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Lanéelle D, Hughes M, Stacey BS, Bashir M, Williams IM, Lewis MH, Bailey DM. Supervised exercise training improves cardiorespiratory fitness and reduces perioperative risk in peripheral artery disease patients with intermittent claudication. Ann R Coll Surg Engl 2024; 106:185-194. [PMID: 37128857 PMCID: PMC10846411 DOI: 10.1308/rcsann.2022.0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 05/03/2023] Open
Abstract
INTRODUCTION This study examined to what extent supervised aerobic and resistance exercise combined with continued unsupervised exercise training improves cardiorespiratory fitness and corresponding perioperative risk in peripheral artery disease (PAD) patients with intermittent claudication. METHODS A total of 106 patients (77% male) were enrolled into the study, alongside 155 healthy non-PAD control participants. Patients completed supervised exercise therapy (aerobic and resistance exercises of the upper and lower limbs) twice a week for 10 weeks. Thereafter, 52 patients completed 12 weeks of an unsupervised tailored home-based exercise. Pain-free walking distance (PWD), maximum walking distance (MWD), peak oxygen uptake ([Formula: see text]) and perioperative risk were assessed before and after both exercise interventions. RESULTS Patients were highly unconditioned relative to healthy controls ([Formula: see text]=11.9 vs 24.2ml/kg/min, p=<0.001) with 91% classified as high perioperative risk (peak oxygen uptake <15ml/kg/min). Supervised exercise increased PWD (+44±81m, p=<0.001), MWD (+44±71m, p=<0.001) and [Formula: see text] (+1.01±1.63ml/kg/min, p=<0.001) and lowered perioperative risk (91% to 85%, p=<0.001). When compared with supervised exercise, the improvements in PWD were maintained following unsupervised exercise (+11±91m vs supervised exercise, p=0.572); however, MWD and [Formula: see text] decreased (-15±48m, p=0.030 and -0.34±1.11ml/kg/min, p=0.030, respectively) and perioperative risk increased (+3%, p=<0.001) although still below baseline (p=<0.001). CONCLUSIONS Supervised aerobic and resistance exercise training and, to a lesser extent, unsupervised tailored exercise improves walking capacity and cardiorespiratory fitness and reduces perioperative risk in PAD patients with intermittent claudication.
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Affiliation(s)
| | - M Hughes
- Department of Physiotherapy, Prince Charles Hospital, Merthyr Tydfil, UK
| | - BS Stacey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | | | | | - MH Lewis
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - DM Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
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An P, Awe C, Barbeau PS, Becker B, Belov V, Bernardi I, Bock C, Bolozdynya A, Bouabid R, Brown A, Browning J, Cabrera-Palmer B, Cervantes M, Conley E, Daughhetee J, Detwiler J, Ding K, Durand MR, Efremenko Y, Elliott SR, Fabris L, Febbraro M, Gallo Rosso A, Galindo-Uribarri A, Germer AC, Green MP, Hakenmüller J, Heath MR, Hedges S, Hughes M, Johnson BA, Johnson T, Khromov A, Konovalov A, Kozlova E, Kumpan A, Kyzylova O, Li L, Link JM, Liu J, Mahoney M, Major A, Mann K, Markoff DM, Mastroberti J, Mattingly J, Mueller PE, Newby J, Parno DS, Penttila SI, Pershey D, Prior CG, Rapp R, Ray H, Raybern J, Razuvaeva O, Reyna D, Rich GC, Ross J, Rudik D, Runge J, Salvat DJ, Sander J, Scholberg K, Shakirov A, Simakov G, Sinev G, Skuse C, Snow WM, Sosnovtsev V, Subedi T, Suh B, Tayloe R, Tellez-Giron-Flores K, Tsai YT, Ujah E, Vanderwerp J, van Nieuwenhuizen EE, Varner RL, Virtue CJ, Visser G, Walkup K, Ward EM, Wongjirad T, Yoo J, Yu CH, Zawada A, Zettlemoyer J, Zderic A. Measurement of Electron-Neutrino Charged-Current Cross Sections on ^{127}I with the COHERENT NaIνE Detector. Phys Rev Lett 2023; 131:221801. [PMID: 38101357 DOI: 10.1103/physrevlett.131.221801] [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] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/02/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023]
Abstract
Using an 185-kg NaI[Tl] array, COHERENT has measured the inclusive electron-neutrino charged-current cross section on ^{127}I with pion decay-at-rest neutrinos produced by the Spallation Neutron Source at Oak Ridge National Laboratory. Iodine is one the heaviest targets for which low-energy (≤50 MeV) inelastic neutrino-nucleus processes have been measured, and this is the first measurement of its inclusive cross section. After a five-year detector exposure, COHERENT reports a flux-averaged cross section for electron neutrinos of 9.2_{-1.8}^{+2.1}×10^{-40} cm^{2}. This corresponds to a value that is ∼41% lower than predicted using the MARLEY event generator with a measured Gamow-Teller strength distribution. In addition, the observed visible spectrum from charged-current scattering on ^{127}I has been measured between 10 and 55 MeV, and the exclusive zero-neutron and one-or-more-neutron emission cross sections are measured to be 5.2_{-3.1}^{+3.4}×10^{-40} and 2.2_{-0.5}^{+0.4}×10^{-40} cm^{2}, respectively.
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Affiliation(s)
- P An
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - C Awe
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - P S Barbeau
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - B Becker
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - V Belov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- National Research Center "Kurchatov Institute," Moscow, 123182, Russian Federation
| | - I Bernardi
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - C Bock
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A Bolozdynya
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - R Bouabid
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - A Brown
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Mathematics and Physics, North Carolina Central University, Durham, North Carolina 27707, USA
| | - J Browning
- Department of Physics, North Carolina State University, Raleigh, North Carolina 27695, USA
| | | | - M Cervantes
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - E Conley
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - J Daughhetee
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Detwiler
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - K Ding
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M R Durand
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - Y Efremenko
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S R Elliott
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - L Fabris
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M Febbraro
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A Gallo Rosso
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - A Galindo-Uribarri
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A C Germer
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - M P Green
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Physics, North Carolina State University, Raleigh, North Carolina 27695, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Hakenmüller
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - M R Heath
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S Hedges
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - M Hughes
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - B A Johnson
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - T Johnson
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - A Khromov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - A Konovalov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - E Kozlova
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - A Kumpan
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - O Kyzylova
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - L Li
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J M Link
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J Liu
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M Mahoney
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - A Major
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - K Mann
- Department of Physics, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - D M Markoff
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Mathematics and Physics, North Carolina Central University, Durham, North Carolina 27707, USA
| | - J Mastroberti
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - J Mattingly
- Department of Nuclear Engineering, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - P E Mueller
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Newby
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - D S Parno
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - S I Penttila
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - D Pershey
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - C G Prior
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - R Rapp
- Washington & Jefferson College, Washington, Pennsylvania 15301, USA
| | - H Ray
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - J Raybern
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - O Razuvaeva
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- National Research Center "Kurchatov Institute," Moscow, 123182, Russian Federation
| | - D Reyna
- Sandia National Laboratories, Livermore, California 94550, USA
| | - G C Rich
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J Ross
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Mathematics and Physics, North Carolina Central University, Durham, North Carolina 27707, USA
| | - D Rudik
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - J Runge
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - D J Salvat
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - J Sander
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - K Scholberg
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - A Shakirov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - G Simakov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- National Research Center "Kurchatov Institute," Moscow, 123182, Russian Federation
| | - G Sinev
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - C Skuse
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - W M Snow
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - V Sosnovtsev
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - T Subedi
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
- Department of Physical and Environmental Sciences, Concord University, Athens, West Virginia 24712, USA
| | - B Suh
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - R Tayloe
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | | | - Y-T Tsai
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - E Ujah
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Mathematics and Physics, North Carolina Central University, Durham, North Carolina 27707, USA
| | - J Vanderwerp
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - E E van Nieuwenhuizen
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - R L Varner
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - C J Virtue
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - G Visser
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - K Walkup
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - E M Ward
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - T Wongjirad
- Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155, USA
| | - J Yoo
- Department of Physics and Astronomy, Seoul National University, Seoul, 08826, Korea
| | - C-H Yu
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A Zawada
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J Zettlemoyer
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - A Zderic
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
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3
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Damian-Serrano A, Hughes M, Sutherland KR. A New Molecular Phylogeny of Salps (Tunicata: Thalicea: Salpida) and the Evolutionary History of Their Colonial Architecture. Integr Org Biol 2023; 5:obad037. [PMID: 37840689 PMCID: PMC10576244 DOI: 10.1093/iob/obad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/15/2023] [Accepted: 09/23/2023] [Indexed: 10/17/2023] Open
Abstract
Salps are marine pelagic tunicates with a complex life cycle, including a solitary and colonial stage composed of asexually budded individuals. These colonies develop into species-specific architectures with distinct zooid orientations, including transversal, oblique, linear, helical, and bipinnate chains, as well as whorls and clusters. The evolutionary history of salp colony architecture has remained obscured due to the lack of an ontology to characterize architectures, as well as a lack of phylogenetic taxon sampling and resolution of critical nodes. We (1) collected and sequenced eight species of salps that had never been sequenced before, (2) inferred the phylogenetic relationships among salps, and (3) reconstructed the evolutionary history of salp colony architecture. We collected salp specimens via offshore SCUBA diving, dissected tissue samples, extracted their DNA, amplified their 18S gene, and sequenced them using Sanger technology. We inferred the phylogeny of Salpida based on 18S using both Maximum Likelihood and Bayesian approaches. Using this phylogeny, we reconstructed the ancestral states of colony architecture using a Bayesian ordered Markov model informed by the presence and absence of specific developmental mechanisms that lead to each architecture. We find that the ancestral salp architecture is either oblique or linear, with every other state being derived. Moreover, linear chains have evolved independently at least three times. While transversal chains are developmentally basal and hypothesized to be ancestral, our phylogenetic topology and reconstructions strongly indicate that they are evolutionarily derived through the loss of zooid torsion. These traits are likely critical to multijet locomotory performance and evolving under natural selection. Our work showcases the need to study the broader diversity of salp species to gain a comprehensive understanding of their organismal biology, evolutionary history, and ecological roles in pelagic ecosystems.
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Affiliation(s)
- A Damian-Serrano
- University of Oregon, Department of Biology, Institute of Ecology and Evolution. 473 Onyx Bridge, 5289 University of Oregon, Eugene OR 97403-5289, USA
| | - M Hughes
- P.O. Box 4979, Kailua Kona HI 96745, USA
| | - K R Sutherland
- University of Oregon, Department of Biology, Institute of Ecology and Evolution. 473 Onyx Bridge, 5289 University of Oregon, Eugene OR 97403-5289, USA
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4
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Akimov D, An P, Awe C, Barbeau PS, Becker B, Belov V, Bernardi I, Blackston MA, Bock C, Bolozdynya A, Browning J, Cabrera-Palmer B, Chernyak D, Conley E, Daughhetee J, Detwiler J, Ding K, Durand MR, Efremenko Y, Elliott SR, Fabris L, Febbraro M, Gallo Rosso A, Galindo-Uribarri A, Green MP, Heath MR, Hedges S, Hoang D, Hughes M, Johnson T, Khromov A, Konovalov A, Kozlova E, Kumpan A, Li L, Link JM, Liu J, Mann K, Markoff DM, Mastroberti J, Mueller PE, Newby J, Parno DS, Penttila SI, Pershey D, Rapp R, Raybern J, Razuvaeva O, Reyna D, Rich GC, Ross J, Rudik D, Runge J, Salvat DJ, Salyapongse AM, Sander J, Scholberg K, Shakirov A, Simakov G, Sinev G, Snow WM, Sosnovtsev V, Suh B, Tayloe R, Tellez-Giron-Flores K, Tolstukhin I, Ujah E, Vanderwerp J, Varner RL, Virtue CJ, Visser G, Wongjirad T, Yen YR, Yoo J, Yu CH, Zettlemoyer J. First Probe of Sub-GeV Dark Matter beyond the Cosmological Expectation with the COHERENT CsI Detector at the SNS. Phys Rev Lett 2023; 130:051803. [PMID: 36800477 DOI: 10.1103/physrevlett.130.051803] [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] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/28/2022] [Indexed: 06/18/2023]
Abstract
The COHERENT Collaboration searched for scalar dark matter particles produced at the Spallation Neutron Source with masses between 1 and 220 MeV/c^{2} using a CsI[Na] scintillation detector sensitive to nuclear recoils above 9 keV_{nr}. No evidence for dark matter is found and we thus place limits on allowed parameter space. With this low-threshold detector, we are sensitive to coherent elastic scattering between dark matter and nuclei. The cross section for this process is orders of magnitude higher than for other processes historically used for accelerator-based direct-detection searches so that our small, 14.6 kg detector significantly improves on past constraints. At peak sensitivity, we reject the flux consistent with the cosmologically observed dark-matter concentration for all coupling constants α_{D}<0.64, assuming a scalar dark-matter particle. We also calculate the sensitivity of future COHERENT detectors to dark-matter signals which will ambitiously test multiple dark-matter spin scenarios.
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Affiliation(s)
- D Akimov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - P An
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - C Awe
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - P S Barbeau
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - B Becker
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - V Belov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- National Research Center "Kurchatov Institute," Moscow 123182, Russian Federation
| | - I Bernardi
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - M A Blackston
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - C Bock
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A Bolozdynya
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - J Browning
- Department of Physics, North Carolina State University, Raleigh, North Carolina 27695, USA
| | | | - D Chernyak
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - E Conley
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - J Daughhetee
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Detwiler
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - K Ding
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M R Durand
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - Y Efremenko
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S R Elliott
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - L Fabris
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M Febbraro
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A Gallo Rosso
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - A Galindo-Uribarri
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M P Green
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- Department of Physics, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - M R Heath
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S Hedges
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Lawrence Livermore National Laboratory, Livermore, California, 94550, USA
| | - D Hoang
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - M Hughes
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - T Johnson
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - A Khromov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - A Konovalov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- National Research Center "Kurchatov Institute," Moscow 123182, Russian Federation
| | - E Kozlova
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- National Research Center "Kurchatov Institute," Moscow 123182, Russian Federation
| | - A Kumpan
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - L Li
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J M Link
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J Liu
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - K Mann
- Department of Physics, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - D M Markoff
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Mathematics and Physics, North Carolina Central University, Durham, North Carolina 27707, USA
| | - J Mastroberti
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - P E Mueller
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Newby
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - D S Parno
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - S I Penttila
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - D Pershey
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - R Rapp
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - J Raybern
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - O Razuvaeva
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- National Research Center "Kurchatov Institute," Moscow 123182, Russian Federation
| | - D Reyna
- Sandia National Laboratories, Livermore, California 94550, USA
| | - G C Rich
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J Ross
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Mathematics and Physics, North Carolina Central University, Durham, North Carolina 27707, USA
| | - D Rudik
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - J Runge
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - D J Salvat
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - A M Salyapongse
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - J Sander
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - K Scholberg
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - A Shakirov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - G Simakov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- National Research Center "Kurchatov Institute," Moscow 123182, Russian Federation
| | - G Sinev
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - W M Snow
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - V Sosnovtsev
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - B Suh
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - R Tayloe
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | | | - I Tolstukhin
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - E Ujah
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - J Vanderwerp
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - R L Varner
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - C J Virtue
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - G Visser
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - T Wongjirad
- Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155, USA
| | - Y-R Yen
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - J Yoo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - C-H Yu
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Zettlemoyer
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
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Branstetter B, Agarwal V, Hughes M. Regarding "Rates of Epidural Blood Patch following Lumbar Puncture Comparing Atraumatic versus Bevel-Tip Needles Stratified for Body Mass Index". AJNR Am J Neuroradiol 2023; 44:E11. [PMID: 36657947 PMCID: PMC9891340 DOI: 10.3174/ajnr.a7562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- B Branstetter
- Department of RadiologyUniversity of Pittsburgh Medical CenterPittsburgh, Pennsylvania
| | - V Agarwal
- Department of RadiologyUniversity of Pittsburgh Medical CenterPittsburgh, Pennsylvania
| | - M Hughes
- Department of RadiologyUniversity of Pittsburgh Medical CenterPittsburgh, Pennsylvania
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6
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Hoegholt NF, Bonetti L, Stevner ABA, Andersen CE, Hughes M, Fernandes HM, Vuust P, Kringelbach ML. A magnetoencephalography study of first-time mothers listening to infant cries. Cereb Cortex 2022; 33:5896-5905. [PMID: 36460612 DOI: 10.1093/cercor/bhac469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 12/05/2022] Open
Abstract
Abstract
Studies using magnetoencephalography (MEG) have identified the orbitofrontal cortex (OFC) to be an important early hub for a “parental instinct” in the brain. This complements the finding from functional magnetic resonance imaging studies linking reward, emotion regulation, empathy, and mentalization networks to the “parental brain.” Here, we used MEG in 43 first-time mothers listening to infant and adult cry vocalizations to investigate the link with mother–infant postpartum bonding scores and their level of sleep deprivation (assessed using both actigraphy and sleep logs). When comparing brain responses to infant versus adult cry vocalizations, we found significant differences at around 800–1,000 ms after stimuli onset in the primary auditory cortex, superior temporal gyrus, hippocampal areas, insula, precuneus supramarginal gyrus, postcentral gyrus, and posterior cingulate gyrus. Importantly, mothers with weaker bonding scores showed decreased brain responses to infant cries in the auditory cortex, middle and superior temporal gyrus, OFC, hippocampal areas, supramarginal gyrus, and inferior frontal gyrus at around 100–300 ms after the stimulus onset. In contrast, we did not find correlations with sleep deprivation scores. The significant decreases in brain processing of an infant’s distress signals could potentially be a novel signature of weaker infant bonding in new mothers and should be investigated in vulnerable populations.
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Affiliation(s)
- N F Hoegholt
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
- Linacre College, University of Oxford Centre for Eudaimonia and Human Flourishing, , Oxford OX37JX , United Kingdom
- Emergency Department at Randers Regional Hospital , 8930 , Denmark
| | - L Bonetti
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
- Linacre College, University of Oxford Centre for Eudaimonia and Human Flourishing, , Oxford OX37JX , United Kingdom
- University of Oxford Department of Psychiatry, , Oxford OX37JX , United Kingdom
| | - A B A Stevner
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
- Linacre College, University of Oxford Centre for Eudaimonia and Human Flourishing, , Oxford OX37JX , United Kingdom
| | - C E Andersen
- Aarhus University Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, , 8000 Aarhus , Denmark
| | - M Hughes
- Linacre College, University of Oxford Centre for Eudaimonia and Human Flourishing, , Oxford OX37JX , United Kingdom
| | - H M Fernandes
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
- Linacre College, University of Oxford Centre for Eudaimonia and Human Flourishing, , Oxford OX37JX , United Kingdom
| | - P Vuust
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
| | - M L Kringelbach
- Aarhus University & The Royal Academy of Music Aarhus/Aalborg Center for Music in the Brain, Department of Clinical Medicine, , 8000 Aarhus , Denmark
- Linacre College Centre for Eudaimonia and Human Flourishing, , University of Oxford, Oxford OX37JX, United Kingdom
- University of Oxford Department of Psychiatry, , Oxford OX37JX , United Kingdom
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Rouzier V, Murrill M, Kim S, Naini L, Shenje J, Mitchell E, Raesi M, Lourens M, Mendoza A, Conradie F, Suryavanshi N, Hughes M, Shah S, Churchyard G, Swindells S, Hesseling A, Gupta A. Caregiver willingness to give TPT to children living with drug-resistant TB patients. Int J Tuberc Lung Dis 2022; 26:949-955. [PMID: 36163664 PMCID: PMC9524515 DOI: 10.5588/ijtld.21.0760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/12/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Pediatric household contacts (HHCs) of patients with multidrug-resistant TB (MDR-TB) are at high risk of infection and active disease. Evidence of caregiver willingness to give MDR-TB preventive therapy (TPT) to children is limited.METHODS This was a cross-sectional study of HHCs of patients with MDR-TB to assess caregiver willingness to give TPT to children aged <13 years.RESULTS Of 743 adult and adolescent HHCs, 299 reported caring for children aged <13 years of age. The median caregiver age was 35 years (IQR 27-48); 75% were women. Among caregivers, 89% were willing to give children MDR TPT. In unadjusted analyses, increased willingness was associated with TB-related knowledge (OR 5.1, 95% CI 2.3-11.3), belief that one can die of MDR-TB (OR 5.2, 95% CI 1.2-23.4), concern for MDR-TB transmission to child (OR 4.5, 95% CI 1.6-12.4), confidence in properly taking TPT (OR 4.5, 95% CI 1.6-12.6), comfort telling family about TPT (OR 5.5, 95% CI 2.1-14.3), and willingness to take TPT oneself (OR 35.1, 95% CI 11.0-112.8).CONCLUSIONS A high percentage of caregivers living with MDR- or rifampicin-resistant TB patients were willing to give children a hypothetical MDR TPT. These results provide important evidence for the potential uptake of effective MDR TPT when implemented.
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Affiliation(s)
- V Rouzier
- GHESKIO Centers, Port-au-Prince, Haiti and Weill Cornell Medicine, Center for Global Health, Department of Medicine, New York, NY
| | - M Murrill
- Johns Hopkins Medical Institutions, Baltimore, MD
| | - S Kim
- Frontier Science Foundation, Brookline, MA
| | - L Naini
- Social and Scientific Systems, Inc., Silver Springs, MD, USA
| | - J Shenje
- South African Tuberculosis Vaccine Initiative (SATVI), Cape Town, South Africa
| | - E Mitchell
- University of Cape Town Lung Institute, Mowbray, South Africa
| | - M Raesi
- Gaborone Clinical Research Site, Gaborone, Botswana
| | - M Lourens
- TASK Applied Science Clinical Research Site, Bellville, South Africa
| | - A Mendoza
- Asociación Civil Impacta Salud y Educación - Barranco Clinical Research Site, Lima, Peru
| | - F Conradie
- Sizwe Tropical Disease Hospital, Johannesburg, South Africa
| | - N Suryavanshi
- Byramjee Jeejeebhoy Government Medical College Clinical Trials Unit, Pune, India
| | - M Hughes
- Harvard T H Chan School of Public Health, Boston, MA
| | - S Shah
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - G Churchyard
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa, Aurum Institute, Johannesburg, South Africa
| | - S Swindells
- University of Nebraska Medical Center, Omaha, NE, USA
| | - A Hesseling
- Desmond Tutu TB Centre, Stellenbosch University, Tygerberg, South Africa
| | - A Gupta
- GHESKIO Centers, Port-au-Prince, Haiti and Weill Cornell Medicine, Center for Global Health, Department of Medicine, New York, NY
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Akimov D, An P, Awe C, Barbeau P, Becker B, Belov V, Bernardi I, Blackston M, Bock C, Bolozdynya A, Bouabid R, Browning J, Cabrera-Palmer B, Chernyak D, Conley E, Daughhetee J, Detwiler J, Ding K, Durand M, Efremenko Y, Elliott S, Fabris L, Febbraro M, Gallo Rosso A, Galindo-Uribarri A, Green M, Heath M, Hedges S, Hoang D, Hughes M, Johnson B, Johnson T, Khromov A, Konovalov A, Kozlova E, Kumpan A, Li L, Link J, Liu J, Major A, Mann K, Markoff D, Mastroberti J, Mattingly J, Mueller P, Newby J, Parno D, Penttila S, Pershey D, Prior C, Rapp R, Ray H, Razuvaeva O, Reyna D, Rich G, Ross J, Rudik D, Runge J, Salvat D, Salyapongse A, Sander J, Scholberg K, Shakirov A, Simakov G, Snow W, Sosnovstsev V, Suh B, Tayloe R, Tellez-Giron-Flores K, Tolstukhin I, Ujah E, Vanderwerp J, Varner R, Virtue C, Visser G, Wongjirad T, Yen YR, Yoo J, Yu CH, Zettlemoyer J. COHERENT constraint on leptophobic dark matter using CsI data. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.052004] [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]
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9
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Pfeifer J, Egger A, Hughes M, Tondl L, High R, Nelson KL. An investigation of stress and anxiety among health professions students in the early stages of the COVID-19 pandemic. Journal of Interprofessional Education & Practice 2022; 28:100531. [PMID: 35814868 PMCID: PMC9249993 DOI: 10.1016/j.xjep.2022.100531] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 03/28/2022] [Accepted: 06/22/2022] [Indexed: 11/23/2022]
Abstract
Background Early studies during the COVID-19 pandemic identify the dissonance between feeling anxious about contracting the illness and the innate desire to serve the sick, as a main stressor for students. Purpose The purpose of this study is to better understand psychological stress and self-reported wellness of Physician Assistant (PA), Physical Therapy (PT), dental, and medical students during the early portions of the COVID-19 pandemic. Methods We utilized the 10-item Perceived Stress Scale (PSS) together with additional questions to assess self-perceived stress, anxiety, and wellness of healthcare students. Discussion There were no significant differences in PSS between professions. As PSS increased (indicating more stress), the odds of answering “worse” versus “same” or “better” to descriptions of anxiety level increased (OR: 2.318). Conclusion Student survey respondents experienced similar levels of perceived stress throughout the COVID-19 pandemic. Institutions should consider students’ perceived levels of stress and the many aspects of student wellness that may have been affected by the COVID-19 pandemic.
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10
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Keenlyside A, Hughes M, Ho JW, Sieradzki J. 73 The Digital Cullen Chart: An App to Assess the Visual Field in the Context of Sellar/parasellar Tumours. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Aim
30 years ago, Cullen1 (a neuro-ophthalmologist) developed and validated a simple paper chart for evaluation of the central 25 degrees of the visual field. We re-developed this concept in digital form (as a smartphone application) and sought to assess its sensitivity and specificity in detecting field loss, through comparison with formal machine-based perimetry.
Method
A case series pilot study was performed to test the app-based Cullen chart for concordance with formal machine-based perimetry (Humphrey and Octopus). 18 patients with a range of sellar/parasellar tumours (pituitary adenoma, craniopharyngioma, and meningioma) being managed in a single neurosurgical centre were involved in this study. Patients underwent formal visual field perimetry as part of standard care. They also underwent assessment using the smartphone-based Cullen chart as part of routine outpatient assessment. 37 eye episodes were assessed, incorporating pre- and post- treatment assessment for a range of potentially compressive pathologies.
Results
The digital Cullen chart had a sensitivity of 75% and specificity of 98% compared with machine-based perimeters. The positive predictive value was 93% and negative predictive value was 92%.
Conclusions
In the context of visual field assessment for patients with sellar/parasellar tumours, this smartphone-based chart shows strong concordance with machine-based perimeters. It is therefore an accessible visual field screening and monitoring tool for clinicians. With further study, there is also potential for approval as a remote patient-led visual field monitoring method.
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Affiliation(s)
- A Keenlyside
- School of Medicine, University of Dundee , Dundee , United Kingdom
| | - M Hughes
- Department of Clinical Neurosciences , BioQuarter, Edinburgh , United Kingdom
| | - JW Ho
- Department of Neurosurgery , North Bristol Trust, Bristol , United Kingdom
| | - J Sieradzki
- University of Edinburgh , Edinburgh , United Kingdom
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11
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Akimov D, An P, Awe C, Barbeau PS, Becker B, Belov V, Bernardi I, Blackston MA, Bock C, Bolozdynya A, Browning J, Cabrera-Palmer B, Chernyak D, Conley E, Daughhetee J, Detwiler J, Ding K, Durand MR, Efremenko Y, Elliott SR, Fabris L, Febbraro M, Gallo Rosso A, Galindo-Uribarri A, Green MP, Heath MR, Hedges S, Hoang D, Hughes M, Johnson T, Khromov A, Konovalov A, Kozlova E, Kumpan A, Li L, Link JM, Liu J, Mann K, Markoff DM, Mastroberti J, Mueller PE, Newby J, Parno DS, Penttila SI, Pershey D, Rapp R, Ray H, Raybern J, Razuvaeva O, Reyna D, Rich GC, Ross J, Rudik D, Runge J, Salvat DJ, Salyapongse AM, Scholberg K, Shakirov A, Simakov G, Sinev G, Snow WM, Sosnovstsev V, Suh B, Tayloe R, Tellez-Giron-Flores K, Tolstukhin I, Ujah E, Vanderwerp J, Varner RL, Virtue CJ, Visser G, Wongjirad T, Yen YR, Yoo J, Yu CH, Zettlemoyer J. Measurement of the Coherent Elastic Neutrino-Nucleus Scattering Cross Section on CsI by COHERENT. Phys Rev Lett 2022; 129:081801. [PMID: 36053683 DOI: 10.1103/physrevlett.129.081801] [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] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/17/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
We measured the cross section of coherent elastic neutrino-nucleus scattering (CEvNS) using a CsI[Na] scintillating crystal in a high flux of neutrinos produced at the Spallation Neutron Source at Oak Ridge National Laboratory. New data collected before detector decommissioning have more than doubled the dataset since the first observation of CEvNS, achieved with this detector. Systematic uncertainties have also been reduced with an updated quenching model, allowing for improved precision. With these analysis improvements, the COHERENT Collaboration determined the cross section to be (165_{-25}^{+30})×10^{-40} cm^{2}, consistent with the standard model, giving the most precise measurement of CEvNS yet. The timing structure of the neutrino beam has been exploited to compare the CEvNS cross section from scattering of different neutrino flavors. This result places leading constraints on neutrino nonstandard interactions while testing lepton flavor universality and measures the weak mixing angle as sin^{2}θ_{W}=0.220_{-0.026}^{+0.028} at Q^{2}≈(50 MeV)^{2}.
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Affiliation(s)
- D Akimov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - P An
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - C Awe
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - P S Barbeau
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - B Becker
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - V Belov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow 117218, Russian Federation
| | - I Bernardi
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - M A Blackston
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - C Bock
- Physics Department, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A Bolozdynya
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - J Browning
- Department of Physics, North Carolina State University, Raleigh, North Carolina 27695, USA
| | | | - D Chernyak
- Physics Department, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - E Conley
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - J Daughhetee
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Detwiler
- Center for Experimental Nuclear Physics and Astrophysics, Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - K Ding
- Physics Department, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M R Durand
- Center for Experimental Nuclear Physics and Astrophysics, Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - Y Efremenko
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S R Elliott
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - L Fabris
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M Febbraro
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A Gallo Rosso
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - A Galindo-Uribarri
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M P Green
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- Department of Physics, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - M R Heath
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S Hedges
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - D Hoang
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - M Hughes
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - T Johnson
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - A Khromov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - A Konovalov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow 117218, Russian Federation
| | - E Kozlova
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow 117218, Russian Federation
| | - A Kumpan
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - L Li
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J M Link
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J Liu
- Physics Department, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - K Mann
- Department of Physics, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - D M Markoff
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Mathematics and Physics, North Carolina Central University, Durham, North Carolina 27707, USA
| | - J Mastroberti
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - P E Mueller
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Newby
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - D S Parno
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - S I Penttila
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - D Pershey
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - R Rapp
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - H Ray
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - J Raybern
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - O Razuvaeva
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow 117218, Russian Federation
| | - D Reyna
- Sandia National Laboratories, Livermore, California 94550, USA
| | - G C Rich
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J Ross
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Mathematics and Physics, North Carolina Central University, Durham, North Carolina 27707, USA
| | - D Rudik
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - J Runge
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - D J Salvat
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - A M Salyapongse
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - K Scholberg
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - A Shakirov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - G Simakov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow 117218, Russian Federation
| | - G Sinev
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - W M Snow
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - V Sosnovstsev
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow 115409, Russian Federation
| | - B Suh
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - R Tayloe
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | | | - I Tolstukhin
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - E Ujah
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Mathematics and Physics, North Carolina Central University, Durham, North Carolina 27707, USA
| | - J Vanderwerp
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - R L Varner
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - C J Virtue
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - G Visser
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - T Wongjirad
- Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155, USA
| | - Y-R Yen
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - J Yoo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - C-H Yu
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Zettlemoyer
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
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Akimov D, An P, Awe C, Barbeau P, Becker B, Belov V, Bernardi I, Blackston M, Bock C, Bolozdynya A, Browning J, Cabrera-Palmer B, Chernyak D, Conley E, Daughhetee J, Detwiler J, Ding K, Durand M, Efremenko Y, Elliott S, Fabris L, Febbraro M, Galambos J, Gallo Rosso A, Galindo-Uribarri A, Green M, Heath M, Hedges S, Hoang D, Hughes M, Iverson E, Johnson T, Khromov A, Konovalov A, Kozlova E, Kumpan A, Li L, Link J, Liu J, Mann K, Markoff D, Mastroberti J, McIntyre M, Mueller P, Newby J, Parno D, Penttila S, Pershey D, Rapp R, Ray H, Raybern J, Razuvaeva O, Reyna D, Rich G, Rimal D, Ross J, Rudik D, Runge J, Salvat D, Salyapongse A, Scholberg K, Shakirov A, Simakov G, Sinev G, Snow W, Sosnovstsev V, Suh B, Tayloe R, Tellez-Giron-Flores K, Tolstukhin I, Trotter S, Ujah E, Vanderwerp J, Varner R, Virtue C, Visser G, Wongjirad T, Yen YR, Yoo J, Yu CH, Zettlemoyer J, Zhang S. Simulating the neutrino flux from the Spallation Neutron Source for the COHERENT experiment. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.032003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Di Donato S, Hughes M, Abignano G, Lettieri G, Ross R, De Lorenzis E, O’Connor P, Kubassova O, Del Galdo F. AB0142 EVIDENCE OF TYPE I INTERFERON ACTIVATION DURING VASCULAR MANIFESTATIONS OF SYSTEMIC SCLEROSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5092] [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
BackgroundVascular involvement in Systemic Sclerosis (SSc) is known to start even before clinical diagnosis, to drive Digital Ulcer disease and later in the disease natural history to cause Pulmonary Artery Hypertension, among other manifestations. Despite the proven immune origin of Scleroderma, vascular involvement is not currently targeted by immune driven interventions. Similarly, little data is available on immune or inflammatory biomarkers and outcome measures of vascular disease in SSc. Digital Artery Volume Index (DAVIX) has been recently proposed as imaging surrogate outcome measure of vascular disease activity in SSc [1].ObjectivesHere we aimed to determine the value of DAVIX as overall biomarker of vascular involvement and its correlation with Type I IFN activation in patients with SSc.MethodsEighty-six patients attending our Scleroderma Program were consecutively enrolled for the evaluation of serum IFN score as previously described [2]. Clinical features including presence or history of Digital Ulcers, Presence of Pulmonary Artery Hypertension (PAH) and DLCO, were recorded. Digital Artery Vascular Index (DAVIX) of the dominant hand’s fingers was calculated using time of flight magnetic resonance images analysed through IAG proprietary algorithm, as previously described [1]. Medians were compared by Mann-Whitney-Wilcoxon test, correlation with clinical parameters was performed using Spearman’s or Pearson test, as appropriate (R).ResultsSixty-two patients fulfilled the 2013 ACR/EULAR classification criteria for SSc (diffuse cutaneous 24.6%, limited cutaneous 75.4%) whereas 23 were classified as Very Early Diagnosis of Scleroderma (Criteria score between 6 and 8). Twenty-three patients had DU disease (History of DUs in the previous 24 weeks, presence of DUs at baseline assessment, or onset of new DUs during the following 24 weeks). Eighteen patients had reduced DLCO (<70) with FVC/DLCO>1.8 (suspected PAH). DAVIX showed a negative correlation with disease duration (r=-0.33 and p=.003) and with FVC/DLCO ratio (r=-0.34 and p=.009). Patients with DU disease presented lower DAVIX than patients without (p=.018).DAVIX showed a significant correlation with Serum IFN score (r=-0.24, p<0.032). Accordingly, patients classified as IFN-HI had lower DAVIX than those within the IFN-LO group (p=0.016).ConclusionDAVIX correlated both with presence of Digital Ulcer disease, DLCO and disease duration. The correlation of DAVIX and Serum IFN score does support the notion of innate immune involvement in vascular disease manifestations of SSc. Prospective testing in the context of Randomised controlled trial will determine the value of DAVIX as surrogate outcome measure of vascular disease severity in SSc.References[1]Gjeloshi K, et al. Arthritis Rheumatol. 2020.[2]Hinchcliff M et al. Arthritis Rheumatol. 2021.Disclosure of InterestsStefano Di Donato: None declared, Mike Hughes: None declared, Giuseppina Abignano: None declared, Giovanni Lettieri: None declared, Rebecca Ross: None declared, Enrico De Lorenzis: None declared, Philip O’Connor: None declared, Olga Kubassova Shareholder of: IAG Image Analysis Group, CEO, Francesco Del Galdo: None declared
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Liu L, Trivedi P, Ho B, Selph C, Hughes M, Casadaban L. Abstract No. 397 Adrenal vein sampling with slow infusion of Cosyntropin for identifying surgically curable cases. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Campochiaro C, Suliman YA, Hughes M, Schoones J, Giuggioli D, Moinzadeh P, Maltez N, Ross L, Baron M, Chung L, Allanore Y, Denton CP, Distler O, Frech T, Furst D, Khanna D, Krieg T, Kuwana M, Matucci-Cerinic M, Pope J, Alunno A. POS0888 NON-SURGICAL LOCAL TREATMENTS FOR DIGITAL ULCERS IN SYSTEMIC SCLEROSIS: A SYSTEMATIC LITERATURE REVIEW. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3098] [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
BackgroundDigital ulcers(DUs) in systemic sclerosis(SSc) represent a major clinical challenge. There are no recommendations for the local management of SSc-DUs. Systemic therapy is considered the standard of care. However, there is a strong rationale for local approaches to DU by avoiding side effects from systemic therapies. The World Scleroderma Foundation DU Working Group intends to develop evidence-based recommendations for DU management including local, non-surgical treatment(ln-sT).ObjectivesTo summarise the literature on the safety and efficacy of ln-sT for SSc-DUs.MethodsA systematic literature review(SLR) of papers describing the use of ln-sT for DU in SSc was performed up to May 2021 according to the PICO framework. References were independently screened by two reviewers who independently assessed the full text of eligible articles and extracted data.ResultsAmong 790 retrieved references, 12 were included. Median(range) number of patients per study was 9(7–84), mean age ranging from 37 to 62.5 years. In 5(41%) studies a control group was included. Background systemic therapies are summarized in Table 1. The most studied treatment was botulin toxin A(BTA). It was used as hand injection in 3 studies (median dose ranging from 90 to 150 U) and as 50 U single finger injection in 1 study. Healing rate after a median time of 8-49 weeks ranged from 71% to 100%. In 2 studies a reduction in VAS pain was observed from 20% to 100%. Transient muscle weakness was the most common side effect in 10% of patients. Amniotic(Am) and hydrocolloid membranes(HyM) were used in 1 study each. They were associated with a good healing rate, statistically significant for the HyM. Tadalafil 2% cream was studied in 1 study and was associated with a reduction in the median DU number from 1.6 to 1 per patient after a median time of 4 weeks and a reduction by 1.4 point in the 10-mm VAS scale. Vitamin E gel was shown to be associated with a statistically significant reduction in the healing time compared to SoC alone in 1 RCT(13.2 ± 2.7 versus 20.9 ± 3.6 weeks, P=<0.001). Low-level light therapy, hydrodissection and corticosteroid injection and extracorporeal shock wave(ESW) were evaluated in 1 study each. They were all associated with positive outcomes which was statistically significant only for the ESW. The only negative trial examined dimethyl sulfoxide and was associated with local toxicity.Table 1.Characteristics of the studies.TreatmentType of studyPatientsBaseline DUBackground therapy (%) ETA CCB APA PG ARB ACE-I PDE-5i ISFollow-up (weeks)Healing rate(%)*Pain Reduction (VAS/10)ComparatorHydrodissection and corticosteroid injectionP1202334.4Rheumatoid ArthritisTadalafil 2% Vitamin E gelRRCT15131.6(1)3.5±2.30462700130704 241(1)Reduced time to heal**1.4SoCAmHyMRP67310001002800002817033143810090**SoCBTAMedian 90 U per handHigh-concentration hand100 U non-dominant handSingle finger 50 URRPP772010314571140718558551008514201001414718 4981277717510020%100%Untreated CHLow-level light therapyP8102537025378100ESWP9493355661144441**1.31Dimethyl sulfoxideDBRCT84No change, skin toxicity with 70% formulation*Unless otherwise stated. **Statistically significant. ARB= angiotensin receptor antagonist. ACEi= ACE inhibitors. APA= anti-platelet agents. CCB= calcium channel blockers. CH= contralateral hand. DBRCT= double blind randomized-controlled trial. ETA = endothelin antagonist. IS= immunosuppression. PG= prostaglandins. PDE-5i= Phosphodiesterase type-5 inhibitors. P = prospective. R = retrospective. SoC= standard of care (as per local protocol).ConclusionOur SLR supports interest to develop ln-sTs for SSc-DUs. The number of studies is limited and mainly case reports and small single studies are present. Treatments were well tolerated and there was evidence of efficacy for BTA, vitamin E, ESW and HyM in refractory DUs. The evidence is not robust and confounding factors (vasodilators background therapies) could impact on the findings. Future research is indicated to conduct larger, well-designed studies.Disclosure of InterestsCorrado Campochiaro: None declared, Yossra A. Suliman: None declared, Michael Hughes Speakers bureau: Actelion pharmaceuticals, Eli Lilly, and Pfizer, outside of the submitted work., Jan Schoones: None declared, Dilia Giuggioli: None declared, Pia Moinzadeh Speakers bureau: speaking fees from Actelion pharmaceuticals and Boehringer Ingelheim, Nancy Maltez: None declared, Laura Ross: None declared, Murray Baron: None declared, Lorinda Chung: None declared, Yannick Allanore: None declared, Christopher P Denton: None declared, Oliver Distler Speakers bureau: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur, Tracy Frech: None declared, Daniel Furst: None declared, Dinesh Khanna Speakers bureau: Janssen and Eicos Sciences, Inc., Thomas Krieg: None declared, Masataka Kuwana Speakers bureau: Speakers fees from AbbVie, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai, Eisai, GlaxoSmithKline, Janssen, Nippon Shinyaku, Ono Pharmaceuticals, Tanabe-Mitsubishi, and Consultant fees from AstraZeneca, Boehringer Ingelheim, Corbus, Kissei, Mochida, outside of the submitted work., Marco Matucci-Cerinic: None declared, Janet Pope: None declared, Alessia Alunno: None declared
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Suliman YA, Campochiaro C, Hughes M, Schoones J, Giuggioli D, Maltez N, Moinzadeh P, Ross L, Chung L, Allanore Y, Baron M, Denton CP, Distler O, Frech T, Furst D, Khanna D, Krieg T, Kuwana M, Matucci-Cerinic M, Pope J, Alunno A. POS0898 SURGICAL MANAGEMENT OF DIGITAL ULCERS IN SYSTEMIC SCLEROSIS: A SYSTEMATIC LITERATURE REVIEW. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3442] [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
BackgroundManagement of digital ulcers (DUs) in systemic sclerosis (SSc) is a major clinical challenge. To date, systemic therapy is generally considered as the ‘standard of care’ for significant SSc-DUs. However, there is a strong rationale to develop local approaches to DUs, to avoid side effects from systemic therapies. World Scleroderma Foundation DU Working Group intends to develop practical, evidence-based recommendations for DU management including local, Surgical Treatment (L-ST).ObjectivesTo summarize the literature on the safety and efficacy of L-ST for SSc-DUs.MethodsA systematic literature review (SLR) was conducted up to May 2021. According to the PICO framework, eligibility criteria were defined and original research articles about surgical treatment of SSc DUs in adult patients were included. References were independently screened by 2 reviewers who assessed the full text of eligible articles and extracted data.ResultsThirteen eligible articles out of 790 total publications were identified (Table 1). Due to the paucity of randomized controlled trials of surgical treatments for SSc-DU, we included retrospective studies and case series with at least 4 patients. Autologous fat (adipose tissue AT) grafting was the surgical modality mostly identified (7 studies of which 1 RCT and 6 prospective open label single arm). The healing rate (HR) with autologous fat grafting (4 studies) ranged from 66-100 %. In the RCT, two age and sex matched groups were included, adipose tissue (AT)group (n=25 pts) and sham procedure (SP) group (n=13), DU healing was reported in 23/25 in AT group versus 1/13 in the SP group in 8 wks, (p<0.0001), 12 pts in the SP group, received rescue AT injection, all of them healed after 8 wks. Three studies reported autologous adipose-derived stromal vascular fraction(SVF) grafting and the HR ranged from 32-60%, followed up to 12 months. Transient edema and paresthesia were reported in 2 studies, and amputation in 2 ulcers in 1 study, and no complications were reported in other studies. Surgical sympathectomy was reported in 3 studies, with a median healing rate of 81%. Bone marrow derived cell transplantation in a single study showed 87% healing rate over (4-24 wks). Two surgical studies (of direct microsurgical revascularization N=4, and microsurgical arteriolysis, N=6), showed 100% healing of ulcers, no complications reported.Table 1.Characteristics of the extracted studies.StudydesignPatients (n)Baseline DU (n)Background therapy (%)Follow-upOutcomeHealed ulcers(%) Adipose tissue graftAutologous fat graftp9.15PG, CCB—100ETA 26PDE-5i 138-12 wks66Adipose tissue graftingRCT25 case13- Ctr25-case13- CtrPG- 100CCB 1008 wks92-case7-CtrAdipose tissue implantp1515no therapy7 wks100Adipose tissue graftp129PG,CCB-100ETA6 month88adipose derived SVFp1215PDE-5i, ccb, PG allowed22m6Adipose derived SVFp1215CCB 50ETA166 m63 Adipose derived SVFp1819CCB 50PG 27ETA 5IS 7124 wks32SympathectomySympathectomyR611CCB-10020 m81SympathectomyR1335PGCCBAPA35Sympathectomy, vascular bypass (+vein graftR1726Ccb 35APA 47PDE-i5 589 m100Bone marrow derived cells transplantation)p88PG-6236 m87Direct microsurgical revascularizationR44m100Limited microsurgical arteriolysisR61712 m100SVF =stromal vascular fraction P = prospective. R = retrospective. RCT= double blind randomized-controlled trial. ETA = endothelin antagonist. CCB= calcium channel blockers. APA= anti-platelet agents. PG= prostaglandins. ARB= angiotensin receptor antagonist. ACEi= ACE inhibitors. PDE-5i= PDE-5 inhibitors. IS= immunosuppression. M=median. SoC= standard of care. HR= healing rateConclusionOur SLR has identified several surgical modalities for SSc-DUs. L-STseemed generally effective and safe for DU healing, thus Significant methodological issues emerged including small numbers of pts, lack of comparator, failure to report confounders such as background therapies and variable follow up. Future research is warranted to rigorously investigate surgical interventions for Dus.Disclosure of InterestsYossra A. Suliman: None declared, Corrado Campochiaro: None declared, Michael Hughes Speakers bureau: speaking fees from Actelion pharmaceuticals, Eli Lilly, and Pfizer, outside of the submitted work, Jan Schoones: None declared, Dilia Giuggioli: None declared, Nancy Maltez: None declared, Pia Moinzadeh Speakers bureau:: speaking fees from Actelion pharmaceuticals and Boehringer Ingelheim, Laura Ross: None declared, Lorinda Chung: None declared, Yannick Allanore: None declared, Murray Baron: None declared, Christopher P Denton: None declared, Oliver Distler Shareholder of: Consultancy relationship with and/or has received research funding from and/or has served as a speaker for the following companies in the area of potential treatments for systemic sclerosis and its complications in the last three calendar years: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur. Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Speakers bureau: Consultancy relationship with and/or has received research funding from and/or has served as a speaker for the following companies in the area of potential treatments for systemic sclerosis and its complications in the last three calendar years: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur. Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Consultant of: Consultancy relationship with and/or has received research funding from and/or has served as a speaker for the following companies in the area of potential treatments for systemic sclerosis and its complications in the last three calendar years: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur. Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Grant/research support from: Consultancy relationship with and/or has received research funding from and/or has served as a speaker for the following companies in the area of potential treatments for systemic sclerosis and its complications in the last three calendar years: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur. Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Tracy Frech: None declared, Daniel Furst: None declared, Dinesh Khanna Speakers bureau: Janssen and Eicos Sciences, Inc., Paid instructor for: Janssen and Eicos Sciences, Inc., Consultant of: Janssen and Eicos Sciences, Inc., Thomas Krieg: None declared, Masataka KUWANA Speakers bureau: Speakers fees from AbbVie, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai, Eisai, GlaxoSmithKline, Janssen, Nippon Shinyaku, Ono Pharmaceuticals, Tanabe-Mitsubishi, and Consultant fees from AstraZeneca, Boehringer Ingelheim, Corbus, Kissei, Mochida, outside of the submitted work., Paid instructor for: Speakers fees from AbbVie, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai, Eisai, GlaxoSmithKline, Janssen, Nippon Shinyaku, Ono Pharmaceuticals, Tanabe-Mitsubishi, and Consultant fees from AstraZeneca, Boehringer Ingelheim, Corbus, Kissei, Mochida, outside of the submitted work., Consultant of: Speakers fees from AbbVie, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai, Eisai, GlaxoSmithKline, Janssen, Nippon Shinyaku, Ono Pharmaceuticals, Tanabe-Mitsubishi, and Consultant fees from AstraZeneca, Boehringer Ingelheim, Corbus, Kissei, Mochida, outside of the submitted work., Marco Matucci-Cerinic: None declared, Janet Pope: None declared, Alessia Alunno: None declared
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Hughes M, Huang S, Alegre Sancho JJ, Carreira P, Engelhart M, Hachulla E, Henes J, Kerzberg E, Pozzi MR, Riemekasten G, Smith V, Szucs G, Vanthuyne M, Zanatta E, Distler O, Gabrielli A, Hoffmann-Vold AM, Steen V, Khanna D. POS0914 LATE SKIN FIBROSIS IN SYSTEMIC SCLEROSIS: A STUDY FROM THE EUSTAR COHORT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4227] [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
BackgroundSkin fibrosis is a cardinal feature of systemic sclerosis (SSc) and associated with significant disability. The early trajectory of skin fibrosis provides insights into the course of the disease including mortality; however, little is known about late skin fibrosis in SSc.ObjectivesThe aims of our study were to ascertain the prevalence and characteristics of late skin fibrosis in SSc.MethodsWe developed and tested three conceptual scenarios of late (>5 years after 1st non-RP sign or symptom) skin fibrosis (Figure 1):Figure 1.Conceptual models/scenarios of late skin fibrosis in SSc. A: worsening and then improvement (>3 mRSS) during the first 5 years, and then worsened again after 5 years. B: worsening for the first time after 5 years. C: worsening in the first 5 years and stayed high after 5 years (i.e., failure to improve).A. Worsening and then improvement (>3 mRSS) during the first 5 years, and then worsened again after 5 years.B. Worsening for the first time after 5 years.C. Worsening in the first 5 years and stayed high after 5 years (i.e., failure to improve).We defined skin worsening as modified Rodnan skin score (mRSS) ≥ 5 units or ≥ 25%. Using strict inclusion criteria including complete mRSS, we identified 1,043 (out of 19,115) patients within the EUSTAR database for our analysis. We further restricted analysis within 887 (out of 1,043) patients who had limited (lcSSc) or diffuse cutaneous SSc (dcSSc) at baseline.ResultsOne-fifth of patients among the whole cohort (n=208/1043, 19.9%) including in patients with lcSSc or dcSSc at baseline (n=193/887, 21.8%) developed late skin fibrosis. This was largely due to new skin worsening or failure to improve. Patients with lower baseline mRSS and lcSSc were more likely to develop late skin fibrosis. Anti-Scl-70 antibodies (Table 1) were associated with progression from baseline lcSSc to dcSSc, and anticentromere antibodies were protective.Table 1.Impact of autoantibody status on progression from baseline limited to diffuse cutaneous SSc (dcSSc).Skin worsening after 5 years (Scenario B) (n=70)Skin worsening within 5 years and failed to improve after 5-year window (Scenario C) (n=61)Progressed to dcSSc (n=23)Not progressed to dcSSc(n=47)P-valueProgressed to dcSSc (n=37)Not progressed to dcSSc(n=24)P-valueAnticentromere+ve2/22 (9.1%)19/42 (45.2%)0.00346/34 (17.6%)14/21 (66.7%)0.0002-ve20/22 (90.9%)23/42 (54.8%)28/34 (82.4%)7/21 (33.3%)Anti-Scl-70+ve15/23 (65.2%)14/44 (31.8%)0.008822/36 (61.1%)8/23 (34.8%)0.0485-ve8/23 (34.8%)30/44 (68.2%)14/36 (38.9%)15/23 (65.2%)Anti-RNA-Polymerase-III+ve0/12 (0.0%)1/22 (4.5%)1.00000/6 (0.0%)0/14 (0.0%)---ve12/12 (100%)21/22 (95.5%)6/6 (100%)14/14 (100%)ConclusionLate skin fibrosis affects approximately 20% of SSc patients >5 years after onset of disease. We have identified different patterns relevant to clinical practice and trial design. Late skin fibrosis is usually due to new worsening or failure of skin to improve. Progression from baseline limited to diffuse cutaneous SSc was associated with anti-Scl-70 antibodies, and anticentromere antibodies were protective. Late skin fibrosis is a neglected manifestation of SSc and warrants further investigation including to determine clinical outcomes and optimal therapeutic strategy.AcknowledgementsOn behalf of EUSTAR collaborators.Disclosure of InterestsMichael Hughes Speakers bureau: Speaking fees from Actelion pharmaceuticals, Eli Lilly, and Pfizer, outside of the submitted work, Suiyuan Huang: None declared, Juan Jose Alegre Sancho Speakers bureau: Speaking and/or investigational fees from Actelion pharmaceuticals, Eli Lilly, Pfizer, Boehringer Ingelheim, Roche, and GSK, outside of the submitted work, Grant/research support from: Speaking and/or investigational fees from Actelion pharmaceuticals, Eli Lilly, Pfizer, Boehringer Ingelheim, Roche, and GSK, outside of the submitted work, Patricia Carreira: None declared, Merete Engelhart: None declared, Eric Hachulla Speakers bureau: Received consulting fees/meeting fees from Johnson & Johnson, Boehringer Ingelheim, Bayer, GSK, Roche-Chugai, Sanofi-Genzyme; speaking fees from Johnson & Johnson, GSK, Roche-Chugai; and research funding from CSL Behring, GSK, Roche-Chugai and Johnson & Johnson., Consultant of: Received consulting fees/meeting fees from Johnson & Johnson, Boehringer Ingelheim, Bayer, GSK, Roche-Chugai, Sanofi-Genzyme; speaking fees from Johnson & Johnson, GSK, Roche-Chugai; and research funding from CSL Behring, GSK, Roche-Chugai and Johnson & Johnson., Jörg Henes Speakers bureau: Lectures for CHUGAI, Boehringer-Ingelheim, Eduardo Kerzberg: None declared, Maria Rosa Pozzi: None declared, Gabriela Riemekasten: None declared, Vanessa Smith: None declared, Gabriella Szucs: None declared, Marie Vanthuyne: None declared, Elisabetta Zanatta: None declared, Oliver Distler: None declared, Armando Gabrielli: None declared, Anna-Maria Hoffmann-Vold: None declared, Viginia Steen: None declared, Dinesh Khanna Shareholder of: DK has stock options in Eicos Sciences, Inc., Consultant of: Consultant for Acceleron, Amgen, Boehringer Ingelheim, CSL Behring, Chemomab, Genentech/Roche, Horizon, Mitsubishi Tanabe Pharma, Prometheus, Talaris., Grant/research support from: Has received grants from Bayer, BMS, Horizon and Pfizer (to University of Michigan).
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Merola JF, Kristensen LE, Yang F, Peterson S, Teneralli R, Massey N, Chakravarty SD, Hughes M, Shawi M, Weatherby S, Contre C, Lin I, Hassan F, Husni ME. POS1099 QUALITY OF LIFE, WORK IMPAIRMENT, AND DAILY ACTIVITY IMPAIRMENT OF PATIENTS WITH PSORIASIS VERSUS PSORIATIC ARTHRITIS: A REAL-WORLD SURVEY IN US AND EUROPE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4752] [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
BackgroundPsoriasis (PsO) and psoriatic arthritis (PsA) and are chronic immune-mediated diseases characterised by joint inflammation and skin lesions which negatively impact patients’ health-related quality of life (HRQoL). Several previous comparative studies have focused on PsA patients with or without skin involvement. Better understanding of the impact of both PsO and PsA on HRQoL and work / activity impairment will improve understanding of the incremental burden of PsA compared to PsO, and may lead to more personalised treatment options.ObjectivesTo compare HRQoL, work impairment, and daily activity impairment of patients with a PsO diagnosis (dx) only, PsO dx with musculoskeletal (MSK) symptoms (sx), PsA dx with active skin sx, and PsA dx without active skin sx.MethodsData were drawn from the Adelphi PsO & PsA Disease Specific Programmes™ (DSP), real-world point-in-time surveys of rheumatologists, dermatologists and their consulting patients in the United States and Europe (France, Germany, Italy, Spain and UK); conducted in 2018/19. Patients were grouped according to their symptoms and confirmed diagnoses, comprising four groups:1. Patients with PsO dx only,2. Patients with PsO dx and with MSK sx,3. Patients with PsA dx and with active skin sx,4. Patients with PsA dx with no active skin sx,Multivariate linear regression analyses with marginal mean predictions examined differences in patient-reported outcome measures (PROMs) between the four groups. Measures included HRQoL (EuroQol 5-Dimension 5-Level [EQ-5D Utility] and EuroQoL Visual Analogue Scale [EQ-VAS]), work impairment, and daily activity impairment (Work Productivity and Activity Impairment Questionnaire [WPAI]). Analyses controlled for demographics (age, sex, BMI), comorbidities present in >10% of patients and current treatment class (biologics, csDMARDs, steroids & other).Results4491 patients were included: Group 1 (n=1833), Group 2 (n=91), Group 3 (n=2451), and Group 4 (n=116). 54% of patients were male, 89% of patients were white, with a mean age of 46.6 years. Demographics were consistent across all patient groups.The model-predicted EQ-5D-Utility was lower in Groups 2, 3 and 4, compared with Group 1 (p=0.003, p<0.001 and p=0.004 respectively). Similarly, predicted EQ-VAS was lower in Group 3 compared with Group 1 (p=0.006), Table 1.Table 1.Predictions of PROMs for PsO-PsA patient groupsPRO toolGroup [n]*Predicted PRO valuePopulation norm (MCID)Regression model p-value (vs. reference group)EQ-5D Utility score (n=1839)1 (ref) [743]0.9220.88 (0.07)2 [32]0.8160.0033 [1023]0.810<0.0014 [41]0.8500.004EQ-VAS (n=1882)1 (ref) [763]78.7878.2 (n/a)2 [36]70.560.0573 [1040]73.890.0064 [43]75.230.248WPAI % overall work impairment (n=1015)1 (ref) [422]15.36n/a (15.0)2 [14]17.860.5603 [558]22.16<0.0014 [21]26.090.014WPAI % work time missed (n=1028)1 (ref) [424]0.91n/a (n/a)2 [14]3.570.4863 [569]4.460.0024 [21]10.430.003WPAI % impairment while working (n=1153)1 (ref) [486]14.90n/a (20.0)2 [18]13.890.8463 [626]19.63<0.0014 [23]17.390.435WPAI % activity impairment (n=1818)1 (ref) [732]18.02n/a (20.0)2 [32]26.250.1223 [1012]26.14<0.0014 [42]25.240.044*n values provided for reference, but margins are predictions as a result of the model and not for the specific number of patients in each subgroup.(1) patients with PsO dx only(2) Patients with PsO dx and MSK sx(3) Patients with PsA dx and with active skin sx(4) Patients with PsA dx with no active skin sxOverall work impairment increased in Groups 3 and 4, compared with Group 1 (p<0.001 and p=0.014 respectively). Furthermore, Groups 3 and 4 missed more work compared with Group 1 (p=0.002 and p=0.003 respectively). Group 3 patients exhibited an increase in presenteeism and activity impairment compared with Group 1 (p<0.001), Table 1.ConclusionPatients experiencing PsA dx or MSK sx experienced an additional disease burden compared to patients with PsO sx alone, as measured by worse HRQoL and work impairment.Disclosure of InterestsJoseph F. Merola Consultant of: Merck Research Laboratories, Abbvie, Dermavant, Eli Lilly and Company, Novartis, Janssen, UCB, Samumed, Celgene, Sanofi Regeneron, GSK, Almirall, Sun Pharma, Biogen, Pfizer, Incyte, Aclaris, and Leo Pharma, Lars Erik Kristensen Speakers bureau: Pfizer, AbbVie, Amgen, UCB, Gilead, Biogen, BMS, MSD, Novartis, Eli Lilly, and Janssen Pharmaceuticals, Consultant of: Pfizer, AbbVie, Amgen, UCB, Gilead, Biogen, BMS, MSD, Novartis, Eli Lilly, and Janssen Pharmaceuticals, Grant/research support from: Novo, UCB, Eli Lilly; Novartis and Abbvie, Feifei Yang Employee of: Employee of Janssen Pharmaceuticals, Steve Peterson Employee of: Employee of Janssen Pharmaceuticals, Rachel Teneralli Employee of: Employee of Janssen Pharmaceuticals, Nicola Massey Employee of: Adelphi Real World, Soumya D. Chakravarty Employee of: Employee of Janssen Pharmaceuticals, Megan Hughes Employee of: Adelphi Real World, May Shawi Employee of: Employee of Janssen Pharmaceuticals, Sarah Weatherby Employee of: Adelphi Real World, Christine Contre Employee of: Employee of Janssen Pharmaceuticals, Iris Lin Employee of: Employee of Janssen Pharmaceuticals, Fareen Hassan Employee of: Employee of Janssen Pharmaceuticals, M Elaine Husni Consultant of: Abbvie, Amgen, Eli Lilly, Novartis, Janssen, UCB, Pfizer, Regeneron, and BMS
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Maltez N, Ross L, Hughes M, Schoones J, Baron M, Chung L, Campochiaro C, Suliman YA, Giuggioli D, Moinzadeh P, Allanore Y, Denton CP, Distler O, Frech T, Furst D, Khanna D, Krieg T, Kuwana M, Matucci-Cerinic M, Pope J, Alunno A. POS0900 SYSTEMIC PHARMACOLOGICAL TREATMENT OF DIGITAL ULCERS IN SYSTEMIC SCLEROSIS: A SYSTEMATIC LITERATURE REVIEW. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3592] [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
BackgroundDigital ulcers (DU) are common in systemic sclerosis (SSc) and associated with reduced survival, high morbidity and poor quality of life. Recommendations have previously been proposed for DU management yet there remains significant unmet patient need. Therefore the World Scleroderma Foundation DU Working Group intends to develop practical evidence based recommendations for DU management.ObjectivesTo summarise data on efficacy and safety of systemic treatments for SSc DU.MethodsA systematic literature review to May 2021 was performed. PubMed, MEDLINE, Embase, Web of Science, Cochrane Library, Emcare (OVID) and Academic Search Premier databases were searched for original studies on adult patients with SSc DU treated with systemic pharmacological treatment. Based on the PICO framework, eligibility criteria were defined and references were independently screened by two reviewers. Reviewers independently assessed the full text of eligible articles. Owing to interstudy heterogeneity narrative summaries were used to present data.ResultsThe search strategy identified 1271 references of which 45 eligible articles were included. Seventeen studies were randomised placebo controlled trials (RCT) pertaining to PDE5 antagonists (PDE5i) (n=3), endothelin receptor antagonists (ERA) (n=3), prostanoids (n=7), antiplatelet agents (n=1) and other (n=3) (Table 1). No head to head RCT was retrieved. All other studies were observational studies (OBS). Studies were highly heterogeneous with application of differing definition of DU, variable study eligibility criteria, clinical endpoints and follow up periods. This limited the calculation of effect size and comparison across studies.Table 1.Characteristics of placebo controlled randomised controlled trialsAuthor YearInterventionnFollow upOutcomeFavours interventionHachulla 2016Sildenafil8312 weeksTime to DU healing-Andrigueti 2017Sildenafil4112 weeksDU healing+Shenoy 2010Tadalafil246 weeksNew DU+Khanna 2016Macitentan55416 weeksNew DU-Matucci-Cerinic 2011Bosentan18832 weeksNew DU Time to healing of DU+-Korn 2004Bosentan12212 weeksNew DU+Kawald 2008IV iloprost5012 monthsDU healing-Wigley 1992IV iloprost3510 weeksDU healing+Wigley 1994IV iloprost739 weeks50% reduction in DU score-Seibold 2017Treprostinil14820 weeksNet DU burden-Vayssairat 1999Beraprost10725 weeks% patients with new DU-Denton 2017Selexipag7412 weeksNumber of new DU DU healing-Lau 1993Cicaprost334 weeksNumber of DU-Abou-Raya 2008Atorvastatin844 monthsNumber of DU+Au 2010Cyclophosphamide15812 monthsNumber of patients with DU-Beckett 1984Dipyridamole / aspirin412 yearsChange in general SSc-Nagaraja 2019Riociguat1732 weeksNet DU burden-+ significantly superior to comparator- non significantly different from comparatorDU: digital ulcers IV: intravenous SSc: systemic sclerosisSeveral RCT found improved DU healing with treatment: two with PDE5i, one with iloprost and one showed improved DU healing and prevention with atorvastatin. Two RCT demonstrated effective prevention of new DU with bosentan. OBS studies with a total of 621 patients showed variable improvements in the healing of DU with CCB, PDE5i, ERA, statins, N-acetylcysteine, prostanoids and ketanserin and prevention of new DU with ERA.Regarding safety, all treatments were generally tolerated with few serious adverse events. Treatment was ceased in 6.25-17.5% of patients in RCT due to treatment related side effects.ConclusionDespite several studies assessing the efficacy and safety of systemic pharmacological treatment of SSc DU, it is not possible to draw solid conclusions due to study heterogeneity. Small RCT have shown treatment benefit with PDE5i, iloprost and atorvastatin. Large studies demonstrated effective prevention of new DU with bosentan. Our results highlight the urgent need for improved clinical trial design to generate more robust evidence and novel therapies to guide the management SSc DU.AcknowledgementsThis work was supported by the World Scleroderma Foundation.Disclosure of InterestsNancy Maltez: None declared, Laura Ross: None declared, Michael Hughes Speakers bureau: Actelion Pharmaceuticals, Eli Lilly and Pfizer outside of the submitted work., Jan Schoones: None declared, Murray Baron: None declared, Lorinda Chung Consultant of: Eicos, Corrado Campochiaro: None declared, Yossra A. Suliman: None declared, Dilia Giuggioli: None declared, Pia Moinzadeh Speakers bureau: Actelion Pharmaceuticals, Boehringer Ingelheim, Yannick Allanore: None declared, Christopher P Denton: None declared, Oliver Distler Speakers bureau: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur., Consultant of: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur., Grant/research support from: Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143), Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur., Tracy Frech: None declared, Daniel Furst: None declared, Dinesh Khanna Consultant of: Eicos Sciences Inc, Janssen, Thomas Krieg: None declared, Masataka Kuwana Speakers bureau: Speaker fees from AbbVie, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai, Eisai, GlaxoSmithKline, Janssen, Nippon Shinyaku, Ono Pharmaceuticals, Tanabe-Mitsubishi, and consultancy fees from AstraZeneca, Boehringer Ingelheim, Corbus, Kissei, Mochida outside of the submitted work., Marco Matucci-Cerinic: None declared, Janet Pope: None declared, Alessia Alunno: None declared
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Matucci Cerinic P, Akpabio A, Hughes M, Schoones J, Terrosu G, Martino A, Vecchiato M, Petri R, Matucci-Cerinic M, Alunno A. POS0895 THE ROLE OF SURGERY IN THE ESOPHAGEAL INVOLVEMENT IN SYSTEMIC SCLEROSIS: A SYSTEMATIC LITERATURE REVIEW. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3303] [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
BackgroundAmong gastrointestinal (GI) manifestations in Systemic Sclerosis (SSc) one of the predominant and challenging problems is gastroesophageal reflux disease (GERD), which occurs in ~75% of patients. Although proton pump inhibitors are useful, they are ineffective in 40% of cases with chronic use at high doses, against the background of long-term risks (e.g., cardiovascular disease and infections) which have been identified in the general population. Surgery might be an option following failure of medical therapy but currently, there is no consensus regarding the optimal surgical procedure for refractory GERD in SSc.ObjectivesTo evaluate, among the surgical approaches to GERD, the feasibility of fundoplication (FP) with regards to its safety, efficacy, indications, and timing.MethodsFour research questions based on the PICO framework were developed to guide the systematic literature review that was conducted up to 22 December 2021. The search and performed across different databases including PubMed, MEDLINE (OVID), EMBASE, Cochrane Library, Web of Science, Google Scholar, Emcare and Academic Search Premier. References were independently screened by two reviewers (PMC and AA) who also independently assessed the full text of eligible articles, and extracted data. Due to heterogeneity of retrieved studies, narrative summaries are used to present the data.ResultsThe search yielded 916 papers of which 30 were eligible for full text review. In these studies, out of 2919 clinically heterogeneous patients, 348 SSc patients were identified (mostly female, mean age 52.7 years). Out of these 348, only 257 underwent anti-reflux surgical procedure and were included in the analysis. Most of the studies were conducted in surgical settings and relevant rheumatological data were largely missing. Refractory GERD symptoms, were the commonest indication for surgery, with post-operative dysphagia being the most frequent complication. In 18 studies, FP was effective, whereas 4 studies had equivocal findings and in 5 a lack of efficacy was reported. The Collis-Nissen FP was the most popular procedure overall as well as in earlier studies, followed by Nissen FP, and Dor FP in relatively more recent studies, reflecting the change in surgical strategy over time. The data extracted shows also an acceptable rate of mortality and morbidity related to surgery, and heterogeneous outcome measures were used hampering any comparison of the studies (Table 1). Due to the heterogeneity of the data, it was not possible to separate the mortality and morbidity rate of SSc patients from the rest of the population.Table 1.GERD ASSESSMENT AND SURGICAL OUTCOMESDomain assessed/outcomeInstrument/MeasurementN° of studiesReflux severityDysphagia: 20Number of antireflux medications: 10High dose PPI: 9pH monitoring (pre-procedure): 11Oesophagitis/Barret 4Reflux improvement (post-procedure)Symptom resolution/reduction 24pH monitoring 12Repeat EGDS 8N° of patientsN° of surgical proceduresTotSSc 257Collis-Nissen FP 54Nissen FP 39Dor FP 37Collis-Belsey FP 20Toupet FP 18RYGB 23Others 30Undefined 36Post-operative surgical complications73 (2,5%)*Mortality (n° deaths)8 (0,27%)**rate in total population (2919)ConclusionOur SLR has highlighted that the surgical management of GERD in SSc patients is still highly challenging since the available evidence is scarce and of poor quality. Among the surgical approaches to the problem of GERD, overall FP seems a safe and effective procedure in SSc. Transient post-operative dysphagia was noted in many studies, particularly related with the posterior FP. In the future, it will be necessary to develop minimal requirement to conduct surgical studies in SSc as well as to design studies aimed at defining the clinical criteria for referral to surgery. Indeed, the right timing for surgery and the best surgical procedure in SSc still remains an unmet need.Disclosure of InterestsNone declared
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Al Kharusi S, Anton G, Badhrees I, Barbeau P, Beck D, Belov V, Bhatta T, Breidenbach M, Brunner T, Cao G, Cen W, Chambers C, Cleveland B, Coon M, Craycraft A, Daniels T, Darroch L, Daugherty S, Davis J, Delaquis S, Der Mesrobian-Kabakian A, DeVoe R, Dilling J, Dolgolenko A, Dolinski M, Echevers J, Fairbank W, Fairbank D, Farine J, Feyzbakhsh S, Fierlinger P, Fudenberg D, Gautam P, Gornea R, Gratta G, Hall C, Hansen E, Hoessl J, Hufschmidt P, Hughes M, Iverson A, Jamil A, Jessiman C, Jewell M, Johnson A, Karelin A, Kaufman L, Koffas T, Krücken R, Kuchenkov A, Kumar K, Lan Y, Larson A, Lenardo B, Leonard D, Li G, Li S, Li Z, Licciardi C, Lin Y, MacLellan R, McElroy T, Michel T, Mong B, Moore D, Murray K, Njoya O, Nusair O, Odian A, Ostrovskiy I, Perna A, Piepke A, Pocar A, Retière F, Robinson A, Rowson P, Ruddell D, Runge J, Schmidt S, Sinclair D, Skarpaas K, Soma A, Stekhanov V, Tarka M, Thibado S, Todd J, Tolba T, Totev T, Tsang R, Veenstra B, Veeraraghavan V, Vogel P, Vuilleumier JL, Wagenpfeil M, Watkins J, Weber M, Wen L, Wichoski U, Wrede G, Wu S, Xia Q, Yahne D, Yang L, Yen YR, Zeldovich O, Ziegler T. Search for Majoron-emitting modes of
Xe136
double beta decay with the complete EXO-200 dataset. Int J Clin Exp Med 2021. [DOI: 10.1103/physrevd.104.112002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Hughes M, Denton CP. The critical need for patient-reported outcome measures to assess the severity and impact of systemic sclerosis. Br J Dermatol 2021; 186:11-12. [PMID: 34726765 DOI: 10.1111/bjd.20777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/04/2021] [Indexed: 12/16/2022]
Affiliation(s)
- M Hughes
- Department of Rheumatology, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - C P Denton
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester, UK.,Centre of Rheumatology, Royal Free Hospital, University College London, London, UK
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Murray V, Burke J, Hughes M, Schofield C, Young A. 1020 Delay to Surgery in Acute Perforated and Ischaemic Gastrointestinal Pathology. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Patients with acute abdominal pathology requiring emergency laparotomy who experience a delay to theatre have an increased risk of morbidity, mortality, and complications. The timeline between symptom onset and operation is ill-defined with international variance in assessment and management. This systematic review aims to define where delays to surgery occur and assess the evidence for previous interventions.
Method
A systematic review was performed searching MEDLINE and EMBASE databases (January 1st 2005 to May 6th 2020). All studies assessing the impact of time to theatre in patients with acute abdominal pathology requiring emergency laparotomy were considered.
Results
Eighty-five results were assessed to include 19 papers in the analysis. Fifteen unique timepoints were identified in the patient pathway between symptom onset and operation which could be classified into four distinct phases. Time from admission to theatre (1 to 72 hours), and mortality rate (10.6-74.5%) varied greatly between studies. Mean time to surgery was significantly higher in deceased patients compared to survivors. Delays were related to imaging, diagnosis, decision-making, theatre availability and staffing. Four of five interventional studies showed a reduced mortality following introduction of an acute laparotomy pathway.
Conclusions
There is wide variation in the definition and measurement of time delays prior to emergency surgery with few studies exploring interventions. Given the heterogenous nature of the patient population and pathologies, an assessment and management framework from onset of symptoms to operation is proposed. This could be incorporated into national mortality prediction and audit tools and assist in the assessment of interventions.
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Affiliation(s)
- V Murray
- University of Leeds, Leeds, United Kingdom
| | - J Burke
- St. James’s University Hospital, Leeds, United Kingdom
| | - M Hughes
- St. James’s University Hospital, Leeds, United Kingdom
| | - C Schofield
- St. James’s University Hospital, Leeds, United Kingdom
| | - A Young
- St. James’s University Hospital, Leeds, United Kingdom
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Ho JW, Hughes M. 1548 Refining the Usability of a Novel Visual Field Assessment App. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
A validated visual field chart designed as a simpler adjunct to formal perimeters is being developed into an app. The app aims to empower patients with pituitary tumours to independently assess their central 25˚ visual field with intra-app instructions and share their results with their clinician. NHSx marked usability as an assessment criterion for validating health apps. This study aims to explore and improve the usability of the beta-version of the app.
Method
Qualitative methods were employed through observation and semi-structured interviews. Recruitment was through convenience sampling. Participants experienced the app solely based on the intra-app information. Meanwhile, a researcher observed the process. Then, qualitative feedback was generated through semi-structured interviews. Observational data was coded and quantified. Thematic analysis was employed to identify common themes and/or categories of the qualitative feedback.
Results
15 participants between 24-58(mean 33.7, SD 10.8) years were recruited. Observational data revealed that 1/15 adhered to all 3 written instructions; 3/15 utilised the hand span distance guidance provided. Participants’ responses on feedback for improvements were coded and categorised. Suggested additional features for improvement – a run-through introduction to the app, a video example of how to conduct the test, a practice run, an option for audio instruction and an option to change font size and type. Suggested additional instructions were to focus on the black dot and remember what you were seeing with the red dots.
Conclusions
Qualitative methods identified aspects of the app requiring improvements. Participants feedback will be utilised to improve the app.
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Affiliation(s)
- J W Ho
- University of Edinburgh, Edinburgh, United Kingdom
| | - M Hughes
- University of Edinburgh, Edinburgh, United Kingdom
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Misbert E, Hughes M, Burke J, Schofield C, Young A. 1308 Investigating the Use of a Novel Pre-Hospital Triage Tool for Acute Abdominal Surgical Emergencies – A Two-Phase Single Centre Cohort Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Background
Despite the recent improvements in mortality in patients undergoing emergency laparotomy(EL) within the UK, delay to theatre continues to be associated with increased mortality. This study aimed to assess if patients requiring urgent surgical intervention for acute abdominal surgical pathology could be identified in the pre-hospital setting.
Method
A two-phase, single-centre, cohort study was performed. Phase 1 retrospectively investigated patients who underwent emergency laparotomy between 01/01/2019-31/12/2019 at Leeds Teaching Hospital Trust (LTHT) through the NELA database. Phase 2 prospectively assessed NEWS2 for all patients presenting to LTHT Surgical Admissions Unit with abdominal pain between 01/01/2020-31/01/2020.
Results
Phase 1: 45 patients were coded through NELA and confirmed through operation note review as undergoing EL for gastrointestinal perforation. 66%(n = 30) were assessed by the ambulance service and 80% (n = 24) had a NEWS2 of 3 or greater. Phase 2: 319 patients were assessed in SAU/ED, of which 69 initially treated by the ambulance service. 30% (n = 21) of these patients had an initial NEWS2 of 3 or above. Sensitivity of a NEWS2 score of >/3 in predicting the need for immediate surgical intervention including EL was 95%(95%CI, 74-99) and specificity was 95% (95%CI, 83-99) with a PPV of 86%(95%CI 67-95) and NPV of 98% (95%CI, 87-99).
Conclusions
A NEWS2 score of >/3 predicts the need for emergency surgical intervention including laparotomy for gastrointestinal perforation with reasonable sensitivity in this cohort. A pre-hospital triage tool for patients presenting with abdominal pain could utilise NEWS2 as an adjunct to decision-making in an acute abdominal pathway.
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Affiliation(s)
- E Misbert
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - M Hughes
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - J Burke
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - C Schofield
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - A Young
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
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Misbert E, Hughes M, Burke J, Schofield C, Young A. 1404 NELA Risk Mortality Scores from Admission to Theatre in Emergency Gastrointestinal Perforation – A Retrospective Cohort Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Patients with acute abdominal pathology requiring emergency laparotomy who experience a delay to theatre have an increased risk of morbidity, mortality and complications. The aim of this study was to assess delay, from symptom onset to theatre in patients with gastrointestinal perforation and its effect on perioperative risk.
Method
A single-centre retrospective study was performed in the Leeds Trust Hospitals, UK investigating the NELA database for patients requiring emergency laparotomy for perforated gastrointestinal viscus who presented to the acute surgical unit or emergency department between 1st February 2018 and 31st January 2020.
Results
101 patients met the inclusion criteria (47% F and 53% M), mean age 59 [21-91]. 37% of patients’ NELA scores worsened from admission to pre-op (median change of + 5.9% IQR 1.3-11.5]), 14% stayed the same and 49% improved (median change of -4.4%[IQR 0.4-9.1]) 3% had their NELA score documented at the time of consent. 18% did not wait for a CT report or went straight to theatre. Mean time from admission to scan report was 9.3 hours (0.9-22.0). Median time from symptom onset to presentation (2 days [IQR 1-13]) was greater in patients with an Index of Multiple Deprivation Decile of 1-5, (n = 64, median 2 days [IQR 1-6]) compared to those in deciles 6-10, (n = 37, median 1 day[IQR 1-3]), p = 0.097.
Conclusions
NELA mortality risk score changes from presentation to surgery in patients with acute gastrointestinal perforation requiring emergency laparotomy. There is suggestion that delay in symptom onset to presentation may correlate with Index of Multiple Deprivation Decile.
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Affiliation(s)
- E Misbert
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - M Hughes
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - J Burke
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - C Schofield
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - A Young
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
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Murray V, Burke JR, Hughes M, Schofield C, Young A. Delay to surgery in acute perforated and ischaemic gastrointestinal pathology: a systematic review. BJS Open 2021; 5:6363074. [PMID: 34476466 PMCID: PMC8413368 DOI: 10.1093/bjsopen/zrab072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Patients with acute abdominal pathology requiring emergency laparotomy who experience a delay to theatre have an increased risk of morbidity, mortality and complications. The timeline between symptom onset and operation is ill defined with international variance in assessment and management. This systematic review aims to define where delays to surgery occur and assess the evidence for interventions trialled across Europe. METHODS A systematic review was performed searching MEDLINE and EMBASE databases (1 January 2005 to 6 May 2020). All studies assessing the impact of time to theatre in patients with acute abdominal pathology requiring emergency laparotomy were considered. RESULTS Sixteen papers, involving 50 653 patients, were included in the analysis. Fifteen unique timepoints were identified in the patient pathway between symptom onset and operation which are classified into four distinct phases. Time from admission to theatre (1-72 hours) and mortality rate (10.6-74.5 per cent) varied greatly between studies. Mean time to surgery was significantly higher in deceased patients compared with that in survivors. Delays were related to imaging, diagnosis, decision making, theatre availability and staffing. Four of five interventional studies showed a reduced mortality rate following introduction of an acute laparotomy pathway. CONCLUSION Given the heterogeneous nature of the patient population and pathologies, an assessment and management framework from onset of symptoms to operation is proposed. This could be incorporated into mortality prediction and audit tools and assist in the assessment of interventions.
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Affiliation(s)
- V Murray
- The University of Leeds Medical School, Leeds, UK
| | - J R Burke
- The John Golligher Colorectal Surgery Unit, St. James's University Hospital, Leeds, UK.,Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St James's University Hospital, Leeds, UK
| | - M Hughes
- The John Golligher Colorectal Surgery Unit, St. James's University Hospital, Leeds, UK.,Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St James's University Hospital, Leeds, UK
| | - C Schofield
- Department of Anaesthetics, St James's University Hospital, Leeds, UK
| | - A Young
- Department of Pancreatic Surgery, St James's University Hospital, Leeds, UK
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Orlandi M, Landini N, Sambataro G, Nardi C, Bruni C, Bellando-Randone S, Denton C, Luppi F, Ruaro B, Tomassetti S, Cavigli E, Melchiorre F, Palmucci S, Guiducci S, Moggi Pignone A, Allanore Y, Bartoloni A, Confalonieri M, Cortese G, Dagna L, De Cobelli F, De Paulis A, Harari S, Khanna D, Kuwana M, Miele V, Taliani G, Hughes M, Vanchieri C, Colagrande S, Matucci-Cerinic M. POS1228 THE ROLE OF CHEST CT IN UNDERSTANDING INTERSTITIAL LUNG DISEASE (ILD): SYSTEMIC SCLEROSIS (SSc). VERSUS COVID-19. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2967] [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
Background:COVID-19 pandemic is a global emergency which may overlap on the clinical and radiological scenario of ILD in SSc. In clinical practice, the striking similarities observed at computed tomography (CT) between the diseases make it difficult to distinguish a COVID-19 superinfection from a progression of SSc-ILD.Objectives:The aim of our study was to identify the main CT features that may help distinguishing SSc-ILD from COVID-19 pneumonia.Methods:22 international readers were included and divided in the radiologist group (RAD) and non-radiologist group (nRAD). The RAD group included non-chest RAD and chest-RAD. A total of 99 patients, 52 with COVID-19 and 47 with SSc-ILD, were included in the study.Results:Fibrosis inside focal ground glass opacities (GGO) in the upper lobes; fibrosis in the lower lobe GGO; reticulations in lower lobes (especially if bilateral and symmetrical or associated with signs of fibrosis) were the CT parameters most frequently associated with SSc-ILD. The CT parameters most frequently associated with COVID- 19 pneumonia were: consolidation (CONS) in the lower lobes, CONS with peripheral (both central/peripheral or patchy distributions), anterior and posterior CONS and rounded-shaped GGOs in the lower lobes. After multivariate analysis, the presence of CONS in the lower lobes (p <0.0001) and signs of fibrosis in GGO in the lower lobes (p <0.0001) remained independently associated with COVID-19 pneumonia or SSc-ILD, respectively. These two variables were combined in a predictive score which resulted positively associated with the COVID-19 diagnosis, with 96.1% sensitivity and 83.3% specificity: 3 different risk class for COVID-19 pneumonia may be identified: high risk for COVID-19 pneumonia (5-9 points); probable overlap COVID-19 pneumonia in SSc-ILD (4 points); low risk for COVID-19 pneumonia (0-3 points).Conclusion:The CT differential diagnosis between COVID-19 Pneumonia and SSc-ILD is possible and may be fostered in practice by the use of a radiological score. In the case where an overlap of both diseases is suspected, the presence of consolidation in the lower lobes may suggest a COVID-19 pneumonia while the presence of fibrosis inside GGO may indicate a SSc-ILD.References:[1]Orlandi M, Landini N, Bruni C, et al. Infection or autoimmunity? The clinical challenge of interstitial lung disease in systemic sclerosis during COVID 19 pandemic. J Rheumatol. 2020 Dec 1: jrheum.200832[2]Simpson S, Kay FU, Abbara S, et al. Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA [published online ahead of print, 2020 Apr 28]. J Thorac Imaging. 2020;10.1097/RTI.0000000000000524.[3]Cheng C, Li C, Zhao T, et al. COVID-19 with rheumatic diseases: a report of 5 cases. Clin Rheumatol. 2020;39(7):2025-2029.[4]Mariano RZ, Rio APTD, Reis F. Covid-19 overlapping with systemic sclerosis. Rev Soc Bras Med Trop. 2020 Sep 21;53:e20200450.Disclosure of Interests:None declared
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Lepri G, Bruni C, Tofani L, Moggi Pignone A, Orlandi M, Sara T, Hughes M, Del Galdo F, Irace R, Distler O, Riccieri V, Allanore Y, Gheorghiu AM, Siegert E, De Vries-Bouwstra J, Hachulla E, Tikly M, Damjanov N, Spertini F, Mouthon L, Hoffmann-Vold AM, Gabrielli A, Guiducci S, Matucci-Cerinic M, Furst D, Bellando Randone S. POS0317 THE PERFORMANCE OF DIFFUSING CAPACITY FOR MONOXIDE CARBON (DLCO) AND FORCED VITAL CAPACITY (FVC) IN PREDICTING THE ONSET OF SYSTEMIC SCLEROSIS (SSc)-INTERSTITIAL LUNG DISEASE (ILD) IN THE EUROPEAN SCLERODERMA TRIALS AND RESEARCH (EUSTAR) DATABASE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3027] [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
Background:In SSc, ILD is a major cause of morbidity and mortality. High resolution computed tomography (HRCT) is the gold standard for the diagnosis. Predictors of ILD onset are eagerly awaited to improve SSc-ILD management. Pulmonary function test (PFTs) are routinely performed to measure lung function changes.Objectives:Our aim was to investigate the performance of DLCO (diffusing capacity of lung carbon monoxide) and FVC (forced vital capacity) in predicting the development of SSc-ILD.Methods:The longitudinal data of DLCO, FVC and ILD on HRCT of SSc patients from the EUSTAR database were evaluated at baseline (t0), after 12 (±4) (t1) and 24 (±4) (t2) months. Patients with negative HRCT for any sign of ILD both at t0 and t1 were included. Patients who presented or developed pulmonary hypertension during the study period were excluded. At baseline, demographic data, disease duration from Raynaud’s onset, disease subsets, autoantibodies and other laboratory and instrumental data were recorded.Results:474/17805 patients were eligible for the study (403 females, 71 males): 26.0% dcSSc, 58.3% lcSSc, 220 (48.0%) patients with positive anticentromere antibodies (ACA) and 117 (25.4%) with positive antitopoisomerase I antibodies (Topo-I abs). Among all enrolled patients, 46 (9.7%) developed HRCT signs of ILD at t2. Patients with Topo-I abs showed an association with ILD development at t2 (16.7% vs 7.8%, p=0.0031), contrarily ACA positive patients were negatively associated with ILD appearance after 2 years of follow-up (4.4% vs 14.4%, p=0.0001). Positive t2 HRCT patients had a significant lower value of DLCO and FVC at all three assessments when compared to patients with a negative HRCT at t2 (Table 1) and both t0 DLCO and FVC values negatively correlated with ILD development (Table 1). The mean t0 to t1 change (Δ) of DLCO in patients with negative t2 HRTC and positive t2 HRCT were -0.5 (±12.6) and -1.0 (±15.1), respectively. The mean t0 to t1 ΔFVC in patients with negative t2 HRTC and positive t2 HRCT were -0.2 (±10.6) and 0.1 (±11.5), respectively. None of them predicted the appearance of ILD at t2 (ΔDLCO: OR (IC) 0.997 (0.97-1.02), p=0.8024; ΔFVC OR (IC) 1.002 (0.97-1.03), p=0.8664). The data showed an association between t0 DLCO value<80% and ILD appearance after 2 years of follow-up [OR(IC): 3.09(1.49-6.40), p=0.0023]. Such association was not observed for t0 FVC value<80% [OR(IC): 1.95(0.81-4.68), p=0.1329]. The predictive capability of t0 DLCO<80% was moderate but stronger than FVC<80% [AU ROC: 0.62 (0.56-0.69), 0.53 (0.48-0.59) respectively, p=0.0205].Conclusion:Our data suggest that an impaired baseline DLCO (<80%) may have a predictive value for the development of ILD on HRCT after 2 years of follow-up. Further rigorous prospective studies are warranted to understand the role of DLCO evaluation in the course of SSc.Table 1.DLCO and FVC values at t0, t1 and t2 values in patients with positive or negative HRCT for ILD at t2 and their statistical differences.Patients without ILD at t2 (mean±SD)Patients with ILD at t2 (mean±SD)OR (95%CL)p-valueDLCO at t079.0 ± 16.669.9 ± 17.40.97 (0.95 - 0.99)0.0006DLCO at t178.4 ± 16.868.9 ± 18.60.97 (0.95 - 0.98)0.0005DLCO at t278.0 ± 17.065.1 ± 19.10.95 (0.93 - 0.97)<0.0001FVC at t0102.2 ± 17.394.6 ± 16.20.97 (0.96 - 0.99)0.0052FVC at t1101.9 ± 17.994.7 ± 16.50.98 (0.96 - 0.99)0.0092FVC at t2101.6 ± 17.694.5 ± 20.00.98 (0.96 - 1)0.0126Disclosure of Interests:Gemma Lepri: None declared, Cosimo Bruni Speakers bureau: CB reports personal fees from Actelion, personal fees from Eli Lilly, Grant/research support from: CB reports personal fees from Actelion, personal fees from Eli Lilly, grants from European Scleroderma Trial and Research (EUSTAR) group, grants from New Horizon Fellowship, grants from Foundation for Research in Rheumatology (FOREUM), grants from Fondazione Italiana per la Ricerca sull’Artrite (FIRA), outside the submitted work, Lorenzo Tofani: None declared, Alberto Moggi Pignone: None declared, Martina Orlandi: None declared, Tomasetti Sara Speakers bureau: Speaker’s fees for Roche and Boehringer Ingelheim, Mike Hughes: None declared, Francesco Del Galdo: None declared, Rosaria Irace: None declared, Oliver Distler Grant/research support from: OD (last three years) has/had consultancy relationship and/or has received research funding in the area of potential treatments for systemic sclerosis and its complications from (last three years): Abbvie, Acceleron Pharma, Amgen, AnaMar, Arxx Therapeutics, Baecon Discovery, Blade Therapeutics, Bayer, Boehringer Ingelheim, ChemomAb, Corbus Pharmaceuticals, CSL Behring, Galapagos NV, Glenmark Pharmaceuticals, GSK, Horizon (Curzion) Pharmaceuticals, Inventiva, iQvia, Italfarmaco, iQone, Kymera Therapeutics, Lilly, Medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Novartis, Pfizer, Roche, Sanofi, Serodapharm, Topadur, Target Bioscience and UCB. Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Valeria Riccieri: None declared, Yannick Allanore Speakers bureau: YA received personal fees from Boehringer, Sanofi, Menarini and Medsenic and grants from Alpine with regards to the management of systemic sclerosis, Grant/research support from: YA received personal fees from Boehringer, Sanofi, Menarini and Medsenic and grants from Alpine with regards to the management of systemic sclerosis, Ana Maria Gheorghiu: None declared, Elise Siegert: None declared, Jeska de Vries-Bouwstra: None declared, Eric Hachulla: None declared, Mohammed Tikly: None declared, Nemanja Damjanov: None declared, Francois Spertini: None declared, Luc Mouthon: None declared, Anna-Maria Hoffmann-Vold Speakers bureau: AMHV: received consulting fees from Actelion, ARXX, Bayer, Boehringer Ingelheim, Lilly, Medscape, Merck Sharp & Dohme and Roche; and grants from Boehringer Ingelheim., Consultant of: AMHV: received consulting fees from Actelion, ARXX, Bayer, Boehringer Ingelheim, Lilly, Medscape, Merck Sharp & Dohme and Roche; and grants from Boehringer Ingelheim., Grant/research support from: AMHV: received consulting fees from Actelion, ARXX, Bayer, Boehringer Ingelheim, Lilly, Medscape, Merck Sharp & Dohme and Roche; and grants from Boehringer Ingelheim., Armando Gabrielli: None declared, Serena Guiducci: None declared, Marco Matucci-Cerinic Speakers bureau: has received consulting fees or honorarium from Actelion, Janssen, Inventiva, Bayer, Biogen, Boehringer, CSL Behring, Corbus, Galapagos, Mitsubishi, Samsung, Regeneron, Acceleron, MSD, Chemomab, Lilly, Pfizer, Roche, Grant/research support from: has received consulting fees or honorarium from Actelion, Janssen, Inventiva, Bayer, Biogen, Boehringer, CSL Behring, Corbus, Galapagos, Mitsubishi, Samsung, Regeneron, Acceleron, MSD, Chemomab, Lilly, Pfizer, Roche, Daniel Furst: None declared, Silvia Bellando Randone: None declared
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Holdsworth E, Lukanova R, Hughes M, Hall J, Austin J, Taylor-Stokes G, Piercy J. POS1205 THE IMPACT OF COVID-19 ON PATIENT MANAGEMENT AND PRESCRIBING STRATEGY ACROSS THE EU AND US: A REAL-WORLD SURVEY OF RHEUMATOLOGISTS, DERMATOLOGISTS, AND GASTROENTEROLOGISTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2103] [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
Background:The COVID-19 pandemic is expected to have impacted patient management on a global level. However, the degree of impact on patient management and prescribing strategy in the fields of rheumatology, dermatology and gastroenterology is unclear.Objectives:Assess the impact of COVID-19 on patient management and prescribing strategy across the EU and US, as described by rheumatologists, dermatologists, and gastroenterologists.Methods:Data were drawn from physician surveys in France, Germany, Italy, Spain, UK and US between July and December 2020. Physicians completed an online or telephone survey assessing how COVID-19 has impacted type and frequency of consultations; choice and prescription of medication.Results:847 physicians took part; 355 rheumatologists, 200 dermatologists (Germany, Spain, UK, and US only), and 282 gastroenterologists. As a result of COVID-19, most physicians stated they have moved at least some patients to video or telephone consultations (70% rheumatologists; 55% dermatologists; 60% gastroenterologists) and reduced overall frequency of consultations with patients (59% rheumatologists; 64% dermatologists; 51% gastroenterologists) (Table 1).35% of rheumatologists, 22% of dermatologists, and 14% of gastroenterologists described COVID-19 as changing the way they choose and prescribe medication, with differences observed between countries (Figure 1). Of those who stated they have made medication changes, rheumatologists stated changing medication to self-administration (62%) and not starting new patients on an advanced therapy (biologic DMARD or targeted synthetic DMARD) (58%) as most frequent. Dermatologists stated changes include changing treatment to more COVID-appropriate treatment (71%) and prescribing repeat prescriptions more regularly without consultation (56%). Gastroenterologists stated changes include changing medication to self-administration (55%) and prescribing a longer course of medication (48%).Comparing across countries, for all specialties, the greatest changes were observed in the UK followed by Spain, with least changes in Germany and Italy.Conclusion:There have been changes in the process of how healthcare is delivered, although treatment prescription was impacted to a lesser extent than consultation type and frequency. This varies across geographies, which may be due to differences in reported prevalence of COVID-19. Differences are also observed across specialities, which may be due to guidance received from specialty bodies. It is unknown what the long-term impact of changes in the management of patients due to COVID-19 will be on patient outcomes, satisfaction, engagement and adherence, and further research is needed.Table 1.Rheumatologist, Dermatologist, and Gastroenterologist described impact on patient management, by countryGlobal(n=847)France(n=90)Germany(n=168)Italy(n=122)Spain(n=161)UK(n=133)US(n=163)Rheumatologistsn=365n=50n=58n=59n=57n=50n=81Moving to video/telephone consultation70%70% 36%47%86%94%84%Fewer visits for individual patients (reduced visiting schedule)59%80%0%41%96%76%65%Dermatologistsn=200-n=50-n=50n=50n=50Moving to video/telephone consultation55%-40%-58%66%56%Fewer visits for individual patients (reduced visiting schedule)64%-60%-54%72%72%Gastroenterologistsn=282n=40n=60n=63n=54n=33n=32Moving to video/telephone consultation60%63%18%54%83%100%69%Fewer visits for individual patients (reduced visiting schedule)51%35%43%51%43%79%69%Figure 1.Proportion of rheumatologists, dermatologists, and gastroenterologists reporting changing the way they choose and prescribe medication as a result of COVID-19Disclosure of Interests:None declared.
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Harn H, Wang S, Lai Y, Van Handel B, Liang Y, Tsai S, Schiessl IM, Sarkar A, Xi H, Hughes M, Kaemmer S, Tang M, Peti-Peterdi J, Pyle A, Woolley T, Evseenko D, Jiang T, Chuong C. 609 Symmetry breaking of tissue mechanics in wound induced hair follicle regeneration. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Akimov D, Albert JB, An P, Awe C, Barbeau PS, Becker B, Belov V, Bernardi I, Blackston MA, Blokland L, Bolozdynya A, Cabrera-Palmer B, Chen N, Chernyak D, Conley E, Cooper RL, Daughhetee J, Del Valle Coello M, Detwiler JA, Durand MR, Efremenko Y, Elliott SR, Fabris L, Febbraro M, Fox W, Galindo-Uribarri A, Gallo Rosso A, Green MP, Hansen KS, Heath MR, Hedges S, Hughes M, Johnson T, Kaemingk M, Kaufman LJ, Khromov A, Konovalov A, Kozlova E, Kumpan A, Li L, Librande JT, Link JM, Liu J, Mann K, Markoff DM, McGoldrick O, Moreno H, Mueller PE, Newby J, Parno DS, Penttila S, Pershey D, Radford D, Rapp R, Ray H, Raybern J, Razuvaeva O, Reyna D, Rich GC, Rudik D, Runge J, Salvat DJ, Scholberg K, Shakirov A, Simakov G, Sinev G, Snow WM, Sosnovtsev V, Suh B, Tayloe R, Tellez-Giron-Flores K, Thornton RT, Tolstukhin I, Vanderwerp J, Varner RL, Virtue CJ, Visser G, Wiseman C, Wongjirad T, Yang J, Yen YR, Yoo J, Yu CH, Zettlemoyer J. First Measurement of Coherent Elastic Neutrino-Nucleus Scattering on Argon. Phys Rev Lett 2021; 126:012002. [PMID: 33480779 DOI: 10.1103/physrevlett.126.012002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 09/28/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
We report the first measurement of coherent elastic neutrino-nucleus scattering (CEvNS) on argon using a liquid argon detector at the Oak Ridge National Laboratory Spallation Neutron Source. Two independent analyses prefer CEvNS over the background-only null hypothesis with greater than 3σ significance. The measured cross section, averaged over the incident neutrino flux, is (2.2±0.7)×10^{-39} cm^{2}-consistent with the standard model prediction. The neutron-number dependence of this result, together with that from our previous measurement on CsI, confirms the existence of the CEvNS process and provides improved constraints on nonstandard neutrino interactions.
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Affiliation(s)
- D Akimov
- Institute for Theoretical and Experimental Physics named by A. I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow, 117218, Russian Federation
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
| | - J B Albert
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - P An
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - C Awe
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - P S Barbeau
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - B Becker
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - V Belov
- Institute for Theoretical and Experimental Physics named by A. I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow, 117218, Russian Federation
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
| | - I Bernardi
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - M A Blackston
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - L Blokland
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - A Bolozdynya
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
| | | | - N Chen
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - D Chernyak
- Physics Department, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - E Conley
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - R L Cooper
- Department of Physics, New Mexico State University, Las Cruces, New Mexico 88003, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Daughhetee
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - M Del Valle Coello
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - J A Detwiler
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - M R Durand
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - Y Efremenko
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S R Elliott
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - L Fabris
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M Febbraro
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - W Fox
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - A Galindo-Uribarri
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A Gallo Rosso
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - M P Green
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
- Department of Physics, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - K S Hansen
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - M R Heath
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S Hedges
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - M Hughes
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - T Johnson
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - M Kaemingk
- Department of Physics, New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - L J Kaufman
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - A Khromov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
| | - A Konovalov
- Institute for Theoretical and Experimental Physics named by A. I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow, 117218, Russian Federation
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
| | - E Kozlova
- Institute for Theoretical and Experimental Physics named by A. I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow, 117218, Russian Federation
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
| | - A Kumpan
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
| | - L Li
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - J T Librande
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - J M Link
- Center for Neutrino Physics, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - J Liu
- Physics Department, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - K Mann
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - D M Markoff
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
- Department of Mathematics and Physics, North Carolina Central University, Durham, North Carolina 27707, USA
| | - O McGoldrick
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - H Moreno
- Department of Physics, New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - P E Mueller
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Newby
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - D S Parno
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - S Penttila
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - D Pershey
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - D Radford
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - R Rapp
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - H Ray
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - J Raybern
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - O Razuvaeva
- Institute for Theoretical and Experimental Physics named by A. I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow, 117218, Russian Federation
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
| | - D Reyna
- Sandia National Laboratories, Livermore, California 94550, USA
| | - G C Rich
- Enrico Fermi Institute and Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - D Rudik
- Institute for Theoretical and Experimental Physics named by A. I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow, 117218, Russian Federation
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
| | - J Runge
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - D J Salvat
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - K Scholberg
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - A Shakirov
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
| | - G Simakov
- Institute for Theoretical and Experimental Physics named by A. I. Alikhanov of National Research Centre "Kurchatov Institute," Moscow, 117218, Russian Federation
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
- Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region 141700, Russian Federation
| | - G Sinev
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - W M Snow
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - V Sosnovtsev
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, 115409, Russian Federation
| | - B Suh
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - R Tayloe
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | | | - R T Thornton
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - I Tolstukhin
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - J Vanderwerp
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - R L Varner
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - C J Virtue
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - G Visser
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
| | - C Wiseman
- Center for Experimental Nuclear Physics and Astrophysics and Department of Physics, University of Washington, Seattle, Washington 98195, USA
| | - T Wongjirad
- Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155, USA
| | - J Yang
- Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155, USA
| | - Y-R Yen
- Department of Physics, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - J Yoo
- Department of Physics at Korea Advanced Institute of Science and Technology (KAIST), Daejeon, 34051, Republic of Korea
- Institute for Basic Science (IBS), Daejeon, 34051, Republic of Korea
| | - C-H Yu
- Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Zettlemoyer
- Department of Physics, Indiana University, Bloomington, Indiana 47405, USA
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Loefroth E, Hughes M, Shi Y, Wang Y, Proudfoot C, Di Domenico M, Modgill V, Schlienger R, Studer R. Patient and clinical characteristics of heart failure patients concomitantly prescribed SGLT2 inhibitors and sacubitril/valsartan, a database cohort study using the Optum electronic health record data. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and purpose
Sacubitril/valsartan (sac/val), an angiotensin receptor neprilysin inhibitor, reduces the risk for cardiovascular (CV) death or hospitalization for heart failure (HF) in HF with reduced ejection fraction (HFrEF). Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are approved in patients with type 2 diabetes (T2D) and have shown to reduce the CV risk in T2D patients with established CV or at risk of CV disease. The SGLT2i dapagliflozin has shown to improve outcomes in patients with chronic HFrEF, with or without T2D, when used in addition to standard of care including sac/val. As the use of SGLT2i in HF evolves, and given the large overlap of HF and T2D populations, it is of interest to understand the population with concomitant use of sac/val and SGLT2i. This study describes the clinical characteristics of patients treated concomitantly with sac/val and SGLT2i or concomitantly with sac/val and dipeptidyl peptidase-4 inhibitors (DPP4i) or glucagon-like peptide-1 receptor agonists (GLP1), two comparable second line anti-diabetic drug classes.
Methods
This retrospective non-interventional study describes two mutually exclusive adult patient cohorts diagnosed with HF and T2D concomitantly prescribed sac/val and SGLT2i (cohort 1), or concomitantly prescribed sac/val and DDP4i/GLP1 (cohort 2). The index date was defined as the first date of concomitant use with prescriptions overlapping a minimum of 21 days. Patients were identified any time between 1/1/2015 and 30/6/2019 in the Optum® de-identified electronic health record (EHR) data from providers across the continuum of care.
Results
2.3 million HF patients were identified, and 41.6% had a T2D diagnosis. 560 patients were concomitantly prescribed sac/val and SGLT2i (cohort 1) and 1,566 concomitantly sac/val and DDP4/GLP1 (cohort 2). There was a higher proportion of females in cohort 2 (35.0% vs 27.9%). Mean age was higher in cohort 2 (66.4 vs 61.4 years). The mean estimated glomerular filtration rate was 85.93 (SD 23.43) ml/min/1.73m2 (cohort 1) and 72.10 (Std. 27.11) ml/min/1.73m2 (cohort 2). The proportion of stage 3 CKD (<60 to >30 ml/min/1.73m2) was 11.8% (cohort 1) and 24.4% (cohort 2). Mean systolic blood pressure was similar, 120 mmHg (cohort 1) and 122 mmHg (cohort 2). Mean hemoglobin was 13.60 g/dl (cohort 1) and 12.43 g/dl (cohort 2). Median (IQR) NT-proBNP differed between the two cohorts, 914 (2154) pg/ml (cohort 1) and 2,290 (5,301) pg/ml (cohort 2) but with complete values available in only 17.7 and 19.0% of each cohort.
Conclusions
This descriptive analysis of concomitant prescription of sac/val and SGLT2i or DPP4/GLP1 highlights differences in the clinical characteristics between the two cohorts. The patients treated with sac/val and SGLT2i start with a more favorable clinical profile compared to the patients treated with sac/val and DPP4/GLP1. Further analyses are needed to determine if these differences are driven by age, gender or other factors.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Novartis Pharma AG
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Affiliation(s)
| | - M Hughes
- Novartis Ireland Limited, Dublin, Ireland
| | - Y Shi
- Novartis Pharmaceuticals Corporation, East Hanover, United States of America
| | - Y Wang
- Novartis Pharmaceuticals Corporation, East Hanover, United States of America
| | | | | | - V Modgill
- Novartis Pharma AG, Basel, Switzerland
| | | | - R Studer
- Novartis Pharma AG, Basel, Switzerland
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Harrison E, Syed S, Ehsan L, Iqbal NT, Sadiq K, Umrani F, Ahmed S, Rahman N, Jakhro S, Ma JZ, Hughes M, Ali SA. Machine learning model demonstrates stunting at birth and systemic inflammatory biomarkers as predictors of subsequent infant growth - a four-year prospective study. BMC Pediatr 2020; 20:498. [PMID: 33126871 PMCID: PMC7597024 DOI: 10.1186/s12887-020-02392-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/15/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Stunting affects up to one-third of the children in low-to-middle income countries (LMICs) and has been correlated with decline in cognitive capacity and vaccine immunogenicity. Early identification of infants at risk is critical for early intervention and prevention of morbidity. The aim of this study was to investigate patterns of growth in infants up through 48 months of age to assess whether the growth of infants with stunting eventually improved as well as the potential predictors of growth. METHODS Height-for-age z-scores (HAZ) of children from Matiari (rural site, Pakistan) at birth, 18 months, and 48 months were obtained. Results of serum-based biomarkers collected at 6 and 9 months were recorded. A descriptive analysis of the population was followed by assessment of growth predictors via traditional machine learning random forest models. RESULTS Of the 107 children who were followed up till 48 months of age, 51% were stunted (HAZ < - 2) at birth which increased to 54% by 48 months of age. Stunting status for the majority of children at 48 months was found to be the same as at 18 months. Most children with large gains started off stunted or severely stunted, while all of those with notably large losses were not stunted at birth. Random forest models identified HAZ at birth as the most important feature in predicting HAZ at 18 months. Of the biomarkers, AGP (Alpha- 1-acid Glycoprotein), CRP (C-Reactive Protein), and IL1 (interleukin-1) were identified as strong subsequent growth predictors across both the classification and regressor models. CONCLUSION We demonstrated that children most children with stunting at birth remained stunted at 48 months of age. Value was added for predicting growth outcomes with the use of traditional machine learning random forest models. HAZ at birth was found to be a strong predictor of subsequent growth in infants up through 48 months of age. Biomarkers of systemic inflammation, AGP, CRP, IL1, were also strong predictors of growth outcomes. These findings provide support for continued focus on interventions prenatally, at birth, and early infancy in children at risk for stunting who live in resource-constrained regions of the world.
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Affiliation(s)
- Elizabeth Harrison
- School of Medicine, University of Virginia, Charlottesville, VA, USA.,Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sana Syed
- School of Medicine, University of Virginia, Charlottesville, VA, USA. .,Department of Paediatrics and Child Health, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi, 74800, Pakistan.
| | - Lubaina Ehsan
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Najeeha T Iqbal
- Department of Paediatrics and Child Health, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi, 74800, Pakistan
| | - Kamran Sadiq
- Department of Paediatrics and Child Health, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi, 74800, Pakistan
| | - Fayyaz Umrani
- Department of Paediatrics and Child Health, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi, 74800, Pakistan
| | - Sheraz Ahmed
- Department of Paediatrics and Child Health, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi, 74800, Pakistan
| | - Najeeb Rahman
- Department of Paediatrics and Child Health, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi, 74800, Pakistan
| | - Sadaf Jakhro
- Department of Paediatrics and Child Health, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi, 74800, Pakistan
| | - Jennie Z Ma
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Molly Hughes
- Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - S Asad Ali
- Department of Paediatrics and Child Health, Aga Khan University, Stadium Road, P. O. Box 3500, Karachi, 74800, Pakistan.
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Sharma A, Hughes M. PCN80 Comparison of Treatment Among Chronic Myeloid Leukemia Patients in China and United States: Results of Primary Market Research Survey of Oncologists. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sharma A, Hughes M. PCN84 Comparison of Treatment Among Peripheral T-CELL Lymphoma and Cutaneous T-CELL Lymphoma in China and United States: Results of Primary Market Research Survey of Oncologists. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hughes M, Rogers S, Carreira J, Moore T, Manning J, Dinsdale G, McCollum C, Herrick AL. Imaging digital arteries in systemic sclerosis by tomographic 3-dimensional ultrasound. Rheumatol Int 2020; 41:1089-1096. [PMID: 32797279 DOI: 10.1007/s00296-020-04675-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/03/2020] [Indexed: 11/25/2022]
Abstract
Objective methods are needed to quantify digital artery disease in systemic sclerosis (SSc) for clinical trials of vascular therapies. Our primary aim was to examine feasibility of a novel tomographic three-dimensional-(3-D) ultrasound (tUS) with high-frequency ultrasound (HFUS) or ultra-high-frequency ultrasound (UHFUS) to assess the digital arteries in patients with SSc compared to healthy controls. A secondary objective was to compare the total wall volume (TWV) as a measure of intimal/medial thickness. Eighteen patients with a confirmed diagnosis of SSc were studied by tUS HFUS (17.5 MHz, n = 10) or tUS UHFUS (48 and 70 MHz, n = 8) with equal numbers of healthy controls of similar age and gender. The majority of patients had limited cutaneous SSc and were representative of a spectrum of digital vasculopathy, with over half (n = 6 HFUS and n = 5 UHFUS) having previous digital ulceration. Over half were receiving oral vasodilatory therapy. TWV was measured in both digital arteries of the middle finger bilaterally. At least, two digital arteries could be identified at 17.5 MHz in all patients and healthy controls. Whereas, at least two digital arteries could be identified in relatively fewer patients compared to healthy controls using 48 MHz (n = 6 and 10) and especially 70 MHz (n = 4 and 10) UHFUS. The median difference in TWV between patients and healthy controls was -6.49 mm3 using 17.5 MHz, 1.9 mm3 at 48 MHz, and -0.4 mm3 at 70 MHz. tUS using UHFUS is a feasible method to measure TWV of digital arteries in SSc. Transducer frequency plays an important factor in successful digital artery measurement, with 48 MHz being the optimal frequency.
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Affiliation(s)
- M Hughes
- Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
- Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK.
- Department of Rheumatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2JF, UK.
| | - S Rogers
- Academic Surgery Unit, Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK.
- Independent Vascular Services Ltd, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK.
| | - J Carreira
- Independent Vascular Services Ltd, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK
| | - T Moore
- Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - J Manning
- Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - G Dinsdale
- Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK
| | - C McCollum
- Academic Surgery Unit, Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK
| | - A L Herrick
- Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK
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Dote-Kwan J, Hughes M, Taylor S. Impact of Early Experiences on the Development of Young Children with Visual Impairments: Revisited. Journal of Visual Impairment & Blindness 2020. [DOI: 10.1177/0145482x9709100206] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined the influence of several variables (maternal behaviors, home environment, and family's socioeconomic status) on the development of young visually impaired children. Specifically, 15 mother-child dyads were observed in their homes during daily routines at two points in time: when the children were aged 20–36 months and about one year later. Overall, the study found that maternal behaviors had more of an impact on the children's development at Time 1 than did the other variables, but at Time 2, the home environment appeared to have a greater influence.
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Affiliation(s)
- J. Dote-Kwan
- Division of Special Education, California State University at Los Angeles. 5151 State University Drive, Los Angeles. CA 90032
| | - M. Hughes
- Department of Special Education, California State University at Fullerton, P.O. Box 6868, Fullerton, CA 92834-6868
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Hughes M, Rogers S, Lepri G, Bruni C, Matucci-Cerinic M. Further evidence that chilblains are a cutaneous manifestation of COVID-19 infection. Br J Dermatol 2020; 183:596-598. [PMID: 32460349 PMCID: PMC7283762 DOI: 10.1111/bjd.19243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- M Hughes
- Department of Rheumatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - S Rogers
- Academic Surgery Unit, Division of Cardiovascular Sciences, The University of Manchester, Manchester Academic Health Science Centre, Wythenshawe Hospital, Manchester University Foundation Trust, Southmoor Road, Manchester, UK.,Independent Vascular Services Ltd, The Vascular Studies Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Southmoor Road, Manchester, UK
| | - G Lepri
- Department of Experimental and Clinical Medicine, University of Florence and Department of Geriatric Medicine, Division of Rheumatology AOUC, Florence, Italy
| | - C Bruni
- Department of Experimental and Clinical Medicine, University of Florence and Department of Geriatric Medicine, Division of Rheumatology AOUC, Florence, Italy
| | - M Matucci-Cerinic
- Department of Experimental and Clinical Medicine, University of Florence and Department of Geriatric Medicine, Division of Rheumatology AOUC, Florence, Italy
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40
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Al Kharusi S, Anton G, Badhrees I, Barbeau PS, Beck D, Belov V, Bhatta T, Breidenbach M, Brunner T, Cao GF, Cen WR, Chambers C, Cleveland B, Coon M, Craycraft A, Daniels T, Darroch L, Daugherty SJ, Davis J, Delaquis S, Der Mesrobian-Kabakian A, DeVoe R, Dilling J, Dolgolenko A, Dolinski MJ, Echevers J, Fairbank W, Fairbank D, Farine J, Feyzbakhsh S, Fierlinger P, Fudenberg D, Gautam P, Gornea R, Gratta G, Hall C, Hansen EV, Hoessl J, Hufschmidt P, Hughes M, Iverson A, Jamil A, Jessiman C, Jewell MJ, Johnson A, Karelin A, Kaufman LJ, Koffas T, Kostensalo J, Krücken R, Kuchenkov A, Kumar KS, Lan Y, Larson A, Lenardo BG, Leonard DS, Li GS, Li S, Li Z, Licciardi C, Lin YH, MacLellan R, McElroy T, Michel T, Mong B, Moore DC, Murray K, Nakarmi P, Njoya O, Nusair O, Odian A, Ostrovskiy I, Piepke A, Pocar A, Retière F, Robinson AL, Rowson PC, Ruddell D, Runge J, Schmidt S, Sinclair D, Skarpaas K, Soma AK, Stekhanov V, Suhonen J, Tarka M, Thibado S, Todd J, Tolba T, Totev TI, Tsang R, Veenstra B, Veeraraghavan V, Vogel P, Vuilleumier JL, Wagenpfeil M, Watkins J, Weber M, Wen LJ, Wichoski U, Wrede G, Wu SX, Xia Q, Yahne DR, Yang L, Yen YR, Zeldovich OY, Ziegler T. Measurement of the Spectral Shape of the β-Decay of ^{137}Xe to the Ground State of ^{137}Cs in EXO-200 and Comparison with Theory. Phys Rev Lett 2020; 124:232502. [PMID: 32603173 DOI: 10.1103/physrevlett.124.232502] [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] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/17/2020] [Accepted: 05/07/2020] [Indexed: 06/11/2023]
Abstract
We report on a comparison between the theoretically predicted and experimentally measured spectra of the first-forbidden nonunique β-decay transition ^{137}Xe(7/2^{-})→^{137}Cs(7/2^{+}). The experimental data were acquired by the EXO-200 experiment during a deployment of an AmBe neutron source. The ultralow background environment of EXO-200, together with dedicated source deployment and analysis procedures, allowed for collection of a pure sample of the decays, with an estimated signal to background ratio of more than 99 to 1 in the energy range from 1075 to 4175 keV. In addition to providing a rare and accurate measurement of the first-forbidden nonunique β-decay shape, this work constitutes a novel test of the calculated electron spectral shapes in the context of the reactor antineutrino anomaly and spectral bump.
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Affiliation(s)
- S Al Kharusi
- Physics Department, McGill University, Montreal, Quebec H3A 2T8, Canada
| | - G Anton
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - I Badhrees
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - P S Barbeau
- Department of Physics, Duke University, and Triangle Universities Nuclear Laboratory (TUNL), Durham, North Carolina 27708, USA
| | - D Beck
- Physics Department, University of Illinois, Urbana-Champaign, Illinois 61801, USA
| | - V Belov
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Centre "Kurchatov Institute", Moscow 117218, Russia
| | - T Bhatta
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M Breidenbach
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - T Brunner
- Physics Department, McGill University, Montreal, Quebec H3A 2T8, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G F Cao
- Institute of High Energy Physics, Beijing 100049, China
| | - W R Cen
- Institute of High Energy Physics, Beijing 100049, China
| | - C Chambers
- Physics Department, McGill University, Montreal, Quebec H3A 2T8, Canada
| | - B Cleveland
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - M Coon
- Physics Department, University of Illinois, Urbana-Champaign, Illinois 61801, USA
| | - A Craycraft
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Daniels
- Department of Physics and Physical Oceanography, University of North Carolina at Wilmington, Wilmington, North Carolina 28403, USA
| | - L Darroch
- Physics Department, McGill University, Montreal, Quebec H3A 2T8, Canada
| | - S J Daugherty
- Physics Department and CEEM, Indiana University, Bloomington, Indiana 47405, USA
| | - J Davis
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - S Delaquis
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | | | - R DeVoe
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - J Dilling
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A Dolgolenko
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Centre "Kurchatov Institute", Moscow 117218, Russia
| | - M J Dolinski
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - J Echevers
- Physics Department, University of Illinois, Urbana-Champaign, Illinois 61801, USA
| | - W Fairbank
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - D Fairbank
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - J Farine
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - S Feyzbakhsh
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - P Fierlinger
- Technische Universität München, Physikdepartment and Excellence Cluster Universe, Garching 80805, Germany
| | - D Fudenberg
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - P Gautam
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - R Gornea
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G Gratta
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - C Hall
- Physics Department, University of Maryland, College Park, Maryland 20742, USA
| | - E V Hansen
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - J Hoessl
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - P Hufschmidt
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - M Hughes
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - A Iverson
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - A Jamil
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06511, USA
| | - C Jessiman
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - M J Jewell
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - A Johnson
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - A Karelin
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Centre "Kurchatov Institute", Moscow 117218, Russia
| | - L J Kaufman
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - T Koffas
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - J Kostensalo
- University of Jyväskylä, Department of Physics, P.O. Box 35 (YFL), Jyväskylä FI-40014, Finland
| | - R Krücken
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A Kuchenkov
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Centre "Kurchatov Institute", Moscow 117218, Russia
| | - K S Kumar
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - Y Lan
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A Larson
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - B G Lenardo
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - D S Leonard
- IBS Center for Underground Physics, Daejeon 34126, Korea
| | - G S Li
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - S Li
- Physics Department, University of Illinois, Urbana-Champaign, Illinois 61801, USA
| | - Z Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06511, USA
| | - C Licciardi
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - Y H Lin
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - R MacLellan
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - T McElroy
- Physics Department, McGill University, Montreal, Quebec H3A 2T8, Canada
| | - T Michel
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - B Mong
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - D C Moore
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06511, USA
| | - K Murray
- Physics Department, McGill University, Montreal, Quebec H3A 2T8, Canada
| | - P Nakarmi
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - O Njoya
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794, USA
| | - O Nusair
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - A Odian
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - I Ostrovskiy
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - A Piepke
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - A Pocar
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - F Retière
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A L Robinson
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - P C Rowson
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - D Ruddell
- Department of Physics and Physical Oceanography, University of North Carolina at Wilmington, Wilmington, North Carolina 28403, USA
| | - J Runge
- Department of Physics, Duke University, and Triangle Universities Nuclear Laboratory (TUNL), Durham, North Carolina 27708, USA
| | - S Schmidt
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - D Sinclair
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - K Skarpaas
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - A K Soma
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - V Stekhanov
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Centre "Kurchatov Institute", Moscow 117218, Russia
| | - J Suhonen
- University of Jyväskylä, Department of Physics, P.O. Box 35 (YFL), Jyväskylä FI-40014, Finland
| | - M Tarka
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - S Thibado
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - J Todd
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Tolba
- Institute of High Energy Physics, Beijing 100049, China
| | - T I Totev
- Physics Department, McGill University, Montreal, Quebec H3A 2T8, Canada
| | - R Tsang
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - B Veenstra
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - V Veeraraghavan
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - P Vogel
- Kellogg Lab, Caltech, Pasadena, California 91125, USA
| | - J-L Vuilleumier
- LHEP, Albert Einstein Center, University of Bern, Bern CH-3012, Switzerland
| | - M Wagenpfeil
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - J Watkins
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - M Weber
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - L J Wen
- Institute of High Energy Physics, Beijing 100049, China
| | - U Wichoski
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - G Wrede
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - S X Wu
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - Q Xia
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06511, USA
| | - D R Yahne
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - L Yang
- Department of Physics, University of California San Diego, La Jolla, California 92093, USA
| | - Y-R Yen
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - O Ya Zeldovich
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Centre "Kurchatov Institute", Moscow 117218, Russia
| | - T Ziegler
- Erlangen Centre for Astroparticle Physics (ECAP), Friedrich-Alexander University Erlangen-Nürnberg, Erlangen 91058, Germany
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Abstract
The aim of this study was to identify specific aspects of the home environment related to the development of young children with visual impairments. The subjects of the study were 18 mothers and their legally blind children, aged 20–36 months, with no other handicapping conditions. The overall home environments were found to be consistently favorable, despite the differences in the parents’ socioeconomic status. However, they were not significantly related to any developmental scores except for the positive relationship between the emotional and verbal responsiveness of some mothers and the expressive pragmatic language abilities of their children.
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Affiliation(s)
- J. Dote-Kwan
- Division of Special Education, California State University, 515 State University Drive, Los Angeles, CA 90032-8144
| | - M. Hughes
- Department of Special Education, California State University, Fullerton, CA 92634
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Quick V, Hughes M, Chan CH. SAT0271 THE “GOLD STANDARD” DIAGNOSTIC TEST FOR GCA IS THE WHOLE GCA FAST TRACK PATHWAY COMBINED. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2038] [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
Background:We have been developing a rheumatologist-led ultrasound driven giant cell arteritis (GCA) fast-track pathway (FTP), which in year 3 had the following structure:1.Rapid access to rheumatology assessment (RAS) to establish clinical probability of GCA (CP-GCA). No referral criteria required2.Temporal and axillary artery ultrasound (TAUS) if GCA not excluded with RAS. TAUS considered positive if bilateral (halo score ≥2/81,2at >1 temporal artery)3.Second test in selected patients:GCA diagnosed in those with mod-high CP-GCA and +ve TAUS and excluded in those with low CP-GCA and -ve TAUS. All others had biopsy (TAB) or large vessel imaging (LVI), presentation depending4.Protocolised withdrawal of prednisolone:Patients only treated for GCA if ≥1 of: high CP-GCA, +ve TAUS, TAB or LVI5.Rapid accessif symptoms recurred on steroid withdrawal for RAS + TAUSObjectives:To compare security of GCA diagnosis, sight loss rate and TAB rate in Year 3 to previous yearsTo assess sensitivity and specificity of all components of the Yr 3 FTP for diagnosis of GCAMethods:As in Yr 2, TAUS was performed by VQ with an Esaote Mylab7, 6-15MHz probe for axillaries, 22MHz for temporal arteries (TAs). In Yr 1 VQ used a GES8 with ML6-15 for axillaries, 18MHz probe for TAs. Year 3 audit data were compared to previous auditsResults:Year 3 Luton GCA FTP compared to previous yearsTraditional ModelYear 1Year 2Year 3Audit period201512 months1/1/16-31/3/1715 months1/4/17-31/3/1812 months1/4/18-31/3/1912 monthsPathway structureNo rapid access to RASTAB, no TAUS servicePatients seen ad-hoc for RAS + TAUSTAB requested in all appropriate cases to compare TAUS to TABRapid access for RAS + TAUS,2 slots/wk2nd test in selected patientsRapid access for RAS + TAUS,3 slots /wk2nd test in selected patientsProtocolised withdrawal prednisoloneNo. referrals with suspected GCA/yrNK50.47090Cases GCA /yr9241825Cases GCA excluded /yrNK26.45265% GCA patients with imaging/TAB +ve GCA44.463.383.392% GCA patients with clinical GCA(high CP-GCA,no +ve test)55.636.716.68% referred whereGCA excluded on clinical grounds aloneNK11.15.75.6% referred whereTAUS performed and TAB avoidedNANA38.650.0% referred who had TABNK (total 27)84.142.831.1% referred where TAUS, then LVI performed instead of TABNA4.812.813.3Mean days on prednisolone for GCA before TAUS (median, range)NA10.6(7, 0-81)4.4(2, 0-54)5.9(3, 0-57)% GCA patients with permanent sight loss due to GCA3323.311.28NA: Not applicable NK: not knownPerformance of components of Year 3 Luton GCA FTP compared to final diagnosis at >6 months*Diagnostic ToolNo. pts**Sensitivity %Specificity %PPV %NPV %Rheumatologist CP GCA (High)***906098.393.886.1Rheumatologist CP GCA (Moderate & High)***908863.548.993Any halo on TAUS8581.591.481.591.4Bilateral positive TAUS8559.398.394.183.8TAB2869.210010078.9LVI (CT or CTPET)128010010087.5Combined diagnostic tests in the whole FTP (bilateral positive TAUS +/or positive TAB +/or positive LVI)889298.395.896.7*using patient record to Oct 2019 **2 patients passed through twice ***before imaging/TABConclusion:Unlike Yr 2, the higher secure diagnosis rate in Yr 3 could not be attributed to shorter time on prednisolone or better equipment. The increase was likely due to several factors including further improved sonographer skill and increased confidence to withdraw steroids in insecure cases with low/moderate CP-GCA. This approach did not increase sight loss. Further reduction in TAB rate financially justified a 3rd FTP slot/wk created in Yr 3.Each component of the FTP was an inadequate diagnostic tool. Combinations of diagnostic tools are needed to obtain the highest sensitivity and specificity for GCA diagnosis. FTPs limit tests to the minimum required for secure diagnosis. The “gold standard” diagnostic test for GCA is the whole FTP combined.References:[1]Schäfer et alRheum (Ox) 2017:56(9);1479-83[2]van der Geest et alARDdoi: 10.1136/annrheumdis-2019-216343Disclosure of Interests:Vanessa Quick Consultant of: Roche, Speakers bureau: Roche, Mark Hughes: None declared, Chi-Hwa Chan: None declared
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Rigamonti L, Dolci A, Galetta F, Stefanelli C, Hughes M, Bartsch M, Seidelmeier I, Bonaventura K, Back DA. Social media and e-learning use among European exercise science students. Health Promot Int 2020; 35:470-477. [PMID: 31071200 DOI: 10.1093/heapro/daz046] [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] [Indexed: 01/25/2023] Open
Abstract
With the rise of digital technologies, electronic learning and communication tools are becoming a firm part of academia to promote knowledge of health sciences. This study sought to analyse the attitude of students regarding social media and digital learning for study purposes in sport and exercise science. A survey was carried out with a questionnaire (20 main items) in six sport science faculties, equally spread across Germany (G), Italy (I) and the United Kingdom (UK) between February and October 2017. The focus areas were students' usage of social media (Facebook, Google+, Instagram, LinkedIn, Skype, Twitter, WhatsApp, YouTube) for academic purposes and their use of e-learning. Data were analysed by quantitative and qualitative methods. 229 students participated in the study (G: 68, I: 121, UK: 40). While YouTube was mostly used for receiving knowledge, WhatsApp and Facebook showed additional preferences for peer contacts for learning purposes and knowledge discussions. Preferred online data sources were PubMed (77%), free access journals (67%), YouTube (66%) and Wikipedia (63%). Often used digital learning materials were own universities' PowerPoints (77%), scripts (59%) and scientific articles (53%). However, some preferences showed national differences. The evaluated participants showed an overall high use of social media and e-learning tools for their studies. Students would like more digital learning sources made available to them by their institutions. However, some differences in preferences of digital learning or communication tools may exist and this should be considered for international approaches to promote health knowledge among students.
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Affiliation(s)
- L Rigamonti
- Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Potsdam, Germany
| | - A Dolci
- Faculty of Science and Technology, University of Westminster, London, UK
| | - F Galetta
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - C Stefanelli
- Department for Life Quality Studies, University of Bologna, Rimini, Italy
| | - M Hughes
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
| | - M Bartsch
- Department of Sport Medicine, Charité - Universitätsmedizin Berlin, Berlin
| | - I Seidelmeier
- Department for Sport Science, Bundeswehr University Munich, Munich, Germany
| | - K Bonaventura
- Outpatient Clinic, Sports Medicine & Sports Orthopaedics, University of Potsdam, Potsdam, Germany.,Department of Internal Medicine/Cardiology and Angiology, Ernst-von-Bergmann Clinic, Potsdam, Germany
| | - D A Back
- Clinic of Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany.,Dieter Scheffner Center for Medical Teaching and Educational Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Sackley CM, Rick C, Au P, Brady MC, Beaton G, Burton C, Caulfield M, Dickson S, Dowling F, Hughes M, Ives N, Jowett S, Masterson-Algar P, Nicoll A, Patel S, Smith CH, Woolley R, Clarke CE. A multicentre, randomised controlled trial to compare the clinical and cost-effectiveness of Lee Silverman Voice Treatment versus standard NHS Speech and Language Therapy versus control in Parkinson's disease: a study protocol for a randomised controlled trial. Trials 2020; 21:436. [PMID: 32460885 PMCID: PMC7251680 DOI: 10.1186/s13063-020-04354-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/27/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) affects approximately 145,519 people in the UK. Speech impairments are common with a reported prevalence of 68%, which increase physical and mental demands during conversation, reliance on family and/or carers, and the likelihood of social withdrawal reducing quality of life. In the UK, two approaches to Speech and Language Therapy (SLT) intervention are commonly available: National Health Service (NHS) SLT or Lee Silverman Voice Treatment (LSVT LOUD®). NHS SLT is tailored to the individuals' needs per local practice typically consisting of six to eight weekly sessions; LSVT LOUD® comprises 16 sessions of individual treatment with home-based practice over 4 weeks. The evidence-base for their effectiveness is inconclusive. METHODS/DESIGN PD COMM is a phase III, multicentre, three-arm, unblinded, randomised controlled trial. Five hundred and forty-six people with idiopathic PD, reporting speech or voice problems will be enrolled. We will exclude those with a diagnosis of dementia, laryngeal pathology or those who have received SLT for speech problems in the previous 2 years. Following informed consent and completion of baseline assessments, participants will be randomised in a 1:1:1 ratio to no-intervention control, NHS SLT or LSVT LOUD® via a central computer-generated programme, using a minimisation procedure with a random element, to ensure allocation concealment. Participants randomised to the intervention groups will start treatment within 4 (NHS SLT) or 7 (LSVT LOUD®) weeks of randomisation. PRIMARY OUTCOME Voice Handicap Index (VHI) total score at 3 months. Secondary outcomes include: VHI subscales, Parkinson's Disease Questionnaire-39; Questionnaire on Acquired Speech Disorders; EuroQol-5D-5 L; ICECAP-O; resource utilisation; adverse events and carer quality of life. Mixed-methods process and health economic evaluations will take place alongside the trial. Assessments will be completed before randomisation and at 3, 6 and 12 months after randomisation. The trial started in December 2015 and will run for 77 months. Recruitment will take place in approximately 42 sites around the UK. DISCUSSION The trial will test the hypothesis that SLT is effective for the treatment of speech or voice problems in people with PD compared to no SLT. It will further test whether NHS SLT or LSVT LOUD® provide greater benefit and determine the cost-effectiveness of both interventions. TRIAL REGISTRATION International Standard Randomised Controlled Trials Number (ISRCTN) Registry, ID: 12421382. Registered on 18 April 2016.
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Affiliation(s)
- C. M. Sackley
- Population Health Sciences, Addison House, King’s College London, Guy’s Campus, London, SE1 1UL UK
- School of Health Science, University of Nottingham, QMC, Nottingham, NG7 2HA UK
| | - C. Rick
- Nottingham Clinical Trials Unit, University of Nottingham, Building 42, University Park, Nottingham, NG7 2RD UK
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, B15 2TT UK
| | - P. Au
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, B15 2TT UK
| | - M. C. Brady
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, G4 0BA UK
| | - G. Beaton
- Queen Elizabeth Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - C. Burton
- School of Allied and Public Health Professions, Canterbury Christ church University, Canterbury, CT1 1QU UK
| | - M. Caulfield
- Bangor Institute for Health and Medical Research, School of Healthcare Sciences, Bangor University, Bangor, UK
| | - S. Dickson
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, G4 0BA UK
| | - F. Dowling
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ UK
| | - M. Hughes
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, B15 2TT UK
| | - N. Ives
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, B15 2TT UK
| | - S. Jowett
- Health Economics, University of Birmingham, Birmingham,, B15 2TT UK
| | - P. Masterson-Algar
- Bangor Institute for Health and Medical Research, School of Healthcare Sciences, Bangor University, Bangor, UK
| | - A. Nicoll
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, G4 0BA UK
| | - S. Patel
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, B15 2TT UK
| | - C. H. Smith
- Division of Psychology and Language Science, Faculty of Brain Sciences, University College London, London, UK
| | - R. Woolley
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, B15 2TT UK
| | - C. E. Clarke
- Institute for Applied Health Research, University of Birmingham, Birmingham, B15 2TT UK
- Department of Neurology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham,, B18 7QH UK
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Hughes M, Matucci-Cerinic M. Impact and associates of digital pitting in patients with systemic sclerosis: a pilot study. Comment on the article by Nolan et al. Scand J Rheumatol Suppl 2020. [DOI: 10.1080/03009742.2020.1735509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- M Hughes
- Department of Rheumatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - M Matucci-Cerinic
- Department of Experimental and Clinical Medicine, University of Florence and Department of Geriatric Medicine, Division of Rheumatology AOUc, Florence, Italy
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Khan A, Hughes M, Ting M, Riding G, Simpson J, Egun A, Banihani M. A 'hot clinic' for cold limbs: the benefit of urgent clinics for patients with critical limb ischaemia. Ann R Coll Surg Engl 2020; 102:412-417. [PMID: 32306742 DOI: 10.1308/rcsann.2020.0068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The national reconfiguration of vascular surgery means that arterial centres serve larger populations with increased demand on resources. Emergency general surgery ambulatory clinics facilitate timely review and intervention, avoiding admission; a critical limb ischaemia (CLI) 'hot clinic' (HC) was implemented to achieve similar for vascular patients. The aim of the study was to determine HC efficacy. METHODS This was a prospective cohort study comparing HC patients with emergency admission (EA) patients between 1 May and 1 December 2017. Age, sex, comorbidities, CLI severity and smoking status were noted. HC patients were provided with satisfaction surveys. Primary outcome measures were freedom from reintervention and major amputation. Secondary outcome measures included time to procedure, length of stay, returns to theatre and 30-day readmission. RESULTS A total of 147 patients (72 HC, 75 EA) were enrolled in the study. No statistical difference was found in age, sex, smoking status, severity of CLI or prevalence of comorbidities between the groups except that diabetes was more prevalent in EA patients (p=0.028). The median length of stay for the HC cohort was shorter (3 days vs 17 days, p<0.001), with no difference between time to procedure, return to theatre or 30-day readmission. HC patients were nearly 6 times more likely to experience freedom from reintervention (odds ratio: 5.824, p<0.001) and 2.5 times less likely to undergo amputation (odds ratio: 2.616, p=0.043). HC utilisation saved a total of 441 bed days. Over 90% of attendees responded with 100% positive feedback. CONCLUSIONS A vascular HC facilitates urgent review and revascularisation. It provides comparable in-hospital outcomes and better long-term outcomes, with greater efficiency than hospital admission, demonstrating its value in treating CLI.
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Affiliation(s)
- A Khan
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - M Hughes
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - M Ting
- University of Manchester, UK
| | - G Riding
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - J Simpson
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - A Egun
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
| | - M Banihani
- Lancashire Teaching Hospitals NHS Foundation Trust, UK
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Feighan SM, Hughes M, Maunder K, Roche E, Gallagher L. A profile of mental health and behaviour in Prader-Willi syndrome. J Intellect Disabil Res 2020; 64:158-169. [PMID: 31849130 DOI: 10.1111/jir.12707] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/01/2019] [Accepted: 11/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a neurogenetic syndrome with an associated behavioural phenotype and a high incidence of behaviours of concern and psychiatric co-morbidity. These associated behaviours and co-morbidities are not well addressed by existing interventions, and they impact significantly on affected individuals and their caregivers. METHODS We undertook a national survey of the needs of individuals with PWS and their families in Ireland. In this paper, we report on the parent/caregiver-reported mental health, behavioural and access to services. RESULTS Over 50% of individuals with PWS in this survey had at least one reported psychiatric diagnosis, the most common diagnosis was anxiety. The most commonly reported behaviours in children were skin picking, repetitive questioning, difficulty transitioning and non-compliance. The same four behaviours were reported by caregivers as being the most commonly occurring in adolescents and adults in addition to food-seeking behaviours. Increased needs for mental health services were also reported by caregivers. Individuals with PWS had an average wait of 22 months for an appointment with a psychologist and 4 months for an appointment with a psychiatrist. CONCLUSION This study highlighted high levels of psychiatric co-morbidities and behavioural concerns in individuals with PWS in Ireland. The findings of this study suggest that there is an urgent need to provide specialist psychiatric and behavioural interventions to manage complex mental health and behavioural needs to better support individuals with PWS and reduce caregiver burden.
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Affiliation(s)
- S-M Feighan
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - M Hughes
- Prader-Willi Syndrome Association of Ireland, Dublin, Ireland
| | - K Maunder
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - E Roche
- Department of Paediatrics, Trinity College Dublin, Dublin, Ireland
| | - L Gallagher
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
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Anton G, Badhrees I, Barbeau PS, Beck D, Belov V, Bhatta T, Breidenbach M, Brunner T, Cao GF, Cen WR, Chambers C, Cleveland B, Coon M, Craycraft A, Daniels T, Danilov M, Darroch L, Daugherty SJ, Davis J, Delaquis S, Der Mesrobian-Kabakian A, DeVoe R, Dilling J, Dolgolenko A, Dolinski MJ, Echevers J, Fairbank W, Fairbank D, Farine J, Feyzbakhsh S, Fierlinger P, Fudenberg D, Gautam P, Gornea R, Gratta G, Hall C, Hansen EV, Hoessl J, Hufschmidt P, Hughes M, Iverson A, Jamil A, Jessiman C, Jewell MJ, Johnson A, Karelin A, Kaufman LJ, Koffas T, Krücken R, Kuchenkov A, Kumar KS, Lan Y, Larson A, Lenardo BG, Leonard DS, Li GS, Li S, Li Z, Licciardi C, Lin YH, MacLellan R, McElroy T, Michel T, Mong B, Moore DC, Murray K, Njoya O, Nusair O, Odian A, Ostrovskiy I, Piepke A, Pocar A, Retière F, Robinson AL, Rowson PC, Ruddell D, Runge J, Schmidt S, Sinclair D, Soma AK, Stekhanov V, Tarka M, Todd J, Tolba T, Totev TI, Veenstra B, Veeraraghavan V, Vogel P, Vuilleumier JL, Wagenpfeil M, Watkins J, Weber M, Wen LJ, Wichoski U, Wrede G, Wu SX, Xia Q, Yahne DR, Yang L, Yen YR, Zeldovich OY, Ziegler T. Search for Neutrinoless Double-β Decay with the Complete EXO-200 Dataset. Phys Rev Lett 2019; 123:161802. [PMID: 31702371 DOI: 10.1103/physrevlett.123.161802] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/30/2019] [Indexed: 06/10/2023]
Abstract
A search for neutrinoless double-β decay (0νββ) in ^{136}Xe is performed with the full EXO-200 dataset using a deep neural network to discriminate between 0νββ and background events. Relative to previous analyses, the signal detection efficiency has been raised from 80.8% to 96.4±3.0%, and the energy resolution of the detector at the Q value of ^{136}Xe 0νββ has been improved from σ/E=1.23% to 1.15±0.02% with the upgraded detector. Accounting for the new data, the median 90% confidence level 0νββ half-life sensitivity for this analysis is 5.0×10^{25} yr with a total ^{136}Xe exposure of 234.1 kg yr. No statistically significant evidence for 0νββ is observed, leading to a lower limit on the 0νββ half-life of 3.5×10^{25} yr at the 90% confidence level.
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Affiliation(s)
- G Anton
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - I Badhrees
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - P S Barbeau
- Department of Physics, Duke University, and Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - D Beck
- Physics Department, University of Illinois, Urbana-Champaign, Illinois 61801, USA
| | - V Belov
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Center "Kurchatov Institute," 117218 Moscow, Russia
| | - T Bhatta
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M Breidenbach
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - T Brunner
- Physics Department, McGill University, Montreal H3A 2T8, Quebec, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G F Cao
- Institute of High Energy Physics, Beijing 100049, China
| | - W R Cen
- Institute of High Energy Physics, Beijing 100049, China
| | - C Chambers
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - B Cleveland
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - M Coon
- Physics Department, University of Illinois, Urbana-Champaign, Illinois 61801, USA
| | - A Craycraft
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Daniels
- Department of Physics and Physical Oceanography, University of North Carolina at Wilmington, Wilmington, North Carolina 28403, USA
| | - M Danilov
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Center "Kurchatov Institute," 117218 Moscow, Russia
| | - L Darroch
- Physics Department, McGill University, Montreal H3A 2T8, Quebec, Canada
| | - S J Daugherty
- Physics Department and CEEM, Indiana University, Bloomington, Indiana 47405, USA
| | - J Davis
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - S Delaquis
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
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- Physics Department, Stanford University, Stanford, California 94305, USA
| | - J Dilling
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A Dolgolenko
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Center "Kurchatov Institute," 117218 Moscow, Russia
| | - M J Dolinski
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - J Echevers
- Physics Department, University of Illinois, Urbana-Champaign, Illinois 61801, USA
| | - W Fairbank
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - D Fairbank
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - J Farine
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - S Feyzbakhsh
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - P Fierlinger
- Physik Department and Excellence Cluster Universe, Technische Universität München, Garching 80805, Germany
| | - D Fudenberg
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - P Gautam
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - R Gornea
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G Gratta
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - C Hall
- Physics Department, University of Maryland, College Park, Maryland 20742, USA
| | - E V Hansen
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - J Hoessl
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - P Hufschmidt
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - M Hughes
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - A Iverson
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - A Jamil
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06511, USA
| | - C Jessiman
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - M J Jewell
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - A Johnson
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - A Karelin
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Center "Kurchatov Institute," 117218 Moscow, Russia
| | - L J Kaufman
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - T Koffas
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - R Krücken
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A Kuchenkov
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Center "Kurchatov Institute," 117218 Moscow, Russia
| | - K S Kumar
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794, USA
| | - Y Lan
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A Larson
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - B G Lenardo
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - D S Leonard
- IBS Center for Underground Physics, Daejeon 34126, Korea
| | - G S Li
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - S Li
- Physics Department, University of Illinois, Urbana-Champaign, Illinois 61801, USA
| | - Z Li
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06511, USA
| | - C Licciardi
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - Y H Lin
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - R MacLellan
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - T McElroy
- Physics Department, McGill University, Montreal H3A 2T8, Quebec, Canada
| | - T Michel
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - B Mong
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - D C Moore
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06511, USA
| | - K Murray
- Physics Department, McGill University, Montreal H3A 2T8, Quebec, Canada
| | - O Njoya
- Department of Physics and Astronomy, Stony Brook University, SUNY, Stony Brook, New York 11794, USA
| | - O Nusair
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - A Odian
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - I Ostrovskiy
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - A Piepke
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - A Pocar
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - F Retière
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A L Robinson
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - P C Rowson
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - D Ruddell
- Department of Physics and Physical Oceanography, University of North Carolina at Wilmington, Wilmington, North Carolina 28403, USA
| | - J Runge
- Department of Physics, Duke University, and Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA
| | - S Schmidt
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - D Sinclair
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A K Soma
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - V Stekhanov
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Center "Kurchatov Institute," 117218 Moscow, Russia
| | - M Tarka
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - J Todd
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Tolba
- Institute of High Energy Physics, Beijing 100049, China
| | - T I Totev
- Physics Department, McGill University, Montreal H3A 2T8, Quebec, Canada
| | - B Veenstra
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - V Veeraraghavan
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - P Vogel
- Kellogg Lab, Caltech, Pasadena, California 91125, USA
| | - J-L Vuilleumier
- LHEP, Albert Einstein Center, University of Bern, Bern CH-3012, Switzerland
| | - M Wagenpfeil
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - J Watkins
- Physics Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - M Weber
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - L J Wen
- Institute of High Energy Physics, Beijing 100049, China
| | - U Wichoski
- Department of Physics, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - G Wrede
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen 91058, Germany
| | - S X Wu
- Physics Department, Stanford University, Stanford, California 94305, USA
| | - Q Xia
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06511, USA
| | - D R Yahne
- Physics Department, Colorado State University, Fort Collins, Colorado 80523, USA
| | - L Yang
- Physics Department, University of Illinois, Urbana-Champaign, Illinois 61801, USA
| | - Y-R Yen
- Department of Physics, Drexel University, Philadelphia, Pennsylvania 19104, USA
| | - O Ya Zeldovich
- Institute for Theoretical and Experimental Physics named by A.I. Alikhanov of National Research Center "Kurchatov Institute," 117218 Moscow, Russia
| | - T Ziegler
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen 91058, Germany
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Cederberg R, So A, Franks E, Hughes M, Mcnagny K, Bennewith K. P1.04-18 Interleukin-5 Drives the Expansion of Pulmonary B-1 B Cells and Restricts Lung Tumor Growth. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tam A, Hughes M, McNagny KM, Obeidat M, Hackett TL, Leung JM, Shaipanich T, Dorscheid DR, Singhera GK, Yang CWT, Paré PD, Hogg JC, Nickle D, Sin DD. Hedgehog signaling in the airway epithelium of patients with chronic obstructive pulmonary disease. Sci Rep 2019; 9:3353. [PMID: 30833624 PMCID: PMC6399332 DOI: 10.1038/s41598-019-40045-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/21/2019] [Indexed: 01/21/2023] Open
Abstract
Genome-wide association studies have linked gene variants of the receptor patched homolog 1 (PTCH1) with chronic obstructive pulmonary disease (COPD). However, its biological role in the disease is unclear. Our objective was to determine the expression pattern and biological role of PTCH1 in the lungs of patients with COPD. Airway epithelial-specific PTCH1 protein expression and epithelial morphology were assessed in lung tissues of control and COPD patients. PTCH1 mRNA expression was measured in bronchial epithelial cells obtained from individuals with and without COPD. The effects of PTCH1 siRNA knockdown on epithelial repair and mucous expression were evaluated using human epithelial cell lines. Ptch1+/− mice were used to assess the effect of decreased PTCH1 on mucous expression and airway epithelial phenotypes. Airway epithelial-specific PTCH1 protein expression was significantly increased in subjects with COPD compared to controls, and its expression was associated with total airway epithelial cell count and thickness. PTCH1 knockdown attenuated wound closure and mucous expression in airway epithelial cell lines. Ptch1+/− mice had reduced mucous expression compared to wildtype mice following mucous induction. PTCH1 protein is up-regulated in COPD airway epithelium and may upregulate mucous expression. PTCH1 provides a novel target to reduce chronic bronchitis in COPD patients.
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Affiliation(s)
- A Tam
- Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - M Hughes
- Biomedical Research Centre (BRC), University of British Columbia, Vancouver, British Columbia, Canada
| | - K M McNagny
- Biomedical Research Centre (BRC), University of British Columbia, Vancouver, British Columbia, Canada
| | - M Obeidat
- Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - T L Hackett
- Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada.,Department of Anaesthesiology, Pharmacology, & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - J M Leung
- Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - T Shaipanich
- Division of Respiratory Medicine, Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - D R Dorscheid
- Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - G K Singhera
- Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - C W T Yang
- Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - P D Paré
- Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - J C Hogg
- Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - D Nickle
- Merck & Co. Inc., Rahway, New Jersey, United States of America
| | - D D Sin
- Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada.
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