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Maruthurkkara S. Cochlear Implant Remote Assist: Clinical and Real-World Evaluation. Int J Audiol 2024:1-11. [PMID: 38696614 DOI: 10.1080/14992027.2024.2337075] [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: 03/23/2023] [Accepted: 03/20/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVES To develop and evaluate Cochlear™ Remote Assist (RA), a smartphone-based cochlear implant (CI) teleaudiology solution. The development phase aimed to identify the minimum features needed to remotely address most issues typically experienced by CI recipients. The clinical evaluation phase assessed ease of use, call clarity, system latency, and CI recipient feedback. DESIGN The development phase involved mixed methods research with experienced CI clinicians. The clinical evaluation phase involved a prospective single-site clinical study and real-world use across 16 clinics. STUDY SAMPLE CI clinicians (N = 23), CI recipients in a clinical study (N = 15 adults) and real-world data (N = 57 CI recipients). RESULTS The minimum feature set required for remote programming in RA, combined with sending replacements by post, should enable the clinician to address 80% of the issues typically seen in CI follow-up sessions. Most recipients completed the RA primary tasks without prior training and gave positive ratings for usefulness, ease of use, effectiveness, reliability, and satisfaction on the Telehealth Usability Questionnaire. System latency was reported to be acceptable. CONCLUSION RA is designed to help clinicians address a significant proportion of issues typically encountered by CI recipients. Clinical study and real-world evaluation confirm RA's ease of use, call quality, and responsiveness.
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Affiliation(s)
- Saji Maruthurkkara
- Cochlear Limited, 1 University Ave Macquarie University, Sydney, Australia
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2
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D'Amario D, Meerkin D, Restivo A, Ince H, Sievert H, Wiese A, Schaefer U, Trani C, Bayes-Genis A, Leyva F, Whinnett ZI, Di Mario C, Jonas M, Manhal H, Amat-Santos IJ, Del Trigo M, Gal TB, Ben Avraham B, Hasin T, Feickert S, D'Ancona G, Altisent OAJ, Koren O, Caspi O, Abraham WT, Crea F, Anker SD, Kornowski R, Perl L. Safety, usability, and performance of a wireless left atrial pressure monitoring system in patients with heart failure: the VECTOR-HF trial. Eur J Heart Fail 2023. [PMID: 37092287 DOI: 10.1002/ejhf.2869] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 04/09/2023] [Accepted: 04/17/2023] [Indexed: 04/25/2023] Open
Abstract
AIMS In heart failure (HF), implantable hemodynamic monitoring devices have been shown to optimize therapy, anticipating clinical decompensation and preventing hospitalization. Direct left-sided hemodynamic sensors offer theoretical benefits beyond pulmonary artery pressure (PAP) monitoring systems. We evaluated the safety, usability, and performance of a novel left atrial pressure (LAP) monitoring system in HF patients. METHODS AND RESULTS The VECTOR-HF study(NCT03775161) was a first-in-human, prospective, multicenter, single-arm, clinical trial enrolling 30 patients with HF. The device consisted of an interatrial positioned leadless sensor, able to transmit LAP data wirelessly. After three months, a right heart catheterization (RHC) was performed to correlate mean pulmonary capillary wedge pressure (PCWP) with simultaneous mean LAP obtained from the device. Remote LAP measurements were then used to guide patient management. The miniaturized device was successfully implanted in all 30 patients, without acute Major Adverse Cardiac and Neurological Events (MACNE). At 3 months, freedom from short-term MACNE was 97%. Agreement between sensor-calculated LAP and PCWP was consistent, with a mean difference of -0.22±4.92mmHg, the correlation coefficient and the Lin's Concordance Correlation Coefficient values were equal to 0.79 (P<0.0001) and 0.776 (95%CI=0.582-0.886), respectively. Preliminary experience with VLAP-based HF management was associated with significant improvements in NYHA functional class (32% of patients reached NYHA II class at 6 months, P<0.005; 60% of patients at 12 months, P<0.005) and 6-minute walk-test distance (from 244.59±119.59m at baseline to 311.78±129.88m after 6 months, P<0.05, and 343.95±146.15m after 12 months, P<0.05). CONCLUSION The V-LAP™ monitoring system proved to be generally safe and provided a good correlation with invasive PCWP. Initial evidence also suggests possible improvement in HF clinical symptoms. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Domenico D'Amario
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Catholic University of the Sacred Heart, Rome, Italy
- Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - David Meerkin
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | | | - Hüseyin Ince
- Department of Cardiology, Vivantes Klinikum im Friedrichshain and Am Urban, Berlin, Germany
- Department of Cardiology, Rostock University, Medical Center, Ernst-Heydemann-Straße 6, Rostock, Germany
| | | | - Andrea Wiese
- Department of Cardiology, Angiology and Intensive Care Medicine, Marienhospital, Hamburg, Germany
| | - Ulrich Schaefer
- Innovative Interventional Cardiology, Cardiovascular Center, Bad Bevensen, Germany
| | - Carlo Trani
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Catholic University of the Sacred Heart, Rome, Italy
| | - Antoni Bayes-Genis
- Department of Cardiology, Germans Trias University Hospital, 08916, Badalona, Spain
| | - Francisco Leyva
- Department of Cardiovascular Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Zachary I Whinnett
- National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Carlo Di Mario
- Structural Interventional Cardiology Division, Department of Experimental & Clinical Medicine, Careggi University Hospital, Florence, Italy
| | - Michael Jonas
- Heart Institute, Kaplan Medical Center, Hebrew University School of Medicine, Rehovot, Israel
| | - Habib Manhal
- Departments of Cardiology, Rambam Medical Centre and B Rappaport Faculty of Medicine, Technion Medical School Haifa, Haifa, Israel
| | - Ignacio J Amat-Santos
- CIBERCV, Cardiology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Maria Del Trigo
- Interventional Cardiology, Hospital Puerta de Hierro Majadahonda, Spain
| | - Tuvia Ben Gal
- Cardiology Department, Rabin Medical Center, Tel-Aviv University, Petach Tikva, Israel
- School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Binyamin Ben Avraham
- Cardiology Department, Rabin Medical Center, Tel-Aviv University, Petach Tikva, Israel
- School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Tal Hasin
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Sebastian Feickert
- Department of Cardiology, Vivantes Klinikum im Friedrichshain and Am Urban, Berlin, Germany
- Department of Cardiology, Rostock University, Medical Center, Ernst-Heydemann-Straße 6, Rostock, Germany
| | - Giuseppe D'Ancona
- Department of Cardiology, Vivantes Klinikum im Friedrichshain and Am Urban, Berlin, Germany
- Department of Cardiology, Rostock University, Medical Center, Ernst-Heydemann-Straße 6, Rostock, Germany
| | - Omar Abdul-Jawad Altisent
- Department of Cardiology, Germans Trias University Hospital, 08916, Badalona, Spain
- Interventional Cardiologist, ICCV Hospital Clínic de Barcelona, Spain
| | - Oran Koren
- School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Oren Caspi
- Departments of Cardiology, Rambam Medical Centre and B Rappaport Faculty of Medicine, Technion Medical School Haifa, Haifa, Israel
| | - William T Abraham
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Filippo Crea
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Catholic University of the Sacred Heart, Rome, Italy
| | - Stefan D Anker
- Department of Cardiology (CVK) of German Heart Center Charité, Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK), partner site Berlin, Charité Universitätsmedizin, Berlin, Germany
| | - Ran Kornowski
- Cardiology Department, Rabin Medical Center, Tel-Aviv University, Petach Tikva, Israel
| | - Leor Perl
- Cardiology Department, Rabin Medical Center, Tel-Aviv University, Petach Tikva, Israel
- School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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3
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Muehlensiepen F, May S, Zarbl J, Vogt E, Boy K, Heinze M, Boeltz S, Labinsky H, Bendzuck G, Korinth M, Elling-Audersch C, Vuillerme N, Schett G, Krönke G, Knitza J. At-home blood self-sampling in rheumatology: a qualitative study with patients and health care professionals. BMC Health Serv Res 2022; 22:1470. [PMID: 36461025 PMCID: PMC9718468 DOI: 10.1186/s12913-022-08787-5] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 11/04/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The goal of the study was to investigate patients' with systemic rheumatic diseases and healthcare professionals' experiences and preferences regarding self-sampling of capillary blood in rheumatology care. METHODS Patients performed a supervised and consecutive unsupervised capillary blood self-collection using an upper arm based device. Subsequently, patients (n = 15) and their attending health care professionals (n = 5) participated in an explorative, qualitative study using problem-centered, telephone interviews. Interview data were analyzed using structured qualitative content analysis. RESULTS Interviewed patients reported easy application and high usability. Patients and health care professionals alike reported time and cost savings, increased independence and flexibility, improved monitoring and reduction of risk of infection during Covid-19 as benefits. Reported drawbacks include limited blood volume, limited usability in case of functional restrictions, and environmental concerns. Older, immobile patients with long journeys to traditional blood collection sites and young patients with little time to spare for traditional blood collection appointments could be user groups, likely to benefit from self-sampling services. CONCLUSIONS At-home blood self-sampling could effectively complement current rheumatology telehealth care. Appropriateness and value of this service needs to be carefully discussed with patients on an individual basis. TRIAL REGISTRATION WHO International Clinical Trials Registry: DRKS00024925. Registered on 15/04/2021.
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Affiliation(s)
- Felix Muehlensiepen
- grid.473452.3Brandenburg Medical School Theodor Fontane, Center for Health Services Research, Seebad 82/83, Rüdersdorf Bei Berlin, 15562 Rüdersdorf, Germany ,grid.473452.3Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany ,grid.450307.50000 0001 0944 2786AGEIS, Université Grenoble Alpes, Grenoble, France
| | - Susann May
- grid.473452.3Brandenburg Medical School Theodor Fontane, Center for Health Services Research, Seebad 82/83, Rüdersdorf Bei Berlin, 15562 Rüdersdorf, Germany
| | - Joshua Zarbl
- grid.5330.50000 0001 2107 3311Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany ,grid.5330.50000 0001 2107 3311Deutsches Zentrum Für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Ekaterina Vogt
- grid.424957.90000 0004 0624 9165Thermo Fisher Scientific, Freiburg, Germany
| | - Katharina Boy
- grid.473452.3Brandenburg Medical School Theodor Fontane, Center for Health Services Research, Seebad 82/83, Rüdersdorf Bei Berlin, 15562 Rüdersdorf, Germany
| | - Martin Heinze
- grid.473452.3Brandenburg Medical School Theodor Fontane, Center for Health Services Research, Seebad 82/83, Rüdersdorf Bei Berlin, 15562 Rüdersdorf, Germany ,grid.473452.3Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
| | - Sebastian Boeltz
- grid.5330.50000 0001 2107 3311Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany ,grid.5330.50000 0001 2107 3311Deutsches Zentrum Für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Hannah Labinsky
- grid.5330.50000 0001 2107 3311Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany ,grid.5330.50000 0001 2107 3311Deutsches Zentrum Für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Gerlinde Bendzuck
- grid.491693.00000 0000 8835 4911Deutsche Rheuma-Liga Bundesverband E.V, Bonn, Germany
| | - Marianne Korinth
- grid.491693.00000 0000 8835 4911Deutsche Rheuma-Liga Bundesverband E.V, Bonn, Germany
| | | | - Nicolas Vuillerme
- grid.450307.50000 0001 0944 2786AGEIS, Université Grenoble Alpes, Grenoble, France ,grid.440891.00000 0001 1931 4817Institut Universitaire de France, Paris, France ,grid.4444.00000 0001 2112 9282LabCom Telecom4Health, Orange Labs & Univ. Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, Grenoble, France
| | - Georg Schett
- grid.5330.50000 0001 2107 3311Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany ,grid.5330.50000 0001 2107 3311Deutsches Zentrum Für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Gerhard Krönke
- grid.5330.50000 0001 2107 3311Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany ,grid.5330.50000 0001 2107 3311Deutsches Zentrum Für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Johannes Knitza
- grid.450307.50000 0001 0944 2786AGEIS, Université Grenoble Alpes, Grenoble, France ,grid.5330.50000 0001 2107 3311Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany ,grid.5330.50000 0001 2107 3311Deutsches Zentrum Für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
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4
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Tong L, George B, Crotty BH, Somai M, Taylor BW, Osinski K, Luo J. Telemedicine and health disparities: Association between patient characteristics and telemedicine, in-person, telephone and message-based care during the COVID-19 pandemic. IPEM Transl 2022; 3:100010. [PMID: 36340828 PMCID: PMC9617798 DOI: 10.1016/j.ipemt.2022.100010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/22/2022] [Accepted: 10/24/2022] [Indexed: 12/05/2022]
Abstract
Telemedicine has been an essential form of care since the onset of the COVID-19 pandemic. However, telemedicine may exacerbate disparities for populations with limited digital literacy or access, such as older adults, racial minorities, patients of low income, rural residences, or limited English proficiency. From March 2020 to March 2022, this retrospective cohort study analyzed the use of in-person, phone/message, and telemedical care at a single tertiary care center in an oncology department. We investigated the association between economic, racial, ethnic, socioeconomic factors and forms of care, including in-person visits, telemedicine-based visits, and telephone/messages. The study results show that telemedicine utilization is lower among patients 65 and older, female patients, American Indian or Alaska Native patients, uninsured patients, and patients who require interpreters during clinical visits. As a result, it is unlikely that telemedicine will provide equal access to clinical care for all populations. On the other hand, in-person care utilization remains low in low-income and rural-living patients compared to the general population, while telephone and message use remains high in low-income and rural-living patients. We conclude that telemedicine is currently unable to close the utilization gap for populations of low socioeconomic status. Patients with low socioeconomic status use in-person care less frequently. For the disadvantaged, unusually high telephone or message utilization is unlikely to provide the same quality as in-person or telemedical care. Understanding the causes of disparity and promoting a solution to improve equal access to care for all patients is critical.
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Affiliation(s)
- Ling Tong
- University of Wisconsin-Milwaukee, Department of Health Informatics and Administration, United States
| | - Ben George
- Medical College of Wisconsin, Clinical and Translational Science Institute of Southeastern Wisconsin, Froedtert Hospital, United States
| | - Bradley H Crotty
- Medical College of Wisconsin, Clinical and Translational Science Institute of Southeastern Wisconsin, United States
| | - Melek Somai
- Medical College of Wisconsin, Clinical and Translational Science Institute of Southeastern Wisconsin, United States
| | - Bradley W Taylor
- Medical College of Wisconsin, Clinical and Translational Science Institute of Southeastern Wisconsin, United States
| | - Kristen Osinski
- Medical College of Wisconsin, Clinical and Translational Science Institute of Southeastern Wisconsin, United States
| | - Jake Luo
- University of Wisconsin-Milwaukee, Department of Health Informatics and Administration, United States
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5
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Banks J, Corrigan D, Grogan R, El-Naggar H, White M, Doran E, Synnott C, Fitzsimons M, Delanty N, Doherty CP. LoVE in a time of CoVID: Clinician and patient experience using telemedicine for chronic epilepsy management. Epilepsy Behav 2021; 115:107675. [PMID: 33342712 PMCID: PMC9760117 DOI: 10.1016/j.yebeh.2020.107675] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/25/2020] [Accepted: 11/25/2020] [Indexed: 02/06/2023]
Abstract
As part of our ongoing interest in patient- and family-centered care in epilepsy, we began, before the onset of the CoVID-19 pandemic, to evaluate the concerns and preferences of those delivering and receiving care via telemedicine. CoVID-19 arrived and acted as an unexpected experiment in nature, catalyzing telemedicine's widespread implementation across many disciplines of medicine. The arrival of CoVID-19 in Ireland gave us the opportunity to record these perceptions pre- and post-CoVID. Data were extracted from the National Epilepsy Electronic Patient Record (EEPR). Power BI Analytics collated data from two epilepsy centers in Dublin. Analysis of data on reasons for using the telephone support line was conducted. A subset of patients and clinicians who attended virtual encounters over both periods were asked for their perception of telemedicine care through a mixed methods survey. Between 23rd December 2019 and 23rd March 2020 (pre-CoVID era), a total of 1180 patients were seen in 1653 clinical encounters. As part of a telemedicine pilot study, 50 of these encounters were scheduled virtual telephone appointments. Twenty eight surveys were completed by clinicians and 18 by patients during that period. From 24th March 2020 to 24th June 2020, 1164 patients were seen in 1693 encounters of which 729 (63%) patients were seen in 748 scheduled virtual encounters. 118 clinician impressions were captured through an online survey and 75 patients or carers completed a telephone survey during the post-CoVID era. There was no backlog of appointments or loss of care continuity forced by the pandemic. Clinicians expressed strong levels of satisfaction, but some doubted the suitability of new patients to the service or candidates for surgery receiving care via telemedicine. Patients reported positive experiences surrounding telephone appointments comparing them favorably to face-to-face encounters. The availability of a shared EEPR demonstrated no loss of care contact for patients with epilepsy. The survey showed that telemedicine is seen as an effective and satisfactory method of delivering chronic outpatient care.
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Affiliation(s)
- Jack Banks
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland; Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
| | - Derek Corrigan
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland
| | - Roger Grogan
- Department of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Hany El-Naggar
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland,Department of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Máire White
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland,Department of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Elisabeth Doran
- Department of Neurology, St. James’s Hospital, Dublin 8, Ireland
| | - Cara Synnott
- Department of Neurology, St. James’s Hospital, Dublin 8, Ireland
| | - Mary Fitzsimons
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland
| | - Norman Delanty
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland,Department of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Colin P. Doherty
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland,Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland,Department of Neurology, St. James’s Hospital, Dublin 8, Ireland
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