Canada
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Chan V, Hurst M, Petersen T, Liu J, Mollayeva T, Colantonio A, Sutton M, Escobar M. A Population-Based Sex-Stratified Study to Understand How Health Status Preceding Traumatic Brain Injury Affects Direct Medical Cost. Arch Phys Med Rehabil 2021. [DOI: 10.1016/j.apmr.2021.07.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chan V, Sutton M, Mollayeva T, Escobar M, Hurst M, Colantonio A. A Population-Based Sex-Stratified Study to Understand How Health Status Preceding Traumatic Brain Injury Affects Functional Outcome. Arch Phys Med Rehabil 2021. [DOI: 10.1016/j.apmr.2021.07.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hanafy S, Xiong C, Chan V, Sutton M, Escobar M, Colantonio A, Mollayeva T. Comorbidity in traumatic brain injury and functional outcomes: a systematic review. Eur J Phys Rehabil Med 2021; 57:535-550. [PMID: 33541041 PMCID: PMC10396401 DOI: 10.23736/s1973-9087.21.06491-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Comorbidities in people with traumatic brain injury (TBI) may negatively impact injury recovery course and result in long-term disability. Despite the high prevalence of several categories of comorbidities in TBI, little is known about their association with patients' functional outcomes. We aimed to systematically review the current evidence to identify comorbidities that affect functional outcomes in adults with TBI. EVIDENCE ACQUISITION A systematic search of Medline, Cochrane Central Register of Controlled Trials, Embase and PsycINFO was conducted from 1997 to 2020 for prospective and retrospective longitudinal studies published in English. Three researchers independently screened and assessed articles for fulfillment of the inclusion criteria. Quality assessment followed the Quality in Prognosis Studies tool and the Scottish Intercollegiate Guidelines Network methodology recommendations. EVIDENCE SYNTHESIS Twenty-two studies of moderate quality discussed effects of comorbidities on functional outcomes of patients with TBI. Cognitive and physical functioning were negatively affected by comorbidities, although the strength of association, even within the same categories of comorbidity and functional outcome, differed from study to study. Severity of TBI, sex/gender, and age were important factors in the relationship. Due to methodological heterogeneity between studies, meta-analyses were not performed. CONCLUSIONS Emerging evidence highlights the adverse effect of comorbidities on functional outcome in patients with TBI, so clinical attention to this topic is timely. Future research on the topic should emphasize time of comorbidity onset in relation to the TBI event, to support prevention, treatment, and rehabilitation. PROSPERO registration (CRD 42017070033).
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Affiliation(s)
- Sara Hanafy
- Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada - .,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada - .,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada -
| | - Chen Xiong
- Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Vincy Chan
- Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Mitchell Sutton
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Michael Escobar
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Angela Colantonio
- Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Tatyana Mollayeva
- Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
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Kwok TSH, Sutton M, Yang Ye J, Pereira D, Chandran V, Gladman DD. Prevalence and factors associated with osteoporosis and bone mineral density testing in psoriatic arthritis. Arthritis Care Res (Hoboken) 2020; 74:1006-1012. [PMID: 33326187 DOI: 10.1002/acr.24538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 10/17/2020] [Accepted: 12/10/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To determine bone mineral density (BMD) in psoriatic arthritis (PsA) patients, factors associated with undergoing BMD testing, and the effect of PsA clinical activity on BMD. METHODS Patients attending the University of Toronto PsA Clinic with a BMD from cohort inception to January 2019 were included. Descriptive statistics summarized lumbar spine, femoral neck and total hip T-scores. Cox proportional hazard regression identified predictors for BMD testing. Logistic regression analysis determined odds of having normal (T-score ≥ -1.0) versus osteoporotic range BMD (T-score ≤ -2.5). A multi-state model determined factors associated with BMD state changes over time. RESULTS Of the 1479 patients, 214 had BMDs. Mean T-scores at the lumbar spine, femoral neck and total hip were -0.30±0.32, -1.10±1.04 and -0.45±0.42 respectively. Osteopenia and osteoporosis occurred in 45.27% and 12.94% of patients. Increasing age, menopause, elevated acute phase reactants, biologic, methotrexate and systemic glucocorticoid use were associated with a higher chance of undergoing BMD testing. Increased BMI and biologic use were associated with a lower chance of having osteoporotic range BMD. In multi-state analysis, polyarthritis may portend lower BMDs over time, although this did not achieve statistical significance due to low patient numbers. CONCLUSIONS The prevalence of osteopenia and osteoporosis in the PsA cohort were similar to the general population. Clinicians are using osteoporosis risk factors and PsA disease severity markers to select patients for BMD testing. Polyarticular disease may portend worse BMDs. Biologic use and increased BMI appear to have a protective effect.
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Affiliation(s)
- Timothy S H Kwok
- Department of Medicine Temerty Faculty of Medicine, University of Toronto, Ontario, Canada, Toronto
| | - Mitchell Sutton
- Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Justine Yang Ye
- Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Daniel Pereira
- Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Vinod Chandran
- Department of Medicine Temerty Faculty of Medicine, University of Toronto, Ontario, Canada, Toronto.,Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Schroeder Arthritis Institute, Krembil Research Institute, University Health Network.,Division of Rheumatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada, Toronto.,Institute of Medical Science, University of Toronto, Ontario, Canada, Toronto
| | - Dafna D Gladman
- Department of Medicine Temerty Faculty of Medicine, University of Toronto, Ontario, Canada, Toronto.,Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Schroeder Arthritis Institute, Krembil Research Institute, University Health Network.,Division of Rheumatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada, Toronto.,Institute of Medical Science, University of Toronto, Ontario, Canada, Toronto
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Goodwin M, Whittaker W, Walsh T, Emsley R, Sutton M, Tickle M, Kelly M, Pretty I. Recruitment and Consent in an observational study. Community Dent Health 2020; 37:287-292. [PMID: 33026721 DOI: 10.1922/cdh_000682020goodwin06] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The study sought to explore the consent rate and associated potential bias across a cohort in a large longitudinal population based study. RESEARCH DESIGN Data were taken from a study designed to examine the effects of the reintroduction of community water fluoridation on children's oral health over a five-year period. Children were recruited from a fluoridated and non-fluoridated area in Cumbria, referred to as Group 1 and Group 2. RESULTS Data were available for 3138 individuals. The consent rate was 12.91 percentage points lower in Group 2 than Group 1 (95% CI -16.27 to -9.56, p⟨0.001). The population in Group 2 was more deprived (higher Index of Multiple Deprivation (IMD)) than Group 1 before consent was taken. Consent was not associated with deprivation in either group. CONCLUSION The cohort appeared to be unaffected by IMD-related non-consent. However there was a difference in consent rate between the two groups. With the population in Group 1 being more deprived than Group 2, it will be important to incorporate these differences into the analysis at the end of this longitudinal study.
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Affiliation(s)
- M Goodwin
- University of Manchester, School of Dentistry, UK
| | - W Whittaker
- University of Manchester, Population Health, Health Services Research & Primary Care, UK
| | - T Walsh
- University of Manchester, School of Dentistry, UK
| | - R Emsley
- King's College London, Psychiatry, Psychology & Neuroscience, UK
| | - M Sutton
- University of Manchester, Population Health, Health Services Research & Primary Care, UK
| | - M Tickle
- University of Manchester, School of Dentistry, UK
| | - M Kelly
- University of Cambridge, Public Health, UK
| | - I Pretty
- University of Manchester, School of Dentistry, UK
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Chan V, Hurst M, Petersen T, Liu J, Mollayeva T, Colantonio A, Sutton M, Escobar MD. A population-based sex-stratified study to understand how health status preceding traumatic brain injury affects direct medical cost. PLoS One 2020; 15:e0240208. [PMID: 33048973 PMCID: PMC7553294 DOI: 10.1371/journal.pone.0240208] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/23/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To understand how pre-injury health status present five-years preceding traumatic brain injury (TBI) affects direct medical cost two years post-injury. METHODS Patients age ≥19 years in the emergency department (ED) or acute care for a TBI between April 1, 2007 and March 31, 2014 in Ontario, Canada (N = 55,669) were identified from population-based health administrative data. Forty-three factors of pre-injury health status (i.e., comorbidities and personal, social, and environmental factors) that were internally validated for the TBI population were assessed in this study. The outcome of interest was direct medical cost within two years of discharge. Sex-specific multivariable linear regressions were conducted to understand the associations between direct medical cost within two years of discharge and pre-injury health status. RESULTS Patients who received care in the ED (81.9% of total sample) incurred a median cost of $2,492/male patient (average $12,342/patient) and $3,508/female patient (average $65,285/patient) within two years of injury; 37 pre-injury factors were significantly associated with increased direct medical costs. Patients who first received care for their TBI in acute care (18.1%) incurred a median cost of $25,081/male patient (average $63,060/patient) and $30,277/female patient (average $65,285/patient) within two years of injury; 21 factors were significantly associated with increased direct medical costs. Among more prevalent factors, those associated with increased medical cost by at least 50% included mental health disorders, substance abuse, disorders or medical conditions frequently observed among the elderly, cardiovascular disorders, stroke and emergencies involving the brain, metabolic disorders and abdominal symptoms, conditions and symptoms of abdomen and pelvis, genitourinary disorders and disorders of prostate, and pulmonary abdominal and other emergencies. CONCLUSIONS Direct medical costs two years post-TBI differed significantly between patients with and without adverse pre-existing health status. Interdisciplinary teams to promote early identification of pre-existing health conditions and appropriate management and integration of these conditions in TBI care across the continuum of healthcare may be opportunities to reduce direct medical costs post-injury.
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Affiliation(s)
- Vincy Chan
- KITE-Toronto Rehab, University Health Network, Toronto, Ontario, Canada
- * E-mail:
| | - Mackenzie Hurst
- KITE-Toronto Rehab, University Health Network, Toronto, Ontario, Canada
| | - Tierza Petersen
- KITE-Toronto Rehab, University Health Network, Toronto, Ontario, Canada
| | - Jingqian Liu
- KITE-Toronto Rehab, University Health Network, Toronto, Ontario, Canada
| | - Tatyana Mollayeva
- KITE-Toronto Rehab, University Health Network, Toronto, Ontario, Canada
| | - Angela Colantonio
- KITE-Toronto Rehab, University Health Network, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Mitchell Sutton
- KITE-Toronto Rehab, University Health Network, Toronto, Ontario, Canada
| | - Michael D. Escobar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Mollayeva T, Hurst M, Chan V, Escobar M, Sutton M, Colantonio A. Pre-injury health status and excess mortality in persons with traumatic brain injury: A decade-long historical cohort study. Prev Med 2020; 139:106213. [PMID: 32693173 PMCID: PMC7494568 DOI: 10.1016/j.ypmed.2020.106213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/15/2020] [Accepted: 07/11/2020] [Indexed: 11/18/2022]
Abstract
An increasing number of patients are able to survive traumatic brain injuries (TBIs) with advanced resuscitation. However, the role of their pre-injury health status in mortality in the following years is not known. Here, we followed 77,088 consecutive patients (59% male) who survived the TBI event in Ontario, Canada for more than a decade, and examined the relationships between their pre-injury health status and mortality rates in excess to the expected mortality calculated using sex- and age-specific life tables. There were 5792 deaths over the studied period, 3163 (6.95%) deaths in male and 2629 (8.33%) in female patients. The average excess mortality rate over the follow-up period of 14 years was 1.81 (95% confidence interval = 1.76-1.86). Analyses of follow-up time windows showed different patterns for the average excess rate of mortality following TBI, with the greatest rates observed in year one after injury. Among identified pre-injury comorbidity factors, 33 were associated with excess mortality rates. These rates were comparable between sexes. Additional analyses in the validation dataset confirmed that these findings were unlikely a result of TBI misclassification or unmeasured confounding. Thus, detection and subsequent management of pre-injury health status should be an integral component of any strategy to reduce excess mortality in TBI patients. The complexity of pre-injury comorbidity calls for integration of multidisciplinary health services to meet TBI patients' needs and prevent adverse outcomes.
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Affiliation(s)
- Tatyana Mollayeva
- KITE-Toronto Rehabilitation Institute, University Health Network, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada.
| | - Mackenzie Hurst
- KITE-Toronto Rehabilitation Institute, University Health Network, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada
| | - Vincy Chan
- KITE-Toronto Rehabilitation Institute, University Health Network, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada
| | - Michael Escobar
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - Mitchell Sutton
- KITE-Toronto Rehabilitation Institute, University Health Network, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada
| | - Angela Colantonio
- KITE-Toronto Rehabilitation Institute, University Health Network, Canada; Acquired Brain Injury Research Lab, University of Toronto, Canada; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Canada; ICES Institute for Clinical Evaluative Sciences, Canada; Occupational Science & Occupational Therapy, University of Toronto, Canada
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Chatzi G, Mason T, Chandola T, Whittaker W, Howarth E, Cotterill S, Ravindrarajah R, McManus E, Sutton M, Bower P. Sociodemographic disparities in non-diabetic hyperglycaemia and the transition to type 2 diabetes: evidence from the English Longitudinal Study of Ageing. Diabet Med 2020; 37:1536-1544. [PMID: 32531074 DOI: 10.1111/dme.14343] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2020] [Indexed: 01/05/2023]
Abstract
AIM To explore whether there are social inequalities in non-diabetic hyperglycaemia (NDH) and in transitions to type 2 diabetes mellitus and NDH low-risk status in England. METHODS Some 9143 men and women aged over 50 years were analysed from waves 2, 4, 6 and 8 (2004-2016) of the English Longitudinal Study of Ageing (ELSA). Participants were categorized as: NDH 'low-risk' [HbA1c < 42 mmol/mol (< 6.0%)], NDH [HbA1c 42-47 mmol/mol (6.0-6.4%)] and type 2 diabetes [HbA1c > 47 mmol/mol (> 6.4%)]. Logistic regression models estimated the association between sociodemographic characteristics and NDH, and the transitions from NDH to diagnosed or undiagnosed type 2 diabetes and low-risk status in future waves. RESULTS NDH was more prevalent in older participants, those reporting a disability, those living in deprived areas and in more disadvantaged social classes. Older participants with NDH were less likely to progress to undiagnosed type 2 diabetes [odds ratio (OR) 0.27, 95% confidence interval (CI) 0.08, 0.96]. NDH individuals with limiting long-standing illness (OR 1.72, 95% CI 1.16, 2.53), who were economically inactive (OR 1.60, 95% CI 1.02, 2.51) or from disadvantaged social classes (OR 1.63, 95% CI 1.02, 2.61) were more likely to progress to type 2 diabetes. Socially disadvantaged individuals were less likely (OR 0.64, 95% CI 0.41, 0.98) to progress to NDH low-risk status. CONCLUSIONS There were socio-economic differences in NDH prevalence, transition to type 2 diabetes and transition to NDH low-risk status. Disparities in transitions included the greater likelihood of disadvantaged social groups with NDH developing type 2 diabetes and greater likelihood of advantaged social groups with NDH becoming low-risk. These socio-economic differences should be taken into account when targeting prevention initiatives.
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Affiliation(s)
- G Chatzi
- Manchester Centre for Health Economics, University of , Manchester, UK
| | - T Mason
- Manchester Centre for Health Economics, University of , Manchester, UK
| | - T Chandola
- Cathie Marsh Institute for Social Research, University of Manchester, Manchester, UK
| | - W Whittaker
- Manchester Centre for Health Economics, University of , Manchester, UK
| | - E Howarth
- Manchester Centre for Health Economics, University of , Manchester, UK
| | - S Cotterill
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - R Ravindrarajah
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
| | - E McManus
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
| | - M Sutton
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
| | - P Bower
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
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Lal J, Lurio LB, Liang D, Narayanan S, Darling SB, Sutton M. Universal dynamics of coarsening during polymer-polymer thin-film spinodal dewetting kinetics. Phys Rev E 2020; 102:032802. [PMID: 33076025 DOI: 10.1103/physreve.102.032802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/23/2020] [Indexed: 06/11/2023]
Abstract
The dewetting dynamics of a supported bilayer polymer thin film on a solid substrate is investigated using grazing incidence x-ray photon correlation spectroscopy. We find that the top layer dewets via the spinodal mechanism. The kinetics of the dewetting is studied by monitoring the time evolution of the surface diffuse x-ray scattering intensity. We study the time evolution of fluctuations about the average surface structure by measuring the two-time x-ray intensity fluctuation correlation functions. Using these two-time correlation functions we quantify the crossover from early-time diffusive dynamics to hydrodynamics. The early diffusive regime satisfies dynamic universality. The two-time correlation functions also quantify the onset of hydrodynamic effects. The hydrodynamic regime is observed during the spinodal dewetting process as these interactions are not screened.
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Affiliation(s)
- J Lal
- Materials Science Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
- Intense Pulsed Neutron Source, Argonne National Laboratory, Argonne, Illinois 60439, USA
- Department of Physics, Northern Illinois University, DeKalb, Illinois 60115, USA
| | - L B Lurio
- Department of Physics, Northern Illinois University, DeKalb, Illinois 60115, USA
| | - D Liang
- Intense Pulsed Neutron Source, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - S Narayanan
- X-ray Science Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - S B Darling
- Chemical Sciences and Engineering, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M Sutton
- Physics Department, McGill University, Montréal, H3A 2T8, Canada
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Chan V, Sutton M, Mollayeva T, Escobar MD, Hurst M, Colantonio A. Data Mining to Understand How Health Status Preceding Traumatic Brain Injury Affects Functional Outcome: A Population-Based Sex-Stratified Study. Arch Phys Med Rehabil 2020; 101:1523-1531. [PMID: 32544398 DOI: 10.1016/j.apmr.2020.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 09/05/2019] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To understand how health status preceding traumatic brain injury (TBI) affects relative functional gain after inpatient rehabilitation using a data mining approach. DESIGN Population-based, sex-stratified, retrospective cohort study using health administrative data from Ontario, Canada (39% of the Canadian population). SETTING Inpatient rehabilitation. PARTICIPANTS Patients 14 years or older (N=5802; 63.4% male) admitted to inpatient rehabilitation within 1 year of a TBI-related acute care discharge between April 1, 2008, and March 31, 2015. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Relative functional gain (RFG) in percentage, calculated as ([discharge FIM-admission FIM]/[126-admission FIM]×100). Health status prior to TBI was identified and internally validated using a data mining approach that categorized all International Classification of Diseases, 10th revision, codes for each patient. RESULTS The average RFG was 52.8%±27.6% among male patients and 51.6%±27.1% among female patients. Sex-specific Bonferroni adjusted multivariable linear regressions identified 10 factors of preinjury health status related to neurology, emergency medicine, cardiology, psychiatry, geriatrics, and gastroenterology that were significantly associated with reduced RFG in FIM for male patients. Only 1 preinjury health status category, geriatrics, was significantly associated with RFG in female patients. CONCLUSIONS Comorbid health conditions present up to 5 years preceding the TBI event were significantly associated with RFG. These findings should be considered when planning and executing interventions to maximize functional gain and to support an interdisciplinary approach. Best practices guidelines and clinical interventions for older male and female patients with TBI should be developed given the increasingly aging population with TBI.
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Affiliation(s)
- Vincy Chan
- KITE-Toronto Rehab, University Health Network, Toronto, Ontario.
| | - Mitchell Sutton
- KITE-Toronto Rehab, University Health Network, Toronto, Ontario
| | | | - Michael D Escobar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
| | - Mackenzie Hurst
- KITE-Toronto Rehab, University Health Network, Toronto, Ontario
| | - Angela Colantonio
- KITE-Toronto Rehab, University Health Network, Toronto, Ontario; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario; Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario; ICES, Toronto, Ontario, Canada
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Björklund E, Pallaroni L, Holst CV, Unglaub W, Bosch J, Calderon-Alvarez F, Costa J, Cowles J, Gaede W, Krause M, Marmo S, Pecoraro S, Reaney S, Sutton M, Thiele D, Wolf C. Method of Determination of Appropriate Heat Treatment of Animal Meal by Immunoassay Developed for Detection of Cooked Beef: Interlaboratory Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/84.6.1839] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
An interlaboratory trial was conducted for the validation of an enzyme-linked immunosorbent assay (ELISA) method for determination of appropriate heat treatment of animal meal. A commercially available ELISA test kit developed for the identification of beef in cooked food was used in the study. Twelve laboratories from 7 European countries examined 2 different analytical protocols to establish the most appropriate analytical method. Three different samples were used, 2 animal waste materials sterilized at 129 and 134°C (wet conditions), respectively, and a meat and bone meal material processed at dry conditions (maximum temperature, 140°C). Statistical evaluation applying t-statistics showed that the animal meal treated according to European legislation (>133°C) was clearly distinguishable from the 2 other test materials at a 99% confidence level using both analytical protocols. This method can be considered as a complementary test to the immunoassay developed for the detection of pork in cooked food that is already applied in routine analysis for the surveillance of rendering plants.
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Affiliation(s)
- Erland Björklund
- European Commission, Joint Research Centre, Food Products and Consumer Goods Unit, I-21020 Ispra (VA), Italy
| | - Lea Pallaroni
- European Commission, Joint Research Centre, Food Products and Consumer Goods Unit, I-21020 Ispra (VA), Italy
| | - Christoph von Holst
- European Commission, Joint Research Centre, Food Products and Consumer Goods Unit, I-21020 Ispra (VA), Italy
| | - Wolfgang Unglaub
- Staatliches Tieraerztliches Untersuchungsamt Aulendorf, Centre for Diagnostic Baden-Wuerttemberg, Loewenbreitestrasse 18-20, D-88326 Aulendorf, Germany
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Lipp M, Anklam E, Stave JW, Bahrs-Windsberger J, Barreto Crespo MT, Benvenuto E, Berben G, Brignon P, Busch U, Cordes C, Eklund E, El Jaziri M, Engel KH, Eriksen F, Eriksson S, Felinger A, Fogher C, Folch I, Garrett S, Hischenhuber C, Hörtner H, Jany KD, Krska R, Kruse L, Kuiper HA, Lobre C, Miraglia M, Mhller W, Nunes Costa JM, Oliveira L, Patel P, Pietsch K, Pöpping B, Remler P, Rentsch J, Schulze M, Sutton M, van Duijn G, van Kan F, Wurz A. Validation of an Immunoassay for Detection and Quantitation of a Genetically Modified Soybean in Food and Food Fractions Using Reference Materials: Interlaboratory Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/83.4.919] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
An immunoassay for detection of a specific genetically modified soybean (Roundup-Ready®) was validated on dried soybean powder in an interlaboratory study. Different percentages of genetically modified soybeans in nonmodified soybean matrix were evaluated in a blind study. Thirty-eight laboratories from 13 countries participated. The immunoassay was evaluated for 2 endpoints: (1) To give a semiquantitative result, i.e., determination of a given sample above or below a given threshold, or (2) to compute a quantitative result, i.e., percentage of genetically modified soybeans in the sample. Semiquantitative results showed that a given sample which contained <2% genetically modified soybeans was identified as below 2% with a 99% confidence level. Quantitative use of the assay resulted in a repeatability (r) and reproducibility (R) that were computed to be RSDr = 7% and RSDR = 10%, respectively, for a sample containing 2% genetically modified soybeans. Application of this method depends on availability of appropriate reference materials for a specific food matrix. Only matrix-matched reference materials can be used for analysis of food or food fractions.
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Affiliation(s)
- Markus Lipp
- European Commission, Joint Research Center, Institute for Health and Consumer Protection, Food Products and Consumer Goods Unit, T.P. 260, I-21020 Ispra (Va), Italy
| | - Elke Anklam
- European Commission, Joint Research Center, Institute for Health and Consumer Protection, Food Products and Consumer Goods Unit, T.P. 260, I-21020 Ispra (Va), Italy
| | - James W Stave
- Strategic Diagnostics, Inc., 111 Pencader Dr, Newark, DE 19702-3322
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Abstract
OBJECTIVES Comorbidity in traumatic brain injury (TBI) has been recognised to alter the clinical course of patients and influence short-term and long-term outcomes. We synthesised the evidence on the effects of different comorbid conditions on early and late mortality post-TBI in order to (1) examine the relationship between comorbid condition(s) and all-cause mortality in TBI and (2) determine the influence of sociodemographic and clinical characteristics of patients with a TBI at baseline on all-cause mortality. DESIGN Systematic review. DATA SOURCES Medline, Central, Embase, PsycINFO and bibliographies of identified articles were searched from May 1997 to January 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Included studies met the following criteria: (1) focused on comorbidity as it related to our outcome of interest in adults (ie, ≥18 years of age) diagnosed with a TBI; (2) comorbidity was detected by any means excluding self-report; (3) reported the proportion of participants without comorbidity and (4) followed participants for any period of time. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted the data and assessed risk of bias using the Quality in Prognosis Studies tool. Data were synthesised through tabulation and qualitative description. RESULTS A total of 27 cohort studies were included. Among the wide range of individual comorbid conditions studied, only low blood pressure was a consistent predictors of post-TBI mortality. Other consistent predictors were traditional sociodemographic risk factors. Higher comorbidity scale, scores and the number of comorbid conditions were not consistently associated with post-TBI mortality. CONCLUSIONS Given the high number of comorbid conditions that were examined by the single studies, research is required to further substantiate the evidence and address conflicting findings. Finally, an enhanced set of comorbidity measures that are suited for the TBI population will allow for better risk stratification to guide TBI management and treatment. PROSPERO REGISTRATION NUMBER CRD42017070033.
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Affiliation(s)
- Chen Xiong
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Sara Hanafy
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Vincy Chan
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Zheng Jing Hu
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mitchell Sutton
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
| | - Michael Escobar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Tatyana Mollayeva
- KITE-Toronto Rehab-University Health Network, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
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Sutton M, Chan V, Mollayeva T, Hu Z, Escobar M, Colantonio A. Comorbid Neck Injuries in Concussion-Related Emergency Department Visits: A Population-Based Study. Arch Phys Med Rehabil 2019. [DOI: 10.1016/j.apmr.2019.08.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sutton M, Chan V, Escobar M, Mollayeva T, Hu Z, Colantonio A. Neck Injury Comorbidity in Concussion-Related Emergency Department Visits: A Population-Based Study of Sex Differences Across the Life Span. J Womens Health (Larchmt) 2018; 28:473-482. [PMID: 30592685 PMCID: PMC6482894 DOI: 10.1089/jwh.2018.7282] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: The cervical spine region can be especially vulnerable to concurrent injury in concussion, with research suggesting that females may be at greater risk due to their weaker and anatomically distinct necks. The main objective of our research was to study sex differences in the rate of neck injury comorbidity across the life span among patients with a concussion diagnosis in the emergency department (ED) setting, by cause of injury (motor vehicle collisions [MVC] and sports). Materials and Methods: All patients with a first concussion-related ED visit between fiscal years 2002/2003 and 2011/2012 (inclusive) in Ontario were identified in population-based health administrative data using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada (ICD-10-CA) codes. Age-dependent odds ratios of comorbid neck injury for sex were estimated using polynomial multivariable logistic regression models, adjusting for sociodemographic characteristics. Results: Females with a concussion had significantly higher odds of sustaining a comorbid neck injury between the ages of 5–49 years for all concussion-related ED visits, 15–49 years for MVC-related concussion ED visits, and 10–39 years for sports-related concussion ED visits, holding all other covariates in the model constant. Conclusions: These results support the consideration of increased screening for comorbid neck injuries, particularly for females, to allow for early intervention. Furthermore, the increased risk of comorbid neck injury in females with a concussion-related ED visit was age-dependent, with the interaction between sex and age following a nonlinear trend. As such, future studies on concussions should consider linear and nonlinear sex and age interactions.
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Affiliation(s)
- Mitchell Sutton
- Toronto Rehabilitation Institute–University Health Network, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Vincy Chan
- Toronto Rehabilitation Institute–University Health Network, Toronto, Canada
| | - Michael Escobar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Tatyana Mollayeva
- Toronto Rehabilitation Institute–University Health Network, Toronto, Canada
- Department of Occupational Sciences and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Zheng Hu
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Angela Colantonio
- Toronto Rehabilitation Institute–University Health Network, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Occupational Sciences and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Institute for Clinical and Evaluative Sciences, Toronto, Canada
- Address correspondence to: Angela Colantonio, PhD, Rehabilitation Sciences Building, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON M5G 1V7, Canada
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Walker T, Edge D, Shaw J, Wilson H, McNair L, Mitchell H, Gutridge K, Senior J, Sutton M, Meacock R, Abel K. Contemporary women's secure psychiatric services in the United Kingdom: A qualitative analysis of staff views. J Psychiatr Ment Health Nurs 2017; 24:660-670. [PMID: 28783204 DOI: 10.1111/jpm.12416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2017] [Indexed: 11/28/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Three pilot UK-only Women's Enhanced Medium Secure Services (WEMSS) was opened in 2007 to support women's movement from high secure care and provide a bespoke, women-only service. Evidence suggests that women's secure services are particularly challenging environments to work in and staffing issues (e.g., high turnover) can cause difficulties in establishing a therapeutic environment. Research in this area has focused on the experiences of service users. Studies which have examined staff views have focused on their feelings towards women in their care and the emotional burden of working in women's secure services. No papers have made a direct comparison between staff working in different services. WHAT DOES THIS STUDY ADD TO EXISTING KNOWLEDGE?: This is the first study to explore the views and experiences of staff in the three UK WEMSS pilot services and contrast them with staff from women's medium secure services. Drawing upon data from eighteen semi-structured interviews (nine WEMSS, nine non-WEMSS), key themes cover staff perceptions of factors important for women's recovery and their views on operational aspects of services. This study extends our understanding of the experiences of staff working with women in secure care and bears relevance for staff working internationally, as well as in UK services. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study reveals the importance of induction and training for bank and agency staff working in women's secure services. Further, regular clinical supervision should be mandatory for all staff so they are adequately supported. ABSTRACT Introduction Women's Enhanced Medium Secure Services (WEMSS) is bespoke, gender-sensitive services which opened in the UK in 2007 at three pilot sites. This study is the first of its kind to explore the experiences of WEMSS staff, directly comparing them to staff in a standard medium secure service for women. The literature to date has focused on the experiences of service users or staff views on working with women in secure care. Aim This qualitative study, embedded in a multimethod evaluation of WEMSS, aimed to explore the views and experiences of staff in WEMSS and comparator medium secure services. Methods Qualitative interviews took place with nine WEMSS staff and nine comparator medium secure staff. Interviews focused on factors important for recovery, barriers to facilitating recovery and operational aspects of the service. Discussion This study provides a rare insight into the perspectives of staff working in UK women's secure services, an under-researched area in the UK and internationally. Findings suggest that the success of services, including WEMSS, is compromised by operational factors such as the use of bank staff. Implications for practice Comprehensive training and supervision should be mandatory for all staff, so best practice is met and staff adequately supported.
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Affiliation(s)
- T Walker
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - D Edge
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - J Shaw
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, Offender Health Research Network, University of Manchester, Manchester, UK
| | - H Wilson
- Lancashire Care NHS Foundation Trust, Preston, UK
| | - L McNair
- Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
| | - H Mitchell
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Centre for Women's Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - K Gutridge
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Centre for Women's Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - J Senior
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, Offender Health Research Network, University of Manchester, Manchester, UK
| | - M Sutton
- Centre for Health Economics, School of Health Sciences, University of Manchester, Manchester, UK
| | - R Meacock
- Centre for Health Economics, School of Health Sciences, University of Manchester, Manchester, UK
| | - K Abel
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Centre for Women's Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
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Mollayeva T, Xiong C, Hanafy S, Chan V, Hu ZJ, Sutton M, Escobar M, Colantonio A. Comorbidity and outcomes in traumatic brain injury: protocol for a systematic review on functional status and risk of death. BMJ Open 2017; 7:e018626. [PMID: 29030415 PMCID: PMC5652528 DOI: 10.1136/bmjopen-2017-018626] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Reports on the association between comorbidity and functional status and risk of death in patients with traumatic brain injury (TBI) have been inconsistent; it is currently unknown which additional clinical entities (comorbidities) have an adverse influence on the evolution of outcomes across the lifespan of men and women with TBI. The current protocol outlines a strategy for a systematic review of the current evidence examining the impact of comorbidity on functional status and early-term and late-term mortality, taking into account known risk factors of these adverse outcomes (ie, demographic (age and sex) and injury-related characteristics). METHODS AND ANALYSIS A comprehensive search strategy for TBI prognosis, functional (cognitive and physical) status and mortality studies has been developed in collaboration with a medical information specialist of the large rehabilitation teaching hospital. All peer-reviewed English language studies with longitudinal design in adults with TBI of any severity, published from May 1997 to April 2017, found through Medline, Central, Embase, Scopus, PsycINFO and bibliographies of identified articles, will be considered eligible. Study quality will be assessed using published guidelines. ETHICS AND DISSEMINATION The authors will publish findings from this review in a peer-reviewed scientific journal(s) and present the results at national and international conferences. This work aims to understand how comorbidity may contribute to adverse outcomes in TBI, to inform risk stratification of patients and guide the management of brain injury acutely and at the chronic stages postinjury on a population level. PROSPERO REGISTRATION NUMBER CRD42017070033.
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Affiliation(s)
- Tatyana Mollayeva
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Research Department, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
- Aquired Brain Injury Research Lab, University of Toronto, Toronto, Canada
| | - Chen Xiong
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Research Department, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
- Aquired Brain Injury Research Lab, University of Toronto, Toronto, Canada
| | - Sara Hanafy
- Research Department, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
- Aquired Brain Injury Research Lab, University of Toronto, Toronto, Canada
| | - Vincy Chan
- Research Department, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
- Aquired Brain Injury Research Lab, University of Toronto, Toronto, Canada
| | - Zheng Jing Hu
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mitchell Sutton
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Michael Escobar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Research Department, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
- Aquired Brain Injury Research Lab, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Britteon P, Cullum N, Sutton M. Association between psychological health and wound complications after surgery. Br J Surg 2017; 104:769-776. [DOI: 10.1002/bjs.10474] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/29/2016] [Accepted: 11/30/2016] [Indexed: 11/09/2022]
Abstract
Abstract
Background
Surgical wound complications remain a major cause of morbidity, leading to higher costs and reduced quality of life. Although psychological health is widely considered to affect wound healing, the evidence on wound outcomes after surgery is mixed. Studies generally focus on small samples of patients undergoing a specific procedure and have limited statistical power.
Methods
This study investigated the relationship between three different measures of anxiety and/or depression and seven adverse surgical outcomes using observational data collected before and after surgery between 2009 and 2011. A wide range of confounding factors was adjusted for, including patient demographics, physical co-morbidities, health-related behaviours, month of operation, procedure complexity and treating hospital.
Results
The estimation sample included 176 827 patients undergoing 59 410 hip replacements, 64 145 knee replacements, 38 328 hernia repairs and 14 944 varicose vein operations. Patients with moderate anxiety or depression had an increased probability of wound complications after a hip replacement (odds ratio (OR) 1·17, 95 per cent c.i. 1·11 to 1·24). They were more likely to be readmitted for a wound complication (OR 1·20, 1·02 to 1·41) and had an increased duration of hospital stay by 0·19 (95 per cent c.i. 0·15 to 0·24) days. Estimated associations were consistent across all four types of operation and for each measure of anxiety and/or depression.
Conclusion
Preoperative psychological health is a significant risk factor for adverse wound outcomes after surgery for four of the procedures most commonly performed in England.
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Affiliation(s)
- P Britteon
- Manchester Centre for Health Economics, University of Manchester, Manchester, UK
| | - N Cullum
- Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - M Sutton
- Manchester Centre for Health Economics, University of Manchester, Manchester, UK
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Abstract
BACKGROUND The establishment of minor eye conditions schemes (MECS) within community optometric practices provides a mechanism for the timely assessment of patients presenting with a range of acute eye conditions. This has the potential to reduce waiting times and avoid unnecessary referrals to hospital eye services (HES). OBJECTIVE To evaluate the clinical effectiveness, impact on hospital attendances and patient satisfaction with a minor eye service provided by community optometrists. METHODS Activity and outcome data were collected for 12 months in the Lambeth and Lewisham MECS. A patient satisfaction questionnaire was given to patients at the end of their MECS appointment. A retrospective difference-in-differences analysis of hospital activity compared changes in the volume of referrals by general practitioners (GPs) from a period before (April 2011-March 2013) to after (April 2013-March 2015) the introduction of the scheme in Lambeth and Lewisham relative to a neighbouring area (Southwark) where the scheme had not been commissioned. Appropriateness of case management was assessed by consensus using clinical members of the research team. RESULTS A total of 2123 patients accessed the scheme. Approximately two-thirds of patients (67.5%) were referred by their GP. The commonest reasons for patients attending for a MECS assessment were 'red eye' (36.7% of patients), 'painful white eye' (11.1%) and 'flashes and floaters' (10.2%). A total of 64.1% of patients were managed in optometric practice and 18.9% were referred to the HES; of these, 89.2% had been appropriately referred. First attendances to HES referred by GPs reduced by 26.8% (95% CI -40.5% to -13.1%) in Lambeth and Lewisham compared to Southwark. CONCLUSIONS The Lambeth and Lewisham MECS demonstrates clinical effectiveness, reduction in hospital attendances and high patient satisfaction and represents a successful collaboration between commissioners, local HES units and primary healthcare providers.
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Affiliation(s)
- E Konstantakopoulou
- Centre for Public Health Research, School of Health Sciences, City University London, London, UK
| | - D F Edgar
- Centre for Public Health Research, School of Health Sciences, City University London, London, UK
| | - R A Harper
- Manchester Academic Health Science Centre, Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - H Baker
- Centre for Public Health Research, School of Health Sciences, City University London, London, UK
- Institute of Ophthalmology, University College London, London, UK
| | - M Sutton
- Manchester Centre for Health Economics, Institute of Population Health, University of Manchester, Manchester, UK
| | - S Janikoun
- Ophthalmology Department, St Thomas’ Hospital, London, UK
| | - G Larkin
- Ophthalmology Department, King's College Hospital, London, UK
| | - J G Lawrenson
- Centre for Public Health Research, School of Health Sciences, City University London, London, UK
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Duckett J, Hunt K, Munro N, Sutton M. The impact of distrust in clinics on hospital utilisation in China 2012-13. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku165.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shofty B, Bokstein F, Ram Z, Ben-Sira L, Freedman S, Kesler A, Constantini S, Shofty B, Mauda-Havakuk M, Ben-Bashat D, Dvir R, Pratt LT, Weizman L, Joskowicz L, Tal M, Ravid L, Ben-Sira L, Constantini S, Dodgshun A, Maixner W, Sullivan M, Hansford J, Ma J, Wang B, Toledano H, Muhsinoglu O, Luckman J, Michowiz S, Goldenberg-Cohen N, Schroeder K, Rosenfeld A, Grant G, McLendon R, Cummings T, Becher O, Gururangan S, Aguilera D, Mazewski C, Janss A, Castellino RC, Schniederjan M, Hayes L, Brahma B, MacDonald T, Osugi Y, Kiyotani C, Sakamoto H, Yanagisawa T, Kanno M, Kamimura S, Kosaka Y, Hirado J, Takimoto T, Nakazawa A, Hara J, Hwang E, Mun A, Kilburn L, Chi S, Knipstein J, Oren M, Dvir R, Hardy K, Rood B, Packer R, Kandels D, Schmidt R, Geh M, Breitmoser-Greiner S, Gnekow AK, Bergthold G, Bandopadhayay P, Rich B, Chan J, Santagata S, Hoshida Y, Ramkissoon S, Ramkissoon L, Golub T, Tabak B, Ferrer-Luna R, Weng PY, Stiles C, Grill J, Kieran MW, Ligon KL, Beroukhim R, Fisher MJ, Levin MH, Armstrong GT, Broad JH, Zimmerman R, Bilaniuk LT, Feygin T, Liu GT, Gan HW, Phipps K, Spoudeas HA, Kohorst M, Warad D, Keating G, Childs S, Giannini C, Wetjen N, Rao; AN, Nakamura H, Makino K, Hide T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Rush S, Madden J, Hemenway M, Foreman N, Sie M, den Dunnen WFA, Lourens HJ, Meeuwsen-de Boer TGJ, Scherpen FJG, Kampen KR, Hoving EW, de Bont ESJM, Gnekow AK, Kandels D, Walker DA, Perilongo G, Grill J, Stokland T, Sehested AM, van Schouten AYN, de Paoli A, de Salvo GL, Pache-Leschhorn S, Geh M, Schmidt R, Gnekow AK, Gass D, Rupani K, Tsankova N, Stark E, Anderson R, Feldstein N, Garvin J, Deel M, McLendon R, Becher O, Karajannis M, Wisoff J, Muh C, Schroeder K, Gururangan S, del Bufalo F, Carai A, Macchiaiolo M, Messina R, Cacchione A, Palmiero M, Cambiaso P, Mastronuzzi A, Anderson M, Leary S, Sun Y, Buhrlage S, Pilarz C, Alberta J, Stiles C, Gray N, Mason G, Packer R, Hwang E, Biassoni V, Schiavello E, Bergamaschi L, Chiaravalli S, Spreafico F, Massimino M, Krishnatry R, Kroupnik T, Zhukova N, Mistry M, Zhang C, Bartels U, Huang A, Adamski J, Dirks P, Laperriere N, Silber J, Hawkins C, Bouffet E, Tabori U, Riccardi R, Rizzo D, Chiaretti A, Piccardi M, Dickmann A, Lazzareschi I, Ruggiero A, Guglielmi G, Salerni A, Manni L, Colosimo C, Falsini B, Rosenfeld A, Etzl M, Miller J, Carpenteri D, Kaplan A, Sieow N, Hoe R, Tan AM, Chan MY, Soh SY, Orphanidou-Vlachou E, MacPherson L, English M, Auer D, Jaspan T, Arvanitis T, Grundy R, Peet A, Bandopadhayay P, Bergthold G, Sauer N, Green A, Malkin H, Dabscheck G, Marcus K, Ullrich N, Goumnerova L, Chi S, Beroukhim R, Kieran M, Manley P, Donson A, Kleinschmidt-DeMasters B, Aisner D, Bemis L, Birks D, Mulcahy-Levy J, Smith A, Handler M, Rush S, Foreman N, Davidson A, Figaji A, Pillay K, Kilborn T, Padayachy L, Hendricks M, van Eyssen A, Parkes J, Gass D, Dewire M, Chow L, Rose SR, Lawson S, Stevenson C, Jones B, Pai A, Sutton M, Pruitt D, Fouladi M, Hummel T, Cruz O, de Torres C, Sunol M, Morales A, Santiago C, Alamar M, Rebollo M, Mora J, Sauer N, Dodgshun A, Malkin H, Bergthold G, Manley P, Chi S, Ramkissoon S, MacGregor D, Beroukhim R, Kieran M, Sullivan M, Ligon K, Bandopadhayay P, Hansford J, Messina R, De Benedictis A, Carai A, Mastronuzzi A, Rebessi E, Palma P, Procaccini E, Marras CE, Aguilera D, Castellino RC, Janss A, Schniederjan M, McNall R, Kim S, MacDOnald T, Mazewski C, Zhukova N, Pole J, Mistry M, Fried I, Krishnatry R, Stucklin AG, Bartels U, Huang A, Laperriere N, Dirks P, Zelcer S, Sylva M, Johnston D, Scheinemann K, An J, Hawkins C, Nathan P, Greenberg M, Bouffet E, Malkin D, Tabori U, Kiehna E, Da Silva S, Margol A, Robison N, Finlay J, McComb JG, Krieger M, Wong K, Bluml S, Dhall G, Ayyanar K, Moriarty T, Moeller K, Farber D. LOW GRADE GLIOMAS. Neuro Oncol 2014; 16:i60-i70. [PMCID: PMC4046289 DOI: 10.1093/neuonc/nou073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
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O'Sullivan S, Sutton M, Fitzpatrick G. Prevalence of elevated cardiac troponin T in ICU patients using the high-sensitivity assay and the relationship with mortality. Crit Care 2014. [PMCID: PMC4068376 DOI: 10.1186/cc13383] [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: 11/10/2022] Open
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Sutton M, Pavord D, Sansourekidou P, Allen C. SU-E-P-12: RayStation Commissioning: A Clinical Implementation Experience. Med Phys 2013. [DOI: 10.1118/1.4814086] [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: 11/07/2022] Open
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Bie L, Ju Y, Jin Z, Donovan L, Birks S, Grunewald L, Zmuda F, Pilkington G, Kaul A, Chen YH, Dahiya S, Emnett R, Gianino S, Gutmann D, Poschl J, Bianchi E, Bockstaller M, Neumann P, Schuller U, Gevorgian A, Morozova E, Kazantsev I, Iukhta T, Safonova S, Punanov Y, Zheludkova O, Afanasyev B, Buss M, Remke M, Gandhi K, Kool M, Northcott P, Pfister S, Taylor M, Castellino R, Thompson J, Margraf L, Donahue D, Head H, Murray J, Burger P, Wortham M, Reitman Z, He Y, Bigner D, Yan H, Lee C, Triscott J, Foster C, Manoranjan B, Pambid MR, Fotovati A, Berns R, Venugopal C, O'Halloran K, Narendran A, Northcott P, Taylor MD, Singh SK, Singhal A, Rassekh R, Maxwell CA, Dunham C, Dunn SE, Pambid MR, Berns R, Hu K, Adomat H, Moniri M, Chin MY, Hessein M, Zisman N, Maurer N, Dunham C, Guns E, Dunn S, Koks C, De Vleeschouwer S, Graf N, Van Gool S, D'Asti E, Huang A, Korshunov A, Pfister S, Rak J, Gump W, Moriarty T, Gump W, Skjei K, Karkare S, Castelo-Branco P, Choufani S, Mack S, Gallagher D, Zhang C, Merino D, Wasserman J, Kool M, Jones DT, Croul S, Kreitzer F, Largaespada D, Conklin B, Taylor M, Weiss W, Garzia L, Morrissy S, Zayne K, Wu X, Dirks P, Hawkins C, Dick J, Stein L, Collier L, Largaespada D, Dupuy A, Taylor M, Rampazzo G, Moraes L, Paniago M, Oliveira I, Hitzler J, Silva N, Cappellano A, Cavalheiro S, Alves MT, Cerutti J, Toledo S, Liu Z, Zhao X, Mao H, Baxter P, Wang JCY, Huang Y, Yu L, Su J, Adekunle A, Perlaky L, Hurwitz M, Hurwitz R, Lau C, Chintagumpala M, Blaney S, Baruchel S, Li XN, Zhang J, Hariono S, Hashizume R, Fan Q, James CD, Weiss WA, Nicolaides T, Madsen PJ, Slaunwhite ES, Dirks PB, Ma JF, Henn RE, Hanno AG, Boucher KL, Storm PB, Resnick AC, Lourdusamy A, Rogers H, Ward J, Rahman R, Malkin D, Gilbertson R, Grundy R, Lourdusamy A, Rogers H, Ward J, Rahman R, Gilbertson R, Grundy R, Karajannis M, Fisher M, Pfister S, Milla S, Cohen K, Legault G, Wisoff J, Harter D, Merkelson A, Bloom M, Dhall G, Jones D, Korshunov A, Taylor MD, Pfister S, Eberhart C, Sievert A, Resnick A, Zagzag D, Allen J, Hankinson T, Gump J, Serrano-Almeida C, Torok M, Weksberg R, Handler M, Liu A, Foreman N, Garancher A, Rocques N, Miquel C, Sainte-Rose C, Delattre O, Bourdeaut F, Eychene A, Tabori U, Pouponnot C, Danielpour M, Levy R, Antonuk CD, Rodriguez J, Aravena JM, Kim GB, Gate D, Bannykh S, Svendsen C, Huang X, Town T, Breunig J, Amakye D, Robinson D, Rose K, Cho YJ, Ligon KL, Sharp T, Ando Y, Geoerger B, He Y, Doz F, Ashley D, Hargrave D, Casanova M, Tawbi H, Heath J, Bouffet E, Brandes AA, Chisholm J, Rodon J, Dubuc AM, Thomas A, Mita A, MacDonald T, Kieran M, Eisenstat D, Song X, Danielpour M, Levy R, Antonuk CD, Rodriguez J, Hashizume R, Aravena JM, Kim GB, Gate D, Bannykh S, Svendsen C, Town T, Breunig J, Morrissy AS, Mayoh C, Lo A, Zhang W, Thiessen N, Tse K, Moore R, Mungall A, Wu X, Van Meter TE, Cho YJ, Collins VP, MacDonald TJ, Li XN, Stehbens S, Fernandez-Lopez A, Malkin D, Marra MA, Taylor MD, Karajannis M, Legault G, Hagiwara M, Vega E, Merkelson A, Wisoff J, Younger S, Golfinos J, Roland JT, Allen J, Antonuk CD, Levy R, Kim GB, Town T, Danielpour M, Breunig J, Pak E, Barshow S, Zhao X, Ponomaryov T, Segal R, Levy R, Antonuk CD, Aravena JM, Kim GB, Svendsen C, Town T, Danielpour M, Zhu S, Breunig J, Chi S, Cohen K, Fisher M, Biegel J, Bowers D, Fangusaro J, Manley P, Janss A, Zimmerman MA, Wu X, Kieran M, Sayour E, Pham C, Sanchez-Perez L, Snyder D, Flores C, Kemeny H, Xie W, Cui X, Bigner D, Taylor MD, Sampson J, Mitchell D, Bandopadhayay P, Nguyen B, Masoud S, Vue N, Gholamin S, Yu F, Schubert S, Bergthold G, Weiss WA, Mitra S, Qi J, Bradner J, Kieran M, Beroukhim R, Cho YJ, Reddick W, Glass J, Ji Q, Paulus E, James CD, Gajjar A, Ogg R, Vanner R, Remke M, Aviv T, Lee L, Zhu X, Clarke I, Taylor M, Dirks P, Shuman MA, Hamilton R, Pollack I, Calligaris D, Liu X, Feldman D, Thompson C, Ide J, Buhrlage S, Gray N, Kieran M, Jan YN, Stiles C, Agar N, Remke M, Cavalli FMG, Northcott PA, Kool M, Pfister SM, Taylor MD, Project MAGIC, Rakopoulos P, Jan LY, Pajovic S, Buczkowicz P, Morrison A, Bouffet E, Bartels U, Becher O, Hawkins C, Truffaux N, Puget S, Philippe C, Gump W, Castel D, Taylor K, Mackay A, Le Dret L, Saulnier P, Calmon R, Boddaert N, Blauwblomme T, Sainte-Rose C, Jones C, Mutchnick I, Grill J, Liu X, Ebling M, Ide J, Wang L, Davis E, Marchionni M, Stuart D, Alberta J, Kieran M, Li KKW, Stiles C, Agar N, Remke M, Cavalli FMG, Northcott PA, Kool M, Pfister SM, Taylor MD, Project MAGIC, Tien AC, Pang JCS, Griveau A, Rowitch D, Ramkissoon L, Horowitz P, Craig J, Ramkissoon S, Rich B, Bergthold G, Tabori U, Taha H, Ng HK, Bowers D, Hawkins C, Packer R, Eberhart C, Goumnerova L, Chan J, Santagata S, Pomeroy S, Ligon A, Kieran M, Jackson S, Beroukhim R, Ligon K, Kuan CT, Chandramohan V, Keir S, Pastan I, Bigner D, Zhou Z, Ho S, Voss H, Patay Z, Souweidane M, Salloum R, DeWire M, Fouladi M, Goldman S, Chow L, Hummel T, Dorris K, Miles L, Sutton M, Howarth R, Stevenson C, Leach J, Griesinger A, Donson A, Hoffman L, Birks D, Amani V, Handler M, Foreman N, Sangar MC, Pai A, Pedro K, Ditzler SH, Girard E, Olson J, Gustafson WC, Meyerowitz J, Nekritz E, Charron E, Matthay K, Hertz N, Onar-Thomas A, Shokat K, Weiss W, Hanaford A, Raabe E, Eberhart C, Griesinger A, Donson A, Hoffman L, Amani V, Birks D, Gajjar A, Handler M, Mulcahy-Levy J, Foreman N, Olow AK, Dasgupta T, Yang X, Mueller S, Hashizume R, Kolkowitz I, Weiss W, Broniscer A, Resnick AC, Sievert AJ, Nicolaides T, Prados MD, Berger MS, Gupta N, James CD, Haas-Kogan DA, Flores C, Pham C, Dietl SM, Snyder D, Sanchez-Perez L, Bigner D, Sampson J, Mitchell D, Prakash V, Batanian J, Guzman M, Geller T, Pham CD, Wolfl M, Pei Y, Flores C, Snyder D, Bigner DD, Sampson JH, Wechsler-Reya RJ, Mitchell DA, Van Ommeren R, Venugopal C, Manoranjan B, Beilhack A, McFarlane N, Hallett R, Hassell J, Dunn S, Singh S, Dasgupta T, Olow A, Yang X, Hashizume R, Mueller S, Riedel S, Nicolaides T, Kolkowitz I, Weiss W, Prados M, Gupta N, James CD, Haas-Kogan D, Zhao H, Li L, Picotte K, Monoranu C, Stewart R, Modzelewska K, Boer E, Picard D, Huang A, Radiloff D, Lee C, Dunn S, Hutt M, Nazarian J, Dietl S, Price A, Lim KJ, Warren K, Chang H, Eberhart CG, Raabe EH, Persson A, Huang M, Chandler-Militello D, Li N, Vince GH, Berger M, James D, Goldman S, Weiss W, Lindquist R, Tate M, Rowitch D, Alvarez-Buylla A, Hoffman L, Donson A, Eyrich M, Birks D, Griesinger A, Amani V, Handler M, Foreman N, Meijer L, Walker D, Grundy R, O'Dowd S, Jaspan T, Schlegel PG, Dineen R, Fotovati A, Radiloff D, Coute N, Triscott J, Chen J, Yip S, Louis D, Toyota B, Hukin J, Weitzel D, Rassekh SR, Singhal A, Dunham C, Dunn S, Ahsan S, Hanaford A, Taylor I, Eberhart C, Raabe E, Sun YG, Ashcraft K, Stiles C, Han L, Zhang K, Chen L, Shi Z, Pu P, Dong L, Kang C, Cordero F, Lewis P, Liu C, Hoeman C, Schroeder K, Allis CD, Becher O, Gururangan S, Grant G, Driscoll T, Archer G, Herndon J, Friedman H, Li W, Kurtzberg J, Bigner D, Sampson J, Mitchell D, Yadavilli S, Kambhampati M, Becher O, MacDonald T, Bellamkonds R, Packer R, Buckley A, Nazarian J, DeWire M, Fouladi M, Stewart C, Wetmore C, Hawkins C, Jacobs C, Yuan Y, Goldman S, Fisher P, Rodriguez R, Rytting M, Bouffet E, Khakoo Y, Hwang E, Foreman N, Gilbert M, Gilbertson R, Gajjar A, Saratsis A, Yadavilli S, Wetzel W, Snyder K, Kambhampati M, Hall J, Raabe E, Warren K, Packer R, Nazarian J, Thompson J, Griesinger A, Foreman N, Spazojevic I, Rush S, Levy JM, Hutt M, Karajannis MA, Shah S, Eberhart CG, Raabe E, Rodriguez FJ, Gump J, Donson A, Tovmasyan A, Birks D, Handler M, Foreman N, Hankinson T, Torchia J, Khuong-Quang DA, Ho KC, Picard D, Letourneau L, Chan T, Peters K, Golbourn B, Morrissy S, Birks D, Faria C, Foreman N, Taylor M, Rutka J, Pfister S, Bouffet E, Hawkins C, Batinic-Haberle I, Majewski J, Kim SK, Jabado N, Huang A, Ladner T, Tomycz L, Watchmaker J, Yang T, Kaufman L, Pearson M, Dewhirst M, Ogg RJ, Scoggins MA, Zou P, Taherbhoy S, Jones MM, Li Y, Glass JO, Merchant TE, Reddick WE, Conklin HM, Gholamin S, Gajjar A, Khan A, Kumar A, Tye GW, Broaddus WC, Van Meter TE, Shih DJH, Northcott PA, Remke M, Korshunov A, Mitra S, Jones DTW, Kool M, Pfister SM, Taylor MD, Mille F, Levesque M, Remke M, Korshunov A, Izzi L, Kool M, Richard C, Northcott PA, Taylor MD, Pfister SM, Charron F, Yu F, Masoud S, Nguyen B, Vue N, Schubert S, Tolliday N, Kong DS, Sengupta S, Weeraratne D, Schreiber S, Cho YJ, Birks D, Jones K, Griesinger A, Amani V, Handler M, Vibhakar R, Achrol A, Foreman N, Brown R, Rangan K, Finlay J, Olch A, Freyer D, Bluml S, Gate D, Danielpour M, Rodriguez J, Shae JJ, Kim GB, Levy R, Bannykh S, Breunig JJ, Town T, Monje-Deisseroth M, Cho YJ, Weissman I, Cheshier S, Buczkowicz P, Rakopoulos P, Bouffet E, Morrison A, Bartels U, Becher O, Hawkins C, Dey A, Kenney A, Van Gool S, Pauwels F, De Vleeschouwer S, Barszczyk M, Buczkowicz P, Castelo-Branco P, Mack S, Nethery-Brokx K, Morrison A, Taylor M, Dirks P, Tabori U, Hawkins C, Chandramohan V, Keir ST, Bao X, Pastan IH, Kuan CT, Bigner DD, Bender S, Jones D, Kool M, Sturm D, Korshunov A, Lichter P, Pfister SM, Chen M, Lu J, Wang J, Keir S, Zhang M, Zhao S, Mook R, Barak L, Lyerly HK, Chen W, Ramachandran C, Nair S, Escalon E, Khatib Z, Quirrin KW, Melnick S, Kievit F, Stephen Z, Wang K, Silber J, Ellenbogen R, Zhang M, Hutzen B, Studebaker A, Bratasz A, Powell K, Raffel C, Guo C, Chang CC, Wortham M, Chen L, Kernagis D, Qin X, Cho YW, Chi JT, Grant G, McLendon R, Yan H, Ge K, Papadopoulos N, Bigner D, He Y, Cristiano B, Venkataraman S, Birks DK, Alimova I, Harris PS, Dubuc A, Taylor MD, Foreman NK, Vibhakar R, Ichimura K, Fukushima S, Totoki Y, Suzuki T, Mukasa A, Saito N, Kumabe T, Tominaga T, Kobayashi K, Nagane M, Iuchi T, Mizoguchi M, Sasaki T, Tamura K, Sugiyama K, Narita Y, Shibui S, Matsutani M, Shibata T, Nishikawa R, Northcott P, Zichner T, Jones D, Kool M, Jager N, Feychting M, Lannering B, Tynes T, Wesenberg F, Hauser P, Ra YS, Zitterbart K, Jabado N, Chan J, Fults D, Mueller S, Grajkowska W, Lichter P, Korbel J, Pfister S, Kool M, Jones DTW, Jaeger N, Northcott PA, Pugh T, Hovestadt V, Markant SL, Esparza LA, Bourdeaut F, Remke M, Taylor MD, Cho YJ, Pomeroy SL, Schueller U, Korshunov A, Eils R, Wechsler-Reya RJ, Lichter P, Pfister SM, Keir S, Pegram C, Lipp E, Rasheed A, Chandramohan V, Kuan CT, Kwatra M, Yan H, Bigner D, Chornenkyy Y, Buczkowicz P, Agnihotri S, Becher O, Hawkins C, Rogers H, Mayne C, Kilday JP, Coyle B, Grundy R, Sun T, Warrington N, Luo J, Brooks M, Dahiya S, Sengupta R, Rubin J, Erdreich-Epstein A, Robison N, Ren X, Zhou H, Ji L, Margo A, Jones D, Pfister S, Kool M, Sposto R, Asgharzadeh S, Clifford S, Gustafsson G, Ellison D, Figarella-Branger D, Doz F, Rutkowski S, Lannering B, Pietsch T, Broniscer A, Tatevossian R, Sabin N, Klimo P, Dalton J, Lee R, Gajjar A, Ellison D, Garzia L, Dubuc A, Pitcher G, Northcott P, Mariampillai A, Chan T, Skowron P, Wu X, Yao Y, Hawkins C, Peacock J, Zayne K, Croul S, Rutka J, Kenney A, Huang A, Yang V, Baylin S, Salter M, Taylor M, Ward S, Sengupta R, Rubin J, Garzia L, Morrissy S, Skowron P, Jelveh S, Lindsay P, Largaespada D, Collier L, Dupuy A, Hill R, Taylor M, Lulla RR, Laskowski J, Fangusaro J, DiPatri AJ, Alden T, Vanin EF, Tomita T, Goldman S, Soares MB, Rajagopal MU, Lau LS, Hathout Y, Gordish-Dressman H, Rood B, Datar V, Bochare S, Singh A, Khatau S, Fangusaro J, Goldman S, Lulla R, Rajaram V, Gopalakrishnan V, Morfouace M, Shelat A, Jaccus M, Freeman B, Zindy F, Robinson G, Guy K, Stewart C, Gajjar A, Roussel M, Krebs S, Chow K, Yi Z, Brawley V, Ahmed N, Gottschalk S, Lerner R, Harness J, Yoshida Y, Santos R, Torre JDL, Nicolaides T, Ozawa T, James D, Petritsch C, Vitte J, Chareyre F, Stemmer-Rachamimov A, Giovannini M, Hashizume R, Yu-Jen L, Tom M, Ihara Y, Huang X, Waldman T, Mueller S, Gupta N, James D, Shevtsov M, Yakovleva L, Nikolaev B, Dobrodumov A, Onokhin K, Bychkova N, Mikhrina A, Khachatryan W, Guzhova I, Martynova M, Bystrova O, Ischenko A, Margulis B, Martin A, Nirschl C, Polanczyk M, Cohen K, Pardoll D, Drake C, Lim M, Crowther A, Chang S, Yuan H, Deshmukh M, Gershon T, Meyerowitz JG, Gustafson WC, Nekritz EA, Swartling F, Shokat KM, Ruggero D, Weiss WA, Bergthold G, Rich B, Bandopadhayay P, Chan J, Santaga S, Hoshida Y, Golub T, Tabak B, Ferrer-Luna R, Grill J, Wen PY, Stiles C, Kieran M, Ligon K, Beroukhim R, Lulla RR, Laskowski J, Gireud M, Fangusaro J, Goldman S, Gopalakrishnan V, Merino D, Shlien A, Pienkowska M, Tabori U, Gilbertson R, Malkin D, Mueller S, Hashizume R, Yang X, Kolkowitz I, Olow A, Phillips J, Smirnov I, Tom M, Prados M, Berger M, Gupta N, Haas-Kogan D, Beez T, Sarikaya-Seiwert S, Janssen G, Felsberg J, Steiger HJ, Hanggi D, Marino AM, Baryawno N, Johnsen JI, Ostman A, Wade A, Engler JR, Robinson AE, Phillips JJ, Witt H, Sill M, Mack SC, Wani KM, Lambert S, Tzaridis T, Bender S, Jones DT, Milde T, Northcott PA, Kool M, von Deimling A, Kulozik AE, Witt O, Lichter P, Collins VP, Aldape K, Taylor MD, Korshunov A, Pfister SM, Hatcher R, Das C, Datar V, Taylor P, Singh A, Lee D, Fuller G, Ji L, Fangusaro J, Rajaram V, Goldman S, Eberhart C, Gopalakrishnan V, Griveau A, Lerner R, Ihrie R, Sugiarto S, Ihara Y, Reichholf B, Huillard E, Mcmahon M, James D, Phillips J, Buylla AA, Rowitch D, Petritsch C, Snuderl M, Batista A, Kirkpatrick N, de Almodovar CR, Riedemann L, Knevels E, Schmidt T, Peterson T, Roberge S, Bais C, Yip S, Hasselblatt M, Rossig C, Ferrara N, Klagsbrun M, Duda D, Fukumura D, Xu L, Carmeliet P, Jain R, Nguyen A, Pencreach E, Lasthaus C, Lobstein V, Guerin E, Guenot D, Entz-Werle N, Diaz R, Golbourn B, Faria C, Shih D, MacKenzie D, Picard D, Bryant M, Smith C, Taylor M, Huang A, Rutka J, Gromeier M, Desjardins A, Sampson JH, Threatt SJE, Herndon JE, Friedman A, Friedman HS, Bigner DD, Cavalli FMG, Morrissy AS, Li Y, Chu A, Remke M, Thiessen N, Mungall AJ, Bader GD, Malkin D, Marra MA, Taylor MD, Manoranjan B, Wang X, Hallett R, Venugopal C, Mack S, McFarlane N, Nolte S, Scheinemann K, Gunnarsson T, Hassell J, Taylor M, Lee C, Triscott J, Foster C, Dunham C, Hawkins C, Dunn S, Singh S, McCrea HJ, Bander E, Venn RA, Reiner AS, Iorgulescu JB, Puchi LA, Schaefer PM, Cederquist G, Greenfield JP, Tsoli M, Luk P, Dilda P, Hogg P, Haber M, Ziegler D, Mack S, Agnihotri S, Witt H, Shih D, Wang X, Ramaswamy V, Zayne K, Bertrand K, Massimi L, Grajkowska W, Lach B, Gupta N, Weiss W, Guha A, Zadeh G, Rutka J, Korshunov A, Pfister S, Taylor M, Mack S, Witt H, Jager N, Zuyderduyn S, Nethery-Brokx K, Garzia L, Zayne K, Wang X, Barszczyk M, Wani K, Bouffet E, Weiss W, Hawkins C, Rutka J, Bader G, Aldape K, Dirks P, Pfister S, Korshunov A, Taylor M, Engler J, Robinson A, Wade A, Molinaro A, Phillips J, Ramaswamy V, Remke M, Bouffet E, Faria C, Shih D, Gururangan S, McLendon R, Schuller U, Ligon K, Pomeroy S, Jabado N, Dunn S, Fouladi M, Rutka J, Hawkins C, Tabori U, Packer R, Pfister S, Korshunov A, Taylor M, Faria C, Dubuc A, Golbourn B, Diaz R, Agnihotri S, Sabha N, Luck A, Leadly M, Reynaud D, Wu X, Remke M, Ramaswamy V, Northcott P, Pfister S, Croul S, Kool M, Korshunov A, Smith C, Taylor M, Rutka J, Pietsch T, Doerner E, Muehlen AZ, Velez-Char N, Warmuth-Metz M, Kortmann R, von Hoff K, Friedrich C, Rutkowski S, von Bueren A, Lu YJ, James CD, Hashizume R, Mueller S, Phillips J, Gupta N, Sturm D, Northcott PA, Jones DTW, Korshunov A, Picard D, Lichter P, Huang A, Pfister SM, Kool M, Ward J, Teague C, Shriyan B, Grundy R, Rahman R, Taylor K, Mackay A, Morozova O, Butterfield Y, Truffaux N, Philippe C, Vinci M, de Torres C, Cruz O, Mora J, Hargrave D, Puget S, Yip S, Jones C, Grill J, Smith S, Ward J, Tan C, Grundy R, Rahman R, Bjerke L, Mackay A, Nandhabalan M, Burford A, Jury A, Popov S, Bax D, Carvalho D, Taylor K, Vinci M, Bajrami I, McGonnell I, Lord C, Reis R, Hargrave D, Ashworth A, Workman P, Jones C, Carvalho D, Mackay A, Burford A, Bjerke L, Chen L, Kozarewa I, Lord C, Ashworth A, Hargrave D, Reis R, Jones C, Marigil M, Jauregui PJ, Alonso M, Chan TS, Hawkins C, Picard D, Henkin J, Huang A, Trubicka J, Kucharczyk M, Pelc M, Chrzanowska K, Ciara E, Perek-Polnik M, Grajkowska W, Piekutowska-Abramczuk D, Jurkiewicz D, Luczak S, Borucka-Mankiewicz M, Kowalski P, Krajewska-Walasek M, de Mola RML, Laskowski J, Fangusaro J, Costa FF, Vanin EF, Goldman S, Soares MB, Lulla RR, Mann A, Venugopal C, Vora P, Singh M, van Ommeren R, McFarlane N, Manoranjan B, Qazi M, Scheinemann K, MacDonald P, Delaney K, Whitton A, Dunn S, Singh S, Sievert A, Lang SS, Boucher K, Madsen P, Slaunwhite E, Choudhari N, Kellet M, Storm P, Resnick A, Agnihotri S, Burrell K, Fernandez N, Golbourn B, Clarke I, Barszczyk M, Sabha N, Dirks P, Jones C, Rutka J, Zadeh G, Hawkins C, Murphy B, Obad S, Bihannic L, Ayrault O, Zindy F, Kauppinen S, Roussel M, Golbourn B, Agnihotri S, Cairns R, Mischel P, Aldape K, Hawkins C, Zadeh G, Rutka J, Rush S, Donson A, Kleinschmidt-DeMasters B, Bemis L, Birks D, Chan M, Smith A, Handler M, Foreman N, Gronych J, Jones DTW, Zuckermann M, Hutter S, Korshunov A, Kool M, Ryzhova M, Reifenberger G, Pfister SM, Lichter P, Jones DTW, Hovestadt V, Picelli S, Wang W, Northcott PA, Kool M, Jager N, Reifenberger G, Rutkowski S, Pietsch T, Sultan M, Yaspo ML, Landgraf P, Eils R, Korshunov A, Zapatka M, Pfister SM, Radlwimmer B, Lichter P, Huang Y, Mao H, Wang Y, Kogiso M, Zhao X, Baxter P, Man C, Wang Z, Zhou Y, Li XN, Chung AH, Crabtree D, Schroeder K, Becher OJ, Panosyan E, Wang Y, Lasky J, Liu Z, Zhao X, Wang Y, Mao H, Huang Y, Kogiso M, Baxter P, Adesina A, Su J, Picard D, Huang A, Perlaky L, Chintagumpala M, Lau C, Blaney S, Li XN, Huang M, Persson A, Swartling F, Moriarity B. Abstracts. Neuro Oncol 2013. [DOI: 10.1093/neuonc/not047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hruszkewycz SO, Sutton M, Fuoss PH, Adams B, Rosenkranz S, Ludwig KF, Roseker W, Fritz D, Cammarata M, Zhu D, Lee S, Lemke H, Gutt C, Robert A, Grübel G, Stephenson GB. High contrast x-ray speckle from atomic-scale order in liquids and glasses. Phys Rev Lett 2012; 109:185502. [PMID: 23215295 DOI: 10.1103/physrevlett.109.185502] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 06/14/2012] [Indexed: 05/20/2023]
Abstract
The availability of ultrafast pulses of coherent hard x rays from the Linac Coherent Light Source opens new opportunities for studies of atomic-scale dynamics in amorphous materials. Here, we show that single ultrafast coherent x-ray pulses can be used to observe the speckle contrast in the high-angle diffraction from liquid Ga and glassy Ni(2)Pd(2)P and B(2)O(3). We determine the thresholds above which the x-ray pulses disturb the atomic arrangements. Furthermore, high contrast speckle is observed in scattering patterns from the glasses integrated over many pulses, demonstrating that the source and optics are sufficiently stable for x-ray photon correlation spectroscopy studies of dynamics over a wide range of time scales.
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Affiliation(s)
- S O Hruszkewycz
- Materials Science Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
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Shih CS, Ekoma S, Ho C, Pradhan K, Hwang E, Jakacki R, Fisher M, Kilburn L, Horn M, Vezina G, Rood B, Packer R, Mittal R, Omar S, Khalifa N, Bedir R, Avery R, Hwang E, Acosta M, Hutcheson K, Santos D, Zand D, Kilburn L, Rosenbaum K, Rood B, Packer R, Kalin-Hajdu E, Ospina L, Carret AS, Marzouki M, Decarie JC, Freeman E, Hershon L, Warmuth-Metz M, Zurakowski D, Bison B, Falkenstein F, Gnekow A, Ehrstedt C, Laurencikas E, Bjorklund AC, Stromberg B, Hedborg F, Pfeifer S, Bertin D, Packer RJ, Vallero S, Basso ME, Romano E, Peretta P, Morra I, D'Alonzo G, Fagioli F, Toledano H, Laviv Y, Dratviman-Storobinsky O, Michowiz S, Yaniv I, Cohen IJ, Goldenberg-Cohen N, Muller K, Gnekow A, Warmuth-Metz M, Pietsch T, Zwiener I, Falkenstein F, Meyer FM, Micke O, Hoffmann W, Kortmann RD, Shofty B, Ben-Sira L, Roth J, Constantini S, Shofty B, Weizmann L, Joskowicz L, Kesler A, Ben-Bashat D, Yalon M, Dvir R, Freedman S, Roth J, Ben-Sira L, Constantini S, Bandopadhayay P, Dagi L, Robison N, Goumnerova L, Ullrich N, Opocher E, De Salvo GL, De Paoli A, Simmons I, Sehested A, Walker DA, Picton SV, Gnekow A, Grill J, Driever PH, Azizi AA, Viscardi E, Perilongo G, Cappellano AM, Bouffet E, Silva F, Paiva P, Cavalheiro S, Seixas MT, Silva NS, Antony R, Fraser K, Lin J, Falkenstein F, Kwiecien R, Mirow C, Thieme B, von Hornstein S, Pietsch T, Faldum A, Warmuth-Metz M, Kortmann RD, Gnekow AK, Shofty B, Bokshtein F, Kesler A, Ben-Sira L, Freedman S, Constantini S, Panandiker AP, Klimo P, Thompson C, Armstrong G, Kun L, Boop F, Sanford A, Orge F, Laschinger K, Gold D, Bangert B, Stearns D, Cappellano AM, Senerchia A, Paiva P, Cavalheiro S, Silva F, Silva NS, Gnekow AK, Falkenstein F, Walker D, Perilongo G, Picton S, Grill J, Kortmann RD, Stokland T, van Meeteren AS, Slavc I, Faldum A, de Salvo GL, Fernandez KS, Antony R, Lulla RR, Flores M, Benavides VC, Mitchell C, AlKofide A, Hassonah M, Khafagh Y, Ayas MA, AlFawaz I, Anas M, Barria M, Siddiqui K, Al-Shail E, Fisher MJ, Ullrich NJ, Ferner RE, Gutmann DH, Listernick R, Packer RJ, Tabori U, Hoffman RO, Ardern-Holmes SL, Hummel TR, Hargrave DR, Charrow J, Loguidice M, Balcer LJ, Liu GT, Fisher MJ, Listernick R, Gutmann DH, Ferner RE, Packer RJ, Ullrich NJ, Tabori U, Hoffman RO, Ardern-Holmes SL, Hummel TR, Hargrave DR, Loguidice M, Balcer LJ, Liu GT, Jeeva I, Nelson O, Guy D, Damani A, Gogi D, Picton S, Simmons I, Jeeva I, Picton S, Guy D, Nelson O, Dewsbery S, Gogi D, Simmons I, Sievert AJ, Lang SS, Boucher K, Slaunwhite E, Brewington D, Madsen P, Storm PB, Resnick AC, Hemenway M, Madden J, Macy M, Foreman N, Rush S, Mascelli S, Raso A, Barla A, Nozza P, Biassoni R, Pignatelli S, Cama A, Verri A, Capra V, Garre M, Bergthold G, Piette C, Raquin MA, Dufour C, Varlet P, Dhermain F, Puget S, Sainte-Rose C, Abely M, Canale S, Grill J, Terashima K, Chow K, Jones J, Ahern C, Jo E, Ellezam B, Paulino A, Okcu MF, Su J, Adesina A, Mahajan A, Dauser R, Whitehead W, Lau C, Chintagumpala M, Kebudi R, Tuncer S, Cakir FB, Gorgun O, Agaoglu FY, Ayan I, Darendeliler E, Wolf D, Cohen K, Jeyapalan JN, Morley ICF, Hill AA, Tatevossian RG, Qaddoumi I, Ellison DW, Sheer D, Donson A, Barton V, Birks D, Kleinschmidt-DeMasters BK, Hemenway M, Handler M, Foreman N, Rush S, Tatevossian R, Qaddoumi I, Tang B, Dalton J, Shurtleff S, Punchihewa C, Orisme W, Neale G, Gajjar A, Baker S, Sheer D, Ellison D, Gilheeney S, Jamzadeh A, Winchester M, Yataghene K, De Braganca K, Khakoo Y, Lyden D, Dunkel I, Terasaki M, Eto T, Morioka M, Ho CY, Bar E, Giannini C, Karajannis MA, Zagzag D, Eberhart CG, Rodriguez FJ, Lee Y, Bartels U, Tabori U, Huang A, Bouffet E, Zaky W, Bluml S, Grimm J, Wong K, McComb G, Gilles F, Finlay J, Dhall G, Chen HH, Chen YW, Chang FC, Lin SC, Chang KP, Ho DM, Wong TT, Lee CC, Azizi AA, Fox R, Grill J, Mirow C, Gnekow A, Walker D, Perilongo G, Opocher E, Wheatley K, van Meeteren AYS, Phuakpet K, Tabori U, Bartels U, Huang A, Kulkarni A, Laperriere N, Bouffet E, Epari S, Nair V, Gupta T, Patil P, Moiyadi A, Shetty P, Kane S, Jalali R, Dorris K, Nadi M, Sutton M, Wang L, Stogner K, Li D, Hurwitz B, Stevenson C, Miles L, Kim MO, Fuller C, Hawkins C, Bouffet E, Jones B, Drake J, Fouladi M, Fontebasso AM, Shirinian M, Jones DTW, Quang DAK, Jacob K, Cin H, Witt H, Gerges N, Montpetit A, Brunet S, Lepage P, Klekner A, Lambert S, Kwan T, Hawkins C, Tabori U, Collins VP, Albrecht S, Pfister SM, Jabado N, Arrington D, Manley P, Kieran M, Chi S, Robison N, Chordas C, Ullrich N. LOW GRADE GLIOMAS. Neuro Oncol 2012; 14:i69-i81. [PMCID: PMC3483338 DOI: 10.1093/neuonc/nos092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
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Murray J, Braly E, Head H, Donahue D, Rush S, Stence N, Liu A, Kleinhenz J, Bison B, Pietsch T, von Hoff K, von Bueren A, Rutkowski S, Warmuth-Metz M, Jaspan T, Brisse H, Potepan P, Warmuth-Metz M, Berg F, Bison B, Pietsch T, Gerber N, Rutkowski S, Warmuth-Metz M, Sugiyama K, Kurisu K, Kajiwara Y, Takayasu T, Saito T, Hanaya R, Yamasaki F, Vicente J, Fuster-Garcia E, Tortajada S, Garcia-Gomez JM, Davies N, Natarajan K, Wilson M, Grundy RG, Wesseling P, Monleon D, Celda B, Robles M, Peet AC, Perret C, Boltshauser E, Scheer I, Kellenberger C, Grotzer M, Steffen-Smith E, Venzon D, Bent R, Baker E, Shandilya S, Warren K, Shih CS, West J, Ho C, Porter D, Wang Y, Saykin A, McDonald B, Arfanakis K, Warren K, Vezina G, Hargrave D, Poussaint TY, Goldman S, Packer R, Wen P, Pollack I, Zurakowski D, Kun L, Prados M, Kieran M, Eckel L, Keating G, Giannini C, Wetjen N, Patton A, Steffen-Smith E, Sarlls J, Pierpaoli C, Walker L, Venzon D, Bent R, Warren K, Perreault S, Lober R, Yeom K, Carret AS, Vogel H, Partap S, Fisher P, Gill SK, Wilson M, Davies NP, MacPherson L, Arvanitis TN, Peet AC, Davies N, Gill S, Wilson M, MacPherson L, Arvanitis T, Peet A, Hayes L, Jones R, Mazewski C, Aguilera D, Palasis S, Bendel A, Patterson R, Petronio J, Meijer L, Jaspan T, Grundy RGG, Walker DA, Robison N, Grant F, Treves ST, Bandopadhayay P, Manley P, Chi S, Zimmerman MA, Chordas C, Goumnerova L, Smith E, Scott M, Ullrich NJ, Poussaint T, Kieran M, Yang JC, Lightner DD, Khakoo Y, Wolden SL, Smee R, Zhao C, Spencer-Trotter B, Hallock A, Konski A, Bhambani K, Mahajan A, Jones J, Ketonen L, Paulino A, Ater J, Grosshans D, Dauser R, Weinberg J, Chintagumpala M, Dvir R, Elhasid R, Corn B, Tempelhoff H, Matceyevsky D, Makrin V, Shtraus N, Yavetz D, Constantini S, Gez E, Yu ES, Kim YJ, Park HJ, Kim HJ, Shin SH, Kim JH, Kim JY, Lee YK, Fiore MR, Sanne C, Mandeville HC, Saran FH, Greenspoon J, Duckworth J, Singh S, Scheinemann K, Whitton A, Gauvain K, Geller T, Elbabaa S, Dombrowski J, Wong K, Olch A, Davidson TB, Venkatramani R, Haley K, Zaky W, Dhall G, Finlay J, Bishop MW, Hummel TR, Leach J, Minturn J, Breneman J, Stevenson C, Wagner L, Sutton M, Miles L, Fouladi M, Goldman S. RADIOLOGY. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Teckle P, Hannaford P, Sutton M. Is the health of people living in rural areas different from those in cities? Evidence from routine data linked with the Scottish Health Survey. BMC Health Serv Res 2012; 12:43. [PMID: 22340710 PMCID: PMC3298709 DOI: 10.1186/1472-6963-12-43] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 02/17/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine the association between rurality and health in Scotland, after adjusting for differences in individual and practice characteristics. METHODS DESIGN Mortality and hospital record data linked to two cross sectional health surveys. SETTING Respondents in the community-based 1995 and 1998 Scottish Health Survey who consented to record-linkage follow-up. MAIN OUTCOME MEASURES Hypertension, all-cause premature mortality, total hospital stays and admissions due to coronary heart disease (CHD). RESULTS Older age and lower social class were strongly associated with an increased risk of each of the four health outcomes measured. After adjustment for individual and practice characteristics, no consistent pattern of better or poorer health in people living in rural areas was found, compared to primary cities. However, individuals living in remote small towns had a lower risk of a hospital admission for CHD and those in very remote rural had lower mortality, both compared with those living in primary cities. CONCLUSION This study has shown how linked data can be used to explore the possible influence of area of residence on health. We were unable to find a consistent pattern that people living in rural areas have materially different health to that of those living in primary cities. Instead, we found stronger relationships between compositional determinants (age, gender and socio-economic status) and health than contextual factors (including rurality).
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Affiliation(s)
- P Teckle
- Canadian Centre for Applied Research in Cancer Control (ARCC) "Advancing health economics, services, policy and ethics", #2-111, 675 West 10th Avenue, Cancer Research Centre, V5Z 1L3, Vancouver, BC, Canada
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | - M Sutton
- University of Manchester, Manchester, UK
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Sutton M, Matthews K, Parker B. SU-E-T-293: Accuracy of Elekta - Image Guided Radiation Therapy. Med Phys 2011. [DOI: 10.1118/1.3612244] [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: 11/07/2022] Open
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Clarke JL, Ennis MM, Lamborn KR, Prados MD, Puduvalli VK, Penas-Prado M, Gilbert MR, Groves MD, Hess KR, Levin VA, de Groot J, Colman H, Conrad CA, Loghin ME, Hunter K, Yung WK, Chen C, Damek D, Liu A, Gaspar LE, Waziri A, Lillehei K, Kavanagh B, Finlay JL, Haley K, Dhall G, Gardner S, Allen J, Cornelius A, Olshefski R, Garvin J, Pradhan K, Etzl M, Goldman S, Atlas M, Thompson S, Hirt A, Hukin J, Comito M, Bertolone S, Torkildson J, Joyce M, Moertel C, Letterio J, Kennedy G, Walter A, Ji L, Sposto R, Dorris K, Wagner L, Hummel T, Drissi R, Miles L, Leach J, Chow L, Turner R, Gragert MN, Pruitt D, Sutton M, Breneman J, Crone K, Fouladi M, Friday BB, Buckner J, Anderson SK, Giannini C, Kugler J, Mazurczac M, Flynn P, Gross H, Pajon E, Jaeckle K, Galanis E, Badruddoja MA, Pazzi MA, Stea B, Lefferts P, Contreras N, Bishop M, Seeger J, Carmody R, Rance N, Marsella M, Schroeder K, Sanan A, Swinnen LJ, Rankin C, Rushing EJ, Hutchins LF, Damek DM, Barger GR, Norden AD, Lesser G, Hammond SN, Drappatz J, Fadul CE, Batchelor TT, Quant EC, Beroukhim R, Ciampa A, Doherty L, LaFrankie D, Ruland S, Bochacki C, Phan P, Faroh E, McNamara B, David K, Rosenfeld MR, Wen PY, Hammond SN, Norden AD, Drappatz J, Phuphanich S, Reardon D, Wong ET, Plotkin SR, Lesser G, Mintz A, Raizer JJ, Batchelor TT, Quant EC, Beroukhim R, Kaley TJ, Ciampa A, Doherty L, LaFrankie D, Ruland S, Smith KH, Wen PY, Chamberlain MC, Graham C, Mrugala M, Johnston S, Kreisl TN, Smith P, Iwamoto F, Sul J, Butman JA, Fine HA, Westphal M, Heese O, Warmuth-Metz M, Pietsch T, Schlegel U, Tonn JC, Schramm J, Schackert G, Melms A, Mehdorn HM, Seifert V, Geletneky K, Reuter D, Bach F, Khasraw M, Abrey LE, Lassman AB, Hormigo A, Nolan C, Gavrilovic IT, Mellinghoff IK, Reiner AS, DeAngelis L, Omuro AM, Burzynski SR, Weaver RA, Janicki TJ, Burzynski GS, Szymkowski B, Acelar SS, Mechtler LL, O'Connor PC, Kroon HA, Vora T, Kurkure P, Arora B, Gupta T, Dhamankar V, Banavali S, Moiyadi A, Epari S, Merchant N, Jalali R, Moller S, Grunnet K, Hansen S, Schultz H, Holmberg M, Sorensen MM, Poulsen HS, Lassen U, Reardon DA, Vredenburgh JJ, Desjardins A, Janney DE, Peters K, Sampson J, Gururangan S, Friedman HS, Jeyapalan S, Constantinou M, Evans D, Elinzano H, O'Connor B, Puthawala MY, Goldman M, Oyelese A, Cielo D, Dipetrillo T, Safran H, Anan M, Seyed Sadr M, Alshami J, Sabau C, Seyed Sadr E, Siu V, Guiot MC, Samani A, Del Maestro R, Bogdahn U, Stockhammer G, Mahapatra AK, Venkataramana NK, Oliushine VE, Parfenov VE, Poverennova IE, Hau P, Jachimczak P, Heinrichs H, Schlingensiepen KH, Shibui S, Kayama T, Wakabayashi T, Nishikawa R, de Groot M, Aronica E, Vecht CJ, Toering ST, Heimans JJ, Reijneveld JC, Batchelor T, Mulholland P, Neyns B, Nabors LB, Campone M, Wick A, Mason W, Mikkelsen T, Phuphanich S, Ashby LS, DeGroot JF, Gattamaneni HR, Cher LM, Rosenthal MA, Payer F, Xu J, Liu Q, van den Bent M, Nabors B, Fink K, Mikkelsen T, Chan M, Trusheim J, Raval S, Hicking C, Henslee-Downey J, Picard M, Reardon D, Kaley TJ, Wen PY, Schiff D, Karimi S, DeAngelis LM, Nolan CP, Omuro A, Gavrilovic I, Norden A, Drappatz J, Purow BW, Lieberman FS, Hariharan S, Abrey LE, Lassman AB, Perez-Larraya JG, Honnorat J, Chinot O, Catry-Thomas I, Taillandier L, Guillamo JS, Campello C, Monjour A, Tanguy ML, Delattre JY, Franz DN, Krueger DA, Care MM, Holland-Bouley K, Agricola K, Tudor C, Mangeshkar P, Byars AW, Sahmoud T, Alonso-Basanta M, Lustig RA, Dorsey JF, Lai RK, Recht LD, Reardon DA, Paleologos N, Groves M, Rosenfeld MR, Meech S, Davis T, Pavlov D, Marshall MA, Sampson J, Slot M, Peerdeman SM, Beauchesne PD, Faure G, Noel G, Schmitt T, Kerr C, Jadaud E, Martin L, Taillandier L, Carnin C, Desjardins A, Reardon DA, Peters KB, Herndon JE, Kirkpatrick JP, Friedman HS, Vredenburgh JJ, Nayak L, Panageas KS, Deangelis LM, Abrey LE, Lassman AB. Ongoing Clinical Trials. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Oxley T, ApSimon H, Dore A, Sutton M, Hall J, Heywood E, Gonzales del Campo T, Warren R. The UK Integrated Assessment Model, UKIAM: A National Scale Approach to the Analysis of Strategies for Abatement of Atmospheric Pollutants Under the Convention on Long-Range Transboundary Air Pollution. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/1389517049051538] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- T. Oxley
- a Department of Environmental Science & Technology Imperial College London SW7 2AX UK
| | - H. ApSimon
- a Department of Environmental Science & Technology Imperial College London SW7 2AX UK
| | - A. Dore
- b Centre for Ecology & Hydrology, Edinburgh Research Station EH26 0QB UK
| | - M. Sutton
- b Centre for Ecology & Hydrology, Edinburgh Research Station EH26 0QB UK
| | - J. Hall
- c Centre for Ecology & Hydrology, Monks Wood Cambridgeshire PE28 2LS UK
| | - E. Heywood
- c Centre for Ecology & Hydrology, Monks Wood Cambridgeshire PE28 2LS UK
| | - T. Gonzales del Campo
- a Department of Environmental Science & Technology Imperial College London SW7 2AX UK
| | - R. Warren
- d Tyndall Centre for Climate Change, University of East Anglia NR4 7TJ UK
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Pangilinan F, Mitchell A, VanderMeer J, Molloy AM, Troendle J, Conley M, Kirke PN, Sutton M, Sequeira JM, Quadros EV, Scott JM, Mills JL, Brody LC. Transcobalamin II receptor polymorphisms are associated with increased risk for neural tube defects. J Med Genet 2010; 47:677-85. [PMID: 20577008 DOI: 10.1136/jmg.2009.073775] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Women who have low cobalamin (vitamin B(12)) levels are at increased risk for having children with neural tube defects (NTDs). The transcobalamin II receptor (TCblR) mediates uptake of cobalamin into cells. Inherited variants in the TCblR gene as NTD risk factors were evaluated. METHODS Case-control and family-based tests of association were used to screen common variation in TCblR as genetic risk factors for NTDs in a large Irish group. A confirmatory group of NTD triads was used to test positive findings. RESULTS 2 tightly linked variants associated with NTDs in a recessive model were found: TCblR rs2336573 (G220R; p(corr)=0.0080, corrected for multiple hypothesis testing) and TCblR rs9426 (p(corr)=0.0279). These variants were also associated with NTDs in a family-based test before multiple test correction (log-linear analysis of a recessive model: rs2336573 (G220R; RR=6.59, p=0.0037) and rs9426 (RR=6.71, p=0.0035)). A copy number variant distal to TCblR and two previously unreported exonic insertion-deletion polymorphisms were described. CONCLUSIONS TCblR rs2336573 (G220R) and TCblR rs9426 represent a significant risk factor in NTD cases in the Irish population. The homozygous risk genotype was not detected in nearly 1000 controls, indicating that this NTD risk factor may be of low frequency and high penetrance. 9 other variants are in perfect linkage disequilibrium with the associated single nucleotide polymorphisms. Additional work is required to identify the disease-causing variant. Our data suggest that variation in TCblR plays a role in NTD risk and that these variants may modulate cobalamin metabolism.
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Affiliation(s)
- F Pangilinan
- Molecular Pathogenesis Section, Genome Technology Branch, National Human Genome Research Institute, 50 South Drive, Bethesda, MD 20892-8004, USA
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