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Younis PA, Davis S, Sweedan AO, ElSabbagh AM, Fernandes RP. Volumetric changes in post hemiglossectomy reconstruction with anterolateral thigh free flap versus radial forearm free flap. Int J Oral Maxillofac Surg 2023:S0901-5027(23)00889-5. [PMID: 38114394 DOI: 10.1016/j.ijom.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
The volume of the reconstructed tongue is considered a critical factor for tongue function. Studies investigating the difference in volume loss between the anterolateral thigh free flap (ALTF) and radial forearm free flap (RFFF) used in reconstruction of the tongue after hemiglossectomy are lacking. The aim of this study was to determine whether there is a significant difference in shrinkage between these two flaps. This was a retrospective study of all patients treated for tongue cancer by hemiglossectomy who underwent either ALTF or RFFF reconstruction at the University of Florida College of Medicine between January 2018 and April 2022. Computed tomography scans were used to measure the volumetric changes in the ALTF and RFFF at two time points over a 6-month period. Of the 85 patients assessed, 10 fulfilled the inclusion criteria: five were reconstructed with an ALTF and five with a RFFF. All underwent adjuvant radiotherapy. The mean ALTF percentage shrinkage was 39.6% ± 3.9%, while for the RFFF it was 51.1% ± 6.2% (P = 0.008). Therefore, it is recommended that the difference in volume loss between the two flaps is taken into consideration. It is suggested that in hemiglossectomy cases, the ALTF is made 1.4 times larger than the defect, while the RFFF is made 1.5 times larger.
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Affiliation(s)
- P A Younis
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt; Department of Oral and Maxillofacial Surgery - Head and Neck Division, University of Florida Health College of Medicine - Jacksonville, Jacksonville, Florida, USA.
| | - S Davis
- Rehabilitation Services, University of Florida Health - Jacksonville, Jacksonville, Florida, USA.
| | - A O Sweedan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - A M ElSabbagh
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - R P Fernandes
- Department of Oral and Maxillofacial Surgery - Head and Neck Division, University of Florida Health College of Medicine - Jacksonville, Jacksonville, Florida, USA.
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Trebes H, Wang Y, Reynolds E, Tiplady K, Harland C, Lopdell T, Johnson T, Davis S, Harris B, Spelman R, Couldrey C. Identification of candidate novel production variants on the Bos taurus chromosome X. J Dairy Sci 2023; 106:7799-7815. [PMID: 37562645 DOI: 10.3168/jds.2022-23095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/26/2023] [Indexed: 08/12/2023]
Abstract
Chromosome X is often excluded from bovine genetic studies due to complications caused by the sex specific nature of the chromosome. As chromosome X is the second largest cattle chromosome and makes up approximately 6% of the female genome, finding ways to include chromosome X in dairy genetic studies is important. Using female animals and treating chromosome X as an autosome, we performed X chromosome inclusive genome-wide association studies in the selective breeding environment of the New Zealand dairy industry, aiming to identify chromosome X variants associated with milk production traits. We report on the findings of these genome-wide association studies and their potential effect within the dairy industry. We identify missense mutations in the MOSPD1 and CCDC160 genes that are associated with decreased milk volume and protein production and increased fat production. Both of these mutations are exonic SNP that are more prevalent in the Jersey breed than in Holstein-Friesians. Of the 2 candidates proposed it is likely that only one is causal, though we have not been able to identify which is more likely.
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Affiliation(s)
- H Trebes
- Research and Development, Livestock Improvement Corporation, Hamilton 3240, New Zealand.
| | - Y Wang
- Research and Development, Livestock Improvement Corporation, Hamilton 3240, New Zealand
| | - E Reynolds
- Research and Development, Livestock Improvement Corporation, Hamilton 3240, New Zealand
| | - K Tiplady
- Research and Development, Livestock Improvement Corporation, Hamilton 3240, New Zealand
| | - C Harland
- Research and Development, Livestock Improvement Corporation, Hamilton 3240, New Zealand
| | - T Lopdell
- Research and Development, Livestock Improvement Corporation, Hamilton 3240, New Zealand
| | - T Johnson
- Research and Development, Livestock Improvement Corporation, Hamilton 3240, New Zealand
| | - S Davis
- Research and Development, Livestock Improvement Corporation, Hamilton 3240, New Zealand
| | - B Harris
- Research and Development, Livestock Improvement Corporation, Hamilton 3240, New Zealand
| | - R Spelman
- Research and Development, Livestock Improvement Corporation, Hamilton 3240, New Zealand
| | - C Couldrey
- Research and Development, Livestock Improvement Corporation, Hamilton 3240, New Zealand
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Imbus JR, Jung AD, Davis S, Oyefule OO, Patel AD, Serrot FJ, Stetler JL, Majumdar MC, Papandria D, Diller ML, Srinivasan JK, Lin E, Hechenbleikner EM. Extended postoperative venous thromboembolism prophylaxis after bariatric surgery: a comparison of existing risk-stratification tools and 5-year MBSAQIP analysis. Surg Obes Relat Dis 2023; 19:808-816. [PMID: 37353413 DOI: 10.1016/j.soard.2023.04.329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/20/2022] [Accepted: 04/05/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Venous thromboembolism (VTE) is a leading cause of 30-day mortality after metabolic and bariatric surgery (MBS). Multiple predictive tools exist for VTE risk assessment and extended VTE chemoprophylaxis determination. OBJECTIVE To review existing risk-stratification tools and compare their predictive abilities. SETTING MBSAQIP database. METHODS Retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was performed (2015-2019) for primary minimally invasive MBS cases. VTE clinical factors and risk-assessment tools were evaluated: body mass index threshold of 50 kg/m2, Caprini risk-assessment model, and 3 bariatric-specific tools: the Cleveland Clinic VTE risk tool, the Michigan Bariatric Surgery Collaborative tool, and BariClot. MBS patients were deemed high risk based on criteria from each tool and further assessed for sensitivity, specificity, and positive predictive value. RESULTS Overall, 709,304 patients were identified with a .37% VTE rate. Bariatric-specific tools included multiple predictors: procedure, age, race, gender, operative time, length of stay, heart failure, and dyspnea at rest; operative time was the only variable common to all. The body mass index cutoff and Caprini risk-assessment model had higher sensitivity but lower specificity when compared with the Michigan Bariatric Surgery Collaborative and BariClot tools. While the sensitivity of the tools varied widely and was overall low, the Cleveland Clinic tool had the highest sensitivity. The bariatric-specific tools would have recommended extended prophylaxis for 1.1%-15.6% of patients. CONCLUSIONS Existing MBS VTE risk-assessment tools differ widely for inclusion variables, high-risk definition, and predictive performance. Further research and registry inclusion of all significant risk factors are needed to determine the optimal risk-stratified approach for predicting VTE events and determining the need for extended prophylaxis.
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Affiliation(s)
- Joseph R Imbus
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia.
| | - Andrew D Jung
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia
| | - S Davis
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia
| | - Omobolanle O Oyefule
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia
| | - Ankit D Patel
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia
| | - Federico J Serrot
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia
| | - Jamil L Stetler
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia
| | - Melissa C Majumdar
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia
| | - Dominic Papandria
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia
| | - Maggie L Diller
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia
| | - Jahnavi K Srinivasan
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia
| | - Edward Lin
- Department of General and Gastrointestinal Surgery, Emory University, Atlanta, Georgia
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D’Isa F, Davis S, Fassina A, Giudicotti L, Manfredi M, Montagnani G, Nigro A, Palombi L, Ricciarini S, Tojo H, Verrecchia M, Pasqualotto R. Design and characterization of the polychromators for JT-60SA Thomson scattering systems. Fusion Engineering and Design 2023. [DOI: 10.1016/j.fusengdes.2023.113591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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Davis S, Loyola C, Peralta J. Statistical inference for unreliable grading using the maximum entropy principle. Chaos 2022; 32:123103. [PMID: 36587360 DOI: 10.1063/5.0106922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/07/2022] [Indexed: 06/17/2023]
Abstract
Quantitatively assessing the level of confidence on a test score can be a challenging problem, especially when the available information is based on multiple criteria. A concrete example beyond the usual grading of tests occurs with recommendation letters, where a recommender assigns a score to a candidate, but the reliability of the recommender must be assessed as well. Here, we present a statistical procedure, based on Bayesian inference and Jaynes' maximum entropy principle, that can be used to estimate the most probable and expected score given the available information in the form of a credible interval. Our results may provide insights on how to properly state and analyze problems related to the uncertain evaluation of performance in learning applied to several contexts, beyond the case study of the recommendation letters presented here.
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Affiliation(s)
- S Davis
- Research Center on the Intersection in Plasma Physics, Matter and Complexity (P 2mc), Comisión Chilena de Energía Nuclear, Casilla 188-D, Santiago, Chile
| | - C Loyola
- Departamento de Física, Facultad de Ciencias Exactas, Universidad Andrés Bello, 8370136 Santiago, Chile
| | - J Peralta
- Departamento de Física, Facultad de Ciencias Exactas, Universidad Andrés Bello, 8370136 Santiago, Chile
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Rastogi J, Ho J, Rastogi J, Lazari J, Jageer P, Davis S, Kirresh A, Yiu J, Jain D, Ahmad M, Providencia R, Bray J. QTc interval in anorexia nervosa: a systematic review and meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients with anorexia nervosa (AN) are at higher risk of sudden cardiac death. Although the underlying aetiology for this association remains unclear. It may be related to prolongation of the QT interval, which can degenerate into fatal ventricular arrhythmias. However, the presence of prolonged heart rate-corrected QT interval (QTc) in AN remains controversial, and two previous meta-analyses on AN and QTc showed contradictory findings [1,2].
Purpose
In this systematic review and meta-analysis, we aimed to evaluate if AN was associated with changes in the QTc interval and dispersion.
Methods
MEDLINE, EMBASE and COCHRANE databases were systematically searched from inception to January 2021. Random-effects meta-analysis and meta-regression were used. The inclusion criteria were (i) confirmed diagnosis of AN, (ii) measurement of QTc on electrocardiogram and (iii) peer-reviewed articles. The primary endpoint of the study was the duration of the QTc interval calculated using the Bazett (QTcB), Hodges (QTcH), Fridericia (QTcF) and Framingham (QTcFr) formulae. The secondary endpoints were QT dispersion (QTd) and QTc dispersion (QTcd).
Results
The 25 eligible studies included 5687 patients (1862 AN, 3825 control) (Figure 1: PRISMA diagram). The majority of patients were female (96.3%) with a mean age between 14.3 to 31.0 years and mean duration of disease ranging from 9.1 to 129.6 months. The mean BMI ranged from 13.7 to 18.5 kg/m2. Pooled analysis did not show significant prolongation between AN versus control in QTcB (mean difference (MD) MD 4.9ms, 95% CI −3.2, 13.1ms, p=0.23; I2=95%; n=24/25 studies; Figure 2A), QTcH (MD 1.3ms, 95% CI −8.5, 11.2ms, p=0.79; I2=71%; n=3/25 studies), and QTcF (MD 3.1ms, 95% CI −21.6, 27.7ms, p=0.81; I2=97%; n=3/25 studies). Only two studies reporting QTcFr showed a significant prolongation between AN and control (MD 15.9ms, 95% CI 0.0, 31.8ms, p=0.05, I2=65%; n=2/25 studies; Figure 2B). However, QTd and QTcd were significantly greater in AN than control (MD 21.3ms, 95% CI 10.4, 32.3ms, p=0.0001, I2=94%; Figure 2C and MD 16.9ms, 95% CI 4.5, 29.3ms, p=0.007 I2=93%; Figure 2D, respectively).
Conclusion
To the best of our knowledge, this is the largest meta-analysis of QTc in AN and the first meta-analysis exploring the significance of QTd and QTcd in AN. AN was not found to be associated with prolongation of QTc calculated using the Bazett, Fridericia and Hodges formulae. However, an association of AN with prolonged QTc was observed in the studies using the Framingham formula. More pronounced dispersion (QTd and QTcd) was also observed in patients with AN.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Rastogi
- University College London, Medical School , London , United Kingdom
| | - J Ho
- Royal Free London NHS Foundation Trust , London , United Kingdom
| | - J Rastogi
- King's College London, Medical School , London , United Kingdom
| | - J Lazari
- Surrey and Sussex Healthcare NHS Trust , Redhill , United Kingdom
| | - P Jageer
- University College London, Medical School , London , United Kingdom
| | - S Davis
- Royal Free London NHS Foundation Trust , London , United Kingdom
| | - A Kirresh
- Royal Free London NHS Foundation Trust , London , United Kingdom
| | - J Yiu
- University College London, Medical School , London , United Kingdom
| | - D Jain
- Kent and Medway NHS and Social Care Partnership Trust , Kent , United Kingdom
| | - M Ahmad
- Royal Free London NHS Foundation Trust , London , United Kingdom
| | | | - J Bray
- Morriston Hospital , Swansea , United Kingdom
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Conlon R, Corey D, Wilson M, Mansbach S, Rosenjack J, Duesler L, Wilson A, Davis S, Michicich M, Schneider M, Traylor Z, Jiang W, LePage D, Mann R, Kelley T, Hodges C. 640 The cystic fibrosis mouse model resource center. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01330-3] [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: 11/06/2022]
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Lang Kuhs KA, Faden DL, Chen L, Smith DK, Pinheiro M, Wood CB, Davis S, Yeager M, Boland JF, Cullen M, Steinberg M, Bass S, Wang X, Liu P, Mehrad M, Tucker T, Lewis JS, Ferris RL, Mirabello L. Genetic variation within the human papillomavirus type 16 genome is associated with oropharyngeal cancer prognosis. Ann Oncol 2022; 33:638-648. [PMID: 35306154 PMCID: PMC9350957 DOI: 10.1016/j.annonc.2022.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 01/02/2023] Open
Abstract
PURPOSE A significant barrier to adoption of de-escalated treatment protocols for human papillomavirus-driven oropharyngeal cancer (HPV-OPC) is that few predictors of poor prognosis exist. We conducted the first large whole-genome sequencing (WGS) study to characterize the genetic variation of the HPV type 16 (HPV16) genome and to evaluate its association with HPV-OPC patient survival. PATIENTS AND METHODS A total of 460 OPC tumor specimens from two large United States medical centers (1980-2017) underwent HPV16 whole-genome sequencing. Site-specific variable positions [single nucleotide polymorphisms (SNPs)] across the HPV16 genome were identified. Cox proportional hazards model estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival by HPV16 SNPs. Harrell C-index and time-dependent positive predictive value (PPV) curves and areas under the PPV curves were used to evaluate the predictive accuracy of HPV16 SNPs for overall survival. RESULTS A total of 384 OPC tumor specimens (83.48%) passed quality control filters with sufficient depth and coverage of HPV16 genome sequencing to be analyzed. Some 284 HPV16 SNPs with a minor allele frequency ≥1% were identified. Eight HPV16 SNPs were significantly associated with worse survival after false discovery rate correction (individual prevalence: 1.0%-5.5%; combined prevalence: 15.10%); E1 gene position 1053 [HR for overall survival (HRos): 3.75, 95% CI 1.77-7.95; Pfdr = 0.0099]; L2 gene positions 4410 (HRos: 5.32, 95% CI 1.91-14.81; Pfdr = 0.0120), 4539 (HRos: 6.54, 95% CI 2.03-21.08; Pfdr = 0.0117); 5050 (HRos: 6.53, 95% CI 2.34-18.24; Pfdr = 0.0030), and 5254 (HRos: 7.76, 95% CI 2.41-24.98; Pfdr = 0.0030); and L1 gene positions 5962 (HRos: 4.40, 95% CI 1.88-10.31; Pfdr = 0.0110) and 6025 (HRos: 5.71, 95% CI 2.43-13.41; Pfdr = 0.0008) and position 7173 within the upstream regulatory region (HRos: 9.90, 95% CI 3.05-32.12; Pfdr = 0.0007). Median survival time for patients with ≥1 high-risk HPV16 SNPs was 3.96 years compared with 18.67 years for patients without a high-risk SNP; log-rank test P < 0.001. HPV16 SNPs significantly improved the predictive accuracy for overall survival above traditional factors (age, smoking, stage, treatment); increase in C-index was 0.069 (95% CI 0.019-0.119, P < 0.001); increase in area under the PPV curve for predicting 5-year survival was 0.068 (95% CI 0.015-0.111, P = 0.008). CONCLUSIONS HPV16 genetic variation is associated with HPV-OPC prognosis and can improve prognostic accuracy.
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Affiliation(s)
- K A Lang Kuhs
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, USA; Department of Medicine, Vanderbilt University Medical Cancer, Nashville, USA.
| | - D L Faden
- Department of Otolaryngology, Massachusetts Eye and Ear, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Broad Institute of MIT and Harvard, Cambridge, USA
| | - L Chen
- Division of Cancer Biostatistics, Department of Internal Medicine and Biostatistics and Bioinformatics Shared Resource Facility, Markey Cancer Center, University of Kentucky, Lexington, USA
| | - D K Smith
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, USA
| | - M Pinheiro
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA
| | - C B Wood
- Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, USA; Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, USA
| | - S Davis
- Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, USA
| | - M Yeager
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA; Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, USA
| | - J F Boland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA; Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, USA
| | - M Cullen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA; Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, USA
| | - M Steinberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA; Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, USA
| | - S Bass
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA; Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, USA
| | - X Wang
- Department of Pharmacology and Regenerative Medicine, The University of Illinois at Chicago, Chicago, USA
| | - P Liu
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, USA
| | - M Mehrad
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, USA
| | - T Tucker
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, USA
| | - J S Lewis
- Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, USA; Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, USA
| | - R L Ferris
- University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, USA; Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - L Mirabello
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, USA
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Bastounis A, Langley T, Davis S, Paskins Z, Gittoes N, Leonardi-Bee J, Sahota O. Comparing medication adherence in patients receiving bisphosphonates for preventing fragility fractures: a comprehensive systematic review and network meta-analysis. Osteoporos Int 2022; 33:1223-1233. [PMID: 35188591 PMCID: PMC9106630 DOI: 10.1007/s00198-022-06350-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/14/2022] [Indexed: 10/24/2022]
Abstract
BACKGROUND Bisphosphonates are effective in preventing fragility fractures; however, high rates of adherence are needed to preserve clinical benefits. OBJECTIVE To investigate persistence and compliance to oral and intravenous bisphosphonates (alendronate, ibandronate, risedronate, and zoledronate). METHODS Searches of 12 databases, unpublished sources, and trial registries were conducted, covering the period from 2000 to April 2021. Screening, data extraction, and risk of bias assessment (Cochrane Collaboration risk-of-bias tool 1.0 & ROBINS-I) were independently undertaken by two study authors. Randomised controlled trials (RCTs) and observational studies that used prescription claim databases or hospital medical records to examine patients' adherence were included. Network meta-analyses (NMA) embedded within a Bayesian framework were conducted, investigating users' likelihood in discontinuing bisphosphonate treatment. Where meta-analysis was not possible, data were synthesised using the vote-counting synthesis method. RESULTS Fifty-nine RCTs and 43 observational studies were identified, resulting in a total population of 2,656,659 participants. Data from 59 RCTs and 24 observational studies were used to populate NMAs. Zoledronate users were the least likely to discontinue their treatment HR = 0.73 (95%CrI: 0.61, 0.88). Higher rates of compliance were observed in those receiving intravenous treatments. The paucity of data and the heterogeneity in the reported medication possession ratio thresholds precluded a NMA of compliance data. CONCLUSIONS Users of intravenously administered bisphosphonates were found to be the most adherent to treatment among bisphosphonates' users. Patterns of adherence will permit the more precise estimation of clinical and cost-effectiveness of bisphosphonates. TRIAL REGISTRATION PROSPERO 2020 CRD42020177166.
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Affiliation(s)
- A. Bastounis
- grid.412920.c0000 0000 9962 2336Division of Epidemiology & Public Health, School of Medicine, University of Nottingham, City Hospital, Nottingham, NG5 1PB UK
| | - T. Langley
- grid.412920.c0000 0000 9962 2336Division of Epidemiology & Public Health, School of Medicine, University of Nottingham, City Hospital, Nottingham, NG5 1PB UK
| | - S. Davis
- grid.11835.3e0000 0004 1936 9262School of Health and Related Research, Regent Court (ScHARR), University of Sheffield, Sheffield, S1 4DA UK
| | - Z. Paskins
- grid.9757.c0000 0004 0415 6205School of Medicine, Keele University, Keele, ST5 5BG UK
- grid.500956.fHaywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent , Staffordshire UK
| | - N. Gittoes
- grid.6572.60000 0004 1936 7486Centre for Endocrinology, Diabetes and Metabolism (CEDAM), University of Birmingham, Birmingham, UK
- grid.412563.70000 0004 0376 6589Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH UK
| | - J. Leonardi-Bee
- grid.412920.c0000 0000 9962 2336Division of Epidemiology & Public Health, School of Medicine, University of Nottingham, City Hospital, Nottingham, NG5 1PB UK
| | - O. Sahota
- grid.240404.60000 0001 0440 1889Queens Medical Centre (QMC), University of Nottingham, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH UK
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Mattia L, Davis S, Mark-Wagstaff C, Abrahamsen B, Peel N, Eastell R, Schini M. Utility of PINP to monitor osteoporosis treatment in primary care, the POSE study (PINP and Osteoporosis in Sheffield Evaluation). Bone 2022; 158:116347. [PMID: 35134571 DOI: 10.1016/j.bone.2022.116347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 12/20/2022]
Abstract
PURPOSE In Sheffield (UK), we introduced the PINP monitoring algorithm for the management of osteoporosis treatment delivered in primary care. Our aims were to evaluate whether this algorithm was associated with better osteoporosis outcomes and was cost-effective compared to standard care. METHODS Inclusion criteria were referral from Sheffield GPs, BMD scans performed between 2012 and 2013 and a report advising initiation of oral bisphosphonate and PINP monitoring. 906 patients were identified and retrospectively divided into Group A (intention to monitor, with baseline PINP, n = 588) and Group B (no intention to monitor, without baseline PINP, n = 318). The model described by Davis and colleagues was used to extrapolate life-time costs and quality-adjusted life-years (QALYs). RESULTS No differences were found in baseline characteristics between groups (age, gender, BMI, BMD and major risk factors for fractures). More patients in Group A started oral treatment (77.4% vs 49.1%; p < 0.001), but there were no differences between groups in the presence of a gap in treatment >3 months or in treatment duration. Patients in Group A were more likely to have follow-up DXA scan at 4-6 years from baseline (46.9% vs 29.2%; p < 0.000) and had a greater increase in total hip BMD (+2.74% vs + 0.42%; p value = 0.003). Fewer new fractures occurred in Group A but this was not statistically significant, but the numbers of fractures were small. Patients in Group A were more likely to change management (p = 0.005) including switching to zoledronate (p = 0.03). The PINP measurement and increased prescribing in Group A resulted in increases in both costs (£30.19) and QALYs (0.0039) relative to Group B, giving an incremental cost effectiveness ratio (ICER) of £7660 in the probabilistic sensitivity analysis. CONCLUSIONS Patients monitored with PINP are more likely to start oral bisphosphonate treatment, switch to zoledronate, have follow-up DXA scans and a greater increase of hip BMD. PINP monitoring has the potential to be cost-effective in a UK NHS setting given that interventions with an ICER under £20,000 are generally considered to be cost-effective.
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Affiliation(s)
- L Mattia
- Department of Oncology and Metabolism University of Sheffield, Sheffield, UK; Department of Clinical and Molecular Medicine, Sapienza University of Rome, Italy
| | - S Davis
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - C Mark-Wagstaff
- Department of Oncology and Metabolism University of Sheffield, Sheffield, UK
| | - B Abrahamsen
- OPEN Patient Exploratory Network, University of Southern Denmark, Odense, Denmark
| | - N Peel
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - R Eastell
- Department of Oncology and Metabolism University of Sheffield, Sheffield, UK
| | - M Schini
- Department of Oncology and Metabolism University of Sheffield, Sheffield, UK; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
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11
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Fidler DJ, Prince MA, Van Deusen K, Esbensen AJ, Thurman AJ, Abbeduto L, Patel L, Mervis C, Schworer EK, Lee NR, Edgin JO, Hepburn S, Davis S, Daunhauer LA. Latent profiles of autism symptoms in children and adolescents with Down syndrome. J Intellect Disabil Res 2022; 66:265-281. [PMID: 34984734 PMCID: PMC9009451 DOI: 10.1111/jir.12910] [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: 06/04/2021] [Revised: 11/12/2021] [Accepted: 11/14/2021] [Indexed: 05/29/2023]
Abstract
BACKGROUND Down syndrome (DS) is associated with elevated rates of autism spectrum disorder (ASD) and autism symptomatology. To better characterise heterogeneity in ASD symptomatology in DS, profiles of caregiver-reported ASD symptoms were modelled for children and adolescents with DS. METHODS Participants (n = 125) were recruited through several multi-site research studies on cognition and language in DS. Using the Social Responsiveness Scale-2 (SRS-2; Constantino and Gruber 2012), two latent profile analyses (LPA) were performed, one on the broad composite scores of social communication and interaction and restricted interests and repetitive behaviour, and a second on the four social dimensions of social communication, social motivation, social awareness, and social cognition. RESULTS A three-profile model was the best fit for both analyses, with each analysis yielding a low ASD symptom profile, an elevated or mixed ASD symptom profile and a high ASD symptom profile. Associations were observed between profile probability scores and IQ, the number of co-occurring biomedical conditions reported, sex, and SRS-2 form. CONCLUSIONS Characterising heterogeneity in ASD symptom profiles can inform more personalised supports in this population, and implications for potential therapeutic approaches for individuals with DS are discussed.
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Affiliation(s)
- D J Fidler
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - M A Prince
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - K Van Deusen
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - A J Esbensen
- Department of Pediatrics, Cincinnati Children's Hospital Medical Campus, Cincinnati, OH, USA
| | - A J Thurman
- Department of Psychiatry, MIND Institute, University of California - Davis Health, Sacramento, CA, USA
| | - L Abbeduto
- Department of Psychiatry, MIND Institute, University of California - Davis Health, Sacramento, CA, USA
| | - L Patel
- Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - C Mervis
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - E K Schworer
- Department of Pediatrics, Cincinnati Children's Hospital Medical Campus, Cincinnati, OH, USA
| | - N R Lee
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - J O Edgin
- Sonoran University Center for Excellence in Developmental Disabilities, University of Arizona, Tucson, AZ, USA
| | - S Hepburn
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - S Davis
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - L A Daunhauer
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
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12
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Joshi S, D'Onise K, Nolan R, Davis S, Glass K, Lokuge K. Acute respiratory infection symptoms and COVID-19 testing behaviour: results based on South Australian health surveys. BMC Public Health 2021; 21:2307. [PMID: 34930193 PMCID: PMC8685806 DOI: 10.1186/s12889-021-12359-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 11/30/2021] [Indexed: 12/03/2022] Open
Abstract
Background Effective syndromic surveillance alongside COVID-19 testing behaviours in the population including in higher risk and hard to reach subgroups is vital to detect re-emergence of COVID-19 transmission in the community. The aim of this paper was to identify the prevalence of acute respiratory infection symptoms and coronavirus testing behaviour among South Australians using data from a population based survey. Methods We used cross-sectional data from the 2020 state-wide population level health survey on 6857 respondents aged 18 years and above. Descriptive statistics were used to explore the risk factors and multivariable logistic regression models were used to assess the factors associated with the acute respiratory infection symptoms and coronavirus testing behaviour after adjusting for gender, age, household size, household income, Aboriginal and/or Torres Strait Islander status, SEIFA, Country of birth, number of chronic diseases, wellbeing, psychological distress, and mental health. Results We found that 19.3% of respondents reported having symptoms of acute respiratory infection and the most commonly reported symptoms were a runny nose (11.2%), coughing (9.9%) and sore throat (6.2%). Fever and cough were reported by 0.8% of participants. Of the symptomatic respondents, 32.6% reported seeking health advice from a nurse, doctor or healthcare provider. Around 18% (n = 130) of symptomatic respondents had sought testing and a further 4.3% (n = 31) reported they intended to get tested. The regression results suggest that older age, larger household size, a higher number of chronic disease, mental health condition, poor wellbeing, and psychological distress were associated with higher odds of ARI symptoms. Higher household income was associated with lower odds of being tested or intending to be tested for coronavirus after adjusting for other explanatory variables. Conclusions There were relatively high rates of self-reported acute respiratory infection during a period of very low COVID-19 prevalence and low rate of coronavirus testing among symptomatic respondents. Ongoing monitoring of testing uptake, including in higher-risk groups, and possible interventions to improve testing uptake is key to early detection of disease.
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Affiliation(s)
- S Joshi
- Epidemiology Branch, Prevention and Population Health, Wellbeing SA, Government of South Australia, Level 9, The Conservatory, Rundle Mall, PO BOX 388, Adelaide, SA, 5000, Australia.
| | - K D'Onise
- Epidemiology Branch, Prevention and Population Health, Wellbeing SA, Government of South Australia, Level 9, The Conservatory, Rundle Mall, PO BOX 388, Adelaide, SA, 5000, Australia
| | - R Nolan
- Epidemiology Branch, Prevention and Population Health, Wellbeing SA, Government of South Australia, Level 9, The Conservatory, Rundle Mall, PO BOX 388, Adelaide, SA, 5000, Australia
| | - S Davis
- Humanitarian Health Research Initiative, Research School of Population Health, Australian National University, 62A Mills Road, Canberra, ACT 2601, Australia
| | - K Glass
- National Centre for Epidemiology and Population Health, Australian National University, 62A Mills Road, ACT 2601, Canberra, Australia
| | - K Lokuge
- Humanitarian Health Research Initiative, Research School of Population Health, Australian National University, 62A Mills Road, Canberra, ACT 2601, Australia
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13
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Deschamp A, Chen Y, Wang W, Rasic M, Hatch J, Sanders D, Ranganathan S, Ferkol T, Perkins D, Davis S, Finn P. 200: The association of growth and the gut microbiome in infants with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Tiddens H, Chen Y, Andrinopoulou E, Davis S, Rosenfeld M, Stukovsky K, Ratjen F. 539: Effect of inhaled hypertonic saline on structural lung disease in preschool children with cystic fibrosis. The SHIP-CT study. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01962-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Wallace J, Hepburn K, O'Hanlon J, Davis S. 1087 Establishing Guidelines for VTE Prophylaxis for Acute ENT Admissions. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
VTE prophylaxis is a vital aspect of patient safety. The decision whether to offer pharmacological thromboprophylaxis is a balance of risk versus benefit. There is a low incidence of VTE in ENT patients, admissions are often short and active bleeding on admission is not uncommon (epistaxis patients, already on anticoagulation are particularly difficult to manage}. There are no clear, specialty specific guidelines to assist in these frequently encountered endeavours.
Method
The number of emergency ENT admissions who had a documented VTE during admission or in the 28 days following was used to calculate the incidence of VTE in acute admissions. An audit of VTE prophylaxis and documentation was also conducted using 20 admissions over 24 hours.
Results
Incidence was 0.12%. 75% had a documented VTE risk assessment. Only 50% patients were prescribed chemical and mechanical thromboprophylaxis. 0% had appropriately documented that the patient did not require thromboprophylaxis on the drug chart (as per trust guidelines).
Conclusions
The results showed that both documentation and prescribing related to VTE prevention were poor. By highlighting the low incidence amongst this patient group, we were able to establish clearer guidance for VTE prophylaxis in acute ENT admissions and a protocol to standardise the management of anticoagulation in actively bleeding epistaxis patients.
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Affiliation(s)
- J Wallace
- Morriston Hospital, Swansea, United Kingdom
| | - K Hepburn
- Morriston Hospital, Swansea, United Kingdom
| | - J O'Hanlon
- Swansea Medical School, Swansea, United Kingdom
| | - S Davis
- Morriston Hospital, Swansea, United Kingdom
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16
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Yee LM, McGee P, Bailit JL, Wapner RJ, Varner MW, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Mallett G, Grobman W, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Leveno K, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, Zhao Y, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Differences in obstetrical care and outcomes associated with the proportion of the obstetrician's shift completed. Am J Obstet Gynecol 2021; 225:430.e1-430.e11. [PMID: 33812810 DOI: 10.1016/j.ajog.2021.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding and improving obstetrical quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been implemented to improve the quality of care provided to obstetrical patients. Although many factors contribute to delivery decisions, a reduced workload has addressed how provider issues such as fatigue or behaviors surrounding impending shift changes may influence the delivery mode and outcomes. OBJECTIVE The objective was to assess whether intrapartum obstetrical interventions and adverse outcomes differ based on the temporal proximity of the delivery to the attending's shift change. STUDY DESIGN This was a secondary analysis from a multicenter obstetrical cohort in which all patients with cephalic, singleton gestations who attempted vaginal birth were eligible for inclusion. The primary exposure used to quantify the relationship between the proximity of the provider to their shift change and a delivery intervention was the ratio of time from the most recent attending shift change to vaginal delivery or decision for cesarean delivery to the total length of the shift. Ratios were used to represent the proportion of time completed in the shift by normalizing for varying shift lengths. A sensitivity analysis restricted to patients who were delivered by physicians working 12-hour shifts was performed. Outcomes chosen included cesarean delivery, episiotomy, third- or fourth-degree perineal laceration, 5-minute Apgar score of <4, and neonatal intensive care unit admission. Chi-squared tests were used to evaluate outcomes based on the proportion of the attending's shift completed. Adjusted and unadjusted logistic models fitting a cubic spline (when indicated) were used to determine whether the frequency of outcomes throughout the shift occurred in a statistically significant, nonlinear pattern RESULTS: Of the 82,851 patients eligible for inclusion, 47,262 (57%) had ratio data available and constituted the analyzable sample. Deliveries were evenly distributed throughout shifts, with 50.6% taking place in the first half of shifts. There were no statistically significant differences in the frequency of cesarean delivery, episiotomy, third- or fourth-degree perineal lacerations, or 5-minute Apgar scores of <4 based on the proportion of the shift completed. The findings were unchanged when evaluated with a cubic spline in unadjusted and adjusted logistic models. Sensitivity analyses performed on the 22.2% of patients who were delivered by a physician completing a 12-hour shift showed similar findings. There was a small increase in the frequency of neonatal intensive care unit admissions with a greater proportion of the shift completed (adjusted P=.009), but the findings did not persist in the sensitivity analysis. CONCLUSION Clinically significant differences in obstetrical interventions and outcomes do not seem to exist based on the temporal proximity to the attending physician's shift change. Future work should attempt to directly study unit culture and provider fatigue to further investigate opportunities to improve obstetrical quality of care, and additional studies are needed to corroborate these findings in community settings.
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17
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Staum B, Hu J, Leal A, Kim S, Purcell W, Lieu C, Messersmith W, Davis S. P-157 Assessing fitness for systemic therapy in hepatocellular carcinoma: Evaluating time on treatment according to Child-Pugh classification, model for end-stage liver disease score, and AFP level. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Ayllon-Guerola J, Cobacho-Rodriguez C, Segado-Fernandez J, Hidalgo-Salaverri J, Mancini A, Nunez-Portillo J, Garcia-Vallejo D, Garcia-Munoz M, Davis S, Tomarchio V, Hajnal N, Piccinni C, Verrecchia M, Phillips G, Vallar M, Perelli Cippo E, Nocente M, Putignano O, Sozzi C, Wanner M. Thermo-mechanical assessment of the JT-60SA fast-ion loss detector. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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Smith AJ, Barber J, Davis S, Jones C, Kotra KK, Losada S, Lyons BP, Mataki M, Potter KD, Devlin MJ. Aquatic contaminants in Solomon Islands and Vanuatu: Evidence from passive samplers and Microtox toxicity assessment. Mar Pollut Bull 2021; 165:112118. [PMID: 33582422 DOI: 10.1016/j.marpolbul.2021.112118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 06/12/2023]
Abstract
Water Quality issues in many Pacific countries are rising, with the increase in coastal populations and associated urban runoff but management requires contamination issues in the aquatic environment to be identified and prioritised. In Vanuatu and Solomon Islands there are few laboratories and resources to assess for the presence or impact of complex chemical contaminants. The extent and impact of chemical contamination of the marine and coastal environment is poorly described. Passive chemical samplers were used to measure a range of aquatic pollutants around the capital cities, Honiara (Solomon Islands) and Port Vila (Vanuatu). We detected a range of chemicals indicative of agricultural and industrial contamination and a few sites had concerning concentrations of specific hydrocarbons and pesticides. The rapid ecotoxicology test, Microtox, indicated toxic impacts in rivers, coastal sites and urban drains This work provides new data on chemical contamination and possible impacts of that contamination for both countries. The techniques could be applied widely across the region to generate critical data for environmental management, guide monitoring efforts and measure the impact of policy or land-use changes.
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Affiliation(s)
- A J Smith
- Cefas, Pakefield Road, Lowestoft NR33 0HT, UK.
| | - J Barber
- Cefas, Pakefield Road, Lowestoft NR33 0HT, UK
| | - S Davis
- Cefas, Pakefield Road, Lowestoft NR33 0HT, UK
| | - C Jones
- Cefas, Pakefield Road, Lowestoft NR33 0HT, UK
| | - K K Kotra
- School of Agriculture, Geography, Environment, Ocean and Natural Sciences (SAGEONS), The University of the South Pacific, Emalus Campus, Port Vila, Vanuatu
| | - S Losada
- Cefas, Pakefield Road, Lowestoft NR33 0HT, UK
| | - B P Lyons
- Cefas, British Embassy, PO Box 2, 13001 Safat, Kuwait; Cefas, The Nothe, Weymouth, Dorset, DT4 8UB, UK
| | - M Mataki
- Ministry of Environment, Climate Change, Disaster Management and Meteorology, P.O. Box 21, Honiara, Solomon Islands
| | - K D Potter
- Cefas, Pakefield Road, Lowestoft NR33 0HT, UK
| | - M J Devlin
- Cefas, Pakefield Road, Lowestoft NR33 0HT, UK
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20
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Lewis C, Davis S, Khukhrin M, Galyautdinova S. Examining online postings on a russian internet self-harm message board: Further evidence of addiction to self-harm? Eur Psychiatry 2021. [PMCID: PMC9480443 DOI: 10.1192/j.eurpsy.2021.1597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction There has been an increasing amount of research examining the addictive nature of self-harm (non-suicidal self-injury). One such area of research has examined if themes related to addiction are present in self-harm board postings on imessages. Recent research from the UK suggests that such themes are evident. Objectives The present aim was to build on previous research to examine if themes of addiction are present in other cultural contexts. Methods A sample of 254 online postings from a self-harm discussion forum on a Russian Internet message board were translated, extracted, read, and re-read before being coded using inductive content analysis to identify themes. Results Five themes were extracted and labelled: “Relationships with Family and Friends”, “Self-Blame and Hatred”, “Ongoing Battle”, “Positive affect”, “Other Mental Health Problems Difficulties”. These themes are somewhat similar to those found within messages in a UK based self-harm forum. Conclusions The present findings, obtained from Russian respondents, provide further evidence demonstrating that repetitive self-harming seems to have addictive aspects.
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21
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Lokuge K, Banks E, Davis S, Roberts L, Street T, O'Donovan D, Caleo G, Glass K. Exit strategies: optimising feasible surveillance for detection, elimination, and ongoing prevention of COVID-19 community transmission. BMC Med 2021; 19:50. [PMID: 33596902 PMCID: PMC7887417 DOI: 10.1186/s12916-021-01934-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/02/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Following implementation of strong containment measures, several countries and regions have low detectable community transmission of COVID-19. We developed an efficient, rapid, and scalable surveillance strategy to detect remaining COVID-19 community cases through exhaustive identification of every active transmission chain. We identified measures to enable early detection and effective management of any reintroduction of transmission once containment measures are lifted to ensure strong containment measures do not require reinstatement. METHODS We compared efficiency and sensitivity to detect community transmission chains through testing of the following: hospital cases; fever, cough and/or ARI testing at community/primary care; and asymptomatic testing; using surveillance evaluation methods and mathematical modelling, varying testing capacities, reproductive number (R) and weekly cumulative incidence of COVID-19 and non-COVID-19 respiratory symptoms using data from Australia. We assessed system requirements to identify all transmission chains and follow up all cases and primary contacts within each chain, per million population. RESULTS Assuming 20% of cases are asymptomatic and 30% of symptomatic COVID-19 cases present for testing, with R = 2.2, a median of 14 unrecognised community cases (8 infectious) occur when a transmission chain is identified through hospital surveillance versus 7 unrecognised cases (4 infectious) through community-based surveillance. The 7 unrecognised community upstream cases are estimated to generate a further 55-77 primary contacts requiring follow-up. The unrecognised community cases rise to 10 if 50% of cases are asymptomatic. Screening asymptomatic community members cannot exhaustively identify all cases under any of the scenarios assessed. The most important determinant of testing requirements for symptomatic screening is levels of non-COVID-19 respiratory illness. If 4% of the community have respiratory symptoms, and 1% of those with symptoms have COVID-19, exhaustive symptomatic screening requires approximately 11,600 tests/million population using 1/4 pooling, with 98% of cases detected (2% missed), given 99.9% sensitivity. Even with a drop in sensitivity to 70%, pooling was more effective at detecting cases than individual testing under all scenarios examined. CONCLUSIONS Screening all acute respiratory disease in the community, in combination with exhaustive and meticulous case and contact identification and management, enables appropriate early detection and elimination of COVID-19 community transmission. An important component is identification, testing, and management of all contacts, including upstream contacts (i.e. potential sources of infection for identified cases, and their related transmission chains). Pooling allows increased case detection when testing capacity is limited, even given reduced test sensitivity. Critical to the effectiveness of all aspects of surveillance is appropriate community engagement, messaging to optimise testing uptake and compliance with other measures.
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Affiliation(s)
- K Lokuge
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia.
| | - E Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - S Davis
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - L Roberts
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - T Street
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - D O'Donovan
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - G Caleo
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - K Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
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22
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Lokuge K, Banks E, Davis S, Roberts L, Street T, O'Donovan D, Caleo G, Glass K. Exit strategies: optimising feasible surveillance for detection, elimination, and ongoing prevention of COVID-19 community transmission. BMC Med 2021; 19:50. [PMID: 33596902 DOI: 10.1101/2020.04.19.20071217] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/02/2021] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Following implementation of strong containment measures, several countries and regions have low detectable community transmission of COVID-19. We developed an efficient, rapid, and scalable surveillance strategy to detect remaining COVID-19 community cases through exhaustive identification of every active transmission chain. We identified measures to enable early detection and effective management of any reintroduction of transmission once containment measures are lifted to ensure strong containment measures do not require reinstatement. METHODS We compared efficiency and sensitivity to detect community transmission chains through testing of the following: hospital cases; fever, cough and/or ARI testing at community/primary care; and asymptomatic testing; using surveillance evaluation methods and mathematical modelling, varying testing capacities, reproductive number (R) and weekly cumulative incidence of COVID-19 and non-COVID-19 respiratory symptoms using data from Australia. We assessed system requirements to identify all transmission chains and follow up all cases and primary contacts within each chain, per million population. RESULTS Assuming 20% of cases are asymptomatic and 30% of symptomatic COVID-19 cases present for testing, with R = 2.2, a median of 14 unrecognised community cases (8 infectious) occur when a transmission chain is identified through hospital surveillance versus 7 unrecognised cases (4 infectious) through community-based surveillance. The 7 unrecognised community upstream cases are estimated to generate a further 55-77 primary contacts requiring follow-up. The unrecognised community cases rise to 10 if 50% of cases are asymptomatic. Screening asymptomatic community members cannot exhaustively identify all cases under any of the scenarios assessed. The most important determinant of testing requirements for symptomatic screening is levels of non-COVID-19 respiratory illness. If 4% of the community have respiratory symptoms, and 1% of those with symptoms have COVID-19, exhaustive symptomatic screening requires approximately 11,600 tests/million population using 1/4 pooling, with 98% of cases detected (2% missed), given 99.9% sensitivity. Even with a drop in sensitivity to 70%, pooling was more effective at detecting cases than individual testing under all scenarios examined. CONCLUSIONS Screening all acute respiratory disease in the community, in combination with exhaustive and meticulous case and contact identification and management, enables appropriate early detection and elimination of COVID-19 community transmission. An important component is identification, testing, and management of all contacts, including upstream contacts (i.e. potential sources of infection for identified cases, and their related transmission chains). Pooling allows increased case detection when testing capacity is limited, even given reduced test sensitivity. Critical to the effectiveness of all aspects of surveillance is appropriate community engagement, messaging to optimise testing uptake and compliance with other measures.
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Affiliation(s)
- K Lokuge
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia.
| | - E Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - S Davis
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - L Roberts
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - T Street
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - D O'Donovan
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - G Caleo
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
| | - K Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 62 Mills Road, ACT, 2601, Acton, Australia
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Rosa WE, Fitzgerald M, Davis S, Farley JE, Khanyola J, Kwong J, Moreland PJ, Rogers M, Sibanda B, Turale S. Leveraging nurse practitioner capacities to achieve global health for all: COVID-19 and beyond. Int Nurs Rev 2020; 67:554-559. [PMID: 33006173 PMCID: PMC7537537 DOI: 10.1111/inr.12632] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [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: 06/02/2020] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 11/28/2022]
Abstract
Aim To argue that nurse practitioners have been under‐utilized generally in the current global health environment, creating barriers to achieving universal health coverage and the Sustainable Development Goals. Background Nurse practitioners are advanced practice nurses possessing expert knowledge and leadership skills that can be optimized to narrow disparities and ensure access to high‐quality health care globally. Nurses worldwide have been challenged to meet global public health needs in the context of COVID‐19 (SARS‐CoV‐2 virus), and there are early indications that nurse practitioners are being called upon to the full extent of their capabilities in the current pandemic. Sources of evidence PubMed; Google Scholar; the International Council of Nurses; World Health Organization; United Nations; and the experiences of the authors. Discussion Several international reports, nursing and health organizations have called for continued investment in and development of nursing to improve mechanisms that promote cost‐effective and universally accessible care. Expanding nurse practitioner scopes of practice across nations will leverage their clinical capacities, policy and advocacy skills, and talents to lead at all levels. Conclusion Ongoing empirical data and policy change is needed to enable the full scope and strategic utilization of nurse practitioners across healthcare systems and contexts. Implications for nursing practice, and nursing and health policy Widespread education regarding nurse practitioner capacities for interdisciplinary partners, policymakers and the public is needed. Policies that safely expand their roles are critical. Role titles and remuneration reflective of their scope and service are required to lead, sustain and grow the workforce internationally.
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Affiliation(s)
- W E Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M Fitzgerald
- Fitzgerald Health Education Associates, LLC, North Andover, MA, USA
| | - S Davis
- Partners In Health, Boston, MA, USA
| | - J E Farley
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - J Khanyola
- University of Global Health Equity, Kigali, Rwanda
| | - J Kwong
- Division of Advanced Practice, School of Nursing, The State University of New Jersey, Rutgers, NJ, USA
| | - P J Moreland
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - M Rogers
- University Teaching Fellow for Advanced Practice and Advanced Nurse Practitioner, University of Huddersfield, Queensgate, Huddersfield, UK
| | - B Sibanda
- Anglophone Africa Advanced Practice Nursing Coalition (Zimbabwe), Queen's University, Belfast, Northern Ireland, UK
| | - S Turale
- Chiang Mai University Faculty of Nursing, Chiang Mai, Thailand
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Weyh A, Davis S, Ciampitti M, Dolan J, Bunnell A, Salman S. The Creation of a Comprehensive Airway Team. J Oral Maxillofac Surg 2020. [DOI: 10.1016/j.joms.2020.07.146] [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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Love MW, Warren JA, Davis S, Ewing JA, Hall AM, Cobb WS, Carbonell AM. Computed tomography imaging in ventral hernia repair: can we predict the need for myofascial release? Hernia 2020; 25:471-477. [PMID: 32277369 DOI: 10.1007/s10029-020-02181-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 03/25/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Currently, the need for additional myofascial release (AMR) in addition to retromuscular dissection during open Rives-Stoppa hernia repair is determined intraoperatively based on the discretion of the surgeon. We developed a novel method to objectively predict the need for AMR preoperatively using computed tomography (CT)-measured rectus width to hernia width ratio (RDR). METHODS A retrospective chart review of all patients who underwent open retro-muscular mesh repair of midline ventral hernia between August 1, 2007 and February 1, 2018, who had a preoperative CT scan within 1 year prior to their operation. The primary endpoint was the ability of the defect ratio to predict the need for AMR in pursuit of fascial closure. The secondary endpoint was the ability of Component Separation Index (CSI) to predict the need for AMR to obtain fascial closure. RESULTS Of 342 patients, 208 repaired with rectus abdominis release alone (RM group), while 134 required AMR (RM + group). An RDR of > 1.34 on area under the curve analysis predicted the need for AMR with 77.6% accuracy. There was a linear decrease in the need for AMR with increasing RDR: RDR < 1 required AMR in 78.8% of cases, RDR 1.1-1.49 in 52%, RDR 1.5-1.99 in 32.1%, and RDR > 2 in just 10.8%. Similarly, CSI > 0.146 predicted the need for AMR with 76.3% accuracy on area under the curve analysis. CONCLUSION The RDR is a practical and reliable tool to predict the ability to close the defect during open Rives-Stoppa ventral hernia repair without AMR. An RDR of > 2 portends fascial closure with rectus abdominis myofascial release alone in 90% of cases.
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Affiliation(s)
- M W Love
- Division of Minimal Access and Bariatric Surgery, Department of Surgery, Prisma Health-Upstate, Greenville, SC, USA
| | - J A Warren
- Division of Minimal Access and Bariatric Surgery, Department of Surgery, University of South Carolina School of Medicine Greenville, Prisma Health-Upstate, 701 Grove Rd. ST3, Greenville, SC, 29605, USA.
| | - S Davis
- Division of Minimal Access and Bariatric Surgery, Department of Surgery, Prisma Health-Upstate, Greenville, SC, USA
| | - J A Ewing
- Health Sciences Center, Prisma Health-Upstate, Greenville, SC, USA
| | - A M Hall
- Division of Minimal Access and Bariatric Surgery, Department of Surgery, Prisma Health-Upstate, Greenville, SC, USA
| | - W S Cobb
- Division of Minimal Access and Bariatric Surgery, Department of Surgery, University of South Carolina School of Medicine Greenville, Prisma Health-Upstate, 701 Grove Rd. ST3, Greenville, SC, 29605, USA
| | - A M Carbonell
- Division of Minimal Access and Bariatric Surgery, Department of Surgery, University of South Carolina School of Medicine Greenville, Prisma Health-Upstate, 701 Grove Rd. ST3, Greenville, SC, 29605, USA
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Davis S, Thibault B, Mangat I, Coutu B, Bennett M, Philippon F, Sandhu R, Sterns L, Essebad V, Nery P, Wells G, Yee R, Exner D, Krahn A, Parkash R. P6546Canadian Registry of Electronic Device Outcomes (CREDO): remote monitoring outcomes in the abbott battery performance alert, a multicentre cohort. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac implantable electronic devices have been known to have lead and device malfunctions leading to advisories. Increased use of remote monitoring of devices has been suggested to allow the identification of abnormal device performance and allow early intervention. We sought to describe the outcomes of patients with and without remote monitoring of in devices in the Abbott Premature Battery Depletion advisory with data from a Canadian registry
Methods
Patients with an Abbott device subject to the Battery Performance Alert Advisory from nine ICD implanting centres in Canada were included in the registry. The use of remote monitoring was identified from baseline and followup data in the registry. The primary outcome was detection of premature battery depletion and all cause mortality.
Results
2679 patents were identified with a device subject to the advisory. Devices were implanted between 2010 and 2017. 1716 patients (64%) had remote monitoring at baseline with this increasing to 83.7% at followup at 12 months. Premature battery depletion occurred in 43 patients (1.6%). Discovery of premature battery depletion was detected by remote monitoring in 70% of patients. There were 492 deaths during the follow up. Mortality was higher in those without a remote monitor compared to those with a remote monitor at follow-up and remote monitor at baseline and follow-up (11.3%, 2.6% versus 6.1% respectively; p=0.0186). There were no deaths attributed to premature battery depletion
Conclusion
The use of remote monitoring in patients with ICD and CRT under advisory reliably detected device failure and was associated with a reduction in all-cause mortality.
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Affiliation(s)
- S Davis
- QE II Health Sciences Center, Halifax, Canada
| | - B Thibault
- Montreal Heart Institute, Montreal, Canada
| | - I Mangat
- St. Michael's Hospital, Toronto, Canada
| | - B Coutu
- University of Montreal, Montreal, Canada
| | - M Bennett
- University of British Columbia, Vancouver, Canada
| | - F Philippon
- Hospital Affiliated with the University of Quebec, Quebec, Canada
| | - R Sandhu
- Mazankowski Alberta Heart Institute, Edmonton, Canada
| | - L Sterns
- Royal Jubilee Hospital, Victoria, Canada
| | - V Essebad
- Hospital du Sacre-Coeur, Montreal, Canada
| | - P Nery
- Ottawa Heart Institute, Ottawa, Canada
| | - G Wells
- Ottawa Heart Institute, Ottawa, Canada
| | - R Yee
- London Health Sciences Centre, London, Canada
| | - D Exner
- Libin Cardiovascular Institute of Alberta, Calgary, Canada
| | - A Krahn
- University of British Columbia, Vancouver, Canada
| | - R Parkash
- QE II Health Sciences Center, Halifax, Canada
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Lang P, Nakano T, Davis S, Matsunaga G, Pégourié B, Ploeckl B, Treuterer W. Final design of the JT-60SA pellet launching system for simultaneous density and ELM control. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2018.11.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Shore RE, Beck HL, Boice JD, Caffrey EA, Davis S, Grogan HA, Mettler FA, Preston RJ, Till JE, Wakeford R, Walsh L, Dauer LT. Reply to Comment on 'Implications of recent epidemiologic studies for the linear nonthreshold model and radiation protection'. J Radiol Prot 2019; 39:655-659. [PMID: 31125317 DOI: 10.1088/1361-6498/ab077f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- R E Shore
- New York University Langone School of Medicine, New York, United States of America. Radiation Effects Research Foundation, Hiroshima, Japan (retired
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MacManus M, Fisher R, Roos D, O'Brien P, Macann A, Tsang R, Davis S, Christie D, McClure B, Joseph D, Seymour J. SYSTEMIC THERAPY AFTER RADIATION THERAPY IN STAGE I-II FOLLICULAR LYMPHOMA: FINAL RESULTS OF AN INTERNATIONAL RANDOMIZED TRIAL TROG 99.03. Hematol Oncol 2019. [DOI: 10.1002/hon.35_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- M.P. MacManus
- Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - R. Fisher
- Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - D. Roos
- Radiation Oncology; Royal Adelaide Hospital; Adelaide Australia
| | - P. O'Brien
- Radiation Oncology; GenesisCare Lake Macquarie Private Hospital; Gateshead Australia
| | - A. Macann
- Radiation Oncology; Auckland City Hospital; Auckland New Zealand
| | - R. Tsang
- Radiation Oncology; Princess Margaret Hospital; Toronto Canada
| | - S. Davis
- Radiation Oncology; Alfred Hospital; Melbourne Australia
| | - D. Christie
- Radiation Oncology; Genesis Care Premion; Southport Australia
| | - B. McClure
- Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - D. Joseph
- Radiation Oncology; Sir Charles Gairdner Hospital; Perth Australia
| | - J. Seymour
- Haematology; Peter MacCallum Cancer Centre; Melbourne Australia
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30
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Beynel L, Appelbaum L, Luber B, Crowell C, Hilbig S, Lim W, Nguyen D, Chrapliwy N, Davis S, Cabeza R, Lisanby H, Deng Z. Effects of online repetitive transcranial magnetic stimulation (rTMS) on cognition: a meta-analysis and recommendations for future studies. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Force J, Plichta J, Stashko I, Kimmick G, Westbrook K, Sammons S, Hwang S, Hyslop T, Kauff N, Castellar E, Nair S, Weinhold K, Davis S, Mashadi-Hossein A, Brauer HA, Marcom PK. Abstract P3-08-07: Distinct biological signatures describe differences in BRCA mutated subgroups. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-07] [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: 11/16/2022]
Abstract
Abstract
Background: BRCA mutated (BRCA+) breast cancers are expected to have increased activation of Homologous Recombination Deficiency (HRD) and altered DNA damage repair pathways when compared to BRCA wildtype (BRCA-). To better understand differences in these populations, biological patterns and immune responses to BRCA+ breast cancers were evaluated. The primary aim of our study was to use novel gene expression tools to assess early stage breast cancers with and without germline BRCA mutations, and within distinct BRCA+ subgroups.
Methods: We identified 124 early stage untreated breast cancers with and without BRCA mutations (n = 62 and 62, respectively). Our BRCA- group was matched by hormone receptor (HR) status, age, and stage to the BRCA+ group. The NanoString Breast Cancer 360 panel was applied to RNA isolated from 80 breast tumors (BRCA+ = 39; BRCA- = 41). The BRCA+ group had a BRCA1+ subgroup (n=17) and a BRCA2+ subgroup (n=22).
Results: There was a significant increase in two BC360 signatures in both the BRCA1+ and BRCA2+ tumors compared with the BRCA- population: Prosigna™Risk of Recurrence (ROR) score [BRCA1+: HR: 1.142 (95% CI 1.019, 1.279), p=0.02; BRCA2+: HR: 1.321 (95% CI 1.190, 1.466), p<0.001] and HRD [BRCA1+: HR: 3.576 (95% CI 2.174, 5.880), p=0.02; BRCA2+: HR: 1.801 (95% CI 1.142, 2.840), p<0.001]. BRCA1+ tumors had lower expression of ESR1 [p=0.03], PGR [p=0.02], ER signaling [p<0.001], and differentiation [p=0.005]; while BRCA2+ tumors had lower expression of stroma markers [p=0.02] and inflammatory chemokines [p=0.001]. The two BRCA+ subgroups had distinct molecular subtype correlation trends that were highly significant. BRCA1+ tumors were positively associated with a basal subtype [p<0.001], whereas this association was not significant for BRCA2+ tumors. BRCA2+ tumors were associated with an increase in luminal B subtype [p=0.05]. All BRCA+ tumors had a decrease in luminal A subtype correlation [BRCA1+: p<0.001; BRCA2+: p=0.002]. In addition to the BC360 signatures, a differential analysis of all genes in the BC360 panel revealed more single gene differences in BRCA2+ than BRCA1+ tumors when compared to BRCA- tumors.
Conclusions: In early stage BRCA+ breast cancer, tumors have higher ROR and increased HRD signature scores compared to BRCA- tumors. Furthermore, BRCA1+ and BRCA2+ tumors have both signature and single gene expression differences when compared to BRCA- tumors, indicating distinct subgroup-related biology. The greater correlation of BRCA1+ tumors with basal-like biology and BRCA2+ tumors with aggressive hormonal biology confirms these trends. Distinctions in hormone receptor signaling, DNA-damage pathways, and microenvironment/inflammatory features between BRCA1 and BRCA2 associated cancers suggest a need for different prevention and therapeutic strategies for each of these breast cancer subtypes. The unique biological patterns identified here should be further evaluated as predictive or prognostic tools that could be translated into clinical care for early stage BRCA+ patients.
Citation Format: Force J, Plichta J, Stashko I, Kimmick G, Westbrook K, Sammons S, Hwang S, Hyslop T, Kauff N, Castellar E, Nair S, Weinhold K, Davis S, Mashadi-Hossein A, Brauer HA, Marcom PK. Distinct biological signatures describe differences in BRCA mutated subgroups [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-07.
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Affiliation(s)
- J Force
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - J Plichta
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - I Stashko
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - G Kimmick
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - K Westbrook
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - S Sammons
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - S Hwang
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - T Hyslop
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - N Kauff
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - E Castellar
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - S Nair
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - K Weinhold
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - S Davis
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - A Mashadi-Hossein
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - HA Brauer
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
| | - PK Marcom
- Duke University Medical Center, Durham, NC; Nanostring Technologies, Seattle, WA
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Khera TK, Burston A, Davis S, Drew S, Gooberman-Hill R, Paskins Z, Peters TJ, Tobias JH, Clark EM. An observational cohort study to produce and evaluate an improved tool to screen older women with back pain for osteoporotic vertebral fractures (Vfrac): study protocol. Arch Osteoporos 2019; 14:11. [PMID: 30684069 PMCID: PMC6347587 DOI: 10.1007/s11657-019-0558-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/03/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED The aim of this study is to produce an easy to use checklist for general practitioners to complete whenever a woman aged over 65 years with back pain seeks healthcare. This checklist will produce a binary output to determine if the patient should have a radiograph to diagnose vertebral fracture. PURPOSE People with osteoporotic vertebral fractures are important to be identified as they are at relatively high risk of further fractures. Despite this, less than a third of people with osteoporotic vertebral fractures come to clinical attention due to various reasons including lack of clear triggers to identify who should have diagnostic spinal radiographs. This study aims to produce and evaluate a novel screening tool (Vfrac) for use in older women presenting with back pain in primary care based on clinical triggers and predictors identified previously. This tool will generate a binary output to determine if a radiograph is required. METHODS The Vfrac study is a two-site, pragmatic, observational cohort study recruiting 1633 women aged over 65 years with self-reported back pain. Participants will be recruited from primary care in two sites. The Vfrac study will use data from two self-completed questionnaires, a simple physical examination, a lateral thoracic and lateral lumbar radiograph and information contained in medical records. RESULTS The primary objective is to develop an easy-to-use clinical screening tool for identifying older women who are likely to have vertebral fractures. CONCLUSIONS This article describes the protocol of the Vfrac study; ISRCTN16550671.
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Affiliation(s)
- T. K. Khera
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - A. Burston
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - S. Davis
- Health Economics and Decision Science, University of Sheffield, Sheffield, UK
| | - S. Drew
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - R. Gooberman-Hill
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Z. Paskins
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, ST5 5BG UK ,Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, ST6 7AG UK
| | - T. J. Peters
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - J. H. Tobias
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - E. M. Clark
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
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Davis S, Khatri O, Gonzalez J. 439 Increasing the Concentration of In Ovo Injected Nicotinamide Riboside has a Positive Influence on Avian Myogenesis. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.497] [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] Open
Affiliation(s)
- S Davis
- Kansas State University,Manhattan, KS, United States
| | - O Khatri
- Kansas State University,Manhattan, KS, United States
| | - J Gonzalez
- Kansas State University,Manhattan, KS, United States
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Pearl K, Speer H, Khatri O, Davis S, Miesner M, Gonzalez J, Titgemeyer E. 483 The effect of supplemental leucine on regulatory signaling in muscle of growing steers. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.591] [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: 11/15/2022] Open
Affiliation(s)
- K Pearl
- Kansas State University,Manhattan, KS, United States
| | - H Speer
- Kansas State University,Manhattan, KS, United States
| | - O Khatri
- Kansas State University,Manhattan, KS, United States
| | - S Davis
- Kansas State University,Manhattan, KS, United States
| | - M Miesner
- Kansas State University,Manhattan, KS, United States
| | - J Gonzalez
- Kansas State University,Manhattan, KS, United States
| | - E Titgemeyer
- Kansas State University,Manhattan, KS, United States
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Davis S, Khatri O, Phelps K, Gonzalez J. PSVII-13 The Effects of In Ovo Injection of Nicotinamide Riboside on Avian Myogenesis. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.121] [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: 11/13/2022] Open
Affiliation(s)
- S Davis
- Kansas State University,Manhattan, KS, United States
| | - O Khatri
- Kansas State University,Manhattan, KS, United States
| | - K Phelps
- Kansas State University,Wichita, KS, United States
| | - J Gonzalez
- Kansas State University,Manhattan, KS, United States
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Costa ML, Achten J, Bruce J, Davis S, Hennings S, Willett K, Petrou S, Jeffery S, Griffin D, Parker B, Masters J, Lamb SE, Tutton E, Parsons N. Negative-pressure wound therapy versus standard dressings for adults with an open lower limb fracture: the WOLLF RCT. Health Technol Assess 2018; 22:1-162. [PMID: 30573002 PMCID: PMC6322061 DOI: 10.3310/hta22730] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Open fractures of the lower limb occur when a broken bone penetrates the skin and is exposed to the outside environment. These are life-changing injuries. The risk of deep infection may be as high as 27%. The type of dressing applied after surgical debridement could potentially reduce the risk of infection in the open-fracture wound. OBJECTIVES To assess the disability, rate of deep infection, quality of life and resource use in patients with severe open fracture of the lower limb treated with negative-pressure wound therapy (NPWT) versus standard wound management after the first surgical debridement of the wound. DESIGN A pragmatic, multicentre randomised controlled trial. SETTING Twenty-four specialist trauma hospitals in the UK Major Trauma Network. PARTICIPANTS A total of 460 patients aged ≥ 16 years with a severe open fracture of the lower limb were recruited from July 2012 through to December 2015. Patients were excluded if they presented more than 72 hours after their injury or were unable to complete questionnaires. INTERVENTIONS Negative-pressure wound therapy (n = 226) where an 'open-cell' solid foam or gauze was placed over the surface of the wound and connected to a suction pump which created a partial vacuum over the dressing versus standard dressings not involving negative pressure (n = 234). MAIN OUTCOME MEASURES Disability Rating Index (DRI) - a score of 0 (no disability) to 100 (completely disabled) at 12 months was the primary outcome measure, with a minimal clinically important difference of 8 points. The secondary outcomes were deep infection, quality of life and resource use collected at 3, 6, 9 and 12 months post randomisaton. RESULTS There was no evidence of a difference in the patients' DRI at 12 months. The mean DRI in the NPWT group was 45.5 points [standard deviation (SD) 28.0 points] versus 42.4 points (SD 24.2 points) in the standard dressing group, giving a difference of -3.9 points (95% confidence interval -8.9 to 1.2 points) in favour of standard dressings (p = 0.132). There was no difference in HRQoL and no difference in the number of surgical site infections or other complications at any point in the 12 months after surgery. NPWT did not reduce the cost of treatment and it was associated with a low probability of cost-effectiveness. LIMITATIONS Owing to the emergency nature of the interventions, we anticipated that some patients who were randomised into the trial would subsequently be unable or unwilling to take part. Such post-randomisation withdrawal of patients could have posed a risk to the external validity of the trial. However, the great majority of these patients (85%) were found to be ineligible after randomisation. Therefore, we can be confident that the patients who took part were representative of the population with severe open fractures of the lower limb. CONCLUSIONS Contrary to the existing literature and current clinical guidelines, NPWT dressings do not provide a clinical or an economic benefit for patients with an open fracture of the lower limb. FUTURE WORK Future work should investigate alternative strategies to reduce the incidence of infection and improve outcomes for patients with an open fracture of the lower limb. Two specific areas of potentially great benefit are (1) the use of topical antibiotic preparations in the open-fracture wound and (2) the role of orthopaedic implants with antimicrobial coatings when fixing the associated fracture. TRIAL REGISTRATION Current Controlled Trials ISRCTN33756652 and UKCRN Portfolio ID 11783. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 73. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Matthew L Costa
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Juul Achten
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Julie Bruce
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Sonia Davis
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Susie Hennings
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Keith Willett
- Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Stavros Petrou
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Damian Griffin
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Ben Parker
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - James Masters
- Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sarah E Lamb
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Elizabeth Tutton
- Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Nick Parsons
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
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Whitson H, Potter G, Davis S, Plassman B, Sloane R, Reynolds K, Schmader K, Welsh-Bohmer K. DIFFERENCE IN BRAIN ACTIVATION WITH HIGHER TASK DEMAND IN ASYMPTOMATIC ADULTS WITH AND WITHOUT AN APOE E4 ALLELE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1502] [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] Open
Affiliation(s)
| | | | - S Davis
- Duke University Medical Center
| | - B Plassman
- Duke University - Joseph and Kathleen Bryan Alzheimer’s Disease Research Center
| | - R Sloane
- Center for the Study of Aging, Duke University Medical Center
| | | | - K Schmader
- Duke University and GRECC-Durham VA Medical Centers
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Affiliation(s)
- L Edelman
- University of Utah College of Nursing
| | - S Neller
- University of Utah College of Nursing
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Tarraf W, Criqui MH, Allison MA, Wright CB, Fornage M, Daviglus M, Kaplan RC, Davis S, Conceicao AS, González HM. Erratum to "Ankle brachial index and cognitive function among Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos." [Atherosclerosis 271 (April 2018) 61-69]. Atherosclerosis 2018; 279:133-134. [PMID: 30253877 DOI: 10.1016/j.atherosclerosis.2018.09.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Wassim Tarraf
- Institute of Gerontology & Department of Health Care Sciences, Wayne State University, 87 East Ferry St., 240 Knapp Building, Detroit, MI, 48202, USA
| | - Michael H Criqui
- Family and Preventative Medicine, University of California San Diego, 9500 Gilman Drive, MC 0607, SCRB 352, La Jolla, CA, 92093-0607, USA
| | - Matthew A Allison
- Family and Preventative Medicine, University of California San Diego, 9500 Gilman Drive, MC 0965, La Jolla, CA, 92093-0607, USA
| | - Clinton B Wright
- Division of Clinical Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 6001 Executive Boulevard Suite 3309, Bethesda, MD, 20892-9531, USA
| | - Myriam Fornage
- University of Texas Health Science Center at Houston, 1825 Pressler Street, Building SRB-530G, Houston, TX, 77030, USA
| | - Martha Daviglus
- Department of Preventative Medicine, University of Illinois-Chicago, Feinberg School of Medicine, 1819 W. Polk Street, MC 764, Suite 246, Chicago, IL, 60612, USA
| | - Robert C Kaplan
- Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Belfer Building Room 1306C, Bronx, NY, 10461, USA
| | - Sonia Davis
- Department of Biostatistics, University of North Carolina at Chapel Hill, 137 East Franklin St, Suite 203, Chapel Hill, NC, 27514, USA
| | - Alan S Conceicao
- Department of Epidemiology & Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Hector M González
- UC San Diego, Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, La Jolla, CA, 92093-0949, USA.
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Tita AT, Jablonski KA, Bailit JL, Grobman WA, Wapner RJ, Reddy UM, Varner MW, Thorp JM, Leveno KJ, Caritis SN, Iams JD, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Wallace M, Northen A, Grant J, Colquitt C, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Shubert P, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Neonatal outcomes of elective early-term births after demonstrated fetal lung maturity. Am J Obstet Gynecol 2018; 219:296.e1-296.e8. [PMID: 29800541 DOI: 10.1016/j.ajog.2018.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 11/09/2016] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Studies of early-term birth after demonstrated fetal lung maturity show that respiratory and other outcomes are worse with early-term birth (370-386 weeks) even after demonstrated fetal lung maturity when compared with full-term birth (390-406 weeks). However, these studies included medically indicated births and are therefore potentially limited by confounding by the indication for delivery. Thus, the increase in adverse outcomes might be due to the indication for early-term birth rather than the early-term birth itself. OBJECTIVE We examined the prevalence and risks of adverse neonatal outcomes associated with early-term birth after confirmed fetal lung maturity as compared with full-term birth in the absence of indications for early delivery. STUDY DESIGN This is a secondary analysis of an observational study of births to 115,502 women in 25 hospitals in the United States from 2008 through 2011. Singleton nonanomalous births at 37-40 weeks with no identifiable indication for delivery were included; early-term births after positive fetal lung maturity testing were compared with full-term births. The primary outcome was a composite of death, ventilator for ≥2 days, continuous positive airway pressure, proven sepsis, pneumonia or meningitis, treated hypoglycemia, hyperbilirubinemia (phototherapy), and 5-minute Apgar <7. Logistic regression and propensity score matching (both 1:1 and 1:2) were used. RESULTS In all, 48,137 births met inclusion criteria; the prevalence of fetal lung maturity testing in the absence of medical or obstetric indications for early delivery was 0.52% (n = 249). There were 180 (0.37%) early-term births after confirmed pulmonary maturity and 47,957 full-term births. Women in the former group were more likely to be non-Hispanic white, smoke, have received antenatal steroids, have induction, and have a cesarean. Risks of the composite (16.1% vs 5.4%; adjusted odds ratio, 3.2; 95% confidence interval, 2.1-4.8 from logistic regression) were more frequent with elective early-term birth. Propensity scores matching confirmed the increased primary composite in elective early-term births: adjusted odds ratios, 4.3 (95% confidence interval, 1.8-10.5) for 1:1 and 3.5 (95% confidence interval, 1.8-6.5) for 1:2 matching. Among components of the primary outcome, CPAP use and hyperbilirubinemia requiring phototherapy were significantly increased. Transient tachypnea of the newborn, neonatal intensive care unit admission, and prolonged neonatal intensive care unit stay (>2 days) were also increased with early-term birth. CONCLUSION Even with confirmed pulmonary maturity, early-term birth in the absence of medical or obstetric indications is associated with worse neonatal respiratory and hepatic outcomes compared with full-term birth, suggesting relative immaturity of these organ systems in early-term births.
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Shore RE, Beck HL, Boice JD, Caffrey EA, Davis S, Grogan HA, Mettler FA, Preston RJ, Till JE, Wakeford R, Walsh L, Dauer LT. Implications of recent epidemiologic studies for the linear nonthreshold model and radiation protection. J Radiol Prot 2018; 38:1217-1233. [PMID: 30004025 DOI: 10.1088/1361-6498/aad348] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The recently published NCRP Commentary No. 27 evaluated the new information from epidemiologic studies as to their degree of support for applying the linear nonthreshold (LNT) model of carcinogenic effects for radiation protection purposes (NCRP 2018 Implications of Recent Epidemiologic Studies for the Linear Nonthreshold Model and Radiation Protection, Commentary No. 27 (Bethesda, MD: National Council on Radiation Protection and Measurements)). The aim was to determine whether recent epidemiologic studies of low-LET radiation, particularly those at low doses and/or low dose rates (LD/LDR), broadly support the LNT model of carcinogenic risk or, on the contrary, demonstrate sufficient evidence that the LNT model is inappropriate for the purposes of radiation protection. An updated review was needed because a considerable number of reports of radiation epidemiologic studies based on new or updated data have been published since other major reviews were conducted by national and international scientific committees. The Commentary provides a critical review of the LD/LDR studies that are most directly applicable to current occupational, environmental and medical radiation exposure circumstances. This Memorandum summarises several of the more important LD/LDR studies that incorporate radiation dose responses for solid cancer and leukemia that were reviewed in Commentary No. 27. In addition, an overview is provided of radiation studies of breast and thyroid cancers, and cancer after childhood exposures. Non-cancers are briefly touched upon such as ischemic heart disease, cataracts, and heritable genetic effects. To assess the applicability and utility of the LNT model for radiation protection, the Commentary evaluated 29 epidemiologic studies or groups of studies, primarily of total solid cancer, in terms of strengths and weaknesses in their epidemiologic methods, dosimetry approaches, and statistical modelling, and the degree to which they supported a LNT model for continued use in radiation protection. Recommendations for how to make epidemiologic radiation studies more informative are outlined. The NCRP Committee recognises that the risks from LD/LDR exposures are small and uncertain. The Committee judged that the available epidemiologic data were broadly supportive of the LNT model and that at this time no alternative dose-response relationship appears more pragmatic or prudent for radiation protection purposes.
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Affiliation(s)
- R E Shore
- New York University School of Medicine, New York, United States of America. Radiation Effects Research Foundation, Hiroshima, Japan
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Guo Y, Moon JY, Laurie CC, North KE, Sanchez-Johnsen LAP, Davis S, Yu B, Nyenhuis SM, Kaplan R, Rastogi D, Qi Q. Genetic predisposition to obesity is associated with asthma in US Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos. Allergy 2018; 73:1547-1550. [PMID: 29603744 DOI: 10.1111/all.13450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Y. Guo
- Department of Occupational and Environmental Health; School of Public Health; Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
- Department of Epidemiology; Harvard T.H. Chan School of Public Health; Boston MA USA
| | - J.-Y. Moon
- Department of Epidemiology and Population Health; Albert Einstein College of Medicine; Bronx NY USA
| | - C. C. Laurie
- Department of Biostatistics; University of Washington; Seattle WA USA
| | - K. E. North
- Department of Biostatistics; Collaborative Studies Coordinating Center; University of North Carolina; Chapel Hill NC USA
| | | | - S. Davis
- Department of Biostatistics; Collaborative Studies Coordinating Center; University of North Carolina; Chapel Hill NC USA
| | - B. Yu
- Department of Epidemiology and Human Genetics Center; UT Health; Houston TX USA
| | - S. M. Nyenhuis
- Department of Medicine; University of Illinois at Chicago; Chicago IL USA
| | - R. Kaplan
- Department of Epidemiology and Population Health; Albert Einstein College of Medicine; Bronx NY USA
| | - D. Rastogi
- Department of Pediatrics; Albert Einstein College of Medicine; Bronx NY USA
| | - Q. Qi
- Department of Epidemiology and Population Health; Albert Einstein College of Medicine; Bronx NY USA
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González HM, Tarraf W, Vásquez P, Sanderlin AH, Rosenberg NI, Davis S, Rodríguez CJ, Gallo LC, Thyagarajan B, Daviglus M, Khambaty T, Cai J, Schneiderman N. Metabolic Syndrome and Neurocognition Among Diverse Middle-Aged and Older Hispanics/Latinos: HCHS/SOL Results. Diabetes Care 2018; 41:1501-1509. [PMID: 29716895 PMCID: PMC6014545 DOI: 10.2337/dc17-1896] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 04/07/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Hispanics/Latinos have the highest risks for metabolic syndrome (MetS) in the U.S. and are also at increased risk for Alzheimer disease. In this study, we examined associations among neurocognitive function, MetS, and inflammation among diverse middle-aged and older Hispanics/Latinos. RESEARCH DESIGN AND METHODS Cross-sectional data (2008-2011) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were analyzed to examine associations between neurocognition and MetS among diverse Hispanics/Latinos (N = 9,136; aged 45-74 years). RESULTS MetS status was associated with lower global neurocognition, mental status, verbal learning and memory, verbal fluency, and executive function. Age significantly modified the associations between MetS and learning and memory measures. Significant associations between MetS and neurocognition were observed among middle-aged Hispanics/Latinos, and all associations remained robust to additional covariates adjustment. CONCLUSIONS We found that MetS was associated with lower neurocognitive function, particularly in midlife. Our findings support and extend current hypotheses that midlife may be a particularly vulnerable developmental period for unhealthy neurocognitive aging.
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Affiliation(s)
- Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California, San Diego, La Jolla, CA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI
| | - Priscilla Vásquez
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California, San Diego, La Jolla, CA
| | - Ashley H Sanderlin
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Natalya I Rosenberg
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL
| | - Sonia Davis
- Collaborative Studies Coordinating Center, Department of Biostatistics, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Carlos J Rodríguez
- Departments of Medicine and Epidemiology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Linda C Gallo
- Institute for Behavioral and Community Health and Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical Center Fairview, Minneapolis, MN
| | - Martha Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL
| | - Tasneem Khambaty
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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Li J, Castillo D, Davis S. 1462 Expression and function of laminin extracellular matrix in wound repair. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1480] [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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Venkateswaran S, Prince J, Cutler DJ, Marigorta UM, Okou DT, Prahalad S, Mack D, Boyle B, Walters T, Griffiths A, Sauer CG, LeLeiko N, Keljo D, Markowitz J, Baker SS, Rosh J, Pfefferkorn M, Heyman MB, Patel A, Otley A, Baldassano R, Noe J, Rufo P, Oliva-Hemker M, Davis S, Zwick ME, Gibson G, Denson LA, Hyams J, Kugathasan S. Enhanced Contribution of HLA in Pediatric Onset Ulcerative Colitis. Inflamm Bowel Dis 2018; 24:829-838. [PMID: 29562276 PMCID: PMC6350448 DOI: 10.1093/ibd/izx084] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The genetic contributions to pediatric onset ulcerative colitis (UC), characterized by severe disease and extensive colonic involvement, are largely unknown. In adult onset UC, Genome Wide Association Study (GWAS) has identified numerous loci, most of which have a modest susceptibility risk (OR 0.84-1.14), with the exception of the human leukocyte antigen (HLA) region on Chromosome 6 (OR 3.59). METHOD To study the genetic contribution to exclusive pediatric onset UC, a GWAS was performed on 466 cases with 2099 healthy controls using UK Biobank array. SNP2HLA was used to impute classical HLA alleles and their corresponding amino acids, and the results are compared with adult onset UC. RESULTS HLA explained the almost entire association signal, dominated with 191 single nucleotide polymorphisms (SNPs) (p = 5 x 10-8 to 5 x 10-10). Although very small effects, established SNPs in adult onset UC loci had similar direction and magnitude in pediatric onset UC. SNP2HLA imputation identified HLA-DRB1*0103 (odds ratio [OR] = 6.941, p = 1.92*10-13) as the most significant association for pediatric UC compared with adult onset UC (OR = 3.59). Further conditioning showed independent effects for HLA-DRB1*1301 (OR = 2.25, p = 7.92*10-9) and another SNP rs17188113 (OR = 0.48, p = 7.56*10-9). Two HLA-DRB1 causal alleles are shared with adult onset UC, while at least 2 signals are unique to pediatric UC. Subsequent stratified analyses indicated that HLA-DRB1*0103 has stronger association for extensive disease (E4: OR = 8.28, p = 4.66x10-10) and female gender (OR = 8.85, p = 4.82x10-13). CONCLUSION In pediatric onset UC, the HLA explains almost the entire genetic associations. In addition, the HLA association is approximately twice as strong in pediatric UC compared with adults, due to a combination of novel and shared effects. We speculate the paramount importance of antigenic stimulation either by infectious or noninfectious stimuli as a causal event in pediatric UC onset.
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Affiliation(s)
- Suresh Venkateswaran
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, GA
| | - Jarod Prince
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, GA
| | - David J Cutler
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA
| | - Urko M Marigorta
- Center for Integrative Genomics, Georgia Institute of Technology, Atlanta, GA
| | - David T Okou
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, GA
| | - Sampath Prahalad
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, GA
| | - David Mack
- Department of Pediatrics, Children’s Hospital of Eastern Ontario IBD Centre and University of Ottawa, Ontario, Canada
| | - Brendan Boyle
- Department of Gastroenterology, Nationwide Children’s Hospital Columbus, OH
| | - Thomas Walters
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Anne Griffiths
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Cary G Sauer
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, GA
| | - Neal LeLeiko
- Division of Pediatric Gastroenterology, Nutrition, and Liver Diseases, Hasbro Children’s Hospital, Providence, RI
| | - David Keljo
- Gastroenterology, Hepatology and Nutrition Department, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA
| | - James Markowitz
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cohen Children’s Medical Center of NY, New Hyde Park, NY
| | - Susan S Baker
- Department of Digestive Diseases and Nutrition Center, University at Buffalo, Buffalo, NY
| | - Joel Rosh
- Department of Pediatrics, Goryeb Children’s Hospital, Morristown, NJ
| | - Marian Pfefferkorn
- Bronson Pediatric Gastroenterology, Bronson Children’s Hospital, Kalamazoo, MI
| | - Melvin B Heyman
- Department of Pediatrics, University of California at San Francisco, San Francisco, CA
| | - Ashish Patel
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX
| | - Anthony Otley
- Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Robert Baldassano
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA
| | - Joshua Noe
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, WI
| | - Paul Rufo
- Division of Gastroenterology and Nutrition, Boston Children’s Hospital, Harvard Medical School, Boston, MA
| | - Maria Oliva-Hemker
- Department of Pediatrics, John Hopkins University School of Medicine, Baltimore, MD
| | - Sonia Davis
- Collaborative Studies Coordinating Center Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Michael E Zwick
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA
| | - Greg Gibson
- Center for Integrative Genomics, Georgia Institute of Technology, Atlanta, GA
| | - Lee A Denson
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Jeffrey Hyams
- Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children’s Medical Center, Hartford, CT
| | - Subra Kugathasan
- Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, GA,Address correspondence to: Subra Kugathasan, MD, Division of Pediatric Gastroenterology, Emory University School of Medicine, 1760 Haygood Drive, W427, Atlanta, GA 30322. E-mail: Tel: 404 727 4542; Fax: 404 727 4069
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Hernandez R, González HM, Tarraf W, Moskowitz JT, Carnethon MR, Gallo LC, Penedo FJ, Isasi CR, Ruiz JM, Arguelles W, Buelna C, Davis S, Gonzalez F, McCurley JL, Wu D, Daviglus ML. Association of dispositional optimism with Life's Simple 7's Cardiovascular Health Index: results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study (SCAS). BMJ Open 2018; 8:e019434. [PMID: 29567845 PMCID: PMC5875660 DOI: 10.1136/bmjopen-2017-019434] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Mounting evidence links positive psychological functioning to restorative health processes and favourable medical outcomes. However, very little is known about the relationship between optimism, an indicator of psychological functioning and the American Heart Association (AHA)-defined concept of cardiovascular health (CVH), particularly in Hispanics/Latinos of diverse backgrounds. To address limitations of existing literature, this study investigated the association between dispositional optimism and CVH in a heterogeneous sample of Hispanics/Latinos residing in the USA. DESIGN Cross-sectional study. PARTICIPANTS AND SETTING Data were analysed from 4919 adults ages 18-75 of the Hispanic Community Health Study/Study of Latinos parent study and the Sociocultural Ancillary Study. MAIN OUTCOME MEASURES Optimism was assessed using the 6-item Life Orientation Test-Revised (range from 6 to 30). AHA classification standards were used to derive an additive CVH score with operationalisation of indicators as Ideal, Intermediate and Poor. The overall CVH score included indicators of diet, body mass index, physical activity, cholesterol, blood pressure, fasting glucose and smoking status. Multivariate linear and logistic regressions were used to examine associations of optimism with CVH (Life's Simple 7), after adjusting for sociodemographic factors and depressive symptoms. RESULTS Each increase in the optimism total score was associated with a greater CVH score (β=0.03 per unit increase, 95% CI 0.01 to 0.05). When modelling tertiles of optimism, participants with moderate (β=0.24 to 95% CI 0.06 to 0.42) and high (β=0.12, 95% CI 0.01 to 0.24) levels of optimism displayed greater CVH scores when compared with their least optimistic peers. CONCLUSION This study offers preliminary evidence for an association between optimism and CVH in a large heterogeneous group of Hispanic/Latino adults. Our study adds scientific knowledge of psychological assets that may promote CVH and suggests a novel therapeutic target for consideration. Future studies are needed to explore causality and potential mechanism underlying the relationship between positive emotion and heart health.
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Affiliation(s)
- Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana Champaign, Urbana, Illinois, USA
| | - Hector M González
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - Wassim Tarraf
- Department of Healthcare Sciences, Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Frank J Penedo
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - John Manuel Ruiz
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - William Arguelles
- Center for Research, Baptist Health South Florida, Coral Gables, Florida, USA
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Christina Buelna
- Office of Institutional Effectiveness, Southwestern College, Chula Vista, California, USA
| | - Sonia Davis
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Franklyn Gonzalez
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jessica L McCurley
- Department of Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
| | - Donghong Wu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Martha L Daviglus
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
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Sauer CG, Loop MS, Venkateswaran S, Tangpricha V, Ziegler TR, Dhawan A, McCall C, Bonkowski E, Mack DR, Boyle B, Griffiths AM, Leleiko NS, Keljo DJ, Markowitz J, Baker SS, Rosh J, Baldassano RN, Davis S, Patel S, Wang J, Marquis A, Spada KL, Kugathasan S, Walters T, Hyams JS, Denson LA. Free and Bioavailable 25-Hydroxyvitamin D Concentrations are Associated With Disease Activity in Pediatric Patients With Newly Diagnosed Treatment Naïve Ulcerative Colitis. Inflamm Bowel Dis 2018; 24:641-650. [PMID: 29462384 PMCID: PMC6176888 DOI: 10.1093/ibd/izx052] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 07/07/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Vitamin D regulates intestinal epithelial and immune functions, and vitamin D receptor deficiency increases the severity of murine colitis. Bioavailable 25-hydroxyvitamin D (25(OH)D) is available to target tissues and may be a driver of immune function. The aim is to evaluate the relationship of bioavailable 25(OH)D to the clinical expression of treatment naive pediatric ulcerative colitis (UC). METHODS The PROTECT (Predicting Response to Standardized Pediatric Colitis Therapy) study enrolled children ≤17 years newly diagnosed with UC. Free and total 25(OH)D were directly measured and 25(OH)D fractions were compared with disease activity measures. RESULTS Data were available on 388 subjects, mean age 12.7 years, 49% female, 84% with extensive/pancolitis. The median (IQR) total 25(OH)D concentration was 28.5 (23.9, 34.8) ng/mL, and 57% of subjects demonstrated insufficient vitamin D status (25(OH)D < 30 ng/mL). We found no evidence of association between total 25(OH)D and disease activity. Regression models adjusted for age, sex, race, and ethnicity demonstrated that an increase from 25th to 75th percentile for bioavailable and free 25(OH)D were associated with a mean (95th CI) decrease in the Pediatric Ulcerative Colitis Activity Index (PUCAI) of -8.7 (-13.7, -3.6) and -3.1 (-5.0, -1.2), respectively. No associations were detected between 25(OH)D fractions and fecal calprotectin or Mayo endoscopy score. CONCLUSIONS Vitamin D insufficiency is highly prevalent in children with newly diagnosed UC. We found associations of free and bioavailable, but not total 25(OH)D, with PUCAI. Bioavailable vitamin D may contribute to UC pathophysiology and clinical activity.
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Affiliation(s)
- Cary G Sauer
- Emory University, Atlanta, GA, USA,Address correspondence to: Cary G. Sauer, MD, MSc, Associate Professor, Department of Pediatrics, Emory University School of Medicine, Training Program Director, Emory Pediatric GI Fellowship, Endoscopy Director, Children’s Healthcare of Atlanta, 2015 Uppergate Dr. NE, Suite 250, Atlanta, GA 30322. E-mail: Tel: 404-712-2160
| | - Matthew S Loop
- Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, NC, USA
| | | | | | | | - Ashish Dhawan
- Cooper University Children’s Regional Hospital, Cincinnati, OH, USA
| | - Courtney McCall
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Erin Bonkowski
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - David R Mack
- Children’s Hospital of East Ontario, Ottawa, Ontario, Canada
| | - Brendan Boyle
- Nationwide Children’s Hospital Connecticut Children’s Medical Center, Hartford, CT, USA
| | | | | | - David J Keljo
- Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - James Markowitz
- Cohen Children’s Medical Center Of New York, New Hyde Park, NY, USA
| | - Susan S Baker
- Women & Children’s Hospital of Buffalo WCHOB, Buffalo, NY, USA
| | - Joel Rosh
- Goryeb Children’s Hospital - Atlantic Health, Morristown, NJ, USA
| | | | - Sonia Davis
- Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, NC, USA
| | | | - Jessie Wang
- Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, NC, USA
| | - Alison Marquis
- Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, NC, USA
| | - Krista L Spada
- Connecticut Children’s Medical Center, Hartford, CT, USA
| | | | | | | | - Lee A Denson
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Tarraf W, Criqui MH, Allison MA, Wright CB, Fornage M, Daviglus M, Kaplan RC, Davis S, Conceicao AS, González HM. Ankle brachial index and cognitive function among Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos. Atherosclerosis 2018; 271:61-69. [PMID: 29459267 DOI: 10.1016/j.atherosclerosis.2018.02.016] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/17/2018] [Accepted: 02/08/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS The Ankle-Brachial index (ABI) is a well-accepted measure of peripheral artery disease (arterial stenosis and stiffness) and has been shown to be associated with cognitive function and disorders; however, these associations have not been examined in Hispanics/Latinos. Therefore, we sought to examine relationships between ABI and cognitive function among diverse middle-age and older Hispanics/Latinos. METHODS We used cross-sectional data on n = 7991 participants aged 45-74 years, without stroke or coronary heart disease, from the Hispanic Community Health Study/Study of Latinos. Our primary outcome, global cognition (GC), was a continuous composite score of four cognitive domains (verbal learning and memory, verbal fluency, executive function, and mental status). Secondary outcomes were the individual tests representing these domains. The ABI was analyzed continuously and categorically with standard clinical cut-points. We tested associations using generalized survey regression models incrementally adjusting for confounding factors. Age, sex, hypertension, diabetes, and dyslipidemia moderations were examined through interactions with the primary exposure. RESULTS In age, sex, and education adjusted models, continuous ABI had an inverse u-shape association with worse GC. We found similar associations with measures of verbal learning and memory, verbal fluency, executive function, but not with low mental status. The associations were attenuated, but not completely explained, by accounting for the confounders and not modified by age, sex, education, and vascular disease risks. CONCLUSIONS In addition to being a robust indicator of arterial compromise, our study suggests that abnormal ABI readings may also be useful for early signaling of subtle cognitive deficits.
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Affiliation(s)
- Wassim Tarraf
- Institute of Gerontology & Department of Health Care Sciences, Wayne State University, 87 East Ferry St., 240 Knapp Building, Detroit, MI, 48202, USA
| | - Michael H Criqui
- Family and Preventative Medicine, University of California San Diego, 9500 Gilman Drive, MC 0607, SCRB 352, La Jolla, CA, 92093-0607, USA
| | - Matthew A Allison
- Family and Preventative Medicine, University of California San Diego, 9500 Gilman Drive, MC 0965, La Jolla, CA, 92093-0607, USA
| | - Clinton B Wright
- Division of Clinical Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 6001 Executive Boulevard Suite 3309, Bethesda, MD, 20892-9531, USA
| | - Myriam Fornage
- University of Texas Health Science Center at Houston, 1825 Pressler Street, Building SRB-530G, Houston, TX, 77030, USA
| | - Martha Daviglus
- Department of Preventative Medicine, University of Illinois-Chicago, Feinberg School of Medicine, 1819 W. Polk Street, MC 764, Suite 246, Chicago, IL, 60612, USA
| | - Robert C Kaplan
- Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Belfer Building Room 1306C, Bronx, NY, 10461, USA
| | - Sonia Davis
- Department of Biostatistics, University of North Carolina at Chapel Hill, 137 East Franklin St, Suite 203, Chapel Hill, NC, 27514, USA
| | - Alan S Conceicao
- Department of Epidemiology & Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Hector M González
- UC San Diego, Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, La Jolla, CA, 92093-0949, USA.
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Allen AJ, O’Leary RA, Davis S, Graziadio S, Jones WS, Simpson AJ, Price DA, Vale L, Power M. Cost implications for the NHS of using the Alere™ i Influenza A & B near patient test with nasal swabs. Diagn Progn Res 2018; 2:15. [PMID: 31093564 PMCID: PMC6460782 DOI: 10.1186/s41512-018-0031-8] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/18/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Influenza is an acute viral infection of the respiratory tract. A rapid confirmatory diagnosis of influenza is important, since it is highly transmissible and outbreaks of influenza within the hospital setting increase morbidity and mortality. The objective of this study was to evaluate the cost implications, from the perspective of the UK NHS, of using on-label nasal swabs with the Alere™ i Influenza A & B test in a near patient setting. METHODS A cost consequence model was developed. The time horizon of the model was from hospital admission on suspicion of influenza until the end of treatment (following a diagnosis of influenza or discharge from hospital). Data on the prevalence of influenza and the sensitivity and specificity of the Alere™ i Influenza A & B test came from two prospective observational diagnostic accuracy studies. Costs were obtained from published resources. Uncertainties in the model data were investigated using deterministic, one-way sensitivity analyses. RESULTS Using the Alere™ i Influenza A & B point of care test with nasal swabs (on label) in NHS medical assessment units and emergency departments could save approximately £242,730 per 1000 adults presenting with influenza-like symptoms. The main cause for this was reduced times to availability of the result compared with the laboratory RT-PCR test. Other key drivers of savings were the cost of isolation, the prevalence of influenza, the specificity of the test, and the availability of isolation resources. CONCLUSIONS The Alere™ i Influenza A & B point of care test would have greatest impact in hospitals that have extensive delays in the time to receive a result. Sensitivity analyses identified the model parameters which would have greatest effect on the result and confirmed that assumptions were conservative, i.e. did not change key results.
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Affiliation(s)
- A. J. Allen
- NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle upon Tyne, UK
- 0000 0001 0462 7212grid.1006.7Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - R. A. O’Leary
- NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle upon Tyne, UK
- 0000 0004 0444 2244grid.420004.2Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - S. Davis
- 0000 0000 9422 8284grid.31410.37Department of Virology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - S. Graziadio
- NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle upon Tyne, UK
- 0000 0004 0444 2244grid.420004.2Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - W. S. Jones
- NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle upon Tyne, UK
- 0000 0001 0462 7212grid.1006.7Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - A. J. Simpson
- NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle upon Tyne, UK
- 0000 0001 0462 7212grid.1006.7Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - D. A. Price
- NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle upon Tyne, UK
- 0000 0004 0641 3236grid.419334.8Department of Infectious Diseases, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - L. Vale
- NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle upon Tyne, UK
- 0000 0001 0462 7212grid.1006.7Health Economics Group, Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, UK
| | - M. Power
- NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle upon Tyne, UK
- 0000 0004 0444 2244grid.420004.2Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Drake FN, Davis S, Khatiwada J, Williams L. Identification and Antimicrobial Susceptibility of <i>Yersinia enterocolitica</i> Found in Chitterlings, Raw Milk and Swine Fecal Samples. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/aim.2018.810053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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