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Herrera MC, Johnson J, Lim S, Morales KH, Wilson JD, Hadland SE, Metzger D, Wood S, Dowshen N. Co-delivery of HIV pre-exposure prophylaxis (PrEP) and HIV testing among publicly insured adolescents and young adults (AYA) receiving medication for opioid use disorder (MOUD). Drug Alcohol Depend 2024; 257:111132. [PMID: 38387256 PMCID: PMC11031309 DOI: 10.1016/j.drugalcdep.2024.111132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 01/22/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Low rates of HIV pre-exposure prophylaxis (PrEP) prescribing contribute to the disproportionate burden of HIV in the United States. Among adolescent and young adults (AYA) with opioid use disorder, HIV testing and PrEP co-prescription rates are poorly characterized. METHODS We performed a retrospective analysis involving deidentified data from Philadelphia's Medicaid beneficiaries ages 16-29 years who were prescribed medication for opioid use disorder (MOUD) from 2015 to 2020 and continuously Medicaid-enrolled for ≥6 months prior to that prescription. After identifying the presence of a qualifying diagnosis signifying a PrEP indication, we examined the outcome of appropriate PrEP co-prescriptions and HIV testing using generalized estimating equations (GEE) modeling. RESULTS We identified 795 AYA Medicaid beneficiaries with 1269 qualified treatment episodes. We calculated a PrEP prescribing rate of 29.47 per 1000 person-years among AYA receiving MOUD. The HIV testing rate was 63.47 per 1000 person-years among AYA receiving MOUD. GEE modeling revealed that individuals receiving methadone were more likely (aOR=2.62, 95% CI=1.06-6.49) to receive HIV testing within 6 months after a PrEP-qualifying diagnosis compared to those receiving other MOUD medications. Those who only saw outpatient behavioral health providers were less likely (aOR=0.48, 95% CI=0.24-0.99) to have received an HIV test within 6 months after the PrEP-qualifying diagnosis compared to those receiving inpatient behavioral health services. CONCLUSIONS Co-prescription of PrEP and HIV testing among AYA receiving MOUD was rare in this large urban publicly insured population. Interventions are needed to increase HIV prevention services for this key population of AYA at risk for HIV infection.
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Affiliation(s)
- M C Herrera
- Division of Adolescent Medicine, Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - J Johnson
- Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA
| | - S Lim
- Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA
| | - K H Morales
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - J Deanna Wilson
- Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - S E Hadland
- Division of Adolescent and Young Adult Medicine, MassGeneral for Children / Harvard Medical School, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - D Metzger
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - S Wood
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - N Dowshen
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Callegari AJ, Tsang J, Park S, Swartzfager D, Kapoor S, Choy K, Lim S. Multimodal machine learning models identify chemotherapy drugs with prospective clinical efficacy in dogs with relapsed B-cell lymphoma. Front Oncol 2024; 14:1304144. [PMID: 38390257 PMCID: PMC10881812 DOI: 10.3389/fonc.2024.1304144] [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: 09/29/2023] [Accepted: 01/16/2024] [Indexed: 02/24/2024] Open
Abstract
Dogs with B-cell lymphoma typically respond well to first-line CHOP-based chemotherapy, but there is no standard of care for relapsed patients. To help veterinary oncologists select effective drugs for dogs with lymphoid malignancies such as B-cell lymphoma, we have developed multimodal machine learning models that integrate data from multiple tumor profiling modalities and predict the likelihood of a positive clinical response for 10 commonly used chemotherapy drugs. Here we report on clinical outcomes that occurred after oncologists received a prediction report generated by our models. Remarkably, we found that dogs that received drugs predicted to be effective by the models experienced better clinical outcomes by every metric we analyzed (overall response rate, complete response rate, duration of complete response, patient survival times) relative to other dogs in the study and relative to historical controls.
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Affiliation(s)
| | | | | | | | | | - Kevin Choy
- Department of Oncology, Blue Pearl Seattle Veterinary Specialist, Kirkland, WA, United States
| | - Sungwon Lim
- ImpriMed Inc., Mountain View, CA, United States
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Park S, Meischke H, Lim S. Effect of Mandatory and Voluntary Overtime Hours on Stress Among 9-1-1 Telecommunicators. Workplace Health Saf 2024; 72:21-29. [PMID: 37873622 DOI: 10.1177/21650799231202794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND 9-1-1 telecommunicators are frequently exposed to indirect traumatic events that impact their mental and physical health and are often required to work overtime with rotating shifts. Previous studies reported various harmful effects of overtime on the health and well-being of workers, such as musculoskeletal injuries, burnout, low job satisfaction, fatigue, and intent to leave. However, there is limited research on the impact of overtime hours on 9-1-1 telecommunicators' stress symptoms, especially mandatory overtime hours. This study aimed to examine the relationship between overtime hours-mandatory and voluntary-and the level of stress symptoms among 9-1-1 telecommunicators. METHODS We used secondary data from the surveys of the "Multi-tasking to hyper-tasking: Investigating the impact of Next Generation 9-1-1" study for analysis. Linear mixed-effects regression was applied to examine the association of overtime hours with the stress level. RESULTS Of the 403 participants, 47.6% reported that they were required to work mandatory overtime, and the mean mandatory overtime was 7.51 (SD = 12.78) hours in the past month. 58.3% reported working voluntary overtime, and the mean voluntary overtime was 11.63 (SD = 17.48) hours. This study found that mandatory overtime hours were associated with an increase in self-reported stress symptoms (β = 0.30, p = .002), whereas no significant association was found between voluntary overtime and the level of stress symptoms (β = -0.01, p = .885). CONCLUSION/APPLICATION TO PRACTICE Study results highlight the importance of reducing mandatory overtime in call centers as one possible strategy for reducing stress levels among this critical workforce.
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Affiliation(s)
| | - Hendrika Meischke
- Department of Health Systems and Population Health, School of Public Health, University of Washington
| | - Sungwon Lim
- School of Nursing, University of Washington
- Department of Nursing, Kangbuk Samsung Hospital
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Boutain DM, Kim E, Wang D, Lim S, Maldonado Nofziger R, Weiner BJ. Unexpected capacity-building experiences of multicultural, multilingual participants in a public health initiative. Public Health Nurs 2023; 40:914-924. [PMID: 37608531 DOI: 10.1111/phn.13239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/05/2023] [Accepted: 07/14/2023] [Indexed: 08/24/2023]
Abstract
AIMS This study of a levy-voter funded public health initiative program (1) identifies capacity-building concerns, (2) summarizes those concerns at the community-based organization (CBO) level, and (3) documents the desired CBO capacity-building outcome. PARTICIPANTS Nineteen participants from nine CBOs were included, representing 95% of participants (19/20) and 90% of CBOs (9/10) from the initiative's program population. METHODS Interviews were conducted. A focus group validated data. Demographic surveys were completed. METHODOLOGY AND ANALYSIS Data were analyzed using demographic and inductive content analyses. Fifteen capacity-building unexpected concerns were identified. Participants from eight out of nine (88.8%) CBOs shared at least ten concerns. Seven CBO capacity-building outcomes were identified. RESULTS Capacity-building providers helped participants mitigate the Initiative's capacity-building testing of the National Implementation Research Network (NIRN) model. Participants' NIRN processes were Western and mainstream. Participants wanted community-designed processes and the funder to understand CBO clients' backgrounds, cultures, and languages. The contract money did not match the needed capacity-building processes, time, and workload. DISCUSSION The funder's pre-selected the NIRN Western majority approach did not fit. Participants wanted to lead. Capacity-building only for home-based program development was less desired. Social justice leadership could have made a difference.
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Affiliation(s)
- Doris M Boutain
- School of Nursing Department of Child, Family and Population Health, University of Washington, Seattle, Washington
| | - Eunjung Kim
- School of Nursing Department of Child, Family and Population Health, University of Washington, Seattle, Washington
| | - Di Wang
- School of Nursing Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, Washington
| | - Sungwon Lim
- School of Nursing Department of Child, Family and Population Health, University of Washington, Seattle, Washington
| | | | - Bryan J Weiner
- School of Public Health Professor, Department of Global Health & Department of Health Services and Population Health, University of Washington, Seattle, Washington
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Lee MW, Lim S, Jeong W, Kim S, Kim JH, Hwang YS, Sung C. Electron Temperature Measurements Using a Two-Filter Soft X-ray Array in VEST. Sensors (Basel) 2023; 23:8357. [PMID: 37896452 PMCID: PMC10610578 DOI: 10.3390/s23208357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/01/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023]
Abstract
A multichannel soft X-ray (SXR) array has been developed to measure the electron temperature in the Versatile Experiment Spherical Torus (VEST). To estimate electron temperature using the two-filter method applied to SXR intensity, we designed a pinhole camera that has two photodiode arrays with different metallic filters. We also adopted a filter wheel and tested various filter parameters to find the optimal filter set. Through tests, the combination of aluminum and beryllium was found to be the most suitable for the current experimental conditions in VEST. The filtered SXR signals were acquired with a low-noise preamplifier, exhibiting sufficient signal-to-noise ratios for electron temperature estimation based on the intensity ratio of two signals obtained with different filters. The estimated electron temperature from the developed two-filter SXR array showed reasonably matched levels and consistent trends with Thomson scattering measurements. Error contribution from impurity line emission is also discussed.
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Affiliation(s)
- M. W. Lee
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea;
| | - S. Lim
- Department of Energy Systems Engineering, Seoul National University, Seoul 08826, Republic of Korea; (S.L.); (W.J.); (S.K.); (J.H.K.); (Y.S.H.)
| | - W. Jeong
- Department of Energy Systems Engineering, Seoul National University, Seoul 08826, Republic of Korea; (S.L.); (W.J.); (S.K.); (J.H.K.); (Y.S.H.)
| | - S. Kim
- Department of Energy Systems Engineering, Seoul National University, Seoul 08826, Republic of Korea; (S.L.); (W.J.); (S.K.); (J.H.K.); (Y.S.H.)
| | - J. H. Kim
- Department of Energy Systems Engineering, Seoul National University, Seoul 08826, Republic of Korea; (S.L.); (W.J.); (S.K.); (J.H.K.); (Y.S.H.)
| | - Y. S. Hwang
- Department of Energy Systems Engineering, Seoul National University, Seoul 08826, Republic of Korea; (S.L.); (W.J.); (S.K.); (J.H.K.); (Y.S.H.)
| | - C. Sung
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea;
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Sabol R, Prionas ND, Calvin C, Pelayo L, Randolph H, Lim S, Devincent C, Ohliger M, Villanueva-Meyer J, Scholey J, Singer L. Impact of Workflow and Educational Interventions on MR Safety in Radiation Oncology. Int J Radiat Oncol Biol Phys 2023; 117:e432-e433. [PMID: 37785410 DOI: 10.1016/j.ijrobp.2023.06.1599] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Magnetic resonance imaging (MRI) is becoming increasingly integrated into radiation oncology (RO) departments with the use of MRI-Linacs and MRI simulation. Due to the number of implants in patients with cancer, adoption of comprehensive patient screening and MR safety workflows in RO is critical. Identifying MR unsafe implants only at the time of MRI simulation leads to same-day cancellations, potentially delaying treatment, and can risk MR safety events (SEs). This quality improvement study evaluated the impact of workflow and educational interventions on MR safety in RO at a single institution. MATERIALS/METHODS In an effort to decrease same-day cancellations and improve safety surrounding use of a 3 Tesla MRI simulator at an academic center, three plan-see-do-act (PDSA) cycles were implemented from 4/18/22 - 1/19/23. MR safety oversight for the simulator was provided by a multidisciplinary team, with input from both radiology and RO. PDSA cycle 1 implemented a two-screen functional workflow, adapted from radiology at the same institution. The first screen is completed by the practice coordinator (PC) at the time of scheduling to triage high-risk patients into a work queue (WQ) for further evaluation by the MR safety team. The second screen is performed by the MR technologist (MRT) at the point of care. PDSA cycle 2 involved education for PCs. PDSA cycle 3 was a second PC educational intervention including a visual aide to assist with WQ use. Efficacy was determined by the number of same-day cancellations, patients in the WQ (a measure of the number of patients identified at the initial screen as having an implant), and SEs in each PDSA cycle. RESULTS PDSA cycle 1 spanned 56 workdays during which 91 MR simulations were scheduled with 6 cancellations (6.5%). PDSA cycle 2 spanned 84 days during which 173 MR simulations were scheduled with 18 cancellations (10.4%). PDSA cycle 3 spanned 39 workdays and had 94 MR simulations, with 7 cancellations (7.4%). The cancellation rate during each PDSA cycle was 0.11, 0.21, and 0.17 cancellations/day, respectively. The number of patients in the WQ during each PDSA cycle, representing successfully screened high-risk patients, was 0, 0, and 3, respectively. There were no SEs during the study. CONCLUSION In this study, an MR safety workflow from radiology was successfully implemented in RO. There were no SEs during the study, but the number of patients successfully screened as high-risk and placed in the WQ increased after repeat PC education. Further increases in WQ use would decrease the demand for implant assessment at point of care, which could decrease burden on the MRT, same day cancellations, and potentially SEs. This will be especially important if case load increases. Future work could expand educational efforts to additional staff.
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Affiliation(s)
- R Sabol
- UCSF Department of Radiation Oncology, San Francisco, CA
| | | | - C Calvin
- University of California, San Francisco, San Francisco, CA
| | - L Pelayo
- University of California, San Francisco, San Francisco, CA
| | - H Randolph
- Department of Radiation Oncology, University of California San Francisco (UCSF), San Francisco, CA
| | - S Lim
- Deparment of Radiation Oncology, San Francisco, CA
| | - C Devincent
- Department of Radiology, University of California San Francisco (UCSF), San Francisco, CA
| | - M Ohliger
- Department of Radiology, University of California San Francisco (UCSF), San Francisco, CA
| | - J Villanueva-Meyer
- Department of Radiology, University of California San Francisco (UCSF), San Francisco, CA
| | - J Scholey
- University of California, San Francisco, San Francisco, CA
| | - L Singer
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA
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Park SS, Lee JC, Byun JM, Choi G, Kim KH, Lim S, Dingli D, Jeon YW, Yahng SA, Shin SH, Min CK, Koo J. ML-based sequential analysis to assist selection between VMP and RD for newly diagnosed multiple myeloma. NPJ Precis Oncol 2023; 7:46. [PMID: 37210456 DOI: 10.1038/s41698-023-00385-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 05/03/2023] [Indexed: 05/22/2023] Open
Abstract
Optimal first-line treatment that enables deeper and longer remission is crucially important for newly diagnosed multiple myeloma (NDMM). In this study, we developed the machine learning (ML) models predicting overall survival (OS) or response of the transplant-ineligible NDMM patients when treated by one of the two regimens-bortezomib plus melphalan plus prednisone (VMP) or lenalidomide plus dexamethasone (RD). Demographic and clinical characteristics obtained during diagnosis were used to train the ML models, which enabled treatment-specific risk stratification. Survival was superior when the patients were treated with the regimen to which they were low risk. The largest difference in OS was observed in the VMP-low risk & RD-high risk group, who recorded a hazard ratio of 0.15 (95% CI: 0.04-0.55) when treated with VMP vs. RD regimen. Retrospective analysis showed that the use of the ML models might have helped to improve the survival and/or response of up to 202 (39%) patients among the entire cohort (N = 514). In this manner, we believe that the ML models trained on clinical data available at diagnosis can assist the individualized selection of optimal first-line treatment for transplant-ineligible NDMM patients.
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Affiliation(s)
- Sung-Soo Park
- Catholic Research Network for Multiple Myeloma, Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
- Department of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Jong Cheol Lee
- Department of Otorhinolaryngology, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung-si, Gangwon-do, 25440, Republic of Korea
| | - Ja Min Byun
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Gyucheol Choi
- ImpriMedKorea, Inc., Seoul, 08507, Republic of Korea
| | - Kwan Hyun Kim
- ImpriMedKorea, Inc., Seoul, 08507, Republic of Korea
| | - Sungwon Lim
- ImpriMedKorea, Inc., Seoul, 08507, Republic of Korea
- ImpriMed, Inc., Palo Alto, CA, 94303, USA
| | - David Dingli
- Division of Hematology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Young-Woo Jeon
- Catholic Research Network for Multiple Myeloma, Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
- Department of Hematology, Yeoido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 07345, Republic of Korea
| | - Seung-Ah Yahng
- Catholic Research Network for Multiple Myeloma, Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
- Department of Hematology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, 22711, Republic of Korea
| | - Seung-Hwan Shin
- Catholic Research Network for Multiple Myeloma, Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
- Department of Hematology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 03312, Republic of Korea
| | - Chang-Ki Min
- Catholic Research Network for Multiple Myeloma, Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
- Department of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
| | - Jamin Koo
- ImpriMedKorea, Inc., Seoul, 08507, Republic of Korea.
- ImpriMed, Inc., Palo Alto, CA, 94303, USA.
- Department of Chemical Engineering, Hongik University, Seoul, 04066, Republic of Korea.
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Poloni C, Sze A, Wang X, Lim S, Steiner T. A36 INVESTIGATING TYPE 1 REGULATORY T CELLS AS A THERAPY FOR INFLAMMATORY BOWEL DISEASE USING A MOUSE MODEL OF ACUTE INTESTINAL EPITHELIAL DAMAGE. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991133 DOI: 10.1093/jcag/gwac036.036] [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: 03/09/2023] Open
Abstract
Background Inflammatory bowel disease (IBD) affects an estimated 270,000 people in Canada and is rapidly increasing in prevalence. All patients have relapsing disease, and a subset of individuals do not respond to current treatments. Further, there are no approved treatment options in Canada that reverse IBD-induced intestinal fibrosis. We have previously shown type 1 regulatory cells (Tr1s) are capable of suppressing inflammatory macrophages, promote barrier function of human intestinal epithelial cells, and induce differentiation of mucin-producing goblet cells. We hypothesize that Tr1 cells can prevent inflammatory damage and fibrosis in an mouse model of acute gut damage. Purpose We hypothesize that Tr1 cells can prevent inflammatory damage and fibrosis in an mouse model of gut damage. Here we evalute the therapeutic potential of Tr1 cells in an model of acute intestinal epithelial damage. Method Tr1 cells were isolated and expanded from CD4+ CD44high FOXP3- cells. Their phenotype was characterized by flow cytometry and cytokine secretion was measured via ELISA. WT B6 mice were given 2% DSS in H2O for 7 days, followed by H2O alone for 7 days. Prior to DSS treatment, mice were sub-lethally irradiated to facilitate engraftment, and given I.P. injections of PBS or 0.5 – 2 x 106 Tr1 cells. Mice weights and health scores were recorded daily. At the endpoint, blood, spleen, and mesenteric lymph nodes were analyzed for Tr1 cell engraftment (or lack thereof) for each mouse. Complete white blood counts were performed for each mouse. Additionally, proximal, medial, and distal portions of the ileum were processed for histologic scoring. Result(s) Tr1 cells isolated from CD4+ CD44high FOXP3- cells produce high levels of IL-10 following stimulation (>35,000 pg/ml/1 x 105 cells). Additionally, these cells express high levels of Tr1 markers CD49b and Lag-3. Optimization experiments indicated no significant differences between mice irradiated and given DSS and mice only given DSS (no irradiation). Our results suggest no significant differences in inflammatory cell infiltrate scores between control and Tr1 treated mice. However, gut architecture scores appeared to improve with increasing Tr1 doses. Further, weight change improved with Tr1 treatment, as compared to PBS controls. Interestingly, Tr1 treatment appeared to decrease total eosinophil and neutrophil counts from peripheral blood. Conclusion(s) Our initial findings indicate Tr1 adoptive transfer prior to acute damage via DSS improves gut damage and weight loss. Please acknowledge all funding agencies by checking the applicable boxes below CIHR Disclosure of Interest None Declared
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Affiliation(s)
- C Poloni
- Microbiology & Immunology, University of British Columbia
| | - A Sze
- BC Children's Hospital Research Institute, Vanccouver
| | - X Wang
- BC Children's Hospital Research Institute, Vanccouver
| | - S Lim
- BC Children's Hospital Research Institute, Vanccouver
| | - T Steiner
- BC Children's Hospital Research Institute, Vancouver, Canada
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Lim S, Meredith S, Agnew S, Clift E, Ibrahim K, Roberts HC. 1323 VOLUNTEER-LED ONLINE GROUP EXERCISE FOR OLDER ADULTS: A FEASIBILITY AND ACCEPTABILITY STUDY. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.047] [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: 01/18/2023] Open
Abstract
Abstract
Introduction
The health benefits of physical activity for older people are well recognised and include reduction in falls, improvement in frailty status and physical function. Nonetheless, physical inactivity remains a significant problem among older adults. This study aimed to determine the feasibility and acceptability of implementing online volunteer-led group exercise for community-dwelling older adults.
Methods
This pre-post mixed methods study was conducted among older adults attending community social clubs. Eligible participants were aged ≥ 65 years, able to walk independently, and able to provide written consent. The intervention consisted of a once weekly volunteer-led online group chair-based exercise. The primary outcomes were the feasibility and acceptability of the intervention. Secondary outcomes included physical activity levels measured using the Community Health Model Activities Program for Seniors (CHAMPS) questionnaire, functional status (Barthel Index), and health-related quality of life (EQ-5D-5L). Outcomes were measured at baseline and at 6 months. Trials registration: NCT04672200.
Results
Nineteen volunteers were recruited, 15 completed training and 9 were retained (mean age 68 years, 7 female). Thirty participants (mean age 77 years, 27 female) received the intervention and attended 54% (IQR 37-67) of exercise sessions. One minor adverse event was reported. Participants had no significant changes in secondary outcome measures, with a trend towards improvement in physical activity levels. The intervention was acceptable to volunteers, participants, and staff. The seated exercises were perceived as safe, manageable and enjoyable. Volunteers were relatable role models providing positive vicarious experiences that improved participants confidence to exercise within a friendly, non-judgmental environment. Technological issues, or reluctance to learn how to use technology were barriers to the intervention. The social interactions and sense of belonging motivated participation.
Conclusions
Trained volunteers can safely deliver online group exercise for community-dwelling older adults and the intervention was feasible and acceptable to older adults, volunteers and club staff.
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Affiliation(s)
- S Lim
- University Hospital Southampton NHS Foundation Trust
- University of Southampton NIHR ARC Wessex and Academic Geriatric Medicine,
| | - S Meredith
- University of Southampton NIHR ARC Wessex and Academic Geriatric Medicine,
| | | | - E Clift
- Southern Health NHS Foundation Trust
| | - K Ibrahim
- University of Southampton NIHR ARC Wessex and Academic Geriatric Medicine,
| | - H C Roberts
- University of Southampton NIHR ARC Wessex and Academic Geriatric Medicine,
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Makama M, Brown WJ, Lim S, Skouteris H, Harrison CL, Joham AE, Mishra GD, Teede H, Moran LJ. Levels of physical activity and sitting time in women with infants, toddlers and preschoolers: a population-based cross-sectional study. Public Health 2023; 214:1-9. [PMID: 36417813 DOI: 10.1016/j.puhe.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/29/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Insufficient physical activity (PA) and prolonged sitting time (ST) increase the risk of chronic disease and mortality. Caring for young children can potentially impact maternal PA and sedentary behaviours. The aims of this study were to explore the levels of PA and ST in women with young children (infants, toddlers and preschoolers) and sociodemographic and behavioural factors associated with these. STUDY DESIGN This was a population-based cross-sectional study. METHODS Survey 5 data collected in 2009 (n = 4290) of the 1973-1978 birth cohort of the Australian Longitudinal Study on Women's Health were used. Multiple linear and logistic regression models were used to examine associations. RESULTS In adjusted models, compared with women with preschoolers, women whose youngest child was an infant aged 0-6 months, aged >6-12 months or toddler had lower PA (-321.3 MET.min/week [95% confidence interval (CI) -416.2, -226.4], -147.9 MET.min/week [95% CI -237.6, -58.1] and -106.4 MET.min/week [95% CI -172.3, -40.5]). ST was higher in women whose youngest child was an infant aged 0-6 months (0.48 h/day; 95% CI 0.19, 0.77) but lower with infants aged >6-12 months (-0.33 h/day; 95% CI -0.60, -0.05) and toddlers (-0.40 h/day; 95% CI -0.60, -0.20) than in those with preschoolers. The findings were similar in the logistic model. Sociodemographic and behavioural factors such as occupation and marital status also influenced PA and ST. CONCLUSIONS Women with infants and toddlers have lower PA than women with preschoolers. Women are more likely to sit more in the first 6 months after childbirth. These findings can inform resources and intervention development to improve activity levels in women with young children through consideration of the age of the youngest child, sociodemographic and behavioural factors.
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Affiliation(s)
- M Makama
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - W J Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia; Faculty of Health Science and Medicine, Bond University, Gold Coast, Australia
| | - S Lim
- Health Systems and Equity, Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - H Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Warwick Business School, Warwick University, Coventry, United Kingdom
| | - C L Harrison
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia; Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
| | - A E Joham
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia; Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
| | - G D Mishra
- Centre for Longitudinal and Life Course Research, University of Queensland, Brisbane, Queensland, Australia
| | - H Teede
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia; Warwick Business School, Warwick University, Coventry, United Kingdom; Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
| | - L J Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia.
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11
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Choy S, Paolino A, Kim B, Lim S, Seo J, Tan S, Tan W, Corbett M, Barker J, Lynch M, Smith C, Mahil S. 100 Deep learning image analyses in dermatology, beyond skin lesions: a systematic review. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.110] [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: 11/19/2022]
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12
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Toh K, Zhao X, Kim J, Stratton G, Lin HW, Lee D, Yoon S, Fang YF, Chang KC, Stirling R, Zalcberg J, Jung H, Yu H, Lim S, Lim S, Chou KP, J.A. kim, Patel D, Kleinman N. 349P EXPLORE-LC: A multi-site real-world evidence research platform for non-small cell lung cancer in Asia-Pacific. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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13
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Kim JH, Franchin L, Hong SJ, Cha JJ, Lim S, Joo HJ, Park JH, Yu CW, Ahn TH, Lim DS, Dascenzo F. The long-term cardiac events after coronary bifurcation stenting with second-generation drug-eluting stents in elderly patients are comparable to those of younger patients. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1256] [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
Elderly patients undergoing percutaneous coronary intervention (PCI) generally have a high risk of adverse clinical outcomes. We investigated the long-term clinical impact of PCI on coronary bifurcation disease in elderly patients in Korea and Italy.
Methods
From the BIFURCAT (comBined Insights from the Unified RAIN and COBIS bifurcAtion regisTries) data, we evaluated 5,537 patients who underwent PCI for coronary bifurcation disease. The primary outcome was major adverse cardiac events (MACEs), defined as the composite of target vessel myocardial infarction, target lesion revascularisation, and stent thrombosis. Kaplan–Meier estimates and Cox proportional hazard models were used to compare elderly patients (aged ≥75 years) and younger patients (aged <75 years).
Results
A total of 1,415 patients (26%) were aged ≥75 years. Elderly patients were more frequently female, had higher rates of hypertension and chronic kidney disease (CKD), and presented more frequently with left main (LM) disease. After a median follow-up of 2.1 years, MACEs were comparable between elderly and younger patients. In multivariable analysis, old age was not an independent predictor of MACEs (p=0.977). In elderly patients, CKD and LM disease were independent predictors of MACEs, whereas in younger patients, hypertension, diabetes, CKD, reduced left ventricular ejection fraction, LM disease, and two-stent strategy usage were independent predictors.
Conclusions
Elderly patients who underwent coronary bifurcation PCI with second-generation drug-eluting stents demonstrated similar clinical outcomes to those of younger patients. Both CKD and LM disease were independent predictors of MACEs, regardless of age after coronary bifurcation PCI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J H Kim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - L Franchin
- University of Turin, Cardiovascular and Thoracic , Turin , Italy
| | - S J Hong
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J J Cha
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - S Lim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - H J Joo
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J H Park
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - C W Yu
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - T H Ahn
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - D S Lim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - F Dascenzo
- University of Turin, Cardiovascular and Thoracic , Turin , Italy
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14
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Lim S, Yu CW, Kim JH, Cha JJ, Kook HD, Joo HJ, Park JH, Choi CU, Hong SJ, Lim DS. The differential effects of antihypertensive drugs on central blood pressure: nebivolol versus telmisartan (ATD-CBP). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2207] [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: 11/13/2022] Open
Abstract
Abstract
Background
Central blood pressure and central pulse pressure have a better correlation with the risk of cardiovascular disease compared to those of peripheral measurement. In a previous study, a second-generation beta-blocker showed poor CBP-lowering effects. However, the effect on CBP by third-generation beta-blockers is not fully elucidated. Thus, this randomised study investigated whether nebivolol-based hypertension treatment may confer advantages over telmisartan, an angiotensin II receptor-blocker, in reducing CBP.
Methods
This was a prospective, randomised, multicentre, open-label, controlled trial that evaluated 98 hypertensive patients. Patients received either nebivolol- (N=49) or telmisartan-based (N=49) treatment for hypertension for 12 weeks with a target BP of ≤140/80. The primary outcome was the difference in change from baseline central systolic BP (cSBP) after 12 weeks.
Results
There were no significant differences between the two groups in baseline central and peripheral SBP. The mean change in cSBP from baseline (ΔcSBP) was −17.2±3 mmHg for nebivolol group (P<0.001) and −29.9±3 mmHg for telmisartan group (P<0.001). The difference in ΔcSBP between the two groups was significant (12.7mmHg, 95% confidence interval [CI], 4.13 to 21.2; P=0.004). Peripheral SBP (pSBP) decreased less in nebivolol group compared to telmisartan group (−18.0±3 in nebivolol group vs. −26.3±3 in telmisartan group, P=0.032). After adjusting for reduction in pSBP, reduction in cSBP was higher in telmisartan group compared to nebivolol group, as shown by the ratio of changes in cSBP and pSBP (ΔcSBP/ΔpSBP; 0.67 for nebivolol group vs. 1.11 for telmisartan group, P=0.080), albeit without statistical significance.
Conclusions
Nebivolol-based hypertension treatment may have less potent CBP-lowering effects compared to telmisartan. However, larger-scale studies are warranted to further elaborate our findings.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Lim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - C W Yu
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J H Kim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J J Cha
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - H D Kook
- Hanyang university medical center , Seoul , Korea (Republic of)
| | - H J Joo
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J H Park
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - C U Choi
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - S J Hong
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - D S Lim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
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15
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Bae SA, Cha JJ, Kim SW, Lim S, Kim JH, Joo HJ, Park JH, Park SM, Hong SJ, Yu CW, Lim DS, Jeong MH, Ahn TH. Effect of an early invasive strategy based on time of symptom onset in patients with non-ST elevation myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1200] [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: 11/13/2022] Open
Abstract
Abstract
Background
A limitation of the current guidelines of the timing of invasive coronary angiography (ICA) for patients with non-ST-segment elevation (NSTE) acute coronary syndrome is based on randomization time. So far, no study has reported the clinical outcomes of invasive strategy timing based on the time of symptom onset. Herein, we aimed to investigate the effect of invasive strategy timing from the time of symptom onset on the 3-year clinical outcomes of patients with NSTE myocardial infarction (MI).
Methods and results
Among 13,104 patients from the Korea Acute Myocardial Infarction Registry-National Institutes of Health, we evaluated 5,856 patients with NSTEMI. The patients were categorized according to symptom-to-catheter (StC) time (<48 h and ≥48 h). The primary outcome was 3-year all-cause mortality, and the secondary outcome was a 3-year composite of all-cause mortality, recurrent MI, and hospitalization for heart failure. Overall, 3,919 (66.9%) patients were classified into the StC time <48 h group. This group had lower all-cause mortality than the StC time ≥48 h group (7.3% vs. 13.4%, p<0.001). The continuous association of StC time and risk of primary and secondary endpoints showed shorter StC time (reference: 48 h), and lower adjusted hazard ratio reduction was observed. In multivariable analysis, independent predictors of delayed ICA were older age, non-specific symptoms, no use of emergency medical services, no ST-segment deviation, chronic kidney disease, and Global Registry of Acute Coronary Events score >140.
Conclusion
Early invasive strategy based on the StC time improves all-cause mortality in patients with NSTEMI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S A Bae
- Yongin Severance Hospital, Yonsei University College of Medicine , Yongin , Korea (Republic of)
| | - J J Cha
- Korea University Anam Hospital, Department of Cardiology , Seoul , Korea (Republic of)
| | - S W Kim
- Chung-Ang University Gwangmyeong Hospital, Department of Cardiology , Gwangmyeong , Korea (Republic of)
| | - S Lim
- Korea University Anam Hospital, Department of Cardiology , Seoul , Korea (Republic of)
| | - J H Kim
- Korea University Anam Hospital, Department of Cardiology , Seoul , Korea (Republic of)
| | - H J Joo
- Korea University Anam Hospital, Department of Cardiology , Seoul , Korea (Republic of)
| | - J H Park
- Korea University Anam Hospital, Department of Cardiology , Seoul , Korea (Republic of)
| | - S M Park
- Korea University Anam Hospital, Department of Cardiology , Seoul , Korea (Republic of)
| | - S J Hong
- Korea University Anam Hospital, Department of Cardiology , Seoul , Korea (Republic of)
| | - C W Yu
- Korea University Anam Hospital, Department of Cardiology , Seoul , Korea (Republic of)
| | - D S Lim
- Korea University Anam Hospital, Department of Cardiology , Seoul , Korea (Republic of)
| | - M H Jeong
- Chonnam National University Medical School, Department of Cardiovascular Medicine , Gwangju , Korea (Republic of)
| | - T H Ahn
- Chung-Ang University Gwangmyeong Hospital, Department of Cardiology , Gwangmyeong , Korea (Republic of)
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16
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Lim S. Towards Carbon‐Neutral Plastic Bio‐Upcycling. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255336] [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: 11/10/2022]
Affiliation(s)
- S. Lim
- Nanyang Technological University (NTU) School of Chemical and Biomedical Engineering Block N1.2, B3-13, 62 Nanyang Drive 637459 Singapore Singapore
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17
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Kim E, Boutain DM, Lim S, Parker S, Wang D, Maldonado Nofziger R, Weiner BJ. Organizational contexts, implementation process, and capacity outcomes of multicultural, multilingual
Home‐Based
Programs in public initiatives: A
Mixed‐Methods
study. J Adv Nurs 2022; 78:3409-3426. [PMID: 35986591 PMCID: PMC9541645 DOI: 10.1111/jan.15276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 02/09/2022] [Accepted: 03/16/2022] [Indexed: 11/29/2022]
Abstract
Aims Design Sample Methods Results Conclusion Impact
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Affiliation(s)
- Eunjung Kim
- University of Washington School of Nursing Seattle WA USA
| | | | - Sungwon Lim
- University of Washington School of Nursing Seattle WA USA
| | | | - Di Wang
- University of Washington School of Nursing Seattle WA USA
| | | | - Byran J. Weiner
- Department of Global Health & Department of Health Services and Population Health University of Washington Seattle WA USA
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18
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Lee B, Bang Y, Lim S, Kang S, Park C, Kim H, Kim T. 067 Dissecting circulating regulatory T cells in severe Korean psoriasis patients by mass cytometry. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.121] [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: 10/17/2022]
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19
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Chen CCJ, Lim S. Examining the effect of COVID-19 pandemic on exercise behavior and perceived academic stress among U.S. college students. J Am Coll Health 2022:1-7. [PMID: 35816754 DOI: 10.1080/07448481.2022.2094202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 06/05/2022] [Accepted: 06/19/2022] [Indexed: 06/15/2023]
Abstract
Objective: The aim of this study was to capture the impact of COVID-19 on exercise behavior in U.S. college students. Exercise behaviors and perceived academic stress were examined from pre-COVID-19 (January-March 2020) and early-COVID-19 (April-July 2020) to continued-COVID-19 times (August-October 2020). Participants: One hundred and thirty-two participants completed the online questionnaires retrospectively. Methods: Two-way analyses of variance were used to examine exercise behaviors and academic stress perception over time between genders. Results: Participants spent much time in sedentary behavior and an increase in academic stress was evident in learning during the early-COVID-19 period. The time spent in sedentary behavior was reduced, but the stress involving coursework remained during the continued-COVID period. The impact of the COVID pandemic was observed to be universal across sex groups. Conclusions: Universities should consider how to support physical and mental health during lockdown and extended closure due to a pandemic.
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Affiliation(s)
- C-C Jj Chen
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi, USA
| | - S Lim
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi, USA
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20
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Haeusler IL, Daniel O, Isitt C, Watts R, Cantrell L, Feng S, Cochet M, Salloum M, Ikram S, Hayter E, Lim S, Hall T, Athaide S, Cosgrove CA, Tregoning JS, Le Doare K. Group B Streptococcus (GBS) colonisation is dynamic over time, whilst GBS capsular polysaccharides-specific antibody remains stable. Clin Exp Immunol 2022; 209:188-200. [PMID: 35802786 PMCID: PMC9390841 DOI: 10.1093/cei/uxac066] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/08/2022] [Accepted: 06/27/2022] [Indexed: 11/20/2022] Open
Abstract
Group B Streptococcus (GBS) is a leading cause of adverse pregnancy outcomes due to invasive infection. This study investigated longitudinal variation in GBS rectovaginal colonization, serum and vaginal GBS capsular polysaccharide (CPS)-specific antibody levels. Non-pregnant women were recruited in the UK and were sampled every 2 weeks over a 12-week period. GBS isolates were taken from recto-vaginal swabs and serotyped by polymerase chain reaction. Serum and vaginal immunoglobulin G (IgG) and nasal immunoglobulin A (IgA) specific to CPS were measured by Luminex, and total IgG/A by ELISA. Seventy women were enrolled, of median age 26. Out of the 66 participants who completed at least three visits: 14/47 (29.8%) women that were GBS negative at screening became positive in follow-up visits and 16/19 (84.2%) women who were GBS positive at screening became negative. There was 50% probability of becoming negative 36 days after the first positive swab. The rate of detectable GBS carriage fluctuated over time, although serum, vaginal, and nasal CPS-specific antibody levels remained constant. Levels of CPS-specific antibodies were higher in the serum of individuals colonized with GBS than in non-colonized, but similar in the vaginal and nasal mucosa. We found correlations between antibody levels in serum and the vaginal and nasal mucosa. Our study demonstrates the feasibility of elution methods to retrieve vaginal and nasal antibodies, and the optimization of immunoassays to measure GBS-CPS-specific antibodies. The difference between the dynamics of colonization and antibody response is interesting and further investigation is required for vaccine development.
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Affiliation(s)
- I L Haeusler
- St George's University of London, Paediatric Infectious Diseases Research Group, London, United Kingdom
| | - O Daniel
- St George's University of London, Paediatric Infectious Diseases Research Group, London, United Kingdom
| | - C Isitt
- St George's University of London, The Vaccine Institute, London, United Kingdom
| | - R Watts
- St George's University of London, Paediatric Infectious Diseases Research Group, London, United Kingdom
| | - L Cantrell
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford
| | - S Feng
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford
| | - M Cochet
- St George's University of London, Paediatric Infectious Diseases Research Group, London, United Kingdom
| | - M Salloum
- St George's University of London, Paediatric Infectious Diseases Research Group, London, United Kingdom.,UnivLyon, Claude Bernard University Lyon I, France
| | - S Ikram
- St George's University of London, The Vaccine Institute, London, United Kingdom
| | - E Hayter
- St George's University of London, The Vaccine Institute, London, United Kingdom
| | - S Lim
- St George's University of London, Paediatric Infectious Diseases Research Group, London, United Kingdom
| | - T Hall
- St George's University of London, Paediatric Infectious Diseases Research Group, London, United Kingdom
| | - S Athaide
- St George's University of London, The Vaccine Institute, London, United Kingdom
| | - C A Cosgrove
- St George's University of London, The Vaccine Institute, London, United Kingdom
| | - J S Tregoning
- Imperial College London, Department of Infectious Disease, London, United Kingdom
| | - K Le Doare
- St George's University of London, Paediatric Infectious Diseases Research Group, London, United Kingdom.,Makerere University John Hopkins Research Collaboration, Kampala, Uganda.,Pathogen Immunology Group, United Kingdom Health Security Agency, Porton Down, United Kingdom
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21
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Wang C, Leng S, Tan R, Chai P, Fam J, Teo L, Chin C, Ong C, Baskaran L, Keng F, Low A, Chan M, Wong A, Chua T, Tan S, Lim S, Zhong L. 517 Computed Tomography Coronary Angiography Based Morphological Index Predicts Coronary Ischemia. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.128] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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22
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Lim S, Pintye J, Seong H, Bekemeier B. Estimating the Association Between Public Health Spending and Sexually Transmitted Disease Rates in the United States: A Systematic Review. Sex Transm Dis 2022; 49:462-468. [PMID: 35312659 DOI: 10.1097/olq.0000000000001627] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Public health spending is important for managing increases in sexually transmitted diseases (STDs) in the United States. Although previous studies suggest that a beneficial link exists between public health spending and changes in STD rates, there have been no systematic reviews synthesizing existing evidence regarding the association for STDs at the population level. The objective of this study was to synthesize evidence from studies that assessed the associations between general and STD-specific public health spending and STD rates. We conducted a systematic review using Ovid-Medline, EMBASE, CINAHL, Cochrane Library, Web of Science, and EconLit for relevant studies that examined the association between public health spending and gonorrhea, syphilis, chlamydia, and chancroid rates following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 5 articles (2 regarding general public health spending and 3 regarding STD-specific public health spending) met our inclusion criteria. There was a significant decrease in gonorrhea, syphilis, chlamydia, and chancroid rates associated with increased public health spending. We also found that STD-specific public health spending has a greater effect on STD rates compared with general public health spending. Our review provides evidence that increases in general and STD-specific public health spending are associated with a reduction of STD rates. Such research regarding estimates of the impact of STD prevention spending can help policy makers identify priority funding areas and inform health resource allocation decisions.
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Affiliation(s)
- Sungwon Lim
- From the Departments of Child, Family, and Population Health
| | - Jillian Pintye
- Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA
| | - Hohyun Seong
- School of Nursing, University of Maryland, Baltimore, MD
| | - Betty Bekemeier
- From the Departments of Child, Family, and Population Health
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23
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Oo T, Aung Z, Barrera V, Arroyo S, Lim S. 957 THE USE OF IPADS AS PART OF PERSON CENTERED CARE IN A TEACHING HOSPITAL IN SINGAPORE. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.018] [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] Open
Abstract
Abstract
The elderly patients are currently the main occupants of acute hospital beds and this trend will likely increase as the world ages. The elderly patients with cognitive issues frequently have behavioural symptoms which may be challenging for the care staff to manage, especially the staff who have not been formally trained in Gerontology. The use of restraints for this group of vulnerable patients should be discouraged as restraints can cause harmful effects.
The use of iPads as a non pharmacological strategy for managing the behavioural symptoms among the elderly in-patients with cognitive issues was effective in reducing agitation, with an improvement in mood and sundown symptoms. The patients were actively and meaningfully engaged with their iPads during therapy.
The nursing staff too, benefited from iPads as a novel therapy for their elderly in-patients with cognitive issues in providing cognitive and social stimulations, which they had no time to provide for. While the patients showed improvement in their behavioural symptoms, the nurses’ stress levels reduced with improved self-reported job satisfaction.
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Affiliation(s)
- T Oo
- Department of Geriatric Medicine, Changi General Hospital , Singapore
| | - Z Aung
- Department of Geriatric Medicine, Changi General Hospital , Singapore
| | - V Barrera
- Department of Geriatric Medicine, Changi General Hospital , Singapore
| | - S Arroyo
- Department of Geriatric Medicine, Changi General Hospital , Singapore
| | - S Lim
- Department of Geriatric Medicine, Changi General Hospital , Singapore
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24
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Lim J, Lim S, Kim J. P-116 Discriminating factors for gastric neoplasm among regenerative atypia found in screening upper gastrointestinal endoscopy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.206] [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: 11/29/2022] Open
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25
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McKenzie J, Kosmider S, Wong R, To Y, Shapiro J, Dunn C, Burge M, Hong W, Caird S, Lim S, Wong H, Lee B, Gibbs P, Wong V. P-187 Epidermal growth factor receptor inhibitors (EGFRi) in patients with left-side, RAS wildtype metastatic colorectal cancer: Clinician use and outcomes for patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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26
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Han A, Kim K, Choi H, Noh H, Cho IJ, Lim S, Lee J. 19P Usefulness of Hounsfield unit on computed tomography, serum neutrophil to lymphocyte ratio, and their combination as prognostic factor in patients with breast cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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27
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Teo K, Cheow Y, Zhang S, Shi J, Lai R, Lim S, Toh W. Exosomes/EVs: MSC-SEVS ALLEVIATE LOCAL AND SYSTEMIC INFLAMMATION TO PROMOTE JOINT REPAIR IN OSTEOARTHRITIS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00252-3] [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: 11/26/2022]
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28
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Jiang Y, Teo K, Zhang S, Shi J, Lai R, Lim S, Toh W. Exosomes/EVs: MSC EXOSOMES ALLEVIATE OSTEOARTHRITIS THROUGH COMPLEMENT INHIBITION. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00251-1] [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: 11/29/2022]
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Kong YK, Cho MU, Park CW, Kim SY, Kim MJ, Moon J, Lim S, Oh BM, Han B, Choi J, Choi KH. Quantification of physical stress experienced by obstetrics and gynecology sonographers: A comparative study of two ultrasound devices. Appl Ergon 2022; 100:103665. [PMID: 34915350 DOI: 10.1016/j.apergo.2021.103665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/11/2021] [Accepted: 12/03/2021] [Indexed: 06/14/2023]
Abstract
This study aims to quantify the stresses of sonographers using two different ultrasound devices, one of conventional and one of ergonomic design. A total of 20 obstetricians and gynecologists participated in this study, and two types of tasks (scanning and positioning) were evaluated while using the two different devices. To quantify workload, four dependent variables (muscle activity, estimated grip force, subjective comfort rating, and task time) were measured. The muscular activity required while using the conventional device was 14.4% MVC (Maximum voluntary contraction) for the scanning task, which was significantly higher than that of the ergonomic device. The subjective comfort rating for the conventional design was lower than that of the ergonomic design. For the positioning task, the ergonomic device (33.2% MVC) resulted in significantly higher muscle activity in the extensor digitorum (ED) and flexor digitorum superficialis (FDS) than the conventional design (22.2% MVC), whereas the deltoid muscle showed significantly lower activity than in users of conventional design (4.5% MVC). Ergonomically-designed ultrasound devices improve ease of moving and the probe's supporters, reduce physical load and increase ease of use for sonographers. Our results may be used as guidelines for usability testing of ultrasound devices.
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Affiliation(s)
- Yong-Ku Kong
- Department of Industrial Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Min-Uk Cho
- Department of Industrial Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Chae-Won Park
- Department of Industrial Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Seoung-Yeon Kim
- Department of Industrial Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Min-Jung Kim
- Department of Industrial Engineering, Sungkyunkwan University, Suwon, South Korea
| | | | | | - Byung-Mo Oh
- Medical Device Usability Testing Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea; Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea; National Traffic Injury Rehabilitation Hospital, Yangpyeong, South Korea
| | - Banseok Han
- Medical Device Usability Testing Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - JunHee Choi
- Medical Device Usability Testing Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Kyeong-Hee Choi
- Department of Industrial Engineering, Sungkyunkwan University, Suwon, South Korea.
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Yim I, Parker K, Lim S. Pulmonary Artery Wave Intensity Analysis in Pulmonary Hypertension Due to Left Heart Disease. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.327] [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: 11/29/2022] Open
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Yim I, Parker K, Lim S. Reservoir Pressure Analysis in Group 2 Pulmonary Hypertension. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.328] [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] Open
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Yoon S, Lim S, Jung H, Kim KP, Kim D, Jeong H, Lim S, Kim J, Kim J, Patel D, Zhao X, Horsburgh D, Yu D, Kim J, Kim S, Lee D. 50P Clinical characteristics, treatment patterns and outcomes of EGFR exon 20 insertion and other EGFR mutations in Korean aNSCLC patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Quinn D, Morley-Smith A, Chue C, Phillips N, Lim S. Deployment, Configuration and Complications of Percutaneous Right Ventricular Assist Device - The Birmingham Experience. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1513] [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] Open
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Lim S, Ranasinghe A, Chue C, Quinn D, Mascaro J. How Does a Protocolized Therapeutic Framework Improve Survival in Cardiogenic Shock Due to End-Stage Heart Failure? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1602] [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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Iglesias I, Kanankege K, Valencia E, Liu C, Blanco C, Lim S, Gomez-Perez J, Tomas-Tenllado C, la Torre AD, Perez A. DiFLUsion: A new spatiotemporal early warning system for HPAI. Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.239] [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: 10/19/2022] Open
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Lehenbauer K, Asch F, Weissman NJ, Grayburn P, Kar S, Lim S, Li D, Puri R, Kapadia S, Sannino A, Lindenfeld J, Abraham W, Mack MJ, Stone GW, Hahn R. Impact of changes in tricuspid regurgitation on clinical outcomes following mitral valve teer compared to guideline-directed medical therapy: a sub-analysis of the COAPT trial. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.206] [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
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT)
Background
Prior studies suggest tricuspid regurgitation (TR) diminishes/resolves following mitral valve surgery and thus do not require treatment and may not influence outcomes.
Purpose
We sought to evaluate the change in TR (ΔTR) and its association with outcomes after transcatheter edge-to-edge repair (TEER) compared with guideline-directed medical therapy (GDMT) in the COAPT trial.
Methods
Patients from the COAPT trial with echo core lab TR assessment at baseline and 30-day follow-up (n = 504) were included and divided into 2 groups: those whose TR worsened (ΔTR-INC) and those with no change or improvement in TR (ΔTR-SAME/DEC). Two-year composite endpoints of death or heart failure hospitalization (HFH) and the individual components were analyzed, after excluding events occurring within the first 30 days.
Results
ΔTR-SAME/DEC occurred in 430 pts (228 TEER, 202 GDMT) while ΔTR-INC was noted in 74 pts (38 TEER, 36 GDMT) (Figure 1A). From 30 days to 2 years, ΔTR-INC pts had a higher rate of the composite outcome of death or HFH compared with ΔTR-SAME/DEC (p = 0.006, Figure 1B). Both 2-year death (HR 1.52, 95% CI 1.01-2.27; p = 0.04) and HFH (HR 1.52, 95% CI 1.04-2.22; p = 0.03) were associated with ΔTR-INC. Assessed by treatment group (Figure 1C and 1D), the relationship between ΔTR-INC and composite death or HFH was significant in GDMT alone pts (HR 1.86, 95% CI 1.21-2.86) but not in TEER pts (HR 1.33, 95% CI 0.79-2.23), although interaction testing demonstrated consistency between the two treatments (Pint = 0.31).
Conclusions
Worsening TR at 30 days occurred in ∼15% of pts in the COAPT trial whether they were treated with TEER or GDMT alone. DTRINC was associated with increased death and HFH during 2-year follow-up. Abstract Figure 1
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Affiliation(s)
- K Lehenbauer
- Columbia University Medical Center, New York, United States of America
| | - F Asch
- Medstar Research Institute, Washington, DC, United States of America
| | - NJ Weissman
- Medstar Research Institute, Washington, DC, United States of America
| | - P Grayburn
- Baylor Scott & White Health, Plano, United States of America
| | - S Kar
- Los Robles Health System, Los Angeles, United States of America
| | - S Lim
- University of Virginia, Charlottesville, United States of America
| | - D Li
- Cardiovascular Research Foundation, New York, United States of America
| | - R Puri
- Cleveland Clinic, Cleveland, United States of America
| | - S Kapadia
- Cleveland Clinic, Cleveland, United States of America
| | - A Sannino
- Baylor Scott & White Health, Plano, United States of America
| | - J Lindenfeld
- Vanderbilt University Medical Center, Nashville, United States of America
| | - W Abraham
- Ohio State University Wexner Medical Center, Columbus, United States of America
| | - MJ Mack
- Baylor Scott & White Health, Plano, United States of America
| | - GW Stone
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Hahn
- Columbia University Medical Center, New York, United States of America
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Lim S, Mangala M, Holliday M, Ross S, Liang W, Ranpura G, Cserne Szappanos H, Hill A, Semsarian C, Hool L. Slow Conduction Velocity Revealed in Hypertrophic Cardiomyopathy Modelled With Patient-Derived Induced Pluripotent Stem Cell Cardiomyocytes. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lim BO, Kim J, Kim SH, Cho JH, Lim S, Lim ST. The effects of taekwondo shoes on anterior cruciate ligament injury risk factors during jump whip kicks. Sci Sports 2022. [DOI: 10.1016/j.scispo.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lim S, Boutain DM, Kim E, Evans-Agnew RA, Parker S, Maldonado Nofziger R. Institutional procedural discrimination, institutional racism, and other institutional discrimination: A nursing research example. Nurs Inq 2021; 29:e12474. [PMID: 34866269 PMCID: PMC9285511 DOI: 10.1111/nin.12474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 10/23/2021] [Accepted: 10/28/2021] [Indexed: 12/13/2022]
Abstract
Institutional discrimination matters. The purpose of this longitudinal community‐based participatory research study was to examine institutional procedural discrimination, institutional racism, and other institutional discrimination, and their relationships with participants' health during a maternal and child health program in a municipal initiative. Twenty participants from nine multilingual, multicultural community‐based organizations were included. Overall reported incidences of institutional procedural discrimination decreased from April 2019 (18.6%) to November 2019 (11.8%) although changes were not statistically significant and participants reporting incidences remained high (n = 15 in April and n = 14 in November). Participants reported experiencing significantly less “[when] different cultural ways of doing things were shared, the project did not support my way” from April 2019 (23.5%, n = 4) to November 2019 (0%, n = 0), Wilcoxon signed‐rank test Z = −2.00, p < 0.05. Some participants reported experiencing institutional racism (29.4%, n = 5) and other institutional discrimination (5.9%, n = 1). Participants experiencing institutional racism, compared to those who did not, reported a higher impact of the Initiative's program on their quality of life (t = 3.62, p < 0.01). Participatory survey designs enable nurse researchers to identify hidden pathways of institutional procedural discrimination, describe the impacts experienced, and examine types of institutional discrimination in health systems.
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Affiliation(s)
- Sungwon Lim
- Department of Child, Family, and Population Health, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Doris M Boutain
- Department of Child, Family, and Population Health, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Eunjung Kim
- Department of Child, Family, and Population Health, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Robin A Evans-Agnew
- School of Nursing and Healthcare Leadership, University of Washington Tacoma, Tacoma, Washington, USA
| | - Sanithia Parker
- Department of Child, Family, and Population Health, School of Nursing, University of Washington, Seattle, Washington, USA
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Koo J, Choi K, Lee P, Polley A, Pudupakam RS, Tsang J, Fernandez E, Han EJ, Park S, Swartzfager D, Qi NSX, Jung M, Ocnean M, Kim HU, Lim S. Predicting Dynamic Clinical Outcomes of the Chemotherapy for Canine Lymphoma Patients Using a Machine Learning Model. Vet Sci 2021; 8:vetsci8120301. [PMID: 34941828 PMCID: PMC8704313 DOI: 10.3390/vetsci8120301] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 11/16/2022] Open
Abstract
First-line treatments of cancer do not always work, and even when they do, they cure the disease at unequal rates mostly owing to biological and clinical heterogeneity across patients. Accurate prediction of clinical outcome and survival following the treatment can support and expedite the process of comparing alternative treatments. We describe the methodology to dynamically determine remission probabilities for individual patients, as well as their prospects of progression-free survival (PFS). The proposed methodology utilizes the ex vivo drug sensitivity of cancer cells, their immunophenotyping results, and patient information, such as age and breed, in training machine learning (ML) models, as well as the Cox hazards model to predict the probability of clinical remission (CR) or relapse across time for a given patient. We applied the methodology using the three types of data obtained from 242 canine lymphoma patients treated by (L)-CHOP chemotherapy. The results demonstrate substantial enhancement in the predictive accuracy of the ML models by utilizing features from all the three types of data. They also highlight superior performance and utility in predicting survival compared to the conventional stratification method. We believe that the proposed methodology can contribute to improving and personalizing the care of cancer patients.
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Affiliation(s)
- Jamin Koo
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
- ImpriMedKorea, Inc., Seoul Startup Hub, Seoul 04147, Korea;
- Department of Chemical Engineering, Hongik University, Seoul 04066, Korea
| | - Kyucheol Choi
- ImpriMedKorea, Inc., Seoul Startup Hub, Seoul 04147, Korea;
| | - Peter Lee
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Amanda Polley
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Raghavendra Sumanth Pudupakam
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Josephine Tsang
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Elmer Fernandez
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Enyang James Han
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Stanley Park
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Deanna Swartzfager
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Nicholas Seah Xi Qi
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Melody Jung
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Mary Ocnean
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
| | - Hyun Uk Kim
- Department of Chemical and Biomolecular Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Korea;
| | - Sungwon Lim
- ImpriMed, Inc., 4030 Fabian Way, Palo Alto, CA 94303, USA or (J.K.); (P.L.); (A.P.); (R.S.P.); (J.T.); (E.F.); (E.J.H.); (S.P.); (D.S.); (N.S.X.Q.); (M.J.); (M.O.)
- ImpriMedKorea, Inc., Seoul Startup Hub, Seoul 04147, Korea;
- Correspondence:
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Park E, Ha J, Lim S, Kim G, Yoon Y. Development of postbiotics by whey bioconversion with Enterococcus faecalis M157 KACC81148BP and Lactococcus lactis CAU2013 KACC81152BP for treating periodontal disease and improving gut health. J Dairy Sci 2021; 104:12321-12331. [PMID: 34600708 DOI: 10.3168/jds.2021-20616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/18/2021] [Indexed: 12/15/2022]
Abstract
This study developed postbiotics with whey bioconversion product produced by Enterococcus faecalis M157 KACC 81148BP, and mixed whey bioconversion products produced by E. faecalis M157 KACC 81148BP and Lactococcus lactis ssp. lactis CAU2013 KACC 81152BP to alleviate periodontitis (PD) and to improve gut health. The powdered whey bioconversion product (EF) produced by E. faecalis M157 KACC 81148BP, mixed whey bioconversion products (EF+LL) from E. faecalis M157 KACC 81148BP and L. lactis CAU2013 KACC 81152BP, and phosphate-buffered saline (PBS; control) were administered orally to PD-induced rats for 8 wk. Infiltration of inflammatory cells and epithelial proliferation in periodontal tissue were found in control, but the lesions were reduced in PD+EF group (administration of EF to PD-induced rats), and no lesions were observed in PD+EF+LL group (administration of EF+LL to PD-induced rats). The bone loss volumes in PD+EF and PD+EF+LL groups were lower than in control. Cytokine production levels related to inflammation were lower and antioxidative stress markers were higher in PD+EF and PD+EF+LL groups than in control for both periodontal tissue and gut. The ratios of Lactobacillus spp. in gut microbiome of PD+EF and PD+EF+LL groups were higher than in control. These results indicate that the whey bioconversion product produced by E. faecalis M157 KACC 81148BP, and mixed whey bioconversion products produced by E. faecalis M157 KACC 81148BP and L. lactis CAU2013 KACC 81152BP are effective on relieving periodontitis and improving the gut health.
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Affiliation(s)
- E Park
- Department of Food and Nutrition, Sookmyung Women's University, Seoul 04310, Korea
| | - J Ha
- Center for Consumer Health Research, CHA Advanced Research Institute, Seongnam 13488, Korea
| | - S Lim
- Food Standard Research Center, Korea Food Research Institute, Jeollabuk-do 55365, Korea
| | - G Kim
- Department of Animal Science and and Technology, Chung-Ang University, Anseong 17546, Korea
| | - Y Yoon
- Department of Food and Nutrition, Sookmyung Women's University, Seoul 04310, Korea; Risk Analysis Research Center, Sookmyung Women's University, Seoul 04310, Korea.
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Mohd Said N, Ho F, Chen M, Ling N, Mohd Rais N, Chun M, Ng Y, Eng W, Chen W, Yao Y, Chien J, Loy Y, Ong J, Luah V, Soh T, Wong W, Lim S, Pang A. Implementation of a multidisciplinary golden (geriatric oncology longitudinal end to end) service in a tertiary cancer centre in Singapore. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00432-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Grembowski D, Lim S, Pantazis A, Bekemeier B. Analytic Approaches to Assess the Impact of Local Spending on Sexually Transmitted Diseases. Health Serv Res 2021; 57:644-653. [PMID: 34806188 DOI: 10.1111/1475-6773.13915] [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: 04/01/2021] [Revised: 08/31/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To compare the estimated associations between annual STD (sexually transmitted diseases) expenditures per capita and STD rates among Florida and Washington local health departments (LHDs) from 2001-2017, using two approaches--a longitudinal regression model with lagged STD spending, and a regression model with the Arellano-Bond panel estimator. DATA SOURCES Secondary data for LHDs were obtained from Florida and Washington state government offices and combined with county sociodemographic and health system data from the federal government. STUDY DESIGN We examined LHDs in Florida and Washington using a longitudinal panel study design to estimate ecological relationships between annual STD expenditures per capita and annual STD incidence rates from 2001 to 2017 with LHDs as the unit of analysis. We compared two regression models: generalized estimating equations (GEE) and the Arellano-Bond panel estimator (an instrumental variable approach). DATA COLLECTION The secondary data were combined to build a longitudinal panel database for LHDs in Florida and Washington from 2001 to 2017. PRINCIPAL FINDINGS In the GEE model with both states, greater STD spending in a prior year was associated unexpectedly with greater STD incidence rates in succeeding years. The Arellano-Bond models for both states had the expected inverse associations but were not significant. In the Arellano-Bond models for Florida, a $1 increase in STD spending in previous years was followed by decreases in STD incidence rates ranging between 29 and 59 points in succeeding years (0.09 ≥ p ≥ 0.04). CONCLUSIONS In longitudinal panel data for LHDs in two states, the Arellano-Bond estimator, or other instrumental variable approach, is preferred over conventional regression models to obtain unbiased estimates of the relationship between annual STD spending rates and annual STD rates. Future studies will require accurate, standardized, and detailed longitudinal data and rigorous analytic approaches, such as those illustrated in our study. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- David Grembowski
- Department of Health Systems and Population Health, University of Washington, Hans Rosling Center, 3980 15th Avenue NE, Box 351622, Seattle, WA, United States
| | - Sungwon Lim
- Department of Child, Family and Population Health Nursing, School of Nursing, University of Washington, Box 357263, 1959 NE Pacific Street, Seattle, WA, United States
| | | | - Betty Bekemeier
- Department of Health Systems and Population Health, University of Washington, Hans Rosling Center, 3980 15th Avenue NE, Box 351622, Seattle, WA, United States.,Department of Child, Family and Population Health Nursing, School of Nursing, University of Washington, Box 357263, 1959 NE Pacific Street, Seattle, WA, United States
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Slade A, O'Hara M, Quinn D, Marley L, Griffith S, Haque M, Calvert M, Lim S, Lane D. Using group concept mapping software to develop a conceptual framework of left ventricular assist device recipients' experiences. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0948] [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: 11/13/2022] Open
Abstract
Abstract
Background
Advanced Heart failure (AHF) carries a high mortality rate. Heart transplantation is one therapeutic option, but low donation rates limits its availability. A left ventricular assist device (LVAD) is an alternative therapy which helps relieve symptoms, while improving prognosis and quality of life. However, lack of donors also means that the LVAD becomes a destination therapy by default.(1) Living with an LVAD requires significant psychological, social and physical adaptation for the recipients' and their families.(2) Patient reported outcome measures (PROMs) are one way of capturing these concerns and ongoing problems. Discussions with a patient and public involvement group found a range of issues not currently captured by available PROMS.
Aim
To develop a conceptual framework which reflects the experiences of LVAD recipients' and evaluate their importance for inclusion in PROMs using a research web platform.
Method
Participants were recruited from a regional transplant centre which covers a wide geographical area in the UK. Ethical approval was obtained and participants were recruited through routine LVAD clinics. Group concept mapping (GCM) is a semi-quantitative mixed methods approach that can be used to capture and quantify recipients' experiences.(3) Groupwisdom concept mapping software was used as the electronic data collection platform.(4) GCM consists of 3 stages: statement generation, thematic statement sorting, and rating statements for importance, relevance and frequency of impact. Multidimensional scaling and hierarchical cluster analysis produces visual representations of recipients' experiences as a points and cluster map, and scoring of statements produces relative importance of items across the clusters.
Results
18 LVAD recipients consented to take part. 101 items and 9 clusters were generated. Clusters represented: Activities; Partner/family dependency; Travel; Mental well-being; LVAD challenges; Equipment and clothing; Physical and cognitive limitations; Restrictions, and LVAD positives. LVAD Positives and LVAD restrictions were rated high for frequency, relevance and importance. Physical and cognitive limitations was rated high for importance and frequency. Equipment was rated high for relevance and frequency, and Challenges was rated high for relevance.
Conclusion
GCM and the online software is a useful tool for developing a conceptual framework and mapping key areas of importance for LVAD recipients, especially, when prioritising important patient reported outcome domains for use in clinical practice, future research and design evolution. Using an electronic platform allowed us to reach participants dispersed over a wide geographical area.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): British Heart FoundationNational Institute for Health Research Cluster Rating Map for Importance
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Affiliation(s)
- A.L Slade
- Institute of Applied Health Research, Centre for Patient Reported Outcomes Research, Birmingham, United Kingdom
| | - M.E O'Hara
- University Hospitals Birmingham NHS Foundation Trust, Research and Development, Birmingham, United Kingdom
| | - D Quinn
- University Hospital Birmingham NHS Foundation trust, Department of cardiopulmonary transplantation, Birmingham, United Kingdom
| | - L Marley
- University Hospital Birmingham NHS Foundation trust, Department of cardiopulmonary transplantation, Birmingham, United Kingdom
| | - S Griffith
- Institute of Applied Health Research, Centre for Patient Reported Outcomes Research, Birmingham, United Kingdom
| | - M.S Haque
- University of Birmingham, Primary Care Clinical Sciences, Birmingham, United Kingdom
| | - M.J Calvert
- Institute of Applied Health Research, Centre for Patient Reported Outcomes Research, Birmingham, United Kingdom
| | - S Lim
- University Hospitals Birmingham NHS Foundation Trust, Cardiology, Birmingham, United Kingdom
| | - D.A Lane
- University of Liverpool, Liverpool Centre for Cardiovascular Science, Liverpool, United Kingdom
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Sharma H, Yuan M, Shakeel I, Morley-Smith A, Nadir MA, Chue C, Myerson SG, Steeds RP, Lim S. Left ventricular assist device therapy improves severe secondary mitral regurgitation without mitral valve repair. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1652] [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
Severe secondary mitral regurgitation (MR) worsens prognosis in patients with medically managed heart failure (HF). In patients treated by left ventricular assist device (LVAD), it is unclear whether severe MR should be corrected at time of LVAD implantation.
Purpose
To evaluate impact of LVAD therapy on severe and non-severe secondary MR over 1 year.
Methods
Retrospective single centre study of consecutive patients who underwent HeartMate (HM)2 or HM3 LVAD implantation between January 2011 and March 2020.
Results
Of 155 patients, 20 were excluded due to LVAD exchange (n=10), mitral valve repair (n=1), or inaccessible pre-LVAD echocardiography (n=9). Based on multiparametric grading, 29/135 patients had severe secondary MR and 106/135 had non-severe secondary MR (including none). Severe MR patients were more often female [10/29 (34%) vs 11/106 (10%); p=0.002] but were of similar age (54±12 vs 55±9 years; p=0.624), size (27±5 vs 27±4 kg/m2; p=1.0), with equivalent renal function (53±22 vs 55±20 ml/min/1.73m2; p=0.641) and median pre-operative NT-proBNP [4076 (IQR 206–5438) vs 4914 (IQR 2706–7518) ng/L; p=0.488]. There were similar proportions of patients with ischaemic aetiology [16/29 (55%) vs 66/106 (62%); p=0.488) and those receiving HM2 [11/29 (38%) vs 32/106 (30%)] and HM3 [18/29 (62%) vs 74/106 (70%); p=0.575] LVAD. Echocardiography before LVAD implantation demonstrated similar left ventricular (LV) size (LV end-diastolic volume: 133±44 vs 118±50ml/m2; p=0.145, end-systolic volume: 107±41 vs 96±59ml/m2; p=0.348) and LV ejection fraction (17±9 vs 17±7%; p=1.0). Severe MR patients had significantly greater (p<0.001) MR by proximal isovolumetric surface area (0.93±0.27 vs 0.60±0.16cm), vena contracta (0.79±0.32 vs 0.57±0.18cm), regurgitant volume (47±25 vs 24±12ml), and fraction (54±15 vs 37±13%). Follow-up (f/u) echocardiography was performed at a median 222 days (range 356 days). Patients who received cardiac transplantation before f/u echocardiography were excluded. Relative severities of MR at f/u were: none = 12 (46%), mild = 8 (31%), moderate = 5 (19%), severe = 1 (4%) amongst patients with severe MR pre-LVAD, and none = 55 (58%), mild = 26 (27%), moderate = 13 (14%), severe = 1 (1%) amongst patients with non-severe MR pre-LVAD. At 1-year, after excluding all patients who underwent cardiac transplantation (severe MR n=4; non-severe MR n=2), rates of HF hospitalisation [5/25 (20%) vs 16/104 (15%); p=0.575] and all-cause mortality [2/25 (18%) vs 22/104 (21%); p=0.129)] were similar, irrespective of pre-LVAD MR severity. No patient who died during follow-up had severe MR prior to death.
Conclusion
LVAD improves severe secondary MR in 96% of cases, resulting in 1-year rates of HF hospitalisation and mortality similar to patients without severe MR pre-LVAD. These data suggest mitral valve surgery at time of LVAD implantation is not warranted.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Sharma
- University of Birmingham, Birmingham, United Kingdom
| | - M Yuan
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | - I Shakeel
- University of Birmingham, Birmingham, United Kingdom
| | - A Morley-Smith
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | - M A Nadir
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | - C Chue
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | - S G Myerson
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom
| | - R P Steeds
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | - S Lim
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
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Lara M, Gubens M, Bacaltos B, Lim S, Li T, Gandara D, Riess J, Blakely C. P47.15 A Phase IA Study of Ceritinib + Trametinib in Patients With Advanced ALK- or ROS1- Rearranged NSCLC: Preliminary Results. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.508] [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: 11/26/2022]
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47
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Pang A, Ho F, Camelia N, Ng Y, Yao Y, Said NM, Chun M, Eng W, Chen W, Chien J, Loy Y, Ong J, Luah V, Soh T, Wong W, Lim S, Chen M. 1699P Introduction of the GOLDEN (Geriatric Oncology LongituDinal End to eNd) programme in a tertiary cancer centre. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1671] [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] Open
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Bond KA, Williams E, Nicholson S, Lim S, Johnson D, Cox B, Putland M, Gardiner E, Tippett E, Graham M, Mordant F, Catton M, Lewin SR, Subbarao K, Howden BP, Williamson DA. Longitudinal evaluation of laboratory-based serological assays for SARS-CoV-2 antibody detection. Pathology 2021; 53:773-779. [PMID: 34412859 PMCID: PMC8289701 DOI: 10.1016/j.pathol.2021.05.093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/02/2021] [Accepted: 05/17/2021] [Indexed: 01/03/2023]
Abstract
Serological assays for SARS-CoV-2 infection are now widely available for use in diagnostic laboratories. Limited data are available on the performance characteristics in different settings, and at time periods remote from the initial infection. Validation of the Abbott (Architect SARS-CoV-2 IgG), DiaSorin (Liaison SARS-CoV-2 S1/S2 IgG) and Roche (Cobas Elecsys Anti-SARS-CoV-2) assays was undertaken utilising 217 serum samples from 131 participants up to 7 months following COVID-19 infection. The Abbott and DiaSorin assays were implemented into routine laboratory workflow, with outcomes reported for 2764 clinical specimens. Sensitivity and specificity were concordant with the range reported by the manufacturers for all assays. Sensitivity across the convalescent period was highest for the Roche at 95.2-100% (95% CI 81.0-100%), then the DiaSorin at 88.1-100% (95% CI 76.0-100%), followed by the Abbott 68.2-100% (95% CI 53.4-100%). Sensitivity of the Abbott assay fell from approximately 5 months; on this assay paired serum samples for 45 participants showed a significant drop in the signal-to-cut-off ratio and 10 sero-reversion events. When used in clinical practice, all samples testing positive by both DiaSorin and Abbott assays were confirmed as true positive results. In this low prevalence setting, despite high laboratory specificity, the positive predictive value of a single positive assay was low. Comprehensive validation of serological assays is necessary to determine the optimal assay for each diagnostic setting. In this low prevalence setting we found implementation of two assays with different antibody targets maximised sensitivity and specificity, with confirmatory testing necessary for any sample which was positive in only one assay.
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Affiliation(s)
- K A Bond
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia.
| | - E Williams
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - S Nicholson
- Victorian Infectious Diseases Reference Laboratory at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - S Lim
- Department of General Medicine and Infectious Diseases, Royal Melbourne Hospital, Melbourne, Vic, Australia; Department of General Medicine, The University of Melbourne, Vic, Australia
| | - D Johnson
- Department of General Medicine and Infectious Diseases, Royal Melbourne Hospital, Melbourne, Vic, Australia; Department of General Medicine, The University of Melbourne, Vic, Australia
| | - B Cox
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of General Medicine and Infectious Diseases, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - M Putland
- Department of Emergency Medicine, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - E Gardiner
- Department of Emergency Medicine, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - E Tippett
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of General Medicine and Infectious Diseases, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - M Graham
- Department of Microbiology and Infectious Diseases, Monash Health, Vic, Australia; The Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and The University of Melbourne, Melbourne, Vic, Australia
| | - F Mordant
- WHO Collaborating Centre for Reference and Research on Influenza at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - M Catton
- Victorian Infectious Diseases Reference Laboratory at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - S R Lewin
- The Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and The University of Melbourne, Melbourne, Vic, Australia; Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Vic, Australia
| | - K Subbarao
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; WHO Collaborating Centre for Reference and Research on Influenza at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - B P Howden
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; The Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and The University of Melbourne, Melbourne, Vic, Australia; Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - D A Williamson
- Department of Microbiology, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; The Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and The University of Melbourne, Melbourne, Vic, Australia; Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
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49
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Wisse LEM, Ravikumar S, Ittyerah R, Lim S, Lane J, Bedard ML, Xie L, Das SR, Schuck T, Grossman M, Lee EB, Tisdall MD, Prabhakaran K, Detre JA, Mizsei G, Trojanowski JQ, Artacho-Pérula E, de Iñiguez de Onzono Martin MM, M Arroyo-Jiménez M, Muñoz Lopez M, Molina Romero FJ, P Marcos Rabal M, Cebada Sánchez S, Delgado González JC, de la Rosa Prieto C, Córcoles Parada M, Wolk DA, Irwin DJ, Insausti R, Yushkevich PA. Downstream effects of polypathology on neurodegeneration of medial temporal lobe subregions. Acta Neuropathol Commun 2021; 9:128. [PMID: 34289895 PMCID: PMC8293481 DOI: 10.1186/s40478-021-01225-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/06/2021] [Indexed: 12/14/2022] Open
Abstract
The medial temporal lobe (MTL) is a nidus for neurodegenerative pathologies and therefore an important region in which to study polypathology. We investigated associations between neurodegenerative pathologies and the thickness of different MTL subregions measured using high-resolution post-mortem MRI. Tau, TAR DNA-binding protein 43 (TDP-43), amyloid-β and α-synuclein pathology were rated on a scale of 0 (absent)-3 (severe) in the hippocampus and entorhinal cortex (ERC) of 58 individuals with and without neurodegenerative diseases (median age 75.0 years, 60.3% male). Thickness measurements in ERC, Brodmann Area (BA) 35 and 36, parahippocampal cortex, subiculum, cornu ammonis (CA)1 and the stratum radiatum lacunosum moleculare (SRLM) were derived from 0.2 × 0.2 × 0.2 mm3 post-mortem MRI scans of excised MTL specimens from the contralateral hemisphere using a semi-automated approach. Spearman's rank correlations were performed between neurodegenerative pathologies and thickness, correcting for age, sex and hemisphere, including all four proteinopathies in the model. We found significant associations of (1) TDP-43 with thickness in all subregions (r = - 0.27 to r = - 0.46), and (2) tau with BA35 (r = - 0.31) and SRLM thickness (r = - 0.33). In amyloid-β and TDP-43 negative cases, we found strong significant associations of tau with ERC (r = - 0.40), BA35 (r = - 0.55), subiculum (r = - 0.42) and CA1 thickness (r = - 0.47). This unique dataset shows widespread MTL atrophy in relation to TDP-43 pathology and atrophy in regions affected early in Braak stageing and tau pathology. Moreover, the strong association of tau with thickness in early Braak regions in the absence of amyloid-β suggests a role of Primary Age-Related Tauopathy in neurodegeneration.
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Affiliation(s)
- L E M Wisse
- Department of Diagnostic Radiology, Lund University, Klinikgatan 13b, Lund, Sweden.
- Department of Radiology, University of Pennsylvania, Philadelphia, USA.
| | - S Ravikumar
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - R Ittyerah
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - S Lim
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - J Lane
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - M L Bedard
- Department of Pharmacology, University of North Carolina At Chapel Hill, Chapel Hill, USA
| | - L Xie
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - S R Das
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - T Schuck
- Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, USA
| | - M Grossman
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - E B Lee
- Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, USA
| | - M D Tisdall
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - K Prabhakaran
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - J A Detre
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - G Mizsei
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - J Q Trojanowski
- Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, USA
| | - E Artacho-Pérula
- Human Neuroanatomy Laboratory, Neuromax CSIC Associated Unit, University of Castilla La Mancha, Albacete, Spain
| | | | - M M Arroyo-Jiménez
- Human Neuroanatomy Laboratory, Neuromax CSIC Associated Unit, University of Castilla La Mancha, Albacete, Spain
| | - M Muñoz Lopez
- Human Neuroanatomy Laboratory, Neuromax CSIC Associated Unit, University of Castilla La Mancha, Albacete, Spain
| | - F J Molina Romero
- Human Neuroanatomy Laboratory, Neuromax CSIC Associated Unit, University of Castilla La Mancha, Albacete, Spain
| | - M P Marcos Rabal
- Human Neuroanatomy Laboratory, Neuromax CSIC Associated Unit, University of Castilla La Mancha, Albacete, Spain
| | - S Cebada Sánchez
- Human Neuroanatomy Laboratory, Neuromax CSIC Associated Unit, University of Castilla La Mancha, Albacete, Spain
| | - J C Delgado González
- Human Neuroanatomy Laboratory, Neuromax CSIC Associated Unit, University of Castilla La Mancha, Albacete, Spain
| | - C de la Rosa Prieto
- Human Neuroanatomy Laboratory, Neuromax CSIC Associated Unit, University of Castilla La Mancha, Albacete, Spain
| | - M Córcoles Parada
- Human Neuroanatomy Laboratory, Neuromax CSIC Associated Unit, University of Castilla La Mancha, Albacete, Spain
| | - D A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - D J Irwin
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
- Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, USA
| | - R Insausti
- Human Neuroanatomy Laboratory, Neuromax CSIC Associated Unit, University of Castilla La Mancha, Albacete, Spain
| | - P A Yushkevich
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
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50
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Abstract
A common problem when using a variety of patient-reported outcomes (PROs) for diverse populations and subgroups is establishing a harmonized scale for the incommensurate outcomes. The lack of comparability in metrics (e.g., raw summed scores vs. scaled scores) among different PROs poses practical challenges in studies comparing effects across studies and samples. Linking has long been used for practical benefit in educational testing. Applying various linking techniques to PRO data has a relatively short history; however, in recent years, there has been a surge of published studies on linking PROs and other health outcomes, owing in part to concerted efforts such as the Patient-Reported Outcomes Measurement Information System (PROMIS®) project and the PRO Rosetta Stone (PROsetta Stone®) project (www.prosettastone.org). Many R packages have been developed for linking in educational settings; however, they are not tailored for linking PROs where harmonization of data across clinical studies or settings serves as the main objective. We created the PROsetta package to fill this gap and disseminate a protocol that has been established as a standard practice for linking PROs.
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Affiliation(s)
| | - S. Lim
- The University of Texas at Austin, USA
| | - B. D. Schalet
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - A. J. Kaat
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - D. Cella
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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