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Johansen SU, Hansen T, Nordborg A, Meyer R, Goll R, Florholmen J, Jensen E. Plasma tryptophan pathway metabolites quantified by liquid chromatography-tandem mass spectrometry as biomarkers in neuroendocrine tumor patients. J Neuroendocrinol 2024; 36:e13372. [PMID: 38361341 DOI: 10.1111/jne.13372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/21/2023] [Accepted: 01/11/2024] [Indexed: 02/17/2024]
Abstract
A good and accessible biomarker is of great clinical value in neuroendocrine tumor (NET) patients, especially considering its frequently indolent nature and long-term follow-up. Plasma chromogranin A (CgA) and 5-hydroxyindoleacetic acid (5-HIAA) are currently used as biomarkers in NET, but their sensitivity and specificity are restricted. 5-HIAA is the main metabolite of serotonin, an important neurotransmitter of the tryptophan pathway. The aim of this study is to estabish a sensitive and accurate method for the quantification of tryptophan pathway metabolites in plasma. We further aimed to evaluate its utility as a clinical tool in NET disease. We obtained plasma samples from NET patients and healthy controls recruited from the University Hospital of North Norway, Tromsø. Samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and eight metabolites of the tryptophan pathway were quantified. We included 130 NET patients (72/130 small intestinal [SI] NET, 35/130 pancreatic NET, 23/130 other origin) and 20 healthy controls. In the SI-NET group, 26/72 patients presented with symptoms of carcinoid syndrome (CS). We found that combining tryptophan metabolites into a serotonin/kynurenine pathway ratio improved diagnostic sensitivity (92.3%) and specificity (100%) in detecting CS patients from healthy controls compared with plasma 5-HIAA alone (sensitivity 84.6%/specificity 100%). Further, a clinical marker based on the combination of plasma serotonin, 5-HIAA, and 5OH-tryptophan, increased diagnostic capacity identifying NET patients with metastasized disease from healthy controls compared with singular plasma 5-HIAA, serotonin, or CgA. In addition, this marker was positive in 61% of curatively operated SI-NET patients compared with only 10% of healthy controls (p < .001). Our results indicate that simultaneous quantification of several tryptophan metabolites in plasma, using LC-MS/MS, may represent a clinically useful diagnostic tool in NET disease.
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Affiliation(s)
- S U Johansen
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
- Medical Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - T Hansen
- Department of Biotechnology and Nanomedicine, SINTEF Industry, Trondheim, Norway
- Department of Pharmacy, UiT the Arctic University of Norway, Tromsø, Norway
| | - A Nordborg
- Department of Biotechnology and Nanomedicine, SINTEF Industry, Trondheim, Norway
| | - R Meyer
- Medical Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - R Goll
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
- Medical Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - J Florholmen
- Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
- Medical Gastroenterology, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - E Jensen
- Department of Pharmacy, UiT the Arctic University of Norway, Tromsø, Norway
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Meyer R, Loncar LR, Jensen E, Raja A, Tunis B, Moreland ML, Tunis J. The Role of Ultrasound in the Management of Ankle Sprains and a Clinically Relevant Geisinger Ankle Sprain Sports Ultrasound Protocol. Curr Sports Med Rep 2023; 22:320-327. [PMID: 37678351 DOI: 10.1249/jsr.0000000000001105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
ABSTRACT Ankle sprains are the most common lower extremity injury in physically active individuals. These injuries are classified as lateral, medial, and/or syndesmotic. Treatment may include functional rehabilitation, bracing, weight-bearing restriction, medications, injections, and surgery. While most sprains heal rapidly, permanent disability and pain may arise. Diagnostic ultrasound has been demonstrated to be accurate in diagnosing ligamentous injuries, but it is often excluded from management algorithms that rely on physical examination alone to diagnose significant injuries. This article proposes a comprehensive, evidence-based diagnostic ankle ultrasound protocol to implement in conjunction with thorough history and physical examination. We also review the current literature to describe where this protocol most improves diagnostic accuracy compared with physical examination alone.
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Affiliation(s)
| | | | | | - Altamash Raja
- Department of Rehabilitation Medicine, Rowan-Virtua School of Osteopathic Medicine, Sewell, NJ
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Archer E, Govender L, Meyer R, Nadkar AA, Smit L. Praxis-Informed Pointers: A Student Guide for Optimizing Clinical Learning in a Resource-Constrained Setting. Teach Learn Med 2023:1-7. [PMID: 37553839 DOI: 10.1080/10401334.2023.2237480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 05/20/2023] [Accepted: 06/15/2023] [Indexed: 08/10/2023]
Abstract
Issue: Health professions education (HPE) is intimately linked with teaching and learning in the clinical environment. While the value of authentic clinical experiences is acknowledged, whether learning actually occurs is to a large extent dependent on students' behaviors and attitudes. The kinds of student behaviors and attitudes that are necessary to optimize learning in the clinical environment thus becomes relevant. Evidence: Tips and recommendations to maximize clinical learning in a variety of settings have been well documented. There is, however, a dearth of literature which takes a narrative-based praxis approach focused on resource-constrained environments. We developed this praxis-orientated article as a means to translate the available literature and theory into a simple, practical guide, focused on optimizing clinical learning from a student perspective, remaining cognizant of the particular challenges present in a resource-constrained setting. Implications: Based on the resource-constrained environments our students are exposed to, we outline the following six key aspects: student-driven learning, integration into the community of practice, student engagement, empathy, interprofessional learning opportunities, and feedback for learning. These aspects provide useful pointers for students in general. Furthermore, exploration into what strategies students may utilize in resource-constrained clinical contexts is addressed.
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Affiliation(s)
- E Archer
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - L Govender
- Division of Anatomical Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - R Meyer
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - A A Nadkar
- Tygerberg Hospital, Western Cape, South Africa
- MBChB Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - L Smit
- Tygerberg Hospital, Western Cape, South Africa
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Garoufalia Z, Freund MR, Gefen R, Meyer R, DaSilva G, Weiss EG, Wexner SD. Does Completeness of the Mesorectal Excision Still Correlate With Local Recurrence? Dis Colon Rectum 2023; 66:898-904. [PMID: 36649177 DOI: 10.1097/dcr.0000000000002551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Total mesorectal excision is the standard surgical procedure for rectal cancer treatment. Several studies have shown a close correlation between the prognosis of patients with rectal cancer and the completeness of the mesorectal specimen. OBJECTIVE To assess the correlation between macroscopic assessment of mesorectal excision and long-term oncological outcomes. DESIGN Retrospective analysis of an Institutional Review Board-approved database. SETTINGS Tertiary referral center. PATIENTS Patients with rectal cancer who were operated on between March 2016 and October 2019 were classified into 3 groups based on the mesorectal specimen quality: complete, near complete, and incomplete. Only patients with a follow-up of ≥2 years and without signs of preoperative distant disease were included. MAIN OUTCOME MEASURES Relationship between total mesorectal excision and local and distant recurrence rates in patients with rectal cancer. RESULTS A total of 124 patients (35.5% females) were included in the analysis, with a mean age of 58.1 (SD 12) years and a mean BMI of 26.4 (SD 4.59) kg/m². Neoadjuvant chemoradiation was administered to 71% of patients, whereas 13.7% received total neoadjuvant therapy. Restorative procedures were performed in 107 patients (86.3%), whereas 17 patients (13.7%) underwent abdominoperineal resection. The majority of mesorectal excision specimens (87.09%) were complete or near complete. Local recurrence rates were 6.3% (1/16) in the incomplete and 7.4% (8/108) in the complete/near complete group ( p = 0.86). Metachronous distant metastases occurred in 6 patients (37.5%) in the incomplete group and in 24 patients (22.2%) in the complete/near complete group (p = 0.18). Thus, specimen quality did not appear to impact disease-free survival. LIMITATIONS Retrospective, single-center study with relatively short follow-up. CONCLUSIONS In the era of a multidisciplinary approach and extensive use of neoadjuvant therapy, macroscopic completeness of total mesorectal excision may not be as valuable a prognosticator as in the past. Larger studies with longer follow-ups are needed to clarify these preliminary findings. See Video Abstract at http://links.lww.com/DCR/C129. LA INTEGRIDAD DE LA ESCISIN MESORRECTAL TODAVA SE CORRELACIONA CON LA RECURRENCIA LOCAL ANTECEDENTES:La escisión total desl mesorrecto es el estándar de oro para el tratamiento del cáncer de recto. Varios estudios han demostrado una estrecha correlación entre el pronóstico de los pacientes con cáncer de recto y la integridad espécimen mesorrectal.OBJETIVO:Evaluar la correlación entre la evaluación macroscópica de la escisión mesorrectal y los resultados oncológicos a largo plazo en pacientes con cáncer de recto.DISEÑO:Análisis retrospectivo de una base de datos aprobada por el IRB.ENTORNO CLINICO:El estudio se realizó en un centro de referencia terciario de una sola institución.PACIENTES:Todos los pacientes con cáncer de recto operados entre 3/2016-10/2019. Los pacientes se clasificaron en 3 grupos, según la calidad del espécimen mesorrectal: completo, casi completo e incompleto. Solo se incluyeron pacientes con seguimiento >2 años y sin signos de enfermedad a distancia preoperatoria.PRINCIPALES MEDIDAS DE RESULTADO:Identificar la relación entre la escisión mesorrectal total y las tasas de recurrencia local y a distancia en pacientes con cáncer de recto.RESULTADOS:Se incluyeron 124 pacientes (35,5% mujeres) con una edad media de 58,1 años (DE 12) y un índice de masa corporal medio de 26,4 (DE 4,59). Se administró quimiorradiación neoadyuvante al 71% de los pacientes, mientras que el 13,7% recibió terapia neoadyuvante total. Se realizaron procedimientos de restauración en 107 pacientes (86,3%), mientras que 17 pacientes (13,7%) se sometieron a resección abdominoperineal. La mayoría (87,09%) de los especímenes de escisión mesorrectal fueron completas o casi completas. Las tasas de recurrencia local fueron 1/16 (6,3%) en el grupo incompleto y 8/108 (7,4%) en el grupo completo/casi completo ( p = 0,86). Se produjeron metástasis a distancia metacrónicas en 6 pacientes (37,5%) en el grupo incompleto y 24 (22,2%) en el grupo completo/casi completo ( p = 0,18). Por lo tanto, la calidad del espécimen no pareció afectar la supervivencia libre de enfermedad.LIMITACIONES:Estudio retrospectivo de un solo centro con pequeño número de casos y seguimiento relativamente corto.CONCLUSIÓN:En la era de un enfoque multidisciplinario y el uso extensivo de la terapia neoadyuvante, la integridad macroscópica de la escisión total del mesorrecto, puede no ser un pronóstico tan valioso como en el pasado. Se necesitan estudios más amplios con períodos de seguimiento más prolongados para aclarar estos hallazgos preliminares. Consulte Video Resumen en http://links.lww.com/DCR/C129 . (Traducción-Dr. Fidel Ruiz Healy ).
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Affiliation(s)
- Zoe Garoufalia
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida
| | - Michael R Freund
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida
| | - Rachel Gefen
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida
- Department of General Surgery, Faculty of Medicine, Hadassah Medical Organization, Hebrew University of Jerusalem, Israel
| | - Ryan Meyer
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida
| | - Giovanna DaSilva
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida
| | - Eric G Weiss
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida
| | - Steven D Wexner
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida
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Weissbach T, Hausman-Kedem M, Yanay Z, Meyer R, Bar-Yosef O, Leibovitch L, Berkenstadt M, Chorin O, Shani H, Massarwa A, Achiron R, Weisz B, Sharon R, Mazaki-Tovi S, Kassif E. Congenital hypotonia: systematic approach for prenatal detection. Ultrasound Obstet Gynecol 2023; 62:94-105. [PMID: 36779229 DOI: 10.1002/uog.26178] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/26/2022] [Revised: 01/07/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Congenital hypotonic conditions are rare and heterogeneous, and some are severely debilitating or lethal. Contrary to its prominent postnatal manifestation, the prenatal presentation of hypotonia is frequently subtle, inhibiting prenatal detection. We aimed to characterize the prenatal sonographic manifestation of congenital hypotonia throughout pregnancy, evaluate the yield of diagnostic tests and propose diagnostic models to increase its prenatal detection. METHODS This was a retrospective observational study of singleton pregnancies with congenital hypotonia, diagnosed either prenatally or immediately after birth, at a single tertiary center between the years 2012 and 2020. Prenatally, hypotonia was diagnosed if a fetus showed sonographic or clinical signs suggestive of hypotonia and had a confirmed underlying genetic condition, or in the absence of a known genetic abnormality if the fetus exhibited multiple prominent signs suggestive of hypotonia. Postnatally, it was diagnosed in neonates displaying reduced muscle tone leading to reduced spontaneous movement, reduced swallowing or feeding difficulty. We reviewed the medical records of pregnant patients carrying fetuses subsequently diagnosed with congenital hypotonia and assessed the yield of ultrasound scans, fetal magnetic resonance imaging, computed tomography and genetic tests. The detection rate of sonographic signs suggesting fetal hypotonia was calculated. The prevalence of non-specific signs, including polyhydramnios, persistent breech presentation, intrauterine growth restriction and maternal perception of reduced fetal movement, were compared between the study group and the local liveborn singleton population. Potential detection rates of different theoretical semiotic diagnostic models, differing in the threshold for referral for a targeted scan, were assessed based on the cohort's data. RESULTS The study group comprised 26 cases of congenital hypotonia, of which 10 (38.5%) were diagnosed prenatally, and the controls included 95 105 singleton live births, giving a prevalence of congenital hypotonia of 1:3658. Nuchal translucency thickness and the early anomaly scan at 13-17 weeks were normal in all 22 and 23 cases, respectively, in which this was performed. The mid-trimester scan performed at 19-25 weeks was abnormal in four of 24 (16.7%) cases. The overall prenatal detection rate of congenital hypotonic conditions in our cohort was 38.5%. Only cases which underwent a targeted scan were detected and, among the 16 cases which underwent this scan, the prenatal detection rate was 62.5% compared with 0% in pregnancies that did not undergo this scan (P = 0.003). An abnormal genetic diagnosis was obtained in 21 (80.8%) cases using the following modalities: chromosomal microarray analysis (CMA) in two (9.5%), whole-exome sequencing (WES) in 14 (66.7%) and methylation analysis in five (23.8%). CMA was abnormal in 8% (2/25) of the cases and WES detected a causative genetic mutation in 87.5% (14/16) of the cases in which these were performed. Comparison of non-specific signs in the study group with those in the local singleton population showed that hypotonic fetuses had significantly more polyhydramnios (64.0% vs 3.0%, P < 0.0001), persistent breech presentation (58.3% vs 4.2%, P < 0.0001), intrauterine growth restriction (30.8% vs 3.0%, P < 0.0001) and maternal perception of reduced fetal movement (32.0% vs 4.7%, P < 0.0001). Prenatally, the most commonly detected signs supporting a diagnosis of hypotonia were structural anomaly (62.5%, 10/16), reduced fetal movement (46.7%, 7/15), joint contractures (46.7%, 7/15) and undescended testes ≥ 30 weeks (42.9%, 3/7 males). Proposed diagnostic strategies that involved performing a targeted scan for a single non-specific ultrasound sign or two such signs, and then carrying out a comprehensive genetic evaluation for any additional sign, offered theoretical detection rates in our cohort of 88.5% and 57.7%, respectively. CONCLUSIONS Congenital hypotonic conditions are rare and infrequently detected prenatally. Sonographic signs are visible from the late second trimester. A targeted scan increases prenatal detection significantly. Comprehensive genetic testing, especially WES, is the cornerstone of diagnosis in congenital hypotonia. Theoretical diagnostic models which may increase prenatal detection are provided. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- T Weissbach
- Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Hausman-Kedem
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Z Yanay
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Schneider Children's Medical Center, Petach Tikva, Israel
| | - R Meyer
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - O Bar-Yosef
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Neurology, Safra Children's Hospital, Sheba, Tel Hashomer, Israel
| | - L Leibovitch
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Neonatal Intensive Care Unit, Sheba Medical Center, Tel Hashomer, Israel
| | - M Berkenstadt
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Danek Institute of Genetics, Sheba Medical Center, Tel Hashomer, Israel
| | - O Chorin
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Danek Institute of Genetics, Sheba Medical Center, Tel Hashomer, Israel
| | - H Shani
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Danek Institute of Genetics, Sheba Medical Center, Tel Hashomer, Israel
| | - A Massarwa
- Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Achiron
- Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - B Weisz
- Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Sharon
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Neurology, Sheba Medical Center, Tel Hashomer, Israel
| | - S Mazaki-Tovi
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - E Kassif
- Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Freund MR, Horesh N, Meyer R, Garoufalia Z, Gefen R, Emile SH, Wexner SD. Can preoperative CT/MR enterography preclude the development of Crohn's disease-like pouch complications in ulcerative colitis patients undergoing J pouch surgery? Colorectal Dis 2023. [PMID: 37128154 DOI: 10.1111/codi.16587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 01/07/2023] [Accepted: 03/13/2023] [Indexed: 05/03/2023]
Abstract
AIM We aimed to determine whether ulcerative colitis patients with preoperative negative computed tomography or magnetic resonance enterography (CTE/MRE) were less likely to develop Crohn's disease-like pouch complications (CDLPC) and establish risk factors and predictors for developing CDLPC. METHODS This was a single centre retrospective analysis of patients with ulcerative colitis (UC) and inflammatory bowel disease unclassified (IBDU) who underwent total proctocolectomy with ileal J-pouch between January 2010 and December 2020. The study group comprised patients with negative preoperative CTE/MRE and the control group included patients operated without preoperative CTE/MRE. RESULTS A total of 131 patients were divided into the negative CTE/MRE study group (76 [58%] patients) and control group (55 [42%] patients). There were no significant differences in incidence rates (21% vs. 23.6%, p = 0.83), time to developing CDLPC from ileostomy closure (22.3 vs. 23.8 months; p = 0.81), pouchitis rates (23.6% vs. 27.2%; p = 0.68), or pouch failure rates (5.2 vs. 7.2; p = 0.71). Multivariate Cox regression analysis showed backwash ileitis (HR 4.1; p = 0.03, CI: 1.1-15.1), severe pouchitis (HR 3.4; p = 0.039, CI: 1.0-10.9), and history of perianal disease (HR 3.4; p = 0.017, CI: 1.4-39.6) were independent predictors for CDLPC. CONCLUSIONS Negative findings on MRE/CTE prior to J-pouch surgery in ulcerative colitis should be interpreted with caution as it is does not reliably exclude or predict development of CDLPC. These patients should be preoperatively counselled concerning the possibility of developing CDLPC regardless of lack of positive findings on preoperative CTE/MRE. Patients with backwash ileitis with a previous history of perianal disease should be informed of the potentially increased risk of developing such complications.
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Affiliation(s)
- Michael R Freund
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Centre, Cleveland Clinic Florida, Weston, Florida, USA
- Department of General Surgery, Shaare Zedek Medical Centre, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nir Horesh
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Centre, Cleveland Clinic Florida, Weston, Florida, USA
- Department of Surgery and Transplantations, Sheba Medical Centre, Ramat Gan, Affiliated with the Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel
| | - Ryan Meyer
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Centre, Cleveland Clinic Florida, Weston, Florida, USA
| | - Zoe Garoufalia
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Centre, Cleveland Clinic Florida, Weston, Florida, USA
| | - Rachel Gefen
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Centre, Cleveland Clinic Florida, Weston, Florida, USA
- Department of General Surgery, Faculty of Medicine, Hadassah Medical Organization, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sameh Hany Emile
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Centre, Cleveland Clinic Florida, Weston, Florida, USA
- Colorectal Surgery Unit, Mansoura University Hospitals, Mansoura, Egypt
| | - Steven D Wexner
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Centre, Cleveland Clinic Florida, Weston, Florida, USA
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Niino C, Tholemeier L, Meyer R, Siedhoff M, Wright K, Truong M. Telemedicine improves visit efficiency in minimally invasive gynecologic surgery practice. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.12.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
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Hamilton K, Konate N, Meyer R, Jasmine G, Wright K, Siedhoff M, Scheib S, Truong M. Racial and gender representation trends among national obstetrics and gynecology society leadership. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.12.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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Henry T, Meyer R, Lao O, Ziadie M, Rainisch M. Melanotic neuroectodermal tumor of infancy presenting as rapidly enlarging cheek mass. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2022.102344] [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: 10/18/2022] Open
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Abstract
ABSTRACT Magnetic resonance imaging is the current gold standard imaging modality for diagnosing anterior cruciate ligament (ACL) tears. However, ultrasound has grown in popularity for detecting ACL injuries because of its low cost, portability, and dynamic assessment capabilities. Recent studies demonstrate high sensitivity and specificity for diagnosing isolated ACL tears via ultrasound, but tremendous heterogeneity remains for optimal technique including patient positioning, transducer placement, and dynamic versus static ultrasound usage. As ultrasound becomes ubiquitous in clinics, training rooms, and on the sidelines, identifying objective and sensitive measurements to appropriately screen athletes for significant knee injuries is imperative. This article aims to review the current role of diagnostic ultrasound in ACL injuries and propose a standardized version of the Prone Lachman with Ultrasound test, which is an objective, reliable, and easily reproducible technique to evaluate ACL competency. Developing a standardized protocol will expand the use of point-of-care ultrasound, which may reduce cost and improve efficiency in care.
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Affiliation(s)
- Altamash E Raja
- Primary Care Sports Medicine, Geisinger Wyoming Valley, Wilkes-Barre, PA
| | - Ryan Meyer
- Primary Care Sports Medicine, Geisinger Wyoming Valley, Wilkes-Barre, PA
| | - Brandon G Tunis
- Primary Care Sports Medicine, Geisinger Wyoming Valley, Wilkes-Barre, PA
| | - Michael L Moreland
- Primary Care Sports Medicine, Geisinger Wyoming Valley, Wilkes-Barre, PA
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Spektor Z, Hussain I, Van Leeuwen RN, Goudy S, Esterhuizen K, Meyer R, Hedrick J. Pharmacokinetics of ciprofloxacin and fluocinolone acetonide otic solution in pediatric patients. Am J Otolaryngol 2022; 43:103573. [DOI: 10.1016/j.amjoto.2022.103573] [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] [Received: 06/15/2022] [Accepted: 07/31/2022] [Indexed: 11/01/2022]
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Cawood AL, Meyer R, Grimshaw KE, Sorensen K, Acosta-Mena D, Stratton RJ. The health economic impact of cow's milk allergy in childhood: A retrospective cohort study. Clin Transl Allergy 2022; 12:e12187. [PMID: 36036235 PMCID: PMC9412243 DOI: 10.1002/clt2.12187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/16/2022] [Accepted: 07/18/2022] [Indexed: 11/23/2022] Open
Abstract
Background Cow's milk allergy (CMA) is one of the most common food allergies among children. Whilst avoidance of cow's milk protein is the cornerstone of management, further treatment of symptoms including those affecting the gastrointestinal, skin and respiratory systems plus other allergic comorbidities, maybe required. This study aimed to quantify the wider economic impact of CMA and its management in the United Kingdom (UK). Methods We conducted a retrospective matched cohort study on children with CMA (diagnosis read code and/or hypoallergenic formula prescription for ≥3 months) examining healthcare data (medication prescriptions and healthcare professional contacts) from case records within The Health Improvement Network (A Cegedim Proprietary Database) in the UK. A comparative cost analysis was calculated based on healthcare tariff and unit costs in the UK. Results 6998 children (54% male; mean observation period 4.2 years) were included (n = 3499 with CMA, mean age at diagnosis 4.04 months; n = 3499 matched controls without CMA). Compared to those without CMA, medications were prescribed to significantly more children with CMA (p < 0.001) at a higher rate (p < 0.001). Children with CMA also required significantly more healthcare contacts (p < 0.001) at higher rate (p < 0.001) compared to those without CMA. CMA was associated with additional potential healthcare costs of £1381.53 per person per year. Conclusion The findings of this large cohort study suggest that CMA and its associated co‐morbidities presents a significant additional healthcare burden with economic impact due to higher prescribing of additional medications. Further research into management approaches that may impact these clinical and economic outcomes of CMA is warranted.
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Affiliation(s)
- Abbie L Cawood
- Institute of Human Nutrition, Faculty of Medicine, Southampton General Hospital, Southampton, UK.,Medical Affairs, Nutricia Ltd, White Horse Business Park, Trowbridge, UK
| | - R Meyer
- Department of Paediatrics, St Mary's Hospital, London, UK
| | - Kate E Grimshaw
- Institute of Human Nutrition, Faculty of Medicine, Southampton General Hospital, Southampton, UK.,Dietetic Department, Salford Care Organisation, Salford Royal NHS Foundation Trust, Salford, UK
| | - Katy Sorensen
- Medical Affairs, Nutricia Ltd, White Horse Business Park, Trowbridge, UK
| | | | - Rebecca J Stratton
- Institute of Human Nutrition, Faculty of Medicine, Southampton General Hospital, Southampton, UK.,Medical Affairs, Nutricia Ltd, White Horse Business Park, Trowbridge, UK
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13
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Freund MR, Kent I, Horesh N, Smith T, Zamis M, Meyer R, Yellinek S, Wexner SD. The effect of the first year of the COVID-19 pandemic on sphincter preserving surgery for rectal cancer: A single referral center experience. Surgery 2022; 171:1209-1214. [PMID: 35337683 PMCID: PMC8849841 DOI: 10.1016/j.surg.2022.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 12/13/2022]
Abstract
Background COVID-19 has significantly impacted healthcare worldwide. Lack of screening and limited access to healthcare has delayed diagnosis and treatment of various malignancies. The purpose of this study was to determine the effect of the first year of the COVID-19 pandemic on sphincter-preserving surgery in patients with rectal cancer. Methods This was a single-center retrospective study of patients undergoing surgery for newly diagnosed rectal cancer. Patients operated on during the first year of the COVID-19 pandemic (March 2020–February 2021) comprised the study group (COVID-19 era), while patients operated on prior to the pandemic (March 2016–February 2020) served as the control group (pre–COVID-19). Results This study included 234 patients diagnosed with rectal cancer; 180 (77%) patients in the pre–COVID-19 group and 54 patients (23%) in the COVID-19–era group. There were no differences between the groups in terms of mean patient age, sex, or body mass index. The COVID-19–era group presented with a significantly higher rate of locally advanced disease (stage T3/T4 79% vs 58%; P = .02) and metastatic disease (9% vs 3%; P = .05). The COVID-19–era group also had a much higher percentage of patients treated with total neoadjuvant therapy (52% vs 15%; P = .001) and showed a significantly lower rate of sphincter-preserving surgery (73% vs 86%; P = .028). Time from diagnosis to surgery in this group was also significantly longer (median 272 vs 146 days; P < .0001). Conclusion Patients undergoing surgery for rectal cancer during the first year of the COVID-19 pandemic presented later and at a more advanced stage. They were more likely to be treated with total neoadjuvant therapy and were less likely candidates for sphincter-preserving surgery.
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Affiliation(s)
- Michael R Freund
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL. https://twitter.com/mikifreund
| | - Ilan Kent
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL. https://twitter.com/ilan_kent
| | - Nir Horesh
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL. https://twitter.com/nirhoresh
| | - Timothy Smith
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL
| | - Marcella Zamis
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL
| | - Ryan Meyer
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL
| | - Shlomo Yellinek
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL. https://twitter.com/SYellinek
| | - Steven D Wexner
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL.
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14
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Meyer R, Lin C, Yenokyan G, Ellen M. Diagnostic Utility of Ultrasound Versus Physical Examination in Assessing Knee Effusions: A Systematic Review and Meta-analysis. J Ultrasound Med 2022; 41:17-31. [PMID: 33675099 DOI: 10.1002/jum.15676] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/23/2021] [Accepted: 02/10/2021] [Indexed: 06/12/2023]
Abstract
Knee effusion can be detected by physical examination, ultrasound and MRI, but the utility of each test is unclear. This study aimed to analyze the diagnostic value of physical examination and ultrasound for knee effusion. A systematic literature search of electronic databases was completed. Bivariate mixed-effects regression modelling was used to estimate sensitivity, specificity and diagnostic odds ratio of physical examination and ultrasound diagnosis of knee effusion. Sensitivity of ultrasound diagnosis of knee effusion was higher than the bulge sign and patellar tap, leading to improved positive and negative predictive values.
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Affiliation(s)
- Ryan Meyer
- Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Gayane Yenokyan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mark Ellen
- The Orthopaedic Institute, Gainesville, Florida, USA
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15
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Raja AE, Shustorovich A, Robinson DM, Alfonso K, Meyer R, Roemmich RT, Eng C, Wisniewski SJ, Cabahug P. Musculoskeletal Ultrasound as a Motivator for Selecting a Physical Medicine and Rehabilitation Residency Program in the United States: A Multicenter Survey Study. Am J Phys Med Rehabil 2022; 101:97-103. [PMID: 33605576 PMCID: PMC8371081 DOI: 10.1097/phm.0000000000001719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
ABSTRACT This study aimed to determine the influence of musculoskeletal ultrasound (MSKUS) curriculum on applicants during the residency-selection process. A survey of 666 applicants for the Johns Hopkins University, Mayo Clinic, and Harvard/Spaulding Rehabilitation Physical Medicine and Rehabilitation programs was conducted in June 2020. A total of 180 respondents scored the influence of a MSKUS curriculum on their decision making for residency selection. In addition, applicants were asked to rank specific areas of physical medicine and rehabilitation that influenced their decision making. Participants most commonly included MSKUS in their top three areas of interest when constructing their rank order list. When asked whether MSKUS presence within a program had an effect during the interview-selection process, 71% responded with "very important" or "absolutely essential" (P < 0.001). For 74% of applicants, exposure to MSKUS in residency was an important factor when creating their rank order list (P < 0.001). More than 92% of applicants stated that they are "likely" or "very likely" to use MSKUS in their future practice and 83% would recommend a program with MSKUS to future candidates (P < 0.001). Based on these results, a large percentage of physical medicine and rehabilitation applicants intend on using MSKUS in their future practice. Therefore, MSKUS may be an important factor for residency selection.
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Affiliation(s)
- Altamash E Raja
- From the Department of Physical Medicine & Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, Maryland (AER, AS, RM, RTR, PC); Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, Massachusetts (DMR, CE); Department of Physical Medicine & Rehabilitation, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota (KA, SJW); and Center for Movement Studies (RTR) and International Center for Spinal Cord Injury (PC), Kennedy Krieger Institute, Baltimore, Maryland
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16
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Mohr-Sasson A, Dadon T, Brandt A, Meyer R, Mashiach R, Zajicek M. A Comparative Analysis of Diagnosis and Measurement of Uterine ‘Niche’ Performed By Non-Specialist and Specialist Sonographers. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Meyer R, Meller N, Mohr-Sasson A, Toussia-Cohen S, Cohen SB, Bart Y, Mashiach R, Levin G. Preoperative Clinical Features of Isolated Fallopian tube Torsion: Evidence from a Large Series. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Bart Y, Mohr-Sasson A, Yousefi S, Goldenberg M, Meyer R, Toussia-Cohen S, Eyal Y, Mazaki-Tovi S, Mashiach R. Adnexal torsion recurrence-is the adnexal twist degree a risk factor? A retrospective cohort study. BJOG 2021; 128:1511-1516. [PMID: 33978295 DOI: 10.1111/1471-0528.16738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate whether the adnexal twist degree is related to torsion recurrence and whether there is a dose-dependent correlation. DESIGN A retrospective cohort study. SETTING Single tertiary medical centre. POPULATION The study includes non-pregnant patients operated, for the first time, for adnexal torsion, between 2011 and 2018. METHODS Information regarding the degree of adnexal twist was collected from surgical reports. Recurrence was identified using a computerised database and ascertained via telephone with a response rate of 87.2% (253/290). MAIN OUTCOME MEASURES Adnexal torsion recurrence rate. RESULTS A total of 182 women who had undergone laparoscopic detorsion met the inclusion criteria. Twenty-two had torsion recurrence (12.1%). Adnexal twist degree in the primary event was associated with a higher recurrence risk: 4.3% of women with twist degree ≤360 (n = 3/70), 14.5% of women with twist degree of 361-720 (n = 9/62) and 20% of women with twist degree >720 (n = 10/50) (P = 0.03). The median twist degree was 540 (interquartile range [IQR] 360-855) and 720 (IQR 675-1080) degrees in the control and study groups, respectively (P = 0.005). Additional possibly associated factors for recurrence were evaluated. Age emerged as a possible risk factor, with a median age of 19 years in the recurrence group (IQR 14-27 years) versus 28.5 (IQR 19-36 years) in the non-recurrence group (P < 0.01). Logistic regression analysis revealed that together with age, adnexal twist degree remained significantly associated with torsion recurrence (odds ratio [OR] 1.98, 95% CI 1.09-3.61; P = 0.02). CONCLUSION Adnexal twist degree was found to be positively associated with the risk of torsion recurrence. TWEETABLE ABSTRACT Adnexal twist degree was found to be positively associated with the risk of torsion recurrence.
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Affiliation(s)
- Y Bart
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Mohr-Sasson
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Yousefi
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel
| | - M Goldenberg
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel
| | - R Meyer
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Toussia-Cohen
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y Eyal
- Kaplan Medical Center, Rehovot, Israel
| | - S Mazaki-Tovi
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Mashiach
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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19
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Beckmann A, Dittrich S, Arenz C, Krogmann ON, Horke A, Tengler A, Meyer R, Bauer UMM, Hofbeck M. German Registry for Cardiac Operations and Interventions in Patients with Congenital Heart Disease: Report 2020-Comprehensive Data from 6 Years of Experience. Thorac Cardiovasc Surg 2021; 69:e21-e31. [PMID: 33638137 PMCID: PMC7920329 DOI: 10.1055/s-0041-1722978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background
Based on a quality assurance initiative of the German Society for Thoracic and Cardiovascular Surgery (DGTHG) and the German Society for Pediatric Cardiology and Congenital Heart Defects (DGPK), a voluntary registry was founded for assessment of treatment and outcomes of patients with congenital heart disease in Germany. This evaluation by the German Registry for cardiac operations and interventions in patients with congenital heart disease reports the data and the outcome over a 6-year period in patients undergoing invasive treatment.
Methods
This real-world database collects clinical characteristics, in-hospital complications, and medium-term outcome of patients who underwent cardiac surgical and interventional procedures within the prospective, all-comers registry. Patients were followed-up for up to 90 days.
Results
In the period from 2013 to 2018, a total of 35,730 patients, 39,875 cases, respectively 46,700 procedures were included at up to 31 German institutions. The cases could be subcategorized according to the treatment intention into 21,027 (52.7%) isolated operations, 17,259 (43.3%) isolated interventions, and 1,589 (4.0%) with multiple procedures. Of these, 4,708 (11.8%) were performed in neonates, 10,047 (25.2%) in infants, 19,351 (48.5%) in children of 1 to 18 years, and 5,769 (14.5%) in adults. Also, 15,845 (33.9%) cases could be allocated to so-called index procedures which underwent a more detailed evaluation to enable meaningful comparability. The mean unadjusted in-hospital mortality of all cases in our registry ranged from 0.3% in patients with isolated interventions and 2.0% in patients with surgical procedures up to 9.1% in patients undergoing multiple procedures.
Conclusion
This annually updated registry of both scientific societies represents voluntary public reporting by accumulating actual information for surgical and interventional procedures in patients with congenital heart disease (CHD) in Germany. It describes advancements in cardiac medicine and is a basis for internal and external quality assurance for all participating institutions. In addition, the registry demonstrates that in Germany, both interventional and surgical procedures for treatment of CHD are offered with high medical quality.
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Affiliation(s)
- Andreas Beckmann
- German Society for Thoracic and Cardiovascular Surgery, Langenbeck-Virchow-Haus, Berlin, Germany
| | - S Dittrich
- Pediatric Cardiology Department, University of Erlangen, Erlangen, Germany
| | - C Arenz
- German Pediatric Heart Center, University of Bonn, Bonn, Germany
| | - O N Krogmann
- Clinic for Pediatric Cardiology-Congenital Heart Defects, Heart Center Duisburg, Duisburg, Germany
| | - A Horke
- Division of Congenital Heart Surgery, Hannover Medical School, Hannover, Germany
| | - A Tengler
- Division of Pediatric Cardiology and Pediatric Intensive Care; Ludwig Maximilian University of Munich, Munich, Germany
| | - R Meyer
- BQS Institute for Quality and Patient Safety, Hamburg, Germany
| | - U M M Bauer
- National Register for Congenital Heart Defects, Berlin, Germany
| | - M Hofbeck
- Department of Pediatric Cardiology, Pulmology and Intensive Care, University Children's Hospital, Tübingen, Germany
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20
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Parsons CM, Judge A, Meyer R, Bruyère O, Petit-Dop F, Chapurlat R, Reginster JY, Cooper C, Inskip H. Determining individual trajectories of joint space loss: improved statistical methods for monitoring knee osteoarthritis disease progression. Osteoarthritis Cartilage 2021; 29:59-67. [PMID: 33246159 DOI: 10.1016/j.joca.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/21/2020] [Accepted: 09/02/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Knee osteoarthritis (KOA) progression is frequently monitored by calculating the change in knee joint space width (JSW) measurements. Such differences are small and sensitive to measurement error. We aimed to assess the utility of two alternative statistical modelling methods for monitoring KOA. MATERIAL AND METHODS We used JSW on radiographs from both the control arm of the Strontium Ranelate Efficacy in Knee Osteoarthritis trial (SEKOIA), a 3-year multicentre, double-blind, placebo-controlled phase three trial, and the Osteoarthritis Initiative (OAI), an open-access longitudinal dataset from the USA comprising participants followed over 8 years. Individual estimates of annualised change obtained from frequentist linear mixed effect (LME) and Bayesian hierarchical modelling, were compared with annualised crude change, and the association of these parameters with change in WOMAC pain was examined. RESULTS Mean annualised JSW changes were comparable for all estimates, a reduction of around 0.14 mm/y in SEKOIA and 0.08 mm/y in OAI. The standard deviation (SD) of change estimates was lower with LME and Bayesian modelling than crude change (SEKOIA SD = 0.12, 0.12 and 0.21 respectively; OAI SD = 0.08, 0.08 and 0.11 respectively). Estimates from LME and Bayesian modelling were statistically significant predictors of change in pain in SEKOIA (LME P-value = 0.04, Bayes P-value = 0.04), while crude change did not predict change in pain (P-value = 0.10). CONCLUSIONS Implementation of LME or Bayesian modelling in clinical trials and epidemiological studies, would reduce sample sizes by enabling all study participants to be included in analysis regardless of incomplete follow up, and precision of change estimates would improve. They provide increased power to detect associations with other measures.
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Affiliation(s)
- C M Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.
| | - A Judge
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK.
| | - R Meyer
- Department of Statistics, University of Auckland, New Zealand.
| | - O Bruyère
- Department of Public Health and Health Economics, University of Liege, 4020, Liege, Belgium.
| | - F Petit-Dop
- Innovative Therapeutic Pole of Rheumatology, Servier, Surenes, France.
| | - R Chapurlat
- INSERUM UMR 1033, Service de Rhumatolgie et Pathologie Osseuse, Hopital Edouard Herriot, Universite de Lyon, Lyon, France.
| | - J-Y Reginster
- Department of Public Health and Health Economics, University of Liege, 4020, Liege, Belgium.
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK; National Institute for Health Research Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, UK.
| | - H Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.
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21
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Carlock H, Meyer R, Young S, Villarroel L, Diaz S, Gundersen E, Ouslander JG. CommentReflections on a Real-Time Advance Care Planning Discussion During Our First Virtual Teaching Rounds in Post-Acute Care. J Am Geriatr Soc 2020; 69:560-562. [PMID: 33372268 DOI: 10.1111/jgs.16990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Hunter Carlock
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Ryan Meyer
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Stacy Young
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Leonardo Villarroel
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Sanya Diaz
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Elizabeth Gundersen
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Joseph G Ouslander
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
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22
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Mohr-Sasson A, Dadon T, Brandt A, Shats M, Excelrod M, Meyer R, Zajicek M, Haas J, Mashiach R. Doctor, I Have Niche - What Does It Mean? J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Levin G, Meller N, Komem D, Cohen A, Abu-Bandora E, Mohr-Sasson A, Cohen S, Mashiach R, Meyer R. Predictive Factors for Recurrence of Adnexal Torsion. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.293] [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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24
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Watad H, Meyer R, Excelrod M, Mohr-Sasson A. Pregnancy Outcomes Following Hysteroscopic Resection of Uterine Septum: Does the Size Matter? J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.280] [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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25
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Reis R, Santos M, Santos A, Santos H, Santos L, Lopes B, Peralva C, Meyer R, Freire S. PERFIL LINFOCITÁRIO NA LEUCEMIA MIELOIDE AGUDA NO DIAGNÓSTICO E APÓS TERAPIA DE INDUÇÃO. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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26
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Bart Y, Yuosefi S, Mohr-Sasson A, Meyer R, Toussia-Cohen S, Mazaki-Tovi S. Adnexal Torsion Recurrence - Is the Degree of Adnexal Twist a Risk Factor? J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.624] [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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27
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Meyer R, Smith C, Sealy L, Mancell S, Marino LV. The use of extensively hydrolysed and amino acid feeds beyond cow's milk allergy: a national survey. J Hum Nutr Diet 2020; 34:13-23. [PMID: 32820586 DOI: 10.1111/jhn.12794] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Extensively hydrolysed formulas (EHFs) and amino acid formulas (AAFs) with proven hypoallergenicity are used for children suffering from cow's milk allergy, when breast milk is not available. However, these feeds are often used in other medical conditions where tolerance and absorption of whole protein is affected, frequently without assessment of efficacy. This practice survey assessed the use of these feeds in paediatric conditions other than cow's milk allergy; aiming to describe the population, growth parameters and micronutrient status. METHODS Four National Health Service tertiary paediatric centres participated in this practice survey. Inclusion: children between 0 and 18 years, consuming >25% of their estimated energy requirements of an EHF/AAF for any condition other than allergic disease. Anonymised data were collected: (i) descriptive information; (ii) indications; (iii) type and route of feeding; (iv) growth status and nutritional deficiencies; and (v) medication and vitamin and mineral supplementation. RESULTS One hundred-and-ninety-one children were included with a median age of 19 months (interquartile range 4-63]. Seventeen percent (33/191) were on AAFs and 83% (158/191) were on EHFs. The feeds were commonly used in cancer for 26% and in critical illness for 31%. The majority (73%) of children had enteral feeds via a nasogastric tube. Nutritional biomarkers were performed in 29% of children and 83% were on a vitamin or mineral supplement. CONCLUSIONS This practice survey found that EHFs and AAFs were used in a variety of medical conditions. Indications for feed choice varied, and evidence-based research supporting the use was scarce. Awaiting further research, children on these types of feeds should have regular nutritional monitoring.
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Affiliation(s)
- R Meyer
- Department of Paediatrics, Imperial College, London, UK
| | - C Smith
- Department of Nutrition and Dietetics, Royal Alexandra Children's Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - L Sealy
- Department of Nutrition & Dietetics, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - S Mancell
- Department of Nutrition & Dietetics, King's College Hospital NHS Foundation Trust, London, UK
| | - L V Marino
- Department of Dietetics/ Speech Therapy, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,NIHR Biomedical Research Centre Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust and School of Health Sciences, University of Southampton, Southampton, UK.,Department of Nutrition & Dietetics, Faculty of Health and Well Being, University of Winchester, Winchester, UK
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Ezra O, Lahav‐Ezra H, Meyer R, Cahan T, Ilan H, Mazaki‐Tovi S, Sivan E, Barzilay E, Haas J. Cephalic extraction versus breech extraction in second‐stage caesarean section: a retrospective study. BJOG 2020; 127:1568-1574. [DOI: 10.1111/1471-0528.16314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2020] [Indexed: 11/29/2022]
Affiliation(s)
- O Ezra
- Department of Obstetrics and Gynecology Sheba Medical Center Tel‐Hashomer Israel
- Sackler School of Medicine Tel‐Aviv University Tel Aviv Israel
| | - H Lahav‐Ezra
- Department of Obstetrics and Gynecology Sheba Medical Center Tel‐Hashomer Israel
- Sackler School of Medicine Tel‐Aviv University Tel Aviv Israel
| | - R Meyer
- Department of Obstetrics and Gynecology Sheba Medical Center Tel‐Hashomer Israel
- Sackler School of Medicine Tel‐Aviv University Tel Aviv Israel
| | - T Cahan
- Department of Obstetrics and Gynecology Sheba Medical Center Tel‐Hashomer Israel
- Sackler School of Medicine Tel‐Aviv University Tel Aviv Israel
| | - H Ilan
- Department of Obstetrics and Gynecology Sheba Medical Center Tel‐Hashomer Israel
- Sackler School of Medicine Tel‐Aviv University Tel Aviv Israel
| | - S Mazaki‐Tovi
- Department of Obstetrics and Gynecology Sheba Medical Center Tel‐Hashomer Israel
- Sackler School of Medicine Tel‐Aviv University Tel Aviv Israel
| | - E Sivan
- Department of Obstetrics and Gynecology Sheba Medical Center Tel‐Hashomer Israel
- Sackler School of Medicine Tel‐Aviv University Tel Aviv Israel
| | - E Barzilay
- Department of Obstetrics and Gynecology Samson Assuta Ashdod University Hospital Ashdod Israel
- Faculty of Health Sciences Ben‐Gurion University of the Negev Beer‐Sheva Israel
| | - J Haas
- Department of Obstetrics and Gynecology Sheba Medical Center Tel‐Hashomer Israel
- Sackler School of Medicine Tel‐Aviv University Tel Aviv Israel
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Ram E, Meyer R, Carter D, Gutman M, Rosin D, Horesh N. The efficacy of sacral neuromodulation in the treatment of low anterior resection syndrome: a systematic review and meta-analysis. Tech Coloproctol 2020; 24:803-815. [PMID: 32350733 DOI: 10.1007/s10151-020-02231-8] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/22/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Sacral neuromodulation (SNM) has become one of the main treatment options in patients with fecal incontinence. The aim of this study was to determine the efficacy of sacral neuromodulation in the treatment of low anterior resection syndrome (LARS). METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search was conducted using the Pubmed, Embase, Ovid, and Cochrane databases, restricted to the English language and to articles published from 2000 to November 2018. RESULTS A total of 434 articles on the efficacy of SNM in the treatment of LARS were retrieved, and 13 studies were included in the final analysis, with a total of 114 patients treated with SNM for LARS The overall success rate excluding study heterogeneity was 83.30% [95% CI (71.33-95.25%)]. Improvement in anal continence was seen in several clinical and functional parameters, including the Wexner Score [10.78 points, 95% CI (8.55-13.02), p < 0.0001], manometric maximum resting pressure [mean improvement of 6.37 mm/Hg, 95% CI (2.67-10.07), p = 0.0007], maximum squeeze pressure [mean improvement of 17.99 mm/Hg, 95% CI (17.42-18.56), p < 0.0001] and maximum tolerated volume [mean improvement of 22.74 ml, 95% CI (10.65-34.83), p = 0.0002]. Quality of life questionnaires also demonstrated significant improvement in patients' quality of life, but were reported only in a small group of included patients. CONCLUSIONS SNM significantly improves symptoms and quality of life in patients suffering from fecal incontinence following low anterior resection.
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Affiliation(s)
- E Ram
- Department of Surgery B, Sheba Medical Centre, Tel Hashomer, Israel.
- Tel Aviv University, Tel Aviv, Israel.
| | - R Meyer
- Tel Aviv University, Tel Aviv, Israel
- Department of Gynecology and Obstetrics, Sheba Medical Centre, Tel Hashomer, Israel
| | - D Carter
- Tel Aviv University, Tel Aviv, Israel
- Department of Gastroenterology, Sheba Medical Centre, Tel Hashomer, Israel
| | - M Gutman
- Department of Surgery B, Sheba Medical Centre, Tel Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - D Rosin
- Department of Surgery B, Sheba Medical Centre, Tel Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - N Horesh
- Department of Surgery B, Sheba Medical Centre, Tel Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
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Ragozzino M, Meyer R, Duan J, Slager B, Salom S. Differences in Early Season Emergence and Reproductive Activity Between Spathius agrili (Hymenoptera: Braconidae) and Spathius galinae, Larval Parasitoids of the Invasive Emerald Ash Borer (Coleoptera: Buprestidae). Environ Entomol 2020; 49:334-341. [PMID: 31913461 DOI: 10.1093/ee/nvz168] [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] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Indexed: 06/10/2023]
Abstract
Both Spathius agrili Yang and Spathius galinae Belokobylskij and Strazanac are host-specific parasitic wasps introduced for biological control of emerald ash borer in North America. Spathius agrili is native to northeastern China and S. galinae comes from a more northern, colder climate in the Russian Far East. Their origin may lead to differing abilities to adapt to climate and their host in North America. We conducted both field and laboratory experiments to determine the timing of early season emergence and synchronization of each parasitoid species to their host in the United States, and if manipulating prerelease conditions could affect emergence time. A cold acclimatization treatment prior to parasitoid emergence was assessed and compared with untreated control group reared with standard rearing protocols. Stands of naturally emerald ash borer-infested ash were sampled at two locations in Virginia throughout the experiment to determine when the parasitoid-susceptible life stage (third to fourth instar) occurred. Untreated S. galinae emerged approximately 2 wk earlier than any other cohort, whereas cold acclimatized S. galinae emerged later than any other cohort. Emergence time of S. agrili was unaffected by cold acclimatization. Cold acclimatization treatment did not affect the parasitism rate of either species, nor did it have multigenerational effects. Emergence time of the subsequent generation of S. agrili was delayed by cold acclimatization treatment, whereas S. galinae experienced no multigenerational effects. At Virginia field sites, susceptible EAB larvae were present during the emergence time of all four groups of parasitoids. Untreated S. galinae had the least overlap with any susceptible EAB larvae.
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Affiliation(s)
- Max Ragozzino
- Department of Entomology, Virginia Tech, Blacksburg, VA
| | - Ryan Meyer
- Department of Entomology, Virginia Tech, Blacksburg, VA
| | - Jian Duan
- USDA ARS BIIRU 501 S. Chapel St, Newark, DE
| | - Ben Slager
- USDA APHIS PPQ 5936 Ford Court Suite 200, Brighton, MI
| | - Scott Salom
- Department of Entomology, Virginia Tech, Blacksburg, VA
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Lipp M, Brodmann P, Pietsch K, Pauwels J, Anklam E, Börchers T, Braunschweiger G, Busch U, Eklund E, Eriksen FD, Fagan J, Fellinger A, Gaugitsch H, Hayes D, Hertel C, Hörtner H, Joudrier P, Kruse L, Meyer R, Miraglia M, Müller W, Philipp P, Pöpping B, Rentsch R, Sawyer J, Schulze M, van Duijn G, Vollenhofer S, Wurtz A. IUPAC Collaborative Trial Study of a Method To Detect Genetically Modified Soy Beans and Maize in Dried Powder. J AOAC Int 2020. [DOI: 10.1093/jaoac/82.4.923] [Citation(s) in RCA: 167] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
This paper presents results of a collaborative trial study (IUPAC project No. 650/93/97) involving 29 laboratories in 13 countries applying a method for detecting genetically modified organisms (GMOs) in food. The method is based on using the polymerase chain reaction to determine the 35S promoter and the NOS terminator for detection of GMOs. Reference materials were produced that were derived from genetically modified soy beans and maize. Correct identification of samples containing 2% GMOs is achievable for both soy beans and maize. For samples containing 0.5% genetically modified soy beans, analysis of the 35S promoter resulted also in a 100% correct classification. However, 3 false-negative results (out of 105 samples analyzed) were reported for analysis of the NOS terminator, which is due to the lower sensitivity of this method. Because of the bigger genomic DNA of maize, the probability of encountering false-negative results for samples containing 0.5% GMOs is greater for maize than for soy beans. For blank samples (0% GMO), only 2 false-positive results for soy beans and one for maize were reported. These results appeared as very weak signals and were most probably due to contamination of laboratory equipment.
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Affiliation(s)
- Markus Lipp
- The National Physical Laboratory of Israel (INPL), Danciger A Bldg., Givat Ram, Jerusalem 91904, Israel, Tel: +972-2-6536534, Fax: +972-2-6520797
| | - Peter Brodmann
- Kantonales Labor Basel, Postfach, CH-4012 Basel, Switzerland
| | - Klaus Pietsch
- Chemische Landesuntersuchungsanstalt Freiburg, Bissierstrasse 5, D-79114 Freiburg, Germany
| | - Jean Pauwels
- European Commission, DG Joint Research Center, Institute for Reference Materials and Measurements, Retieseweg, B-2440 Geel, Belgium
| | - Elke Anklam
- European Commission, DG Joint Research Center, Institute for Health and Consumer Protection, Food Products Unit, 1-21020 Ispra(Va), Italy
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Russbueldt P, Weitenberg J, Schulte J, Meyer R, Meinhardt C, Hoffmann HD, Poprawe R. Scalable 30 fs laser source with 530 W average power. Opt Lett 2019; 44:5222-5225. [PMID: 31674973 DOI: 10.1364/ol.44.005222] [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] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
We present a power-scalable laser source with 30 fs pulse duration, 530 W average power at 500 kHz repetition rate, and beam quality M2<1.2. The compact and efficient setup consists of ytterbium-based Innoslab amplifiers and subsequent nonlinear pulse compression with an argon-filled Herriott cell.
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Gholmie Y, Lozinsky A, Godwin H, Reeve K, Dzubiak R, Shah N, Meyer R. Tolerance of soya lecithin in children with non‐immunoglobulin E‐mediated soya allergy: a randomised, double‐blind, cross‐over trial. J Hum Nutr Diet 2019; 33:232-240. [DOI: 10.1111/jhn.12708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Y. Gholmie
- Department of Health and Behavioral Sciences Teachers College of Columbia University New York, NY USA
| | - A.C. Lozinsky
- Department of Gastroenterology Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - H. Godwin
- Great Ormond Street Hospital London UK
| | - K. Reeve
- Paediatric A&E The Royal London Hospital London UK
| | | | - N. Shah
- Great Ormond Street Hospital London UK
| | - R. Meyer
- Imperial College London London UK
- Department Paediatrics Imperial College London London UK
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Meyer R, Schacht S, Buschmann L, Begemann M, Kraft F, Haag N, Kochs A, Schulze A, Kurth I, Elbracht M. Biallelic CSGALNACT1-mutations cause a mild skeletal dysplasia. Bone 2019; 127:446-451. [PMID: 31325655 DOI: 10.1016/j.bone.2019.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/03/2019] [Accepted: 07/14/2019] [Indexed: 11/16/2022]
Abstract
Genetic causes of skeletal disorders are manifold and affect, among others, enzymes of bone and connective tissue synthesis pathways. We present a twelve-year-old boy with a mild skeletal dysplasia, hypermobility of joints and axial malalignment of lower limbs and feet. Exome sequencing revealed a biallelic loss of function mutation in CSGALNACT1, which encodes chondroitin sulfate N-acetylgalactosaminyltransferase 1 and plays a major role in the chondroitin sulfate chain biosynthesis and therefore in the synthesis of glycosaminoglycans. Recently, the first case of a pediatric patient with a mild skeletal dysplasia due to a compound heterozygous large intragenic deletion and a damaging missense variant in CSGALNACT1 was reported. We here identify a second case and the first juvenile patient with a homozygous frameshift variant in CSGALNACT1 which corroborates its role in mild and non-progressive skeletal dysplasia with joint laxity.
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Affiliation(s)
- R Meyer
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - S Schacht
- Department for Radiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - L Buschmann
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - M Begemann
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - F Kraft
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - N Haag
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - A Kochs
- Gemeinschaftspraxis Dr. Kochs/Dr. Rode, Aachen, Germany
| | - A Schulze
- Department for Orthopedics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - I Kurth
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - M Elbracht
- Institute of Human Genetics, Medical Faculty, RWTH Aachen University, Aachen, Germany.
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Elbracht M, Meyer R, Eggermann T, Kurth I. [Rational use of genetic tests in internal medicine : Possibilities and limitations of next generation sequencing diagnostics]. Internist (Berl) 2019; 59:756-765. [PMID: 29946883 DOI: 10.1007/s00108-018-0457-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND New methods of molecular genetic diagnostics enable a more comprehensive genetic analysis of patients. OBJECTIVES Rational use and benefits of molecular genetic testing in patients with various internal diseases. METHOD Evaluation of topic-related literature, discussion of own experiences, as well as consideration of current guidelines. RESULTS New genetic tests, such as next generation sequencing (NGS), improve the diagnosis of hereditary diseases; however, the use of this technology also leads to additional findings, which must be carefully considered. CONCLUSION The rational use of genetic tests is a benefit for patients and can significantly influence the prevention and treatment of a disease. The increasing complexity of genetic findings requires interdisciplinary approaches involving human genetics, internal medicine, and other disciplines.
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Affiliation(s)
- M Elbracht
- Institut für Humangenetik, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - R Meyer
- Institut für Humangenetik, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - T Eggermann
- Institut für Humangenetik, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - I Kurth
- Institut für Humangenetik, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
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Meyer R. Using Energy Crops for Biofuels or Food: The Choice. Von A. Paschalidou, M. Tsatiris, K. Kitikidou, C. Papadopoulou. CHEM-ING-TECH 2019. [DOI: 10.1002/cite.201970809] [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: 11/12/2022]
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Meyer R, Wright K, Vieira MC, Chong KW, Chatchatee P, Vlieg-Boerstra BJ, Groetch M, Dominguez-Ortega G, Heath S, Lang A, Archibald-Durham L, Rao R, De Boer R, Assa'ad A, Trewella E, Venter C. International survey on growth indices and impacting factors in children with food allergies. J Hum Nutr Diet 2018; 32:175-184. [DOI: 10.1111/jhn.12610] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- R. Meyer
- Department Paediatrics; Imperial College; London UK
| | - K. Wright
- Allergy Service; Department of Paediatric Medicine; KK Women's and Children's Hospital; Singapore Singapore
| | - M. C. Vieira
- Center for Pediatric Gastroenterology (Hospital Pequeno Príncipe) and School of Medicine (Pontifical University of Paraná); Curitiba Brazil
| | - K. W. Chong
- Allergy Service; Department of Paediatric Medicine; KK Women's and Children's Hospital; Singapore Singapore
| | - P. Chatchatee
- Division of Allergy and Immunology; Department of Pediatrics; Faculty of Medicine; King Chulalongkorn Memorial Hospital; Chulalongkorn University; Bangkok Thailand
| | | | - M. Groetch
- Division of Paediatric Allergy & Immunology; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - G. Dominguez-Ortega
- Gastroenterology and Nutrition Department; Children Hospital Niño Jesús University Children Hospital; Madrid Spain
| | - S. Heath
- Department of Dietetics; Kings College Hospital NHS Trust; London UK
| | - A. Lang
- Wits University Donald Gordon Medical Centre; Johannesburg South Africa
| | | | - R. Rao
- KK women's and Children's Hospital; Singapore Singapore
| | - R. De Boer
- Department of Pediatric Allergy; Guy's and St. Thomas National Health Service Trust; London UK
| | - A. Assa'ad
- Division of Allergy and Immunology; Cincinnati Children's Hospital; Cincinnati OH USA
| | - E. Trewella
- Department Nutrition and Dietetics; Chelsea and Westminster Hospital; London UK
| | - C. Venter
- Children's Hospital Colorado; Aurora Colorado USA
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Loureiro D, Moura-Costa LF, Jordão RS, Menezes NC, Macedo ES, Guimarães TS, Meyer R, Portela RW. Seroprevalence of antibodies against bacterial pathogens in sheep from Equatorial Guinea. REV SCI TECH OIE 2018; 36:965-970. [PMID: 30160687 DOI: 10.20506/rst.36.3.2728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Equatorial Guinea (EG) is a country in Central Africa with typical tropical weather. Sheep are an important source of food in EG, but the absence of information regarding infectious diseases that affect the native flocks of small ruminants is a concern. The country is currently implementing several new practices in the sheep industry associated with the importation of sheep from other countries. This study aimed to evaluate the seroprevalence of bacterial infections that are important to the sheep industry in EG sheep flocks. The detection of specific antibodies for the four agents studied was performed using enzyme-linked immunosorbent assay in 1,002 serum samples from EG sheep. The results showed a true prevalence of 13.37% for antibodies against Corynebacterium pseudotuberculosis, 0.59% for Brucella ovis, 19.89% for Chlamydophila abortus and 0.79% for Mycoplasma agalactiae in animals from production flocks. Among a group of 35 samples from isolated native animals, 47.56% were seropositive for antibodies against C. pseudotuberculosis, 42.84% for B. ovis, 54.28% for C. abortus and 11.35% for M. agalactiae. These results comprise the first report of the prevalence of infectious diseases in sheep in EG. They highlight the importance of adopting adequate measures to prevent infection by bacteria endemic to EG native flocks during the development of the sheep industry in the country.
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Gil-Villalba A, Meyer R, Giust R, Rapp L, Billet C, Courvoisier F. Single shot femtosecond laser nano-ablation of CVD monolayer graphene. Sci Rep 2018; 8:14601. [PMID: 30279433 PMCID: PMC6168448 DOI: 10.1038/s41598-018-32957-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 02/28/2017] [Accepted: 09/19/2018] [Indexed: 11/28/2022] Open
Abstract
We investigate ablation of CVD monolayer graphene by femtosecond pulses in the single shot regime. We show that the ablation probability of flat graphene drastically reduces for small illumination diameters even if the ablation threshold is exceeded. However, the presence of graphene wrinkles enhances the ablation probability. This is interpreted in terms of electron and energy diffusion within the graphene layer. This differentiated behavior is a drawback for single shot laser nanopatterning. The morphology of the holes with minimal diameter depends on the fluence distribution at ablation threshold. Strong fluence gradients due to strong focussing produce an explosive folding of graphene during ablation.
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Affiliation(s)
- A Gil-Villalba
- FEMTO-ST institute, Univ. Bourgogne Franche-Comté, CNRS, 15B avenue des Montboucons, 25030, Besançon Cedex, France
| | - R Meyer
- FEMTO-ST institute, Univ. Bourgogne Franche-Comté, CNRS, 15B avenue des Montboucons, 25030, Besançon Cedex, France
| | - R Giust
- FEMTO-ST institute, Univ. Bourgogne Franche-Comté, CNRS, 15B avenue des Montboucons, 25030, Besançon Cedex, France
| | - L Rapp
- FEMTO-ST institute, Univ. Bourgogne Franche-Comté, CNRS, 15B avenue des Montboucons, 25030, Besançon Cedex, France
| | - C Billet
- FEMTO-ST institute, Univ. Bourgogne Franche-Comté, CNRS, 15B avenue des Montboucons, 25030, Besançon Cedex, France
| | - F Courvoisier
- FEMTO-ST institute, Univ. Bourgogne Franche-Comté, CNRS, 15B avenue des Montboucons, 25030, Besançon Cedex, France.
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Meyer R, Bar-Yosef O, Barzilay E, Hoffman D, Toussia-Cohen S, Zvi E, Achiron R, Katorza E. Neurodevelopmental outcome of fetal isolated ventricular asymmetry without dilation: a cohort study. Ultrasound Obstet Gynecol 2018; 52:467-472. [PMID: 29607569 DOI: 10.1002/uog.19065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 11/18/2017] [Revised: 02/10/2018] [Accepted: 03/23/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Fetal isolated ventricular asymmetry (IVA) is a relatively common finding in pregnancy, but data regarding its effect on neurodevelopmental outcome are scarce and founded principally on ultrasound-based studies. The purpose of this study was to assess the neurodevelopmental outcome of IVA cases in a magnetic resonance imaging (MRI)-based study. METHODS Cases referred for fetal brain MRI as part of the assessment of IVA without ventriculomegaly (lateral ventricular atrial diameter ≤ 10 mm), identified during routine ultrasound examination, were assessed for possible inclusion. Asymmetry was defined as a difference in width of ≥ 2 mm between the two lateral ventricles. Forty-three cases were included in the study group and compared with a control group of 94 normal cases without IVA. Children were assessed at ages 13-74 months using the Vineland-II Adaptive Behavior Scales (VABS-II). RESULTS VABS-II scores were within normal range. There was no significant difference in composite VABS-II score between the study and control groups (106.5 vs 108.0; P = 0.454). VABS-II scores did not differ between the groups when matched for gender and age at VABS-II interview (109.6 in study group vs 107.8 in control group; P = 0.690). CONCLUSION In cases of IVA without ventriculomegaly on MRI, neurodevelopmental test scores were normal and did not differ from cases without IVA. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- R Meyer
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - O Bar-Yosef
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
- Pediatric Neurology Unit, The Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - E Barzilay
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - D Hoffman
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - S Toussia-Cohen
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - E Zvi
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - R Achiron
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - E Katorza
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
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Andersen L, Conrad M, Gil J, Hu X, Reynolds W, Schmidt L, Hartge E, Häring H, Kreft C, Meyer R, Zetzl C, Heinrich S, Kaltschmitt M, Lim C, Smirnova I. Aufbau einer Vollverwertungskette für ligninhaltige Biomasse über Hochdruckverfahrenstechnik: Neue Produkte durch Extraktion, Hydrolyse, überkritische Trocknung und Extrusion. CHEM-ING-TECH 2018. [DOI: 10.1002/cite.201855120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- L. Andersen
- Verbio Bioenergie AG; Thura Mark 18 06780 Zörbig Deutschland
| | - M. Conrad
- Sigmar Mothes Hochdrucktechnik; Vollmerstraße 7b 14489 Berlin Deutschland
| | - J. Gil
- Technische Universität Hamburg; Institut für Thermische Verfahrenstechnik; Eissendorfer Straße 38 21073 Hamburg Deutschland
| | - X. Hu
- Technische Universität Hamburg; Institut für Thermische Verfahrenstechnik; Eissendorfer Straße 38 21073 Hamburg Deutschland
| | - W. Reynolds
- Technische Universität Hamburg; Institut für Thermische Verfahrenstechnik; Eissendorfer Straße 38 21073 Hamburg Deutschland
| | - L. M. Schmidt
- Technische Universität Hamburg; Institut für Umwelttechnik und Energiewirtschaft; Eissendorfer Straße 40 21073 Hamburg Deutschland
| | - E. U. Hartge
- Technische Universität Hamburg; Institut für Feststoffverfahrenstechnik; Denickestraße 15 21073 Hamburg Deutschland
| | - H. Häring
- Sigmar Mothes Hochdrucktechnik; Vollmerstraße 7b 14489 Berlin Deutschland
| | - C. Kreft
- Verbio Bioenergie AG; Thura Mark 18 06780 Zörbig Deutschland
| | - R. Meyer
- Technische Universität Hamburg; Institut für Thermische Verfahrenstechnik; Eissendorfer Straße 38 21073 Hamburg Deutschland
| | - C. Zetzl
- Technische Universität Hamburg; Institut für Thermische Verfahrenstechnik; Eissendorfer Straße 38 21073 Hamburg Deutschland
| | - S. Heinrich
- Technische Universität Hamburg; Institut für Feststoffverfahrenstechnik; Denickestraße 15 21073 Hamburg Deutschland
| | - M. Kaltschmitt
- Technische Universität Hamburg; Institut für Umwelttechnik und Energiewirtschaft; Eissendorfer Straße 40 21073 Hamburg Deutschland
| | - C. Lim
- tesa SE; Forschung und Entwicklung; Hugo-Kirchberg-Straße 1 22848 Norderstedt Deutschland
| | - I. Smirnova
- Technische Universität Hamburg; Institut für Thermische Verfahrenstechnik; Eissendorfer Straße 38 21073 Hamburg Deutschland
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Lieback E, Nawrocki M, Meyer R, Bellach J, Warnecke H, Cohnert T. The clinical value of ultrasonic tissue characterization in the management of heart transplant patients. Transpl Int 2018. [DOI: 10.1111/tri.1992.5.s1.231] [Citation(s) in RCA: 3] [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: 11/30/2022]
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Bednarek AT, Wyborn C, Cvitanovic C, Meyer R, Colvin RM, Addison PFE, Close SL, Curran K, Farooque M, Goldman E, Hart D, Mannix H, McGreavy B, Parris A, Posner S, Robinson C, Ryan M, Leith P. Boundary spanning at the science-policy interface: the practitioners' perspectives. Sustain Sci 2018; 13:1175-1183. [PMID: 30147800 PMCID: PMC6086300 DOI: 10.1007/s11625-018-0550-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/08/2018] [Indexed: 05/24/2023]
Abstract
Cultivating a more dynamic relationship between science and policy is essential for responding to complex social challenges such as sustainability. One approach to doing so is to "span the boundaries" between science and decision making and create a more comprehensive and inclusive knowledge exchange process. The exact definition and role of boundary spanning, however, can be nebulous. Indeed, boundary spanning often gets conflated and confused with other approaches to connecting science and policy, such as science communication, applied science, and advocacy, which can hinder progress in the field of boundary spanning. To help overcome this, in this perspective, we present the outcomes from a recent workshop of boundary-spanning practitioners gathered to (1) articulate a definition of what it means to work at this interface ("boundary spanning") and the types of activities it encompasses; (2) present a value proposition of these efforts to build better relationships between science and policy; and (3) identify opportunities to more effectively mainstream boundary-spanning activities. Drawing on our collective experiences, we suggest that boundary spanning has the potential to increase the efficiency by which useful research is produced, foster the capacity to absorb new evidence and perspectives into sustainability decision-making, enhance research relevance for societal challenges, and open new policy windows. We provide examples from our work that illustrate this potential. By offering these propositions for the value of boundary spanning, we hope to encourage a more robust discussion of how to achieve evidence-informed decision-making for sustainability.
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Affiliation(s)
| | - C. Wyborn
- Luc Hoffmann Institute, WWF International, Gland, Switzerland
- College of Forestry and Conservation, University of Montana, Missoula, Montana USA
| | - C. Cvitanovic
- Centre for Marine Socioecology, University of Tasmania, Hobart, Tasmania Australia
| | - R. Meyer
- Center for Community and Citizen Science, University of California, Davis, California USA
| | - R. M. Colvin
- Climate Change Institute, Australian National University, Canberra, Australia
| | | | - S. L. Close
- The Pew Charitable Trusts, Washington, DC, USA
| | - K. Curran
- The Pew Charitable Trusts, Washington, DC, USA
| | - M. Farooque
- Consortium for Science, Policy and Outcomes, Arizona State University, Tempe, Arizona USA
| | - E. Goldman
- COMPASS Science Communication, Portland, Oregon USA
| | - D. Hart
- Senator George J. Mitchell Center for Sustainability Solutions, School of Biology and Ecology, University of Maine, Orono, Maine USA
| | - H. Mannix
- COMPASS Science Communication, Portland, Oregon USA
| | - B. McGreavy
- Department of Communication and Journalism, Senator George J. Mitchell Center for Sustainability Solutions, University of Maine, Orono, Maine USA
| | - A. Parris
- Science and Resilience Institute at Jamaica Bay, City University of New York, Brooklyn College, New York, New York USA
| | - S. Posner
- COMPASS Science Communication, Portland, Oregon USA
- Gund Institute for Environment, University of Vermont, Burlington, Vermont USA
| | - C. Robinson
- Engaging Scientists and Engineers in Policy, Washington, DC, USA
| | - M. Ryan
- Luc Hoffmann Institute, WWF International, Gland, Switzerland
- University of Cambridge Conservation Research Institute, Cambridge, UK
| | - P. Leith
- Tasmanian Institute of Agriculture, School of Land and Food, University of Tasmania, Hobart, Tasmania Australia
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Affiliation(s)
- H. Frei
- Laboratory for Physical Chemistry, Swiss Federal Institute of Technology , Universitätstrasse 22, CH-8006, Zurich, Switzerland
| | - R. Meyer
- Laboratory for Physical Chemistry, Swiss Federal Institute of Technology , Universitätstrasse 22, CH-8006, Zurich, Switzerland
| | - A. Bauder
- Laboratory for Physical Chemistry, Swiss Federal Institute of Technology , Universitätstrasse 22, CH-8006, Zurich, Switzerland
| | - Hs. Günthard
- Laboratory for Physical Chemistry, Swiss Federal Institute of Technology , Universitätstrasse 22, CH-8006, Zurich, Switzerland
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Abstract
Background To minimize thrombogeneity of small diameter PTFE grafts they are usually coated in vitro with endothelial cells under static culture conditions. The disadvantage of this technique is that a cell layer is formed that fails to withstand shear stress typical in normal blood flow. Method Since the in vivo functional and structural status of endothelial cells correlates with the applied shear stress, we developed a computer-controlled perfusion system to seed and culture cells on PTFE-grafts up to a confluent monolayer under the influence of increasing shear stress. The confluence of endothelial coating was defined by immunohistological staining of cross sections, and by upper light microscopy of flattened graft samples. In addition, the expression of fibronectin as an important adhesion molecule was estimated. Results and discussion The application of pulsatile shear stress (6.6 dyn/cm2, 5 min) to grafts endothelialized under perfusion (n = 7) did not lead to a disruption of the confluent cell layer. In contrast, a 5 min long shear stress of 3 dyn/cm2was sufficient to wash more than 50% of cells off the PTFE-graft cultured under static conditions (n = 6). The perfusion cultures showed a significantly higher proliferation rate in comparison with static cultures. This effect was reproducibile in both serum-containing and serum-free culture media. The expression of fibronectin by endothelial cells was significantly higher in the perfused graft compared to the static one. These results suggest the practicability of endothelialized PTFE vascular grafts, preconditioned to shear rates similar to the in vivo situation, as an alternative bypass material in cardiac surgery.
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Affiliation(s)
| | | | - R. Meyer
- German Heart Center, Berlin - Germany
| | - R. Hetzer
- German Heart Center, Berlin - Germany
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Pohl M, Meyer R, Kühnel R, Talukder NK, Wendt MO. Different Types of Aortic Stenosis and Simulation of their Morphological-Hydrodynamic Interdependence - in Vitro Study with Allografts and Stenotic Valve Models. Int J Artif Organs 2018. [DOI: 10.1177/039139880102401209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Biological valves display a dependence of valve resistance and valve area on flow and a phase shift between systolic flow through the valves and pressure difference across the valves. The pressure-flow relations of stenosed valves raise questions about the “best measure of stenosis”. There is a need for quantitative evaluation of the hydrodynamic performance of homografts and allografts. In the present paper, we report on in vitro studies of the hydrodynamic behavior of homografts from human donors, allografts from different animal species as well as three valve models. Valve model I was designed to simulate flow-dependence of valve area, valve model II was designed to simulate restricted valve opening independent of flow, and valve model III was designed to simulate a flow-dependent movement of valve root in flow direction. Among other aspects, the effect of increased viscosity of the test fluid on the pressure difference and the effects of water absorption by valve tissue on valve characteristics were investigated. The results of the present studies clearly indicate that any biological valve may be modelled as a serial connection of a model I type valve and a model II type valve. From the results, the dependence of the characteristic pressure-flow relationship of a valve on valve size and valve distensibility can be clearly seen and the clinical significance of the characteristic coefficients of the pressure-flow relationship of a valve can be elucidated. Further, it was shown that the characteristic phase shift between flow and pressure difference displayed by biological valves is due to their movable valve plane similar to that of valve model III.
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Affiliation(s)
- M. Pohl
- Institute for Medical Physics and Biophysics, Humboldt-University, Berlin - Germany
| | - R. Meyer
- German Heart Institute, Berlin - Germany
| | - R. Kühnel
- Department of Cardiac Surgery, Heart Center, Brandenburg, Bernau - Germany
| | - N. K. Talukder
- Department of Engineering, Clark Atlanta University, Atlanta, Georgia - USA
| | - M.-O. Wendt
- Institute for Medical Physics and Biophysics, Humboldt-University, Berlin - Germany
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van Bergen JMG, Li X, Quevenco FC, Gietl AF, Treyer V, Meyer R, Buck A, Kaufmann PA, Nitsch RM, van Zijl PCM, Hock C, Unschuld PG. Simultaneous quantitative susceptibility mapping and Flutemetamol-PET suggests local correlation of iron and β-amyloid as an indicator of cognitive performance at high age. Neuroimage 2018; 174:308-316. [PMID: 29548847 DOI: 10.1016/j.neuroimage.2018.03.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/17/2018] [Accepted: 03/10/2018] [Indexed: 12/11/2022] Open
Abstract
The accumulation of β-amyloid plaques is a hallmark of Alzheimer's disease (AD), and recently published data suggest that increased brain iron burden may reflect pathologies that synergistically contribute to the development of cognitive dysfunction. While preclinical disease stages are considered most promising for therapeutic intervention, the link between emerging AD-pathology and earliest clinical symptoms remains largely unclear. In the current study we therefore investigated local correlations between iron and β-amyloid plaques, and their possible association with cognitive performance in healthy older adults. 116 older adults (mean age 75 ± 7.4 years) received neuropsychological testing to calculate a composite cognitive score of performance in episodic memory, executive functioning, attention, language and communication. All participants were scanned on a combined PET-MRI instrument and were administered T1-sequences for anatomical mapping, quantitative susceptibility mapping (QSM) for assessing iron, and 18F-Flutemetamol-PET for estimating β-amyloid plaque load. Biological parametric mapping (BPM) was used to generate masks indicating voxels with significant (p < 0.05) correlation between susceptibility and 18F-Flutemetamol-SUVR. We found a bilateral pattern of clusters characterized by a statistical relationship between magnetic susceptibility and 18F-Flutemetamol-SUVR, indicating local correlations between iron and β-amyloid plaque deposition. For two bilateral clusters, located in the frontal and temporal cortex, significant relationships (p<0.05) between local β-amyloid and the composite cognitive performance score could be observed. No relationship between whole-cortex β-amyloid plaque load and cognitive performance was observable. Our data suggest that the local correlation of β-amyloid plaque load and iron deposition may provide relevant information regarding cognitive performance of healthy older adults. Further studies are needed to clarify pathological correlates of the local interaction of β-amyloid, iron and other causes of altered magnetic susceptibility.
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Affiliation(s)
- J M G van Bergen
- Institute for Regenerative Medicine, University of Zurich, Switzerland.
| | - X Li
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - F C Quevenco
- Institute for Regenerative Medicine, University of Zurich, Switzerland
| | - A F Gietl
- Institute for Regenerative Medicine, University of Zurich, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Switzerland
| | - V Treyer
- Institute for Regenerative Medicine, University of Zurich, Switzerland; Department of Nuclear Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - R Meyer
- Institute for Regenerative Medicine, University of Zurich, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Switzerland
| | - A Buck
- Department of Nuclear Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - P A Kaufmann
- Department of Nuclear Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - R M Nitsch
- Institute for Regenerative Medicine, University of Zurich, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Switzerland
| | - P C M van Zijl
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - C Hock
- Institute for Regenerative Medicine, University of Zurich, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Switzerland
| | - P G Unschuld
- Institute for Regenerative Medicine, University of Zurich, Switzerland; Hospital for Psychogeriatric Medicine, University of Zurich, Switzerland
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Abstract
Summary
Objective Clinical data mining is the application of data mining techniques using clinical data. We review the literature in order to provide a general overview by identifying the status-of-practice and the challenges ahead.
Methods The nine data mining steps proposed by Fayyad in 1996 [4] were used as the main themes of the review. MEDLINE was used as primary source and 84 papers were retained based on our inclusion criteria.
Results Clinical data mining has three objectives: understanding the clinical data, assist healthcare professionals, and develop a data analysis methodology suitable for medical data. Classification is the most frequently used data mining function with a predominance of the implementation of Bayesian classifiers, neural networks, and SVMs (Support Vector Machines). A myriad of quantitative performance measures were proposed with a predominance of accuracy, sensitivity, specificity, and ROC curves. The latter are usually associated with qualitative evaluation.
Conclusion Clinical data mining respects its commitment to extracting new and previously unknown knowledge from clinical databases. More efforts are still needed to obtain a wider acceptance from the healthcare professionals and for generalization of the knowledge and reproducibility of its extraction process: better description of variables, systematic report of algorithm parameters including the method to obtain them, use of easy-to-understand models and comparisons of the efficiency of clinical data mining with traditional statistical analyses. More and more data will be available for data miners and they have to develop new methodologies and infrastructures to analyze the increasingly complex medical data.
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Venter C, Groetch M, Netting M, Meyer R. Cover Image. Clin Exp Allergy 2018. [DOI: 10.1111/cea.13110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Venter C, Groetch M, Netting M, Meyer R. A patient-specific approach to develop an exclusion diet to manage food allergy in infants and children. Clin Exp Allergy 2018; 48:121-137. [DOI: 10.1111/cea.13087] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/07/2017] [Accepted: 11/08/2017] [Indexed: 12/19/2022]
Affiliation(s)
- C. Venter
- Children's Hospital Colorado; University of Colorado; Aurora CO USA
| | - M. Groetch
- Icahn School of Medicine at Mount Sinai; Jaffe Food Allergy Institute; New York NY USA
| | - M. Netting
- Healthy Mothers Babies and Children's Theme; South Australian Health & Medical Research Institute; Adelaide SA Australia
- Discipline of Paediatrics; School of Medicine; University of Adelaide; Adelaide SA Australia
- Nutrition Department; Women's and Children's Health Network; Adelaide SA Australia
| | - R. Meyer
- Department Paediatrics; Imperial College; London UK
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