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Ronca F, Blodgett JM, Bruinvels G, Lowery M, Raviraj M, Sandhar G, Symeonides N, Jones C, Loosemore M, Burgess PW. Attentional, anticipatory and spatial cognition fluctuate throughout the menstrual cycle: potential implications for female sport. Neuropsychologia 2024:108909. [PMID: 38762068 DOI: 10.1016/j.neuropsychologia.2024.108909] [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: 02/02/2024] [Revised: 05/06/2024] [Accepted: 05/15/2024] [Indexed: 05/20/2024]
Abstract
Current research suggests that menstruating female athletes might be at greater risk of musculoskeletal injury in relation to hormonal changes throughout the menstrual cycle. A separate body of work suggests that spatial cognition might also fluctuate in a similar manner. Changes in spatial cognition could, in theory, be a contributing risk factor for injury, especially in fast-paced sports that require precise, millisecond accuracy in interactions with moving objects in the environment. However, existing theories surrounding causes for increased injury risk in menstruating females largely focus on biomechanical mechanisms, with little consideration of possible cognitive determinants of injury risk. Therefore, the aim of this proof-of-principle study was to explore whether menstruating females exhibit fluctuations in cognitive processes throughout their cycle on a novel sport-oriented cognitive test battery, designed to measure some of the mental processes putatively involved in these sporting situations. A total of 394 participants completed an online cognitive battery, a mood scale and a symptom questionnaire twice, 14 days apart. After exclusions, 241 eligible participants were included in the analyses (mean: 28 ± 6 years) (male = 96, female(menstruating) = 105, female(contraception) = 47). Cycle phase for menstruating females was based on self-reported information. The cognitive battery was designed to measure reaction times, attention, visuospatial functions (including 3D mental rotation) and timing anticipation. Three composite scores were generated using factor analysis with varimax rotation (Errors, Reaction Time, Intra-Individual Variability). Mixed model ANOVAs and repeated measures ANOVAs were performed to test for between and within-subject effects. There was no group difference in reaction times and accuracy between males and females (using contraception and not). However, within subject analyses revealed that regularly menstruating females performed better during menstruation compared to being in any other phase, with faster reaction times (10ms c.ca, p < .01), fewer errors (p < .05) and lower dispersion intra-individual variability (p < .05). In contrast they exhibited slower reaction times (10ms c.ca, p < .01) and poorer timing anticipation (p < .01) in the luteal phase, and more errors in the predicted ovulatory phase (p < .01). Self-reported mood, cognitive and physical symptoms were all worst during menstruation (p < .01), and a significant proportion of females felt that their symptoms were negatively affecting their cognitive performance during menstruation on testing day, which was incongruent with their actual performance. These findings suggest that visuospatial and anticipatory processes may fluctuate throughout the menstrual cycle in the general population, with better performance during the menstrual phase and poorer performance during the luteal phase. If these extend to associations between phase-specific cognitive performance and injury incidence, they would support a cognitive theory of determinants of injury risk in cycling female athletes, opening an opportunity to develop mitigation strategies where appropriate.
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Affiliation(s)
- F Ronca
- Institute of Sport, Exercise and Health, University College London, London, UK.
| | - J M Blodgett
- Institute of Sport, Exercise and Health, University College London, London, UK; NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - G Bruinvels
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - M Lowery
- Institute of Sport, Exercise and Health, University College London, London, UK; Sport and Wellbeing Analytics Limited, Swansea, UK
| | - M Raviraj
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - G Sandhar
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - N Symeonides
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - C Jones
- Institute of Sport, Exercise and Health, University College London, London, UK; Sport and Wellbeing Analytics Limited, Swansea, UK
| | - M Loosemore
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - P W Burgess
- Institute of Cognitive Neuroscience, University College London, London, UK
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2
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Khawar H, Jones C, Eardley W, Johansen A, Inman D, Whitehouse M, Evans J. The burden of periprosthetic femoral fractures in England and Wales: Insights from the first two years of data collection in the National Hip Fracture Database and regional variation in care. Injury 2024; 55:111609. [PMID: 38781619 DOI: 10.1016/j.injury.2024.111609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/24/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Periprosthetic femoral fractures (PPFFs) represent an important healthcare problem, with a rising incidence noted due to an increase in the number of arthroplasty surgeries being performed. There is a current lack of national consensus as to how these complex, often frail patients are managed. AIMS Our primary aim was to present the epidemiology of PPFFs in England and Wales over the first two years of data collection by the National Hip Fracture Database (NHFD). Secondary aims included how well the NHFD Key Performance Indicators (KPIs) are met for PPFF patients, whether centres reporting a higher burden of PPFF patients are more likely to meet KPIs compared to lower volume centres, and to also identify if regional variation in care for these patients exist. METHODS Patients aged 60 years or over, admitted to any acute hospital in England or Wales with a PPFF within the period 1st January 2020 to 31st December 2021 were included. Fractures were classified using the Vancouver system. The primary outcome of interest was the incidence of PPFF in England and Wales. Secondary outcomes included i) geographical distribution, ii) pattern of injury, iii) treatment received, iv) KPI performance nationally, v) KPI performance by top 5 highest volume hospitals vs the rest, vi) KPI performance by region and vii) KPI performance compared with native hip fracture patients. RESULTS A total of 5,566 PPFFs were reported during our study period. A 31 % increase in cases was seen between 2020 and 2021 (2,405 to 3,161). The South-West of England reported the highest burden of PPFFs (14 % of all cases reported in 2021). Vancouver B subtypes were most common around hip replacements (62 %) and C subtype around knee replacements (55 %). A total of 4,598 patients (82.6 %) underwent operative management. There was regional variation in KPI attainment. When compared to KPI attainment for native hip fractures PPFF care under performed in most regions and domains. High volume PPFF centres were not associated with improved attainment of KPIs. CONCLUSION We have described the incidence, nature, and management of PPFF at national and regional levels using routinely collected NHFD data. Both numerically and due to case complexity, PPFF are a considerable challenge to patients and health services alike. This epidemiology is not captured by other existing datasets and increased case contribution to the NHFD is encouraged to improve understanding and enable prioritisation and delivery of further care and research.
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Affiliation(s)
| | - Conor Jones
- Royal Devon University Healthcare NHS Trust, United Kingdom
| | | | | | - Dominic Inman
- Northumbria Healthcare NHS Foundation Trust, United Kingdom
| | | | - Jonathan Evans
- Royal Devon University Healthcare NHS Trust, United Kingdom
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3
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Kuhnl A, Roddie C, Kirkwood AA, Chaganti S, Norman J, Lugthart S, Osborne W, Gibb A, Gonzalez Arias C, Latif A, Uttenthal B, Seymour F, Jones C, Springell D, Brady JL, Illidge T, Stevens A, Alexander E, Hawley L, O'Rourke N, Bedi C, Prestwich R, Frew J, Burns D, O'Reilly M, Sanderson R, Sivabalasingham S, Mikhaeel NG. Outcome and feasibility of radiotherapy bridging in large B-cell lymphoma patients receiving CD19 CAR T in the UK. Br J Haematol 2024. [PMID: 38594876 DOI: 10.1111/bjh.19453] [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: 02/06/2024] [Revised: 03/07/2024] [Accepted: 03/27/2024] [Indexed: 04/11/2024]
Abstract
Radiotherapy (RT) has potential synergistic effects with chimeric antigen receptor (CAR) T but is not widely used as bridging therapy due to logistical challenges and lack of standardised protocols. We analysed RT bridging in a multicentre national cohort of large B-cell lymphoma patients approved for 3L axicabtagene ciloleucel or tisagenlecleucel across 12 UK centres. Of 763 approved patients, 722 were leukapheresed, 717 had data available on bridging therapy. 169/717 (24%) received RT bridging, 129 as single modality and 40 as combined modality treatment (CMT). Of 169 patients, 65.7% had advanced stage, 36.9% bulky disease, 86.5% elevated LDH, 41.7% international prognostic index (IPI) ≥3 and 15.2% double/triple hit at the time of approval. Use of RT bridging varied from 11% to 32% between centres and increased over time. Vein-to-vein time and infusion rate did not differ between bridging modalities. RT-bridged patients had favourable outcomes with 1-year progression-free survival (PFS) of 56% for single modality and 47% for CMT (1-year PFS 43% for systemic bridging). This is the largest cohort of LBCL patients receiving RT bridging prior to CAR T reported to date. Our results show that RT bridging can be safely and effectively used even in advanced stage and high-risk disease, with low dropout rates and excellent outcomes.
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Affiliation(s)
- A Kuhnl
- Department of Haematology, King's College Hospital, London, UK
| | - C Roddie
- University College London Hospitals, London, UK
- UCL Cancer Institute, University College London, London, UK
| | - A A Kirkwood
- Cancer Research UK & UCL Cancer Trials Centre, UCL Cancer Institute, UCL, London, UK
| | - S Chaganti
- Queen Elizabeth Hospital, Birmingham, UK
| | - J Norman
- Department of Haematology, Manchester Royal Infirmary, Manchester, UK
| | - S Lugthart
- University Hospitals Bristol and Weston, Bristol, UK
| | - W Osborne
- Freeman Hospital, Newcastle, UK
- Newcastle University, Newcastle, UK
| | - A Gibb
- Department of Medical Oncology, The Christie Hospital, Manchester, UK
| | | | - A Latif
- Queen Elizabeth University Hospital, Glasgow, UK
| | - B Uttenthal
- Department of Haematology, Addenbrooke's Hospital, Cambridge, UK
| | | | - C Jones
- Department of Haematology, University Hospital of Wales, Cardiff, UK
| | - D Springell
- University College London Hospitals, London, UK
| | - J L Brady
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - T Illidge
- Cancer Sciences, University of Manchester Christie NHS Trust, Manchester NIHR BRC, Manchester, UK
| | - A Stevens
- Queen Elizabeth Hospital, Birmingham, UK
| | | | - L Hawley
- University Hospitals Bristol and Weston, Bristol, UK
| | - N O'Rourke
- Queen Elizabeth University Hospital, Glasgow, UK
| | - C Bedi
- Western General Hospital, Edinburgh, UK
| | | | - J Frew
- Freeman Hospital, Newcastle, UK
| | - D Burns
- Queen Elizabeth Hospital, Birmingham, UK
| | - M O'Reilly
- University College London Hospitals, London, UK
| | - R Sanderson
- Department of Haematology, King's College Hospital, London, UK
| | | | - N G Mikhaeel
- Guy's and St Thomas' NHS Foundation Trust, London, UK
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4
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Rosenberg E, Andersen TI, Samajdar R, Petukhov A, Hoke JC, Abanin D, Bengtsson A, Drozdov IK, Erickson C, Klimov PV, Mi X, Morvan A, Neeley M, Neill C, Acharya R, Allen R, Anderson K, Ansmann M, Arute F, Arya K, Asfaw A, Atalaya J, Bardin JC, Bilmes A, Bortoli G, Bourassa A, Bovaird J, Brill L, Broughton M, Buckley BB, Buell DA, Burger T, Burkett B, Bushnell N, Campero J, Chang HS, Chen Z, Chiaro B, Chik D, Cogan J, Collins R, Conner P, Courtney W, Crook AL, Curtin B, Debroy DM, Barba ADT, Demura S, Di Paolo A, Dunsworth A, Earle C, Faoro L, Farhi E, Fatemi R, Ferreira VS, Burgos LF, Forati E, Fowler AG, Foxen B, Garcia G, Genois É, Giang W, Gidney C, Gilboa D, Giustina M, Gosula R, Dau AG, Gross JA, Habegger S, Hamilton MC, Hansen M, Harrigan MP, Harrington SD, Heu P, Hill G, Hoffmann MR, Hong S, Huang T, Huff A, Huggins WJ, Ioffe LB, Isakov SV, Iveland J, Jeffrey E, Jiang Z, Jones C, Juhas P, Kafri D, Khattar T, Khezri M, Kieferová M, Kim S, Kitaev A, Klots AR, Korotkov AN, Kostritsa F, Kreikebaum JM, Landhuis D, Laptev P, Lau KM, Laws L, Lee J, Lee KW, Lensky YD, Lester BJ, Lill AT, Liu W, Locharla A, Mandrà S, Martin O, Martin S, McClean JR, McEwen M, Meeks S, Miao KC, Mieszala A, Montazeri S, Movassagh R, Mruczkiewicz W, Nersisyan A, Newman M, Ng JH, Nguyen A, Nguyen M, Niu MY, O'Brien TE, Omonije S, Opremcak A, Potter R, Pryadko LP, Quintana C, Rhodes DM, Rocque C, Rubin NC, Saei N, Sank D, Sankaragomathi K, Satzinger KJ, Schurkus HF, Schuster C, Shearn MJ, Shorter A, Shutty N, Shvarts V, Sivak V, Skruzny J, Smith WC, Somma RD, Sterling G, Strain D, Szalay M, Thor D, Torres A, Vidal G, Villalonga B, Heidweiller CV, White T, Woo BWK, Xing C, Yao ZJ, Yeh P, Yoo J, Young G, Zalcman A, Zhang Y, Zhu N, Zobrist N, Neven H, Babbush R, Bacon D, Boixo S, Hilton J, Lucero E, Megrant A, Kelly J, Chen Y, Smelyanskiy V, Khemani V, Gopalakrishnan S, Prosen T, Roushan P. Dynamics of magnetization at infinite temperature in a Heisenberg spin chain. Science 2024; 384:48-53. [PMID: 38574139 DOI: 10.1126/science.adi7877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 03/01/2024] [Indexed: 04/06/2024]
Abstract
Understanding universal aspects of quantum dynamics is an unresolved problem in statistical mechanics. In particular, the spin dynamics of the one-dimensional Heisenberg model were conjectured as to belong to the Kardar-Parisi-Zhang (KPZ) universality class based on the scaling of the infinite-temperature spin-spin correlation function. In a chain of 46 superconducting qubits, we studied the probability distribution of the magnetization transferred across the chain's center, [Formula: see text]. The first two moments of [Formula: see text] show superdiffusive behavior, a hallmark of KPZ universality. However, the third and fourth moments ruled out the KPZ conjecture and allow for evaluating other theories. Our results highlight the importance of studying higher moments in determining dynamic universality classes and provide insights into universal behavior in quantum systems.
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Affiliation(s)
- E Rosenberg
- Google Research, Mountain View, CA, USA
- Department of Physics, Cornell University, Ithaca, NY, USA
| | | | - R Samajdar
- Department of Physics, Princeton University, Princeton, NJ, USA
- Princeton Center for Theoretical Science, Princeton University, Princeton, NJ, USA
| | | | - J C Hoke
- Department of Physics, Stanford University, Stanford, CA, USA
| | - D Abanin
- Google Research, Mountain View, CA, USA
| | | | - I K Drozdov
- Google Research, Mountain View, CA, USA
- Department of Physics, University of Connecticut, Storrs, CT, USA
| | | | | | - X Mi
- Google Research, Mountain View, CA, USA
| | - A Morvan
- Google Research, Mountain View, CA, USA
| | - M Neeley
- Google Research, Mountain View, CA, USA
| | - C Neill
- Google Research, Mountain View, CA, USA
| | - R Acharya
- Google Research, Mountain View, CA, USA
| | - R Allen
- Google Research, Mountain View, CA, USA
| | | | - M Ansmann
- Google Research, Mountain View, CA, USA
| | - F Arute
- Google Research, Mountain View, CA, USA
| | - K Arya
- Google Research, Mountain View, CA, USA
| | - A Asfaw
- Google Research, Mountain View, CA, USA
| | - J Atalaya
- Google Research, Mountain View, CA, USA
| | - J C Bardin
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of Massachusetts, Amherst, MA, USA
| | - A Bilmes
- Google Research, Mountain View, CA, USA
| | - G Bortoli
- Google Research, Mountain View, CA, USA
| | | | - J Bovaird
- Google Research, Mountain View, CA, USA
| | - L Brill
- Google Research, Mountain View, CA, USA
| | | | | | - D A Buell
- Google Research, Mountain View, CA, USA
| | - T Burger
- Google Research, Mountain View, CA, USA
| | - B Burkett
- Google Research, Mountain View, CA, USA
| | | | - J Campero
- Google Research, Mountain View, CA, USA
| | - H-S Chang
- Google Research, Mountain View, CA, USA
| | - Z Chen
- Google Research, Mountain View, CA, USA
| | - B Chiaro
- Google Research, Mountain View, CA, USA
| | - D Chik
- Google Research, Mountain View, CA, USA
| | - J Cogan
- Google Research, Mountain View, CA, USA
| | - R Collins
- Google Research, Mountain View, CA, USA
| | - P Conner
- Google Research, Mountain View, CA, USA
| | | | - A L Crook
- Google Research, Mountain View, CA, USA
| | - B Curtin
- Google Research, Mountain View, CA, USA
| | | | | | - S Demura
- Google Research, Mountain View, CA, USA
| | | | | | - C Earle
- Google Research, Mountain View, CA, USA
| | - L Faoro
- Google Research, Mountain View, CA, USA
| | - E Farhi
- Google Research, Mountain View, CA, USA
| | - R Fatemi
- Google Research, Mountain View, CA, USA
| | | | | | - E Forati
- Google Research, Mountain View, CA, USA
| | | | - B Foxen
- Google Research, Mountain View, CA, USA
| | - G Garcia
- Google Research, Mountain View, CA, USA
| | - É Genois
- Google Research, Mountain View, CA, USA
| | - W Giang
- Google Research, Mountain View, CA, USA
| | - C Gidney
- Google Research, Mountain View, CA, USA
| | - D Gilboa
- Google Research, Mountain View, CA, USA
| | | | - R Gosula
- Google Research, Mountain View, CA, USA
| | | | - J A Gross
- Google Research, Mountain View, CA, USA
| | | | - M C Hamilton
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA
| | - M Hansen
- Google Research, Mountain View, CA, USA
| | | | | | - P Heu
- Google Research, Mountain View, CA, USA
| | - G Hill
- Google Research, Mountain View, CA, USA
| | | | - S Hong
- Google Research, Mountain View, CA, USA
| | - T Huang
- Google Research, Mountain View, CA, USA
| | - A Huff
- Google Research, Mountain View, CA, USA
| | | | - L B Ioffe
- Google Research, Mountain View, CA, USA
| | | | - J Iveland
- Google Research, Mountain View, CA, USA
| | - E Jeffrey
- Google Research, Mountain View, CA, USA
| | - Z Jiang
- Google Research, Mountain View, CA, USA
| | - C Jones
- Google Research, Mountain View, CA, USA
| | - P Juhas
- Google Research, Mountain View, CA, USA
| | - D Kafri
- Google Research, Mountain View, CA, USA
| | - T Khattar
- Google Research, Mountain View, CA, USA
| | - M Khezri
- Google Research, Mountain View, CA, USA
| | - M Kieferová
- Google Research, Mountain View, CA, USA
- QSI, Faculty of Engineering & Information Technology, University of Technology Sydney, Ultimo, NSW, Australia
| | - S Kim
- Google Research, Mountain View, CA, USA
| | - A Kitaev
- Google Research, Mountain View, CA, USA
| | - A R Klots
- Google Research, Mountain View, CA, USA
| | - A N Korotkov
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of California, Riverside, CA, USA
| | | | | | | | - P Laptev
- Google Research, Mountain View, CA, USA
| | - K-M Lau
- Google Research, Mountain View, CA, USA
| | - L Laws
- Google Research, Mountain View, CA, USA
| | - J Lee
- Google Research, Mountain View, CA, USA
- Department of Chemistry, Columbia University, New York, NY, USA
| | - K W Lee
- Google Research, Mountain View, CA, USA
| | | | | | - A T Lill
- Google Research, Mountain View, CA, USA
| | - W Liu
- Google Research, Mountain View, CA, USA
| | | | - S Mandrà
- Google Research, Mountain View, CA, USA
| | - O Martin
- Google Research, Mountain View, CA, USA
| | - S Martin
- Google Research, Mountain View, CA, USA
| | | | - M McEwen
- Google Research, Mountain View, CA, USA
| | - S Meeks
- Google Research, Mountain View, CA, USA
| | - K C Miao
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - M Newman
- Google Research, Mountain View, CA, USA
| | - J H Ng
- Google Research, Mountain View, CA, USA
| | - A Nguyen
- Google Research, Mountain View, CA, USA
| | - M Nguyen
- Google Research, Mountain View, CA, USA
| | - M Y Niu
- Google Research, Mountain View, CA, USA
| | | | - S Omonije
- Google Research, Mountain View, CA, USA
| | | | - R Potter
- Google Research, Mountain View, CA, USA
| | - L P Pryadko
- Department of Physics and Astronomy, University of California, Riverside, CA, USA
| | | | | | - C Rocque
- Google Research, Mountain View, CA, USA
| | - N C Rubin
- Google Research, Mountain View, CA, USA
| | - N Saei
- Google Research, Mountain View, CA, USA
| | - D Sank
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - A Shorter
- Google Research, Mountain View, CA, USA
| | - N Shutty
- Google Research, Mountain View, CA, USA
| | - V Shvarts
- Google Research, Mountain View, CA, USA
| | - V Sivak
- Google Research, Mountain View, CA, USA
| | - J Skruzny
- Google Research, Mountain View, CA, USA
| | | | - R D Somma
- Google Research, Mountain View, CA, USA
| | | | - D Strain
- Google Research, Mountain View, CA, USA
| | - M Szalay
- Google Research, Mountain View, CA, USA
| | - D Thor
- Google Research, Mountain View, CA, USA
| | - A Torres
- Google Research, Mountain View, CA, USA
| | - G Vidal
- Google Research, Mountain View, CA, USA
| | | | | | - T White
- Google Research, Mountain View, CA, USA
| | - B W K Woo
- Google Research, Mountain View, CA, USA
| | - C Xing
- Google Research, Mountain View, CA, USA
| | | | - P Yeh
- Google Research, Mountain View, CA, USA
| | - J Yoo
- Google Research, Mountain View, CA, USA
| | - G Young
- Google Research, Mountain View, CA, USA
| | - A Zalcman
- Google Research, Mountain View, CA, USA
| | - Y Zhang
- Google Research, Mountain View, CA, USA
| | - N Zhu
- Google Research, Mountain View, CA, USA
| | - N Zobrist
- Google Research, Mountain View, CA, USA
| | - H Neven
- Google Research, Mountain View, CA, USA
| | - R Babbush
- Google Research, Mountain View, CA, USA
| | - D Bacon
- Google Research, Mountain View, CA, USA
| | - S Boixo
- Google Research, Mountain View, CA, USA
| | - J Hilton
- Google Research, Mountain View, CA, USA
| | - E Lucero
- Google Research, Mountain View, CA, USA
| | - A Megrant
- Google Research, Mountain View, CA, USA
| | - J Kelly
- Google Research, Mountain View, CA, USA
| | - Y Chen
- Google Research, Mountain View, CA, USA
| | | | - V Khemani
- Department of Physics, Stanford University, Stanford, CA, USA
| | | | - T Prosen
- Faculty of Mathematics and Physics, University of Ljubljana, Ljubljana, Slovenia
| | - P Roushan
- Google Research, Mountain View, CA, USA
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5
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Mi X, Michailidis AA, Shabani S, Miao KC, Klimov PV, Lloyd J, Rosenberg E, Acharya R, Aleiner I, Andersen TI, Ansmann M, Arute F, Arya K, Asfaw A, Atalaya J, Bardin JC, Bengtsson A, Bortoli G, Bourassa A, Bovaird J, Brill L, Broughton M, Buckley BB, Buell DA, Burger T, Burkett B, Bushnell N, Chen Z, Chiaro B, Chik D, Chou C, Cogan J, Collins R, Conner P, Courtney W, Crook AL, Curtin B, Dau AG, Debroy DM, Del Toro Barba A, Demura S, Di Paolo A, Drozdov IK, Dunsworth A, Erickson C, Faoro L, Farhi E, Fatemi R, Ferreira VS, Burgos LF, Forati E, Fowler AG, Foxen B, Genois É, Giang W, Gidney C, Gilboa D, Giustina M, Gosula R, Gross JA, Habegger S, Hamilton MC, Hansen M, Harrigan MP, Harrington SD, Heu P, Hoffmann MR, Hong S, Huang T, Huff A, Huggins WJ, Ioffe LB, Isakov SV, Iveland J, Jeffrey E, Jiang Z, Jones C, Juhas P, Kafri D, Kechedzhi K, Khattar T, Khezri M, Kieferová M, Kim S, Kitaev A, Klots AR, Korotkov AN, Kostritsa F, Kreikebaum JM, Landhuis D, Laptev P, Lau KM, Laws L, Lee J, Lee KW, Lensky YD, Lester BJ, Lill AT, Liu W, Locharla A, Malone FD, Martin O, McClean JR, McEwen M, Mieszala A, Montazeri S, Morvan A, Movassagh R, Mruczkiewicz W, Neeley M, Neill C, Nersisyan A, Newman M, Ng JH, Nguyen A, Nguyen M, Niu MY, O'Brien TE, Opremcak A, Petukhov A, Potter R, Pryadko LP, Quintana C, Rocque C, Rubin NC, Saei N, Sank D, Sankaragomathi K, Satzinger KJ, Schurkus HF, Schuster C, Shearn MJ, Shorter A, Shutty N, Shvarts V, Skruzny J, Smith WC, Somma R, Sterling G, Strain D, Szalay M, Torres A, Vidal G, Villalonga B, Heidweiller CV, White T, Woo BWK, Xing C, Yao ZJ, Yeh P, Yoo J, Young G, Zalcman A, Zhang Y, Zhu N, Zobrist N, Neven H, Babbush R, Bacon D, Boixo S, Hilton J, Lucero E, Megrant A, Kelly J, Chen Y, Roushan P, Smelyanskiy V, Abanin DA. Stable quantum-correlated many-body states through engineered dissipation. Science 2024; 383:1332-1337. [PMID: 38513021 DOI: 10.1126/science.adh9932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 02/13/2024] [Indexed: 03/23/2024]
Abstract
Engineered dissipative reservoirs have the potential to steer many-body quantum systems toward correlated steady states useful for quantum simulation of high-temperature superconductivity or quantum magnetism. Using up to 49 superconducting qubits, we prepared low-energy states of the transverse-field Ising model through coupling to dissipative auxiliary qubits. In one dimension, we observed long-range quantum correlations and a ground-state fidelity of 0.86 for 18 qubits at the critical point. In two dimensions, we found mutual information that extends beyond nearest neighbors. Lastly, by coupling the system to auxiliaries emulating reservoirs with different chemical potentials, we explored transport in the quantum Heisenberg model. Our results establish engineered dissipation as a scalable alternative to unitary evolution for preparing entangled many-body states on noisy quantum processors.
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Affiliation(s)
- X Mi
- Google Research, Mountain View, CA, USA
| | - A A Michailidis
- Department of Theoretical Physics, University of Geneva, Geneva, Switzerland
| | - S Shabani
- Google Research, Mountain View, CA, USA
| | - K C Miao
- Google Research, Mountain View, CA, USA
| | | | - J Lloyd
- Department of Theoretical Physics, University of Geneva, Geneva, Switzerland
| | | | - R Acharya
- Google Research, Mountain View, CA, USA
| | - I Aleiner
- Google Research, Mountain View, CA, USA
| | | | - M Ansmann
- Google Research, Mountain View, CA, USA
| | - F Arute
- Google Research, Mountain View, CA, USA
| | - K Arya
- Google Research, Mountain View, CA, USA
| | - A Asfaw
- Google Research, Mountain View, CA, USA
| | - J Atalaya
- Google Research, Mountain View, CA, USA
| | - J C Bardin
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of Massachusetts, Amherst, MA, USA
| | | | - G Bortoli
- Google Research, Mountain View, CA, USA
| | | | - J Bovaird
- Google Research, Mountain View, CA, USA
| | - L Brill
- Google Research, Mountain View, CA, USA
| | | | | | - D A Buell
- Google Research, Mountain View, CA, USA
| | - T Burger
- Google Research, Mountain View, CA, USA
| | - B Burkett
- Google Research, Mountain View, CA, USA
| | | | - Z Chen
- Google Research, Mountain View, CA, USA
| | - B Chiaro
- Google Research, Mountain View, CA, USA
| | - D Chik
- Google Research, Mountain View, CA, USA
| | - C Chou
- Google Research, Mountain View, CA, USA
| | - J Cogan
- Google Research, Mountain View, CA, USA
| | - R Collins
- Google Research, Mountain View, CA, USA
| | - P Conner
- Google Research, Mountain View, CA, USA
| | | | - A L Crook
- Google Research, Mountain View, CA, USA
| | - B Curtin
- Google Research, Mountain View, CA, USA
| | - A G Dau
- Google Research, Mountain View, CA, USA
| | | | | | - S Demura
- Google Research, Mountain View, CA, USA
| | | | | | | | | | - L Faoro
- Google Research, Mountain View, CA, USA
| | - E Farhi
- Google Research, Mountain View, CA, USA
| | - R Fatemi
- Google Research, Mountain View, CA, USA
| | | | | | - E Forati
- Google Research, Mountain View, CA, USA
| | | | - B Foxen
- Google Research, Mountain View, CA, USA
| | - É Genois
- Google Research, Mountain View, CA, USA
| | - W Giang
- Google Research, Mountain View, CA, USA
| | - C Gidney
- Google Research, Mountain View, CA, USA
| | - D Gilboa
- Google Research, Mountain View, CA, USA
| | | | - R Gosula
- Google Research, Mountain View, CA, USA
| | - J A Gross
- Google Research, Mountain View, CA, USA
| | | | - M C Hamilton
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA
| | - M Hansen
- Google Research, Mountain View, CA, USA
| | | | | | - P Heu
- Google Research, Mountain View, CA, USA
| | | | - S Hong
- Google Research, Mountain View, CA, USA
| | - T Huang
- Google Research, Mountain View, CA, USA
| | - A Huff
- Google Research, Mountain View, CA, USA
| | | | - L B Ioffe
- Google Research, Mountain View, CA, USA
| | | | - J Iveland
- Google Research, Mountain View, CA, USA
| | - E Jeffrey
- Google Research, Mountain View, CA, USA
| | - Z Jiang
- Google Research, Mountain View, CA, USA
| | - C Jones
- Google Research, Mountain View, CA, USA
| | - P Juhas
- Google Research, Mountain View, CA, USA
| | - D Kafri
- Google Research, Mountain View, CA, USA
| | | | - T Khattar
- Google Research, Mountain View, CA, USA
| | - M Khezri
- Google Research, Mountain View, CA, USA
| | - M Kieferová
- Google Research, Mountain View, CA, USA
- Centre for Quantum Software and Information (QSI), Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia
| | - S Kim
- Google Research, Mountain View, CA, USA
| | - A Kitaev
- Google Research, Mountain View, CA, USA
| | - A R Klots
- Google Research, Mountain View, CA, USA
| | - A N Korotkov
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of California, Riverside, CA, USA
| | | | | | | | - P Laptev
- Google Research, Mountain View, CA, USA
| | - K-M Lau
- Google Research, Mountain View, CA, USA
| | - L Laws
- Google Research, Mountain View, CA, USA
| | - J Lee
- Google Research, Mountain View, CA, USA
- Department of Chemistry, Columbia University, New York, NY, USA
| | - K W Lee
- Google Research, Mountain View, CA, USA
| | | | | | - A T Lill
- Google Research, Mountain View, CA, USA
| | - W Liu
- Google Research, Mountain View, CA, USA
| | | | | | - O Martin
- Google Research, Mountain View, CA, USA
| | | | - M McEwen
- Google Research, Mountain View, CA, USA
| | | | | | - A Morvan
- Google Research, Mountain View, CA, USA
| | | | | | - M Neeley
- Google Research, Mountain View, CA, USA
| | - C Neill
- Google Research, Mountain View, CA, USA
| | | | - M Newman
- Google Research, Mountain View, CA, USA
| | - J H Ng
- Google Research, Mountain View, CA, USA
| | - A Nguyen
- Google Research, Mountain View, CA, USA
| | - M Nguyen
- Google Research, Mountain View, CA, USA
| | - M Y Niu
- Google Research, Mountain View, CA, USA
| | | | | | | | - R Potter
- Google Research, Mountain View, CA, USA
| | - L P Pryadko
- Google Research, Mountain View, CA, USA
- Department of Physics and Astronomy, University of California, Riverside, CA, USA
| | | | - C Rocque
- Google Research, Mountain View, CA, USA
| | - N C Rubin
- Google Research, Mountain View, CA, USA
| | - N Saei
- Google Research, Mountain View, CA, USA
| | - D Sank
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - A Shorter
- Google Research, Mountain View, CA, USA
| | - N Shutty
- Google Research, Mountain View, CA, USA
| | - V Shvarts
- Google Research, Mountain View, CA, USA
| | - J Skruzny
- Google Research, Mountain View, CA, USA
| | - W C Smith
- Google Research, Mountain View, CA, USA
| | - R Somma
- Google Research, Mountain View, CA, USA
| | | | - D Strain
- Google Research, Mountain View, CA, USA
| | - M Szalay
- Google Research, Mountain View, CA, USA
| | - A Torres
- Google Research, Mountain View, CA, USA
| | - G Vidal
- Google Research, Mountain View, CA, USA
| | | | | | - T White
- Google Research, Mountain View, CA, USA
| | - B W K Woo
- Google Research, Mountain View, CA, USA
| | - C Xing
- Google Research, Mountain View, CA, USA
| | - Z J Yao
- Google Research, Mountain View, CA, USA
| | - P Yeh
- Google Research, Mountain View, CA, USA
| | - J Yoo
- Google Research, Mountain View, CA, USA
| | - G Young
- Google Research, Mountain View, CA, USA
| | - A Zalcman
- Google Research, Mountain View, CA, USA
| | - Y Zhang
- Google Research, Mountain View, CA, USA
| | - N Zhu
- Google Research, Mountain View, CA, USA
| | - N Zobrist
- Google Research, Mountain View, CA, USA
| | - H Neven
- Google Research, Mountain View, CA, USA
| | - R Babbush
- Google Research, Mountain View, CA, USA
| | - D Bacon
- Google Research, Mountain View, CA, USA
| | - S Boixo
- Google Research, Mountain View, CA, USA
| | - J Hilton
- Google Research, Mountain View, CA, USA
| | - E Lucero
- Google Research, Mountain View, CA, USA
| | - A Megrant
- Google Research, Mountain View, CA, USA
| | - J Kelly
- Google Research, Mountain View, CA, USA
| | - Y Chen
- Google Research, Mountain View, CA, USA
| | - P Roushan
- Google Research, Mountain View, CA, USA
| | | | - D A Abanin
- Google Research, Mountain View, CA, USA
- Department of Theoretical Physics, University of Geneva, Geneva, Switzerland
- Department of Physics, Princeton University, Princeton, NJ, USA
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Yu A, Lee L, Yi T, Fice M, Achar RK, Tepper S, Jones C, Klein E, Buac N, Lopez-Hisijos N, Colman MW, Gitelis S, Blank AT. Development and external validation of a machine learning model for prediction of survival in extremity leiomyosarcoma. Surg Oncol 2024:102057. [PMID: 38462387 DOI: 10.1016/j.suronc.2024.102057] [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: 11/14/2023] [Revised: 01/25/2024] [Accepted: 02/28/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE Machine learning (ML) models have been used to predict cancer survival in several sarcoma subtypes. However, none have investigated extremity leiomyosarcoma (LMS). ML is a powerful tool that has the potential to better prognosticate extremity LMS. METHODS The Surveillance, Epidemiology, and End Results (SEER) database was queried for cases of histologic extremity LMS (n = 634). Patient, tumor, and treatment characteristics were recorded, and ML models were developed to predict 1-, 3-, and 5-year survival. The best performing ML model was externally validated using an institutional cohort of extremity LMS patients (n = 46). RESULTS All ML models performed best at the 1-year time point and worst at the 5-year time point. On internal validation within the SEER cohort, the best models had c-statistics of 0.75-0.76 at the 5-year time point. The Random Forest (RF) model was the best performing model and used for external validation. This model also performed best at 1-year and worst at 5-year on external validation with c-statistics of 0.90 and 0.87, respectively. The RF model was well calibrated on external validation. This model has been made publicly available at https://rachar.shinyapps.io/lms_app/ CONCLUSIONS: ML models had excellent performance for survival prediction of extremity LMS. Future studies incorporating a larger institutional cohort may be needed to further validate the ML model for LMS prognostication.
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Affiliation(s)
- Austin Yu
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - Linus Lee
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - Thomas Yi
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - Michael Fice
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - Rohan K Achar
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - Sarah Tepper
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - Conor Jones
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - Evan Klein
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - Neil Buac
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
| | | | - Matthew W Colman
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - Steven Gitelis
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
| | - Alan T Blank
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, Chicago, IL, USA.
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7
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Lee L, Yi T, Fice M, Achar RK, Jones C, Klein E, Buac N, Lopez-Hisijos N, Colman MW, Gitelis S, Blank AT. Development and external validation of a machine learning model for prediction of survival in undifferentiated pleomorphic sarcoma. Musculoskelet Surg 2024; 108:77-86. [PMID: 37658174 DOI: 10.1007/s12306-023-00795-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/20/2023] [Indexed: 09/03/2023]
Abstract
PURPOSE Machine learning (ML) algorithms to predict cancer survival have recently been reported for a number of sarcoma subtypes, but none have investigated undifferentiated pleomorphic sarcoma (UPS). ML is a powerful tool that has the potential to better prognosticate UPS. METHODS The Surveillance, Epidemiology, and End Results (SEER) database was queried for cases of histologically confirmed undifferentiated pleomorphic sarcoma (UPS) (n = 665). Patient, tumor, and treatment characteristics were recorded, and ML models were developed to predict 1-, 3-, and 5-year survival. The best performing ML model was externally validated using an institutional cohort of UPS patients (n = 151). RESULTS All ML models performed best at the 1-year time point and worst at the 5-year time point. On internal validation within the SEER cohort, the best models had c-statistics of 0.67-0.69 at the 5-year time point. The Multi-Layer Perceptron Neural Network (MLP) model was the best performing model and used for external validation. Similarly, the MLP model performed best at 1-year and worst at 5-year on external validation with c-statistics of 0.85 and 0.81, respectively. The MLP model was well calibrated on external validation. The MLP model has been made publicly available at https://rachar.shinyapps.io/ups_app/ . CONCLUSION Machine learning models perform well for survival prediction in UPS, though this sarcoma subtype may be more difficult to prognosticate than other subtypes. Future studies are needed to further validate the machine learning approach for UPS prognostication.
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Affiliation(s)
- L Lee
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA.
| | - T Yi
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - M Fice
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - R K Achar
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - C Jones
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - E Klein
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - N Buac
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - N Lopez-Hisijos
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - M W Colman
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - S Gitelis
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - A T Blank
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
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Jones C, Jakubowski BE, Stevens R, Roberts N, McManus RJ, Tucker KL. The diagnostic Accuracy of Visual versus automated dipstick proteinuria testing in Pregnancy: A systematic review and Meta-Analysis. Pregnancy Hypertens 2024; 35:73-81. [PMID: 38262144 DOI: 10.1016/j.preghy.2024.01.133] [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] [Received: 03/20/2023] [Revised: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVE To evaluate the diagnostic accuracy of point-of-care (POC) tests for detecting proteinuria in pregnant women. DESIGN Systematic review and meta-analysis. DATA SOURCES MEDLINE and EMBASE databases were searched from inception to 13 November 2020. ELIGIBILITY CRITERIA AND DATA ANALYSIS Included studies measured the sensitivity and specificity ofPOC proteinuria testing compared to laboratory reference standards (protein-creatinine ratio (PCR), 24-hour urine collection). Bivariate meta-analyses determined pooled sensitivity and specificity. Random-effects inverse-variance model determinedheterogeneity. MAIN OUTCOME MEASURES The primary outcome was overall sensitivity and specificity, stratified by method of POC testing and reference standard. Secondary outcomes were sensitivity and specificity within thesubgroupstest brand, reference standard, and hypertension status. RESULTS 1078 studies were identified, 17 studies comprising 23 comparisons were included. The meta-analysis included 13 studies with 19 comparisons. Pooled sensitivity and specificity of visual dipsticks against PCR was 72 % (95 % CI: 56 % to 84 %) and 92 % (95 % CI: 76 % to 98 %), respectively. Pooled sensitivity and specificity of visual dipsticks against 24-hour collection was 69 % (55 % to 80 %) and 70 % (51 % to 84 %), respectively. Pooled sensitivity and specificity for automated readers against PCR was 73 % (53 % to 86 %) and 91 % (83 % to 95 %), respectively. Pooled sensitivity and specificity of automated readers against 24-hour collection was 65 % (42 % to 83 %) and 82 % (46 % to 96 %), respectively. CONCLUSION Visual dipsticks have comparable accuracy to automated readers, yet are notadequate as a rule-out test for proteinuria. Proteinuria POC testing maybe beneficial inantenatal care when repeatfollow-up tests are performed. PROSPERO Registration Number: CRD42021231914.
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Affiliation(s)
- C Jones
- Nuffield Department of Primary Health Care Sciences, University of Oxford, UK
| | - B E Jakubowski
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course and Population Sciences, Kings College London, UK
| | - R Stevens
- Nuffield Department of Primary Health Care Sciences, University of Oxford, UK
| | - N Roberts
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course and Population Sciences, Kings College London, UK
| | - R J McManus
- Nuffield Department of Primary Health Care Sciences, University of Oxford, UK
| | - K L Tucker
- Nuffield Department of Primary Health Care Sciences, University of Oxford, UK.
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Boyle S, Roddie C, O'Reilly M, Menne T, Norman J, Gibb A, Lugthart S, Chaganti S, Gonzalez Arias C, Jones C, Latif A, Uttenthal BJ, Seymour F, Osborne W, Springell D, Hardefeldt P, Yallop D, Thoulouli E, Bloor A, Besley C, Mathew A, Burns D, Cwynarski K, Sanderson R, Kuhnl A. Improved outcomes of large B-cell lymphoma patients treated with CD19 CAR T in the UK over time. Br J Haematol 2024; 204:507-513. [PMID: 37848384 DOI: 10.1111/bjh.19157] [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] [Received: 07/08/2023] [Revised: 09/11/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023]
Abstract
The success of CD19 Chimeric antigen receptor (CAR) T-cell therapy in large B-cell lymphoma (LBCL) has been partially offset by toxicity and logistical challenges, which off-the-shelf agents like CD20xCD3 bispecific antibodies might potentially overcome. However, when using CAR T outcomes as the 'standard-of-care comparator̕ for relapsed/refractory (r/r) LBCL, a potential learning curve with implementing a novel, complex therapy like CAR T needs to be considered. To address this, we analysed 726 UK patients intended to be treated with CD19 CAR T for r/r LBCL and compared outcomes between the first year of the national CAR T programme (Era 1; 2019) and the more recent treatment era (Era 2; 2020-2022). We identified significant improvements for Era 2 versus Era 1 in dropout rate (17% vs. 27%, p = 0.001), progression-free survival (1-year PFS 50% vs. 32%, p < 0.001) and overall survival (1-year OS 60% vs. 40%, p < 0.001). We also observed increased use of bridging therapy, improvement in bridging outcomes, more tocilizumab/corticosteroid use, reduced high-grade cytokine release syndrome (4% vs. 9%, p = 0.01) and intensive care unit admissions (20% vs. 32%, p = 0.001). Our results demonstrate significant improvement in CAR T outcomes over time, highlighting the importance of using up-to-date clinical data when comparing CAR T against new treatment options for r/r LBCL.
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Affiliation(s)
- S Boyle
- Department of Haematology, King's College Hospital, London, UK
| | - C Roddie
- Department of Haematology, University College London Hospitals, London, UK
| | - M O'Reilly
- Department of Haematology, University College London Hospitals, London, UK
- Department of Haematology, UCL Cancer Institute, University College London, London, UK
| | - T Menne
- Department of Haematology, Freeman Hospital, Newcastle, UK
| | - J Norman
- Department of Haematology, Manchester Royal Infirmary, Manchester, UK
| | - A Gibb
- Department of Medical Oncology, The Christie Hospital, Manchester, UK
| | - S Lugthart
- Department of Haematology, University Hospitals Bristol and Weston, Bristol, UK
| | - S Chaganti
- Department of Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | | | - C Jones
- Department of Haematology, University Hospital of Wales, Cardiff, UK
| | - A Latif
- Department of Haematology, Queen Elizabeth II Hospital, Glasgow, UK
| | - B J Uttenthal
- Department of Haematology, Cambridge University Hospitals, Cambridge, UK
| | - F Seymour
- Department of Haematology, Leeds Teaching Hospitals, Leeds, UK
| | - W Osborne
- Department of Haematology, Freeman Hospital, Newcastle, UK
| | - D Springell
- Department of Haematology, University College London Hospitals, London, UK
| | - P Hardefeldt
- Department of Haematology, King's College Hospital, London, UK
| | - D Yallop
- Department of Haematology, King's College Hospital, London, UK
| | - E Thoulouli
- Department of Haematology, Manchester Royal Infirmary, Manchester, UK
| | - A Bloor
- Department of Haematology, The Christie Hospital, Manchester, UK
| | - C Besley
- Department of Haematology, University Hospitals Bristol and Weston, Bristol, UK
| | - A Mathew
- Department of Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - D Burns
- Department of Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - K Cwynarski
- Department of Haematology, University College London Hospitals, London, UK
| | - R Sanderson
- Department of Haematology, King's College Hospital, London, UK
| | - A Kuhnl
- Department of Haematology, King's College Hospital, London, UK
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10
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Klobasa I, Denham G, Baird M, Sim J, Petrie D, Roebuck DJ, Tonks A, Tu C, Sarrami P, Best J, Abood J, Jones C. Real-time x-ray abnormality alerts for emergency departments using a radiographer comment model - a multisite pilot study. Radiography (Lond) 2024; 30:52-60. [PMID: 37866158 DOI: 10.1016/j.radi.2023.10.001] [Citation(s) in RCA: 1] [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: 07/09/2023] [Revised: 09/11/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION The timely communication of clinically significant image appearances to Emergency Department (ED) referrers is necessary for optimum patient care. Australian reliance on verbal communication only is time-limited, open to misinterpretation and lacks transparency. A combined radiographer alert and comment model was designed to reliably communicate image abnormalities to ED referrers in real-time. METHODS A multidisciplinary steering group designed the model for all ED general imaging. Protocols were developed to document radiographer comments (critical, urgent and clinically significant) in patients' medical records. Critical findings were communicated directly to ED. Five NSW hospitals varying in size, complexity and population demographics piloted the model between three to twelve months during 2021-2022. Site auditors compared comments with the radiology report and designated each as True Positive (TP), False Positive (FP), indeterminate and clinically significant. Indeterminate cases were analysed by an external radiologist. Inter-observer consensus was obtained for all classifications via two independent auditors. The Positive Predictive Value (PPV), or precision of the comment, was calculated for each site. RESULTS Radiographers (n = 69) provided comments for 1102 cases. The pooled average PPV for TP was 0.96; (0.947-0.971; 95% CI). The weighted mean error (FP comments) was 3.9%; (2.9% - 5.3%.; 95% CI). CONCLUSION The Radiographer Comment model provided consistent levels of commenting precision and reproducibility across a range of sites with a pooled average PPV (0.96). The False Positive rate or weighted mean error (FP) of 3.9% (2.9% - 5.3%.; 95% CI) was low. IMPLICATIONS FOR FUTURE PRACTICE A strategic, interprofessional approach in the implementation of an image alert combined with a Radiographer Comment can be adapted across a variety of hospital settings for ED and other departments.
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Affiliation(s)
- I Klobasa
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
| | - G Denham
- Manning District Hospital, Taree, New South Wales, Australia
| | - M Baird
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - J Sim
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - D Petrie
- School of Health Economics, Monash University, Clayton, Victoria, Australia
| | - D J Roebuck
- Department of Medical Imaging, Perth Children's Hospital, Nedlands 6009, Australia; Division of Paediatrics, Medical School, University of Western Australia, Crawley 6009, Western Australia, Australia
| | - A Tonks
- Sydney Adventist Hospital, Wahroonga, New South Wales, Australia
| | - C Tu
- Sydney Adventist Hospital, Wahroonga, New South Wales, Australia
| | - P Sarrami
- Agency for Clinical Innovation (ACI), NSW Health. St Leonards New South Wales, Australia; South-Western Sydney Clinical School University of New South Wales, Australia
| | - J Best
- Wyong Hospital, Wyong, New South Wales, Australia
| | - J Abood
- Bathurst Hospital, Bathurst, New South Wales, Australia
| | - C Jones
- Broken Hill Hospital, Broken Hill, New South Wales, Australia
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Jenner LA, Farran EK, Welham A, Jones C, Moss J. The use of eye-tracking technology as a tool to evaluate social cognition in people with an intellectual disability: a systematic review and meta-analysis. J Neurodev Disord 2023; 15:42. [PMID: 38044457 PMCID: PMC10694880 DOI: 10.1186/s11689-023-09506-9] [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: 04/24/2023] [Accepted: 10/25/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Relatively little is known about social cognition in people with intellectual disability (ID), and how this may support understanding of co-occurring autism. A limitation of previous research is that traditional social-cognitive tasks place a demand on domain-general cognition and language abilities. These tasks are not suitable for people with ID and lack the sensitivity to detect subtle social-cognitive processes. In autism research, eye-tracking technology has offered an effective method of evaluating social cognition-indicating associations between visual social attention and autism characteristics. The present systematic review synthesised research which has used eye-tracking technology to study social cognition in ID. A meta-analysis was used to explore whether visual attention on socially salient regions (SSRs) of stimuli during these tasks correlated with degree of autism characteristics presented on clinical assessment tools. METHOD Searches were conducted using four databases, research mailing lists, and citation tracking. Following in-depth screening and exclusion of studies with low methodological quality, 49 articles were included in the review. A correlational meta-analysis was run on Pearson's r values obtained from twelve studies, reporting the relationship between visual attention on SSRs and autism characteristics. RESULTS AND CONCLUSIONS Eye-tracking technology was used to measure different social-cognitive abilities across a range of syndromic and non-syndromic ID groups. Restricted scan paths and eye-region avoidance appeared to impact people's ability to make explicit inferences about mental states and social cues. Readiness to attend to social stimuli also varied depending on social content and degree of familiarity. A meta-analysis using a random effects model revealed a significant negative correlation (r = -.28, [95% CI -.47, -.08]) between visual attention on SSRs and autism characteristics across ID groups. Together, these findings highlight how eye-tracking can be used as an accessible tool to measure more subtle social-cognitive processes, which appear to reflect variability in observable behaviour. Further research is needed to be able to explore additional covariates (e.g. ID severity, ADHD, anxiety) which may be related to visual attention on SSRs, to different degrees within syndromic and non-syndromic ID groups, in order to determine the specificity of the association with autism characteristics.
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Affiliation(s)
- L A Jenner
- School of Psychology, University of Surrey, Surrey, UK.
| | - E K Farran
- School of Psychology, University of Surrey, Surrey, UK
| | - A Welham
- School of Psychology, University of Birmingham, Birmingham, UK
| | - C Jones
- School of Psychology, University of Birmingham, Birmingham, UK
| | - J Moss
- School of Psychology, University of Surrey, Surrey, UK
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12
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Randhawa H, Jones C, McGrath M, Braga LH. Non-refluxing Primary Megaureter in Children Resolves From Proximal to Distal. Urology 2023; 182:225-230. [PMID: 37776954 DOI: 10.1016/j.urology.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES To evaluate a population of children with non-refluxing primary megaureter (NRPM), we investigated spontaneous resolution of ureteral dilation and the pattern (proximal to distal or distal to proximal) in which it occurs. METHODS From our prospectively collected prenatal hydronephrosis (HN) database (0-24 months, 2008-2017), selecting those with NRPM (n = 92). We excluded patients who underwent surgery (n = 20), children with <6 months follow-up (n = 2) and without a voiding cystourethrogram (VCUG) (n = 4). Images were segregated into 198 ureteric segments (proximal/mid/distal). We defined resolution as Society for Fetal Urology (SFU) (0/1), anteroposterior diameter (APD) <10 mm, and ureteric dilatation <5 mm. Descriptive statistics and Kaplan-Meier curves were created for time-to-resolution analyses. RESULTS Of 66 patients and 198 ureteral segments, median age at presentation was 2 months (0-12), 83% were male (33% circumcised). Mean APD at baseline was 11 ± 4 mm, and 79% had (SFU 3/4) HN. Mean dilatation of ureteral segments (mm) at baseline was: 9 ± 2 proximal, 9 ± 2 mid, and 11 ± 3 distal. At a median follow-up time of 26 (7-83) months, dilation of 55 (83%) proximal, 48 (72%) mid, and 22 (33%) distal ureteric segments had resolved. Overall, HN resolution occurred in 76% of patients. Resolution rates were similar for proximal/mid-ureters (83% vs 72%; P = .20); however, they were significantly different from distal segments (83% proximal vs 33% distal; 72% mid vs 33% distal, P <.01). CONCLUSION Our data suggest that spontaneous resolution of NRPM follows a proximal to distal progression. Distal ureteric dilatation takes up to 10 months longer to resolve compared to that of proximal and mid-ureteric segments, as well as that of the renal pelvis.
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Affiliation(s)
- Harkanwal Randhawa
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Conor Jones
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Melissa McGrath
- Division of Pediatric Urology, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Luis H Braga
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Division of Pediatric Urology, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada; Department of Health, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
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13
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Bryant RN, Houghton JL, Jones C, Pasquier V, Halevy I, Fike DA. Deconvolving microbial and environmental controls on marine sedimentary pyrite sulfur isotope ratios. Science 2023; 382:912-915. [PMID: 37995248 DOI: 10.1126/science.adg6103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023]
Abstract
Reconstructions of past environmental conditions and biological activity are often based on bulk stable isotope proxies, which are inherently open to multiple interpretations. This is particularly true of the sulfur isotopic composition of sedimentary pyrite (δ34Spyr), which is used to reconstruct ocean-atmosphere oxidation state and track the evolution of several microbial metabolic pathways. We present a microanalytical approach to deconvolving the multiple signals that influence δ34Spyr, yielding both the unambiguous determination of microbial isotopic fractionation (εmic) and new information about depositional conditions. We applied this approach to recent glacial-interglacial sediments, which feature over 70‰ variations in bulk δ34Spyr across these environmental transitions. Despite profound environmental change, εmic remained essentially invariant throughout this interval and the observed range in δ34Spyr was instead driven by climate-induced variations in sedimentation.
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Affiliation(s)
- R N Bryant
- Department of Earth & Planetary Sciences, Washington University in St. Louis, St. Louis, MO, USA
- Department of Earth, Atmospheric, and Planetary Sciences, Purdue University, West Lafayette, IN, USA
| | - J L Houghton
- Department of Earth & Planetary Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - C Jones
- Department of Earth & Planetary Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - V Pasquier
- Department of Earth & Planetary Sciences, Weizmann Institute of Science, Rehovot, Israel
| | - I Halevy
- Department of Earth & Planetary Sciences, Weizmann Institute of Science, Rehovot, Israel
| | - D A Fike
- Department of Earth & Planetary Sciences, Washington University in St. Louis, St. Louis, MO, USA
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14
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Jones C, Jadva V, Zadeh S, Golombok S. Single fathers' experiences of using egg donation and surrogacy to start a family. Hum Reprod 2023; 38:1981-1990. [PMID: 37528054 PMCID: PMC10546079 DOI: 10.1093/humrep/dead152] [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: 12/16/2022] [Revised: 07/05/2023] [Indexed: 08/03/2023] Open
Abstract
STUDY QUESTION What are the experiences of single men using egg donation and surrogacy as a route to parenthood? SUMMARY ANSWER The fathers mainly had a positive relationship with the surrogate and simultaneously exercised agency, and experienced challenges, during the process of surrogacy. WHAT IS KNOWN ALREADY Little is known about single men's experiences of egg donation and surrogacy arrangements. Studies have focused on single men's decision-making processes about the use of surrogacy and family functioning once these families are formed. Questions remain about how fathers experience and navigate the process of surrogacy as a single man. STUDY DESIGN, SIZE, DURATION The study is an international, in-depth qualitative study of fathers who chose to begin a family and parent alone. Data were collected between 2018 and 2021 as part of a larger study of solo fathers with different routes to parenthood. The present study reports on 21 fathers who used surrogacy and egg donation to begin their family. The average age of the fathers was 44 years, the fathers had young children aged 6 years or younger, and lived in countries across Australia, Europe, and North America. PARTICIPANTS/MATERIALS, SETTING, METHODS Purposive sampling was used to recruit participants. In-depth semi-structured interviews were conducted. Interview topics included fathers' experiences of the process of using egg donation and surrogacy, and navigating the relationship with the surrogate. The audio-recorded interviews lasted around 2 hours and were subsequently transcribed verbatim. MAIN RESULTS AND THE ROLE OF CHANCE Data were analysed using reflexive thematic analysis and qualitative content analysis. Most of the fathers chose an identifiable egg donor. Regarding the relationship with the surrogate, many fathers had remained in contact with her, but to differing degrees, and they generally reported positive relationships. Thematic analysis led to the identification of three themes relating to the fathers' experiences of choosing surrogacy as a single man: the ability to make choices; challenges and constraints; and special relationship. LIMITATIONS, REASONS FOR CAUTION Due to the variation between different countries regarding laws on surrogacy, contextual factors may have impacted on the experiences of single fathers, and the sample size was small. However, the research provides new insights into an area with little academic literature. WIDER IMPLICATIONS OF THE FINDINGS Given the growing trend of single men having children through surrogacy, the findings suggest that this new path to parenthood can be both rewarding and challenging. Single men may benefit from tailored support and counselling to help them navigate the surrogacy journey. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Wellcome Trust (grant number 208013/Z/17/Z). The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER n/a.
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Affiliation(s)
- C Jones
- Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, UK
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - V Jadva
- UCL Institute for Women’s Health, University College London, London, UK
| | - S Zadeh
- Thomas Coram Research Unit, University College London, London, UK
| | - S Golombok
- Centre for Family Research, University of Cambridge, Cambridge, UK
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15
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Hoke JC, Ippoliti M, Rosenberg E, Abanin D, Acharya R, Andersen TI, Ansmann M, Arute F, Arya K, Asfaw A, Atalaya J, Bardin JC, Bengtsson A, Bortoli G, Bourassa A, Bovaird J, Brill L, Broughton M, Buckley BB, Buell DA, Burger T, Burkett B, Bushnell N, Chen Z, Chiaro B, Chik D, Cogan J, Collins R, Conner P, Courtney W, Crook AL, Curtin B, Dau AG, Debroy DM, Del Toro Barba A, Demura S, Di Paolo A, Drozdov IK, Dunsworth A, Eppens D, Erickson C, Farhi E, Fatemi R, Ferreira VS, Burgos LF, Forati E, Fowler AG, Foxen B, Giang W, Gidney C, Gilboa D, Giustina M, Gosula R, Gross JA, Habegger S, Hamilton MC, Hansen M, Harrigan MP, Harrington SD, Heu P, Hoffmann MR, Hong S, Huang T, Huff A, Huggins WJ, Isakov SV, Iveland J, Jeffrey E, Jiang Z, Jones C, Juhas P, Kafri D, Kechedzhi K, Khattar T, Khezri M, Kieferová M, Kim S, Kitaev A, Klimov PV, Klots AR, Korotkov AN, Kostritsa F, Kreikebaum JM, Landhuis D, Laptev P, Lau KM, Laws L, Lee J, Lee KW, Lensky YD, Lester BJ, Lill AT, Liu W, Locharla A, Martin O, McClean JR, McEwen M, Miao KC, Mieszala A, Montazeri S, Morvan A, Movassagh R, Mruczkiewicz W, Neeley M, Neill C, Nersisyan A, Newman M, Ng JH, Nguyen A, Nguyen M, Niu MY, O’Brien TE, Omonije S, Opremcak A, Petukhov A, Potter R, Pryadko LP, Quintana C, Rocque C, Rubin NC, Saei N, Sank D, Sankaragomathi K, Satzinger KJ, Schurkus HF, Schuster C, Shearn MJ, Shorter A, Shutty N, Shvarts V, Skruzny J, Smith WC, Somma R, Sterling G, Strain D, Szalay M, Torres A, Vidal G, Villalonga B, Heidweiller CV, White T, Woo BWK, Xing C, Yao ZJ, Yeh P, Yoo J, Young G, Zalcman A, Zhang Y, Zhu N, Zobrist N, Neven H, Babbush R, Bacon D, Boixo S, Hilton J, Lucero E, Megrant A, Kelly J, Chen Y, Smelyanskiy V, Mi X, Khemani V, Roushan P. Measurement-induced entanglement and teleportation on a noisy quantum processor. Nature 2023; 622:481-486. [PMID: 37853150 PMCID: PMC10584681 DOI: 10.1038/s41586-023-06505-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/01/2023] [Indexed: 10/20/2023]
Abstract
Measurement has a special role in quantum theory1: by collapsing the wavefunction, it can enable phenomena such as teleportation2 and thereby alter the 'arrow of time' that constrains unitary evolution. When integrated in many-body dynamics, measurements can lead to emergent patterns of quantum information in space-time3-10 that go beyond the established paradigms for characterizing phases, either in or out of equilibrium11-13. For present-day noisy intermediate-scale quantum (NISQ) processors14, the experimental realization of such physics can be problematic because of hardware limitations and the stochastic nature of quantum measurement. Here we address these experimental challenges and study measurement-induced quantum information phases on up to 70 superconducting qubits. By leveraging the interchangeability of space and time, we use a duality mapping9,15-17 to avoid mid-circuit measurement and access different manifestations of the underlying phases, from entanglement scaling3,4 to measurement-induced teleportation18. We obtain finite-sized signatures of a phase transition with a decoding protocol that correlates the experimental measurement with classical simulation data. The phases display remarkably different sensitivity to noise, and we use this disparity to turn an inherent hardware limitation into a useful diagnostic. Our work demonstrates an approach to realizing measurement-induced physics at scales that are at the limits of current NISQ processors.
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16
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Palmer S, Coad J, Gamble J, Jones C, Lees-Deutsch L, McWilliams D, Murphy E, Kneafsey R. Nursing, midwifery, and allied health professions research capacities and cultures: a survey of staff within a university and acute healthcare organisation. BMC Health Serv Res 2023; 23:647. [PMID: 37328877 DOI: 10.1186/s12913-023-09612-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/28/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND There is an increasing focus on the development of research capacity and culture in Nursing, Midwifery and Allied Health Professions (NMAHP). However, better understanding of the existing research success and skills, motivators, barriers, and development needs of NMAHP professionals is required to inform this development. This study sought to identify such factors within a university and an acute healthcare organisation. METHODS An online survey, incorporating the Research Capacity and Culture tool, was administered to NMAHP professionals and students at a university and an acute healthcare organisation in the United Kingdom. Ratings of success/skill levels of teams and individuals were compared between professional groups using Mann-Whitney U tests. Motivators, barriers, and development needs were reported using descriptive statistics. Descriptive thematic analysis was used for open-ended text responses. RESULTS A total of 416 responses were received (N&M n = 223, AHP n = 133, Other n = 60). N&M respondents were more positive than their AHP counterparts about the success/skill levels of their teams. There were no significant differences between N&M and AHP in their ratings of individual successes/skills. Finding and critically reviewing relevant literature were identified as specific individual strengths; with weaknesses in securing research funding, submitting ethics applications, writing for publication, and advising less experienced researchers. The main motivators for research were to develop skills, increased job satisfaction, and career advancement; whilst barriers included lack of time for research and other work roles taking priority. Key support needs identified included mentorship (for teams and individuals) and in-service training. Open-ended questions generated main themes of 'Employment & staffing', 'Professional services support', 'Clinical & academic management', 'Training & development', 'Partnerships' and 'Operating principles'. Two cross-cutting themes described issues common to multiple main themes: 'Adequate working time for research' and 'Participating in research as an individual learning journey'. CONCLUSIONS Rich information was generated to inform the development of strategies to enhance research capacity and culture in NMAHP. Much of this can be generic but some nuances may be required to address some specific differences between professional groups, particularly related to perceived team success/skills and priorities identified for support and development.
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Affiliation(s)
- S Palmer
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - J Coad
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
- School of Health Sciences, Nottingham University Queen's Medical Centre, Nottingham, UK
| | - J Gamble
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - C Jones
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - L Lees-Deutsch
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - D McWilliams
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - E Murphy
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK
| | - R Kneafsey
- Centre for Care Excellence, Coventry University and University Hospitals Coventry and Warwickshire NHS Trust, Richard Crossman Building, Jordan Well, Coventry, CV1 5RW, UK.
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Andersen TI, Lensky YD, Kechedzhi K, Drozdov IK, Bengtsson A, Hong S, Morvan A, Mi X, Opremcak A, Acharya R, Allen R, Ansmann M, Arute F, Arya K, Asfaw A, Atalaya J, Babbush R, Bacon D, Bardin JC, Bortoli G, Bourassa A, Bovaird J, Brill L, Broughton M, Buckley BB, Buell DA, Burger T, Burkett B, Bushnell N, Chen Z, Chiaro B, Chik D, Chou C, Cogan J, Collins R, Conner P, Courtney W, Crook AL, Curtin B, Debroy DM, Del Toro Barba A, Demura S, Dunsworth A, Eppens D, Erickson C, Faoro L, Farhi E, Fatemi R, Ferreira VS, Burgos LF, Forati E, Fowler AG, Foxen B, Giang W, Gidney C, Gilboa D, Giustina M, Gosula R, Dau AG, Gross JA, Habegger S, Hamilton MC, Hansen M, Harrigan MP, Harrington SD, Heu P, Hilton J, Hoffmann MR, Huang T, Huff A, Huggins WJ, Ioffe LB, Isakov SV, Iveland J, Jeffrey E, Jiang Z, Jones C, Juhas P, Kafri D, Khattar T, Khezri M, Kieferová M, Kim S, Kitaev A, Klimov PV, Klots AR, Korotkov AN, Kostritsa F, Kreikebaum JM, Landhuis D, Laptev P, Lau KM, Laws L, Lee J, Lee KW, Lester BJ, Lill AT, Liu W, Locharla A, Lucero E, Malone FD, Martin O, McClean JR, McCourt T, McEwen M, Miao KC, Mieszala A, Mohseni M, Montazeri S, Mount E, Movassagh R, Mruczkiewicz W, Naaman O, Neeley M, Neill C, Nersisyan A, Newman M, Ng JH, Nguyen A, Nguyen M, Niu MY, O’Brien TE, Omonije S, Petukhov A, Potter R, Pryadko LP, Quintana C, Rocque C, Rubin NC, Saei N, Sank D, Sankaragomathi K, Satzinger KJ, Schurkus HF, Schuster C, Shearn MJ, Shorter A, Shutty N, Shvarts V, Skruzny J, Smith WC, Somma R, Sterling G, Strain D, Szalay M, Torres A, Vidal G, Villalonga B, Heidweiller CV, White T, Woo BWK, Xing C, Yao ZJ, Yeh P, Yoo J, Young G, Zalcman A, Zhang Y, Zhu N, Zobrist N, Neven H, Boixo S, Megrant A, Kelly J, Chen Y, Smelyanskiy V, Kim EA, Aleiner I, Roushan P. Non-Abelian braiding of graph vertices in a superconducting processor. Nature 2023; 618:264-269. [PMID: 37169834 DOI: 10.1038/s41586-023-05954-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/14/2023] [Indexed: 06/09/2023]
Abstract
Indistinguishability of particles is a fundamental principle of quantum mechanics1. For all elementary and quasiparticles observed to date-including fermions, bosons and Abelian anyons-this principle guarantees that the braiding of identical particles leaves the system unchanged2,3. However, in two spatial dimensions, an intriguing possibility exists: braiding of non-Abelian anyons causes rotations in a space of topologically degenerate wavefunctions4-8. Hence, it can change the observables of the system without violating the principle of indistinguishability. Despite the well-developed mathematical description of non-Abelian anyons and numerous theoretical proposals9-22, the experimental observation of their exchange statistics has remained elusive for decades. Controllable many-body quantum states generated on quantum processors offer another path for exploring these fundamental phenomena. Whereas efforts on conventional solid-state platforms typically involve Hamiltonian dynamics of quasiparticles, superconducting quantum processors allow for directly manipulating the many-body wavefunction by means of unitary gates. Building on predictions that stabilizer codes can host projective non-Abelian Ising anyons9,10, we implement a generalized stabilizer code and unitary protocol23 to create and braid them. This allows us to experimentally verify the fusion rules of the anyons and braid them to realize their statistics. We then study the prospect of using the anyons for quantum computation and use braiding to create an entangled state of anyons encoding three logical qubits. Our work provides new insights about non-Abelian braiding and, through the future inclusion of error correction to achieve topological protection, could open a path towards fault-tolerant quantum computing.
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18
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Harrison H, Burns M, Darko N, Jones C. Exploring the benefits of nature-based interventions in socio-economically deprived communities: a narrative review of the evidence to date. Perspect Public Health 2023; 143:156-172. [PMID: 37178030 DOI: 10.1177/17579139231170768] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
AIM Socio-economic deprivation encompasses the relative disadvantage experienced by individuals or communities in relation to financial, material or social resources. Nature-based interventions (NBIs) are a public health approach that promote sustainable, healthy communities through engagement with nature and show potential to address inequalities experienced by socio-economically deprived communities. This narrative review aims to identify and evaluate the benefits of NBIs in socio-economically deprived communities. METHOD A systematic literature search of six electronic publication databases (APA PsycInfo, CENTRAL, CDSR, CINAHL, Medline and Web of Science) was conducted on 5 February 2021 and repeated on 30 August 2022. In total, 3852 records were identified and 18 experimental studies (published between 2015 and 2022) were included in this review. RESULTS Interventions including therapeutic horticulture, care farming, green exercise and wilderness arts and craft were evaluated in the literature. Key benefits were observed for cost savings, diet diversity, food security, anthropometric outcomes, mental health outcomes, nature visits, physical activity and physical health. Age, gender, ethnicity, level of engagement and perception of environment safety influenced the effectiveness of the interventions. CONCLUSION Results demonstrate there are clear benefits of NBIs on economic, environmental, health and social outcomes. Further research including qualitative analyses, more stringent experimental designs and use of standardised outcome measures is recommended.
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Affiliation(s)
- H Harrison
- Department of Psychology and Vision Sciences, University of Leicester, Leicester, LE1 7RH, UK
| | - M Burns
- School of Biological Sciences, University of Leicester, Leicester, UK
| | - N Darko
- NIHR Leicester Biomedical Research Centre & School of Media, Communication and Sociology, University of Leicester, Leicester, UK
| | - C Jones
- Clinical Psychology, Psychology and Vision Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, UK
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19
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Oezel L, Okano I, Jones C, Salzmann SN, Shue J, Adl Amini D, Moser M, Chiapparelli E, Sama AA, Carrino JA, Cammisa FP, Girardi FP, Hughes AP. MRI-based vertebral bone quality score compared to quantitative computed tomography bone mineral density in patients undergoing cervical spinal surgery. Eur Spine J 2023; 32:1636-1643. [PMID: 36882579 DOI: 10.1007/s00586-023-07570-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/18/2023] [Accepted: 01/30/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE The vertebral bone quality (VBQ) score based on magnetic resonance imaging (MRI) was introduced as a bone quality marker in the lumbar spine. Prior studies showed that it could be utilized as a predictor of osteoporotic fracture or complications after instrumented spine surgery. The objective of this study was to evaluate the correlation between VBQ scores and bone mineral density (BMD) measured by quantitative computer tomography (QCT) in the cervical spine. METHODS Preoperative cervical CT and sagittal T1-weighted MRIs from patients undergoing ACDF were retrospectively reviewed and included. The VBQ score in each cervical level was calculated by dividing the signal intensity of the vertebral body by the signal intensity of the cerebrospinal fluid on midsagittal T1-weighted MRI images and correlated with QCT measurements of the C2-T1 vertebral bodies. A total of 102 patients (37.3% female) were included. RESULTS VBQ values of C2-T1 vertebrae strongly correlated with each other. C2 showed the highest VBQ value [Median (range) 2.33 (1.33, 4.23)] and T1 showed the lowest VBQ value [Median (range) 1.64 (0.81, 3.88)]. There was significant weak to moderate negative correlations between and VBQ Scores for all levels [C2: p < 0.001; C3: p < 0.001; C4: p < 0.001; C5: p < 0.004; C6: p < 0.001; C7: p < 0.025; T1: p < 0.001]. CONCLUSION Our results indicate that cervical VBQ scores may be insufficient in the estimation of BMDs, which might limit their clinical application. Additional studies are recommended to determine the utility of VBQ and QCT BMD to evaluate their potential use as bone status markers.
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Affiliation(s)
- Lisa Oezel
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
- Department of Orthopedic Surgery and Traumatology, University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Ichiro Okano
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Conor Jones
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Stephan N Salzmann
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Jennifer Shue
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Dominik Adl Amini
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
- Department of Orthopedic Surgery and Traumatology, Charité University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Manuel Moser
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
- Department of Spine Surgery, Cantonal Hospital of Lucerne, Spitalstrasse, 6000, Lucerne, Switzerland
| | - Erika Chiapparelli
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Andrew A Sama
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - John A Carrino
- Department of Radiology and Imaging, 535 East 70th Street, New York, NY, 10021, USA
| | - Frank P Cammisa
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Federico P Girardi
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
| | - Alexander P Hughes
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
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Plate RC, Jones C, Zhao S, Flum MW, Steinberg J, Daley G, Corbett N, Neumann C, Waller R. "But not the music": psychopathic traits and difficulties recognising and resonating with the emotion in music. Cogn Emot 2023; 37:748-762. [PMID: 37104122 DOI: 10.1080/02699931.2023.2205105] [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] [Received: 02/25/2022] [Revised: 12/23/2022] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
Recognising and responding appropriately to emotions is critical to adaptive psychological functioning. Psychopathic traits (e.g. callous, manipulative, impulsive, antisocial) are related to differences in recognition and response when emotion is conveyed through facial expressions and language. Use of emotional music stimuli represents a promising approach to improve our understanding of the specific emotion processing difficulties underlying psychopathic traits because it decouples recognition of emotion from cues directly conveyed by other people (e.g. facial signals). In Experiment 1, participants listened to clips of emotional music and identified the emotional content (Sample 1, N = 196) or reported on their feelings elicited by the music (Sample 2, N = 197). Participants accurately recognised (t(195) = 32.78, p < .001, d = 4.69) and reported feelings consistent with (t(196) = 7.84, p < .001, d = 1.12) the emotion conveyed in the music. However, psychopathic traits were associated with reduced emotion recognition accuracy (F(1, 191) = 19.39, p < .001) and reduced likelihood of feeling the emotion (F(1, 193) = 35.45, p < .001), particularly for fearful music. In Experiment 2, we replicated findings for broad difficulties with emotion recognition (Sample 3, N = 179) and emotional resonance (Sample 4, N = 199) associated with psychopathic traits. Results offer new insight into emotion recognition and response difficulties that are associated with psychopathic traits.
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Affiliation(s)
- R C Plate
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - C Jones
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - S Zhao
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - M W Flum
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - J Steinberg
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - G Daley
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - N Corbett
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - C Neumann
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - R Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
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Forlenza EM, Terhune EB, Higgins JDD, Jones C, Geller JA, Della Valle CJ. Invasive Gastrointestinal Endoscopy Following Total Joint Arthroplasty Increases the Risk for Periprosthetic Joint Infection. J Arthroplasty 2023:S0883-5403(23)00401-1. [PMID: 37105326 DOI: 10.1016/j.arth.2023.04.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 04/09/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The safety of postoperative colonoscopy and endoscopy following total joint arthroplasty (TJA) remains largely unknown. The objective of this study was to characterize the effect of gastrointestinal endoscopic procedures after TJA on the risk of postoperative periprosthetic joint infection (PJI). METHODS Using a large national database, patients who underwent an endoscopic procedure (colonoscopy or esophagogastroduodenoscopy (EGD)) within 12 months after primary TJA were identified and matched in a 1:1 fashion based on procedure (primary total knee arthroplasty (TKA) vs. total hip arthroplasty (THA), age, sex, Charlson Comorbidity Index (CCI), and smoking status with patients who did not undergo endoscopy. A total of 142,055 patients who underwent endoscopy within 12 months following TJA (96,804 TKA and 45,251 THA) were identified and matched. The impact of timing of endoscopy relative to TJA on postoperative outcomes was assessed. Pre-operative comorbidity profiles and 1-year complications were compared. Statistical analyses included Chi-squared tests and multivariate logistic regressions with outcomes considered significant at P <0.05. RESULTS Multivariate analyses revealed that endoscopy within 2 months following TKA and 1 month of THA was associated with a significantly increased odds of periprosthetic joint infection (Odds Ratio (OR): 1.29 [1.08-1.53]; P=.004; OR: 1.41 [1.01-1.90]; P=0.033, respectively). Patients who underwent endoscopy greater than 2 months from the timing of their TKA and 1 month from THA were not at significantly greater risk of developing PJI. CONCLUSION This data suggests that invasive endoscopic procedures should be delayed if possible by at least 2 months following TKA and 1 month following THA to minimize the risk of PJI.
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Affiliation(s)
- Enrico M Forlenza
- Rush University Medical Center, 1611 W Harrison St, Chicago, IL, 60612.
| | - E Bailey Terhune
- Rush University Medical Center, 1611 W Harrison St, Chicago, IL, 60612
| | - John D D Higgins
- Rush University Medical Center, 1611 W Harrison St, Chicago, IL, 60612
| | - Conor Jones
- Rush University Medical Center, 1611 W Harrison St, Chicago, IL, 60612
| | - Jeffrey A Geller
- NY-Presbyterian-Columbia University Medical Center, 161 Fort Washington Ave, New York, NY, 10032
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Kuhnl A, Kirkwood AA, Roddie C, Menne T, Tholouli E, Bloor A, Besley C, Chaganti S, Osborne W, Norman J, Gibb A, Sharplin K, Cuadrado M, Correia de Farias M, Cheok K, Neill L, Latif AL, González Arias C, Uttenthal B, Jones C, Johnson R, McMillan A, Sanderson R, Townsend W. CAR T in patients with large B-cell lymphoma not fit for autologous transplant. Br J Haematol 2023. [PMID: 37082780 DOI: 10.1111/bjh.18810] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/22/2023]
Abstract
Large B-cell lymphoma (LBCL) patients with comorbidities and/or advanced age are increasingly considered for treatment with CD19 CAR T, but data on the clinical benefit of CAR T in the less fit patient population are still limited. We analysed outcomes of consecutive patients approved for treatment with axicabtagene ciloleucel (axi-cel) or tisagenlecleucel (tisa-cel) by the UK National CAR T Clinical Panel, according to fitness for autologous stem cell transplant (ASCT). 81/404 (20%) of approved patients were deemed unfit for ASCT. Unfit patients were more likely to receive tisa-cel versus axi-cel (52% vs. 48%) compared to 20% versus 80% in ASCT-fit patients; p < 0.0001. The drop-out rate from approval to infusion was significantly higher in the ASCT-unfit group (34.6% vs. 23.5%; p = 0.042). Among infused patients, response rate, progression-free and overall survival were similar in both cohorts. CAR T was well-tolerated in ASCT-unfit patients with an incidence of grade ≥3 cytokine release syndrome and neurotoxicity of 2% and 11%, respectively. Results from this multicentre real-world cohort demonstrate that CD19 CAR T can be safely delivered in carefully selected older patients and patients with comorbidities who are not deemed suitable for transplant.
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Affiliation(s)
- A Kuhnl
- Department of Haematology, King's College Hospital, London, UK
| | - A A Kirkwood
- Cancer Research UK & UCL Cancer Trials Centre, UCL Cancer Institute, University College London, London, UK
| | - C Roddie
- Department of Haematology, University College London Hospitals, London, UK
- UCL Cancer Institute, University College London, London, UK
| | - T Menne
- Department of Haematology, Freeman Hospital, Newcastle, UK
| | - E Tholouli
- Department of Haematology, Manchester Royal Infirmary, Manchester, UK
| | - A Bloor
- Department of Haematology, The Christie Hospital, Manchester, UK
| | - C Besley
- Department of Haematology, University Hospitals Bristol and Weston, Bristol, UK
| | - S Chaganti
- Department of Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - W Osborne
- Department of Haematology, Freeman Hospital, Newcastle, UK
| | - J Norman
- Department of Haematology, Manchester Royal Infirmary, Manchester, UK
| | - A Gibb
- Department of Haematology, The Christie Hospital, Manchester, UK
| | - K Sharplin
- Department of Haematology, University Hospitals Bristol and Weston, Bristol, UK
| | - M Cuadrado
- Department of Haematology, King's College Hospital, London, UK
| | | | - K Cheok
- Department of Haematology, University College London Hospitals, London, UK
| | - L Neill
- Department of Haematology, University College London Hospitals, London, UK
| | - A L Latif
- Department of Haematology, Queen Elizabeth II Hospital, Glasgow, UK
| | | | - B Uttenthal
- Department of Haematology, Addenbrooke's Hospital, Cambridge, UK
| | - C Jones
- Department of Haematology, University Hospital of Wales, Cardiff, UK
| | - R Johnson
- Department of Haematology, St. James's Hospital, Leeds, UK
| | - A McMillan
- Department of Haematology, Nottingham University Hospitals, Nottingham, UK
| | - R Sanderson
- Department of Haematology, King's College Hospital, London, UK
| | - W Townsend
- Department of Haematology, University College London Hospitals, London, UK
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Jadva V, Jones C, Hall P, Imrie S, Golombok S. 'I know it's not normal but it's normal to me, and that's all that matters': experiences of young adults conceived through egg donation, sperm donation, and surrogacy. Hum Reprod 2023; 38:908-916. [PMID: 36921279 PMCID: PMC10152165 DOI: 10.1093/humrep/dead048] [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: 07/15/2022] [Revised: 02/10/2023] [Indexed: 03/17/2023] Open
Abstract
STUDY QUESTION What are thoughts and feelings of young adults born following egg donation, sperm donation, and surrogacy? SUMMARY ANSWER Young adults felt either unconcerned or positive about the method of their conception. WHAT IS KNOWN ALREADY Much of what we know about adults born to heterosexual couples following anonymous donation has come from samples of donor conceived people who had found out about their origins during adulthood. There have been no studies of how young adults born through surrogacy feel about their conception and towards their surrogate. STUDY DESIGN, SIZE, DURATION Thirty-five young adults were interviewed as part of the seventh phase of a larger multi-method, multi-informant longitudinal study of assisted conception families in the UK. Adults were conceived using either egg donation, sperm donation, gestational surrogacy, or genetic surrogacy and were raised in households headed by heterosexual couples. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants had a mean age of 20 years and were born following traditional surrogacy (n = 10), gestational surrogacy (n = 5), egg donation (n = 11), or sperm donation (n = 9). All young adults born following sperm donation and most (n = 10) born from egg donation had an anonymous donor. In all surrogacy arrangements, the parents had met the surrogate prior to treatment. The majority of young adults were told about their conception by the age of 4 years. Participants were interviewed over the internet using a semi-structured interview. Interviews were transcribed verbatim and analysed using qualitative content analysis to understand young adults' thoughts and experiences related to their conception and whether they were interested in meeting their donor or surrogate. MAIN RESULTS AND THE ROLE OF CHANCE Fourteen (40%) young adults felt their conception made them feel special or unique, with the remainder feeling either neutral or unconcerned (n = 21, 60%). A higher proportion of young adults conceived using egg donation (n = 8, 73%) felt unique/special compared to young adults born following sperm donation and surrogacy. For 10 of the young adults, their feelings about their conception had changed over time, with most becoming more positive (n = 9, 26%). For most young adults (n = 22, 63%), conception was rarely or infrequently discussed with others. However, when it was, these conversations were largely conducted with ease. Most (n = 25, 71%) did not know other individuals born through the same method of conception as themselves, and the vast majority (n = 34, 97%) were not members of any support groups. For the 25 young adults not in contact with their donor or surrogate, 11 wished to meet them, 8 did not want to have contact, and 6 were unsure. Young adults in contact with their donor or surrogate had varying levels of closeness to them. Only one young adult had searched for the identity of their donor. LIMITATIONS, REASONS FOR CAUTION Of the 47 young adults invited to participate in the present study, 35 agreed to take part resulting in a response rate of 74%. It is therefore not known how those who did not take part felt about their conception. Given that the families reported here had been taking part in this longitudinal study from when the target child was aged 1 year, they may have been more likely to discuss the child's conception than other families. The study also utilized self-report measures, which may have been prone to social desirability, with donor conceived young adults wanting to present their experiences in a positive light. WIDER IMPLICATIONS OF THE FINDINGS The findings suggest that young adults born through surrogacy and donor conception do not feel negatively about their birth and this may be a consequence of the young age at which they found out about their conception. Although some young adults said they wished to meet their donor, this did not necessarily mean they were actively searching for them. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by the Wellcome Trust [grant number 208013/Z/17/Z]. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- V Jadva
- Centre for Family Research, University of Cambridge, Cambridge, UK.,Institute for Women's Health, University College London, London, UK.,Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, UK
| | - C Jones
- Social, Genetic & Developmental Psychiatry Centre, King's College London, London, UK
| | - P Hall
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - S Imrie
- Centre for Family Research, University of Cambridge, Cambridge, UK.,Murray Edwards College, University of Cambridge, Cambridge, UK
| | - S Golombok
- Centre for Family Research, University of Cambridge, Cambridge, UK
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Hartley L, Jones C, Lui D, Bernard J, Bishop T, Herzog J, Chan D, Stokes O, Gardner A. An Examination of the Number of Adolescent Scoliotic Curves That Are Braceable at First Presentation to a Scoliosis Service. Healthcare (Basel) 2023; 11:healthcare11030445. [PMID: 36767020 PMCID: PMC9914198 DOI: 10.3390/healthcare11030445] [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: 12/31/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
Adolescent idiopathic scoliosis (AIS) affects between 0.5% and 5.2% of adolescents and is progressive in two-thirds of cases. Bracing is an effective non-operative treatment for AIS and has been shown to prevent up to 72% of curves from requiring surgery. This paper explores the presentation of AIS in the UK and identifies who would be suitable for bracing, as per guidelines published by the Scoliosis Research Society (SRS) and British Scoliosis Society (BSS), through curve severity and skeletal maturity at presentation. There were 526 patients with AIS eligible for inclusion across three tertiary referral centres in the UK. The study period was individualised to each centre, between January 2012 and December 2021. Only 10% were appropriate for bracing via either SRS or BSS criteria. The rest were either too old, skeletally mature or had a curve size too large to benefit. By the end of data collection, 38% had undergone surgery for their scoliosis. In the UK, bracing for AIS is only suitable for a small number at presentation. Future efforts to minimise delays in specialist review and intervention will increase the number of those with AIS suitable for bracing and reduce the number and burden of operative interventions for AIS in the UK.
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Affiliation(s)
- Laura Hartley
- The Royal Orthopaedic Hospital, NHS Foundation Trust, Birmingham B31 2AP, UK
| | - Conor Jones
- The Royal Devon and Exeter, NHS Foundation Trust, Exeter EX2 5DW, UK
| | - Darren Lui
- St George’s University Hospitals, NHS Foundation Trust, London SW17 0OT, UK
| | - Jason Bernard
- St George’s University Hospitals, NHS Foundation Trust, London SW17 0OT, UK
| | - Timothy Bishop
- St George’s University Hospitals, NHS Foundation Trust, London SW17 0OT, UK
| | - Jan Herzog
- St George’s University Hospitals, NHS Foundation Trust, London SW17 0OT, UK
| | - Daniel Chan
- The Royal Devon and Exeter, NHS Foundation Trust, Exeter EX2 5DW, UK
| | - Oliver Stokes
- The Royal Devon and Exeter, NHS Foundation Trust, Exeter EX2 5DW, UK
| | - Adrian Gardner
- The Royal Orthopaedic Hospital, NHS Foundation Trust, Birmingham B31 2AP, UK
- Correspondence: ; Tel.: +44-7841-638236
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Jones C, Gray S, Brown M, Brown J, Mc Closkey E, Rai B, Clarke N, Sachdeva A. Fracture and fall risk in men with advanced or metastatic prostate cancer treated with novel androgen receptor signalling inhibitors: A systematic review and meta-analysis of randomised controlled trials. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01036-9] [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: 02/12/2023]
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Churchill J, Sachdeva A, Jones C, Issa A, Fankhauser C, Hudson A, Tran A, Oliveira P, Johnson H, Lau M, Parnham A, Sangar V. P16 status is an independent predictor of overall survival in metastatic penile cancer in a large contemporary cohort. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00680-2] [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: 02/12/2023]
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Jones C, Sachdeva A, Murphy L, Murray M, Brown L, Brown J, Mc Closkey E, Attard G, Parmar M, James N, Sydes M, Clarke N. Clinical fracture incidence in metastatic hormone-sensitive prostate cancer and risk-reduction following addition of zoledronic acid to androgen deprivation therapy with or without docetaxel: Long-term results from the STAMPEDE trial. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01237-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: 02/12/2023]
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Moser M, Adl Amini D, Jones C, Zhu J, Okano I, Oezel L, Chiapparelli E, Tan ET, Shue J, Sama AA, Cammisa FP, Girardi FP, Hughes AP. The predictive value of psoas and paraspinal muscle parameters measured on MRI for severe cage subsidence after standalone lateral lumbar interbody fusion. Spine J 2023; 23:42-53. [PMID: 35351664 DOI: 10.1016/j.spinee.2022.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/03/2022] [Accepted: 03/22/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND CONTEXT The effect of psoas and paraspinal muscle parameters on cage subsidence after minimally invasive techniques, such as standalone lateral lumbar interbody fusion (SA-LLIF), is unknown. PURPOSE This study aimed to determine whether the functional cross-sectional area (FCSA) of psoas and lumbar spine extensor muscles (multifidus and erector spinae), and psoas FCSA normalized to the vertebral body area (FCSA/VBA) differ among levels with severe cage subsidence after SA-LLIF when compared to levels without severe cage subsidence. STUDY DESIGN Retrospective single center cohort study. PATIENT SAMPLE Patients who underwent SA-LLIF between 2008 and 2020 for degenerative conditions using exclusively polyetheretherketone (PEEK) cages, had a lumbar magnetic resonance imaging (MRI) scan within 12 months, a lumbar computed tomography (CT) scan within 6 months prior to surgery, and a postoperative clinical and radiographic follow-up at a minimum of 6 months were included. OUTCOME MEASURES Severe cage subsidence. METHODS MRI measurements included psoas and combined multifidus and erector spinae (paraspinal) FCSA and FCSA/VBA at the L3-L5 pedicles. Following manual segmentation of muscles on axial T2-weighted images using ITK-SNAP (version 3.8.0), the FCSA was calculated using a custom written program on Matlab (version R2019a, The MathWorks, Inc.) that used an automated pixel intensity threshold method to differentiate between fat and muscle. Mean volumetric bone mineral density (vBMD) at L1/2 was measured by quantitative CT. The primary endpoint was severe cage subsidence per level according to the classification by Marchi et al. Multivariable logistic regression analysis was performed using generalized linear mixed models. All analyses were stratified by biological sex. RESULTS 95 patients (45.3% female) with a total of 188 operated levels were included in the analysis. The patient population was 92.6% Caucasian with a median age at surgery of 65 years. Overall subsidence (Grades 0-III) was 49.5% (53/107 levels) in men versus 58.0% (47/81 levels) in women (p=.302), and severe subsidence (Grades II-III) was 22.4% (24/107 levels) in men versus 25.9% (21/81 levels) in women (p=.608). In men, median psoas FCSA and psoas FCSA/VBA at L3 and L4 were significantly greater in the severe subsidence group when compared to the non-severe subsidence group. No such difference was observed in women. Paraspinal muscle parameters did not differ significantly between non-severe and severe subsidence groups for both sexes. In the multivariable logistic regression analysis with adjustments for vBMD and cage length, psoas FCSA at L3 (OR 1.002; p=.020) and psoas FCSA/VBA at L3 (OR 8.655; p=.029) and L4 (OR 4.273; p=.043) were found to be independent risk factors for severe cage subsidence in men. CONCLUSIONS Our study demonstrated that greater psoas FCSA at L3 and psoas FCSA/VBA at L3 and L4 were independent risk factors for severe cage subsidence in men after SA-LLIF with PEEK cages. The higher compressive forces the psoas exerts on lumbar segments as a potential stabilizer might explain these findings. Additional pedicle screw fixation might be warranted in these patients to avoid severe cage subsidence.
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Affiliation(s)
- Manuel Moser
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA; Department of Spine Surgery, Lucerne Cantonal Hospital, Spitalstrasse, 6000 Lucerne, Switzerland
| | - Dominik Adl Amini
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA; Department of Orthopedic Surgery and Traumatology, Charité University Hospital Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Conor Jones
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA; Department of Orthopedic Surgery, Rush University Medical Center, 1611 W. Harrison St, Chicago, IL 60612, USA
| | - Jiaqi Zhu
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA
| | - Ichiro Okano
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA; Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Lisa Oezel
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA; Department of Orthopedic Surgery and Traumatology, University Hospital Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Germany
| | - Erika Chiapparelli
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA
| | - Ek T Tan
- Department of Radiology and Imaging, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA
| | - Jennifer Shue
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA
| | - Andrew A Sama
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA
| | - Frank P Cammisa
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA
| | - Federico P Girardi
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA
| | - Alexander P Hughes
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th St, New York, NY 10021, USA.
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Swaminathan M, Angelakas A, Baxter M, Cotton J, Dobeson C, Feeney L, Gault A, Hughes D, Jones C, Lee R, Mughal S, Parikh S, Pritchard M, Rodgers L, Rowe M, Salawu A, Shotton R, Tinsley N, Tivey A, Olsson-Brown A. 241P Treatment and outcomes of patients with gastrointestinal toxicity following immunotherapy: A large multi-center retrospective study in the United Kingdom by the National Oncology Trainees Collaborative for Healthcare Research (NOTCH). Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Affiliation(s)
- D J Harriss
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - C Jones
- Cardiff School of Sport and Health Sciences/Ysgol Chwaraeon a Gwyddorau Iechyd Caerdydd, Cardiff Metropolitan University/Prifysgol Fetropolitan Caerdydd, Wales, UK
| | - A MacSween
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
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31
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Morvan A, Andersen TI, Mi X, Neill C, Petukhov A, Kechedzhi K, Abanin DA, Michailidis A, Acharya R, Arute F, Arya K, Asfaw A, Atalaya J, Bardin JC, Basso J, Bengtsson A, Bortoli G, Bourassa A, Bovaird J, Brill L, Broughton M, Buckley BB, Buell DA, Burger T, Burkett B, Bushnell N, Chen Z, Chiaro B, Collins R, Conner P, Courtney W, Crook AL, Curtin B, Debroy DM, Del Toro Barba A, Demura S, Dunsworth A, Eppens D, Erickson C, Faoro L, Farhi E, Fatemi R, Flores Burgos L, Forati E, Fowler AG, Foxen B, Giang W, Gidney C, Gilboa D, Giustina M, Grajales Dau A, Gross JA, Habegger S, Hamilton MC, Harrigan MP, Harrington SD, Hoffmann M, Hong S, Huang T, Huff A, Huggins WJ, Isakov SV, Iveland J, Jeffrey E, Jiang Z, Jones C, Juhas P, Kafri D, Khattar T, Khezri M, Kieferová M, Kim S, Kitaev AY, Klimov PV, Klots AR, Korotkov AN, Kostritsa F, Kreikebaum JM, Landhuis D, Laptev P, Lau KM, Laws L, Lee J, Lee KW, Lester BJ, Lill AT, Liu W, Locharla A, Malone F, Martin O, McClean JR, McEwen M, Meurer Costa B, Miao KC, Mohseni M, Montazeri S, Mount E, Mruczkiewicz W, Naaman O, Neeley M, Nersisyan A, Newman M, Nguyen A, Nguyen M, Niu MY, O'Brien TE, Olenewa R, Opremcak A, Potter R, Quintana C, Rubin NC, Saei N, Sank D, Sankaragomathi K, Satzinger KJ, Schurkus HF, Schuster C, Shearn MJ, Shorter A, Shvarts V, Skruzny J, Smith WC, Strain D, Sterling G, Su Y, Szalay M, Torres A, Vidal G, Villalonga B, Vollgraff-Heidweiller C, White T, Xing C, Yao Z, Yeh P, Yoo J, Zalcman A, Zhang Y, Zhu N, Neven H, Bacon D, Hilton J, Lucero E, Babbush R, Boixo S, Megrant A, Kelly J, Chen Y, Smelyanskiy V, Aleiner I, Ioffe LB, Roushan P. Formation of robust bound states of interacting microwave photons. Nature 2022; 612:240-245. [PMID: 36477133 PMCID: PMC9729104 DOI: 10.1038/s41586-022-05348-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/14/2022] [Indexed: 12/12/2022]
Abstract
Systems of correlated particles appear in many fields of modern science and represent some of the most intractable computational problems in nature. The computational challenge in these systems arises when interactions become comparable to other energy scales, which makes the state of each particle depend on all other particles1. The lack of general solutions for the three-body problem and acceptable theory for strongly correlated electrons shows that our understanding of correlated systems fades when the particle number or the interaction strength increases. One of the hallmarks of interacting systems is the formation of multiparticle bound states2-9. Here we develop a high-fidelity parameterizable fSim gate and implement the periodic quantum circuit of the spin-½ XXZ model in a ring of 24 superconducting qubits. We study the propagation of these excitations and observe their bound nature for up to five photons. We devise a phase-sensitive method for constructing the few-body spectrum of the bound states and extract their pseudo-charge by introducing a synthetic flux. By introducing interactions between the ring and additional qubits, we observe an unexpected resilience of the bound states to integrability breaking. This finding goes against the idea that bound states in non-integrable systems are unstable when their energies overlap with the continuum spectrum. Our work provides experimental evidence for bound states of interacting photons and discovers their stability beyond the integrability limit.
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Affiliation(s)
- A Morvan
- Google Research, Mountain View, CA, USA
| | | | - X Mi
- Google Research, Mountain View, CA, USA
| | - C Neill
- Google Research, Mountain View, CA, USA
| | | | | | - D A Abanin
- Google Research, Mountain View, CA, USA
- Department of Theoretical Physics, University of Geneva, Geneva, Switzerland
| | - A Michailidis
- Department of Theoretical Physics, University of Geneva, Geneva, Switzerland
| | - R Acharya
- Google Research, Mountain View, CA, USA
| | - F Arute
- Google Research, Mountain View, CA, USA
| | - K Arya
- Google Research, Mountain View, CA, USA
| | - A Asfaw
- Google Research, Mountain View, CA, USA
| | - J Atalaya
- Google Research, Mountain View, CA, USA
| | - J C Bardin
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of Massachusetts, Amherst, MA, USA
| | - J Basso
- Google Research, Mountain View, CA, USA
| | | | - G Bortoli
- Google Research, Mountain View, CA, USA
| | | | - J Bovaird
- Google Research, Mountain View, CA, USA
| | - L Brill
- Google Research, Mountain View, CA, USA
| | | | | | - D A Buell
- Google Research, Mountain View, CA, USA
| | - T Burger
- Google Research, Mountain View, CA, USA
| | - B Burkett
- Google Research, Mountain View, CA, USA
| | | | - Z Chen
- Google Research, Mountain View, CA, USA
| | - B Chiaro
- Google Research, Mountain View, CA, USA
| | - R Collins
- Google Research, Mountain View, CA, USA
| | - P Conner
- Google Research, Mountain View, CA, USA
| | | | - A L Crook
- Google Research, Mountain View, CA, USA
| | - B Curtin
- Google Research, Mountain View, CA, USA
| | | | | | - S Demura
- Google Research, Mountain View, CA, USA
| | | | - D Eppens
- Google Research, Mountain View, CA, USA
| | | | - L Faoro
- Google Research, Mountain View, CA, USA
| | - E Farhi
- Google Research, Mountain View, CA, USA
| | - R Fatemi
- Google Research, Mountain View, CA, USA
| | | | - E Forati
- Google Research, Mountain View, CA, USA
| | | | - B Foxen
- Google Research, Mountain View, CA, USA
| | - W Giang
- Google Research, Mountain View, CA, USA
| | - C Gidney
- Google Research, Mountain View, CA, USA
| | - D Gilboa
- Google Research, Mountain View, CA, USA
| | | | | | - J A Gross
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - S Hong
- Google Research, Mountain View, CA, USA
| | - T Huang
- Google Research, Mountain View, CA, USA
| | - A Huff
- Google Research, Mountain View, CA, USA
| | | | | | - J Iveland
- Google Research, Mountain View, CA, USA
| | - E Jeffrey
- Google Research, Mountain View, CA, USA
| | - Z Jiang
- Google Research, Mountain View, CA, USA
| | - C Jones
- Google Research, Mountain View, CA, USA
| | - P Juhas
- Google Research, Mountain View, CA, USA
| | - D Kafri
- Google Research, Mountain View, CA, USA
| | - T Khattar
- Google Research, Mountain View, CA, USA
| | - M Khezri
- Google Research, Mountain View, CA, USA
| | - M Kieferová
- Google Research, Mountain View, CA, USA
- Centre for Quantum Computation and Communication Technology, Centre for Quantum Software and Information, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, New South Wales, Australia
| | - S Kim
- Google Research, Mountain View, CA, USA
| | - A Y Kitaev
- Google Research, Mountain View, CA, USA
- Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, CA, USA
| | | | - A R Klots
- Google Research, Mountain View, CA, USA
| | - A N Korotkov
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of California, Riverside, CA, USA
| | | | | | | | - P Laptev
- Google Research, Mountain View, CA, USA
| | - K-M Lau
- Google Research, Mountain View, CA, USA
| | - L Laws
- Google Research, Mountain View, CA, USA
| | - J Lee
- Google Research, Mountain View, CA, USA
| | - K W Lee
- Google Research, Mountain View, CA, USA
| | | | - A T Lill
- Google Research, Mountain View, CA, USA
| | - W Liu
- Google Research, Mountain View, CA, USA
| | | | - F Malone
- Google Research, Mountain View, CA, USA
| | - O Martin
- Google Research, Mountain View, CA, USA
| | | | - M McEwen
- Google Research, Mountain View, CA, USA
- Department of Physics, University of California, Santa Barbara, CA, USA
| | | | - K C Miao
- Google Research, Mountain View, CA, USA
| | - M Mohseni
- Google Research, Mountain View, CA, USA
| | | | - E Mount
- Google Research, Mountain View, CA, USA
| | | | - O Naaman
- Google Research, Mountain View, CA, USA
| | - M Neeley
- Google Research, Mountain View, CA, USA
| | | | - M Newman
- Google Research, Mountain View, CA, USA
| | - A Nguyen
- Google Research, Mountain View, CA, USA
| | - M Nguyen
- Google Research, Mountain View, CA, USA
| | - M Y Niu
- Google Research, Mountain View, CA, USA
| | | | - R Olenewa
- Google Research, Mountain View, CA, USA
| | | | - R Potter
- Google Research, Mountain View, CA, USA
| | | | - N C Rubin
- Google Research, Mountain View, CA, USA
| | - N Saei
- Google Research, Mountain View, CA, USA
| | - D Sank
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - A Shorter
- Google Research, Mountain View, CA, USA
| | - V Shvarts
- Google Research, Mountain View, CA, USA
| | - J Skruzny
- Google Research, Mountain View, CA, USA
| | - W C Smith
- Google Research, Mountain View, CA, USA
| | - D Strain
- Google Research, Mountain View, CA, USA
| | | | - Y Su
- Google Research, Mountain View, CA, USA
| | - M Szalay
- Google Research, Mountain View, CA, USA
| | - A Torres
- Google Research, Mountain View, CA, USA
| | - G Vidal
- Google Research, Mountain View, CA, USA
| | | | | | - T White
- Google Research, Mountain View, CA, USA
| | - C Xing
- Google Research, Mountain View, CA, USA
| | - Z Yao
- Google Research, Mountain View, CA, USA
| | - P Yeh
- Google Research, Mountain View, CA, USA
| | - J Yoo
- Google Research, Mountain View, CA, USA
| | - A Zalcman
- Google Research, Mountain View, CA, USA
| | - Y Zhang
- Google Research, Mountain View, CA, USA
| | - N Zhu
- Google Research, Mountain View, CA, USA
| | - H Neven
- Google Research, Mountain View, CA, USA
| | - D Bacon
- Google Research, Mountain View, CA, USA
| | - J Hilton
- Google Research, Mountain View, CA, USA
| | - E Lucero
- Google Research, Mountain View, CA, USA
| | - R Babbush
- Google Research, Mountain View, CA, USA
| | - S Boixo
- Google Research, Mountain View, CA, USA
| | - A Megrant
- Google Research, Mountain View, CA, USA
| | - J Kelly
- Google Research, Mountain View, CA, USA
| | - Y Chen
- Google Research, Mountain View, CA, USA
| | | | - I Aleiner
- Google Research, Mountain View, CA, USA.
| | - L B Ioffe
- Google Research, Mountain View, CA, USA.
| | - P Roushan
- Google Research, Mountain View, CA, USA.
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Mi X, Sonner M, Niu MY, Lee KW, Foxen B, Acharya R, Aleiner I, Andersen TI, Arute F, Arya K, Asfaw A, Atalaya J, Bardin JC, Basso J, Bengtsson A, Bortoli G, Bourassa A, Brill L, Broughton M, Buckley BB, Buell DA, Burkett B, Bushnell N, Chen Z, Chiaro B, Collins R, Conner P, Courtney W, Crook AL, Debroy DM, Demura S, Dunsworth A, Eppens D, Erickson C, Faoro L, Farhi E, Fatemi R, Flores L, Forati E, Fowler AG, Giang W, Gidney C, Gilboa D, Giustina M, Dau AG, Gross JA, Habegger S, Harrigan MP, Hoffmann M, Hong S, Huang T, Huff A, Huggins WJ, Ioffe LB, Isakov SV, Iveland J, Jeffrey E, Jiang Z, Jones C, Kafri D, Kechedzhi K, Khattar T, Kim S, Kitaev AY, Klimov PV, Klots AR, Korotkov AN, Kostritsa F, Kreikebaum JM, Landhuis D, Laptev P, Lau KM, Lee J, Laws L, Liu W, Locharla A, Martin O, McClean JR, McEwen M, Meurer Costa B, Miao KC, Mohseni M, Montazeri S, Morvan A, Mount E, Mruczkiewicz W, Naaman O, Neeley M, Neill C, Newman M, O’Brien TE, Opremcak A, Petukhov A, Potter R, Quintana C, Rubin NC, Saei N, Sank D, Sankaragomathi K, Satzinger KJ, Schuster C, Shearn MJ, Shvarts V, Strain D, Su Y, Szalay M, Vidal G, Villalonga B, Vollgraff-Heidweiller C, White T, Yao Z, Yeh P, Yoo J, Zalcman A, Zhang Y, Zhu N, Neven H, Bacon D, Hilton J, Lucero E, Babbush R, Boixo S, Megrant A, Chen Y, Kelly J, Smelyanskiy V, Abanin DA, Roushan P. Noise-resilient edge modes on a chain of superconducting qubits. Science 2022; 378:785-790. [DOI: 10.1126/science.abq5769] [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: 11/18/2022]
Abstract
Inherent symmetry of a quantum system may protect its otherwise fragile states. Leveraging such protection requires testing its robustness against uncontrolled environmental interactions. Using 47 superconducting qubits, we implement the one-dimensional kicked Ising model, which exhibits nonlocal Majorana edge modes (MEMs) with
ℤ
2
parity symmetry. We find that any multiqubit Pauli operator overlapping with the MEMs exhibits a uniform late-time decay rate comparable to single-qubit relaxation rates, irrespective of its size or composition. This characteristic allows us to accurately reconstruct the exponentially localized spatial profiles of the MEMs. Furthermore, the MEMs are found to be resilient against certain symmetry-breaking noise owing to a prethermalization mechanism. Our work elucidates the complex interplay between noise and symmetry-protected edge modes in a solid-state environment.
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Affiliation(s)
- X. Mi
- Google Research, Mountain View, CA, USA
| | - M. Sonner
- Department of Theoretical Physics, University of Geneva, Geneva, Switzerland
| | - M. Y. Niu
- Google Research, Mountain View, CA, USA
| | - K. W. Lee
- Google Research, Mountain View, CA, USA
| | - B. Foxen
- Google Research, Mountain View, CA, USA
| | | | | | | | - F. Arute
- Google Research, Mountain View, CA, USA
| | - K. Arya
- Google Research, Mountain View, CA, USA
| | - A. Asfaw
- Google Research, Mountain View, CA, USA
| | | | - J. C. Bardin
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of Massachusetts, Amherst, MA, USA
| | - J. Basso
- Google Research, Mountain View, CA, USA
| | | | | | | | - L. Brill
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - Z. Chen
- Google Research, Mountain View, CA, USA
| | - B. Chiaro
- Google Research, Mountain View, CA, USA
| | | | - P. Conner
- Google Research, Mountain View, CA, USA
| | | | | | | | - S. Demura
- Google Research, Mountain View, CA, USA
| | | | - D. Eppens
- Google Research, Mountain View, CA, USA
| | | | - L. Faoro
- Google Research, Mountain View, CA, USA
| | - E. Farhi
- Google Research, Mountain View, CA, USA
| | - R. Fatemi
- Google Research, Mountain View, CA, USA
| | - L. Flores
- Google Research, Mountain View, CA, USA
| | - E. Forati
- Google Research, Mountain View, CA, USA
| | | | - W. Giang
- Google Research, Mountain View, CA, USA
| | - C. Gidney
- Google Research, Mountain View, CA, USA
| | - D. Gilboa
- Google Research, Mountain View, CA, USA
| | | | - A. G. Dau
- Google Research, Mountain View, CA, USA
| | | | | | | | | | - S. Hong
- Google Research, Mountain View, CA, USA
| | - T. Huang
- Google Research, Mountain View, CA, USA
| | - A. Huff
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - Z. Jiang
- Google Research, Mountain View, CA, USA
| | - C. Jones
- Google Research, Mountain View, CA, USA
| | - D. Kafri
- Google Research, Mountain View, CA, USA
| | | | | | - S. Kim
- Google Research, Mountain View, CA, USA
| | - A. Y. Kitaev
- Google Research, Mountain View, CA, USA
- Institute for Quantum Information and Matter, California Institute of Technology, Pasadena, CA, USA
| | | | | | - A. N. Korotkov
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of California, Riverside, CA, USA
| | | | | | | | - P. Laptev
- Google Research, Mountain View, CA, USA
| | - K.-M. Lau
- Google Research, Mountain View, CA, USA
| | - J. Lee
- Google Research, Mountain View, CA, USA
| | - L. Laws
- Google Research, Mountain View, CA, USA
| | - W. Liu
- Google Research, Mountain View, CA, USA
| | | | - O. Martin
- Google Research, Mountain View, CA, USA
| | | | - M. McEwen
- Google Research, Mountain View, CA, USA
- Department of Physics, University of California, Santa Barbara, CA, USA
| | | | | | | | | | - A. Morvan
- Google Research, Mountain View, CA, USA
| | - E. Mount
- Google Research, Mountain View, CA, USA
| | | | - O. Naaman
- Google Research, Mountain View, CA, USA
| | - M. Neeley
- Google Research, Mountain View, CA, USA
| | - C. Neill
- Google Research, Mountain View, CA, USA
| | - M. Newman
- Google Research, Mountain View, CA, USA
| | | | | | | | - R. Potter
- Google Research, Mountain View, CA, USA
| | | | | | - N. Saei
- Google Research, Mountain View, CA, USA
| | - D. Sank
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - D. Strain
- Google Research, Mountain View, CA, USA
| | - Y. Su
- Google Research, Mountain View, CA, USA
| | - M. Szalay
- Google Research, Mountain View, CA, USA
| | - G. Vidal
- Google Research, Mountain View, CA, USA
| | | | | | - T. White
- Google Research, Mountain View, CA, USA
| | - Z. Yao
- Google Research, Mountain View, CA, USA
| | - P. Yeh
- Google Research, Mountain View, CA, USA
| | - J. Yoo
- Google Research, Mountain View, CA, USA
| | | | - Y. Zhang
- Google Research, Mountain View, CA, USA
| | - N. Zhu
- Google Research, Mountain View, CA, USA
| | - H. Neven
- Google Research, Mountain View, CA, USA
| | - D. Bacon
- Google Research, Mountain View, CA, USA
| | - J. Hilton
- Google Research, Mountain View, CA, USA
| | - E. Lucero
- Google Research, Mountain View, CA, USA
| | | | - S. Boixo
- Google Research, Mountain View, CA, USA
| | | | - Y. Chen
- Google Research, Mountain View, CA, USA
| | - J. Kelly
- Google Research, Mountain View, CA, USA
| | | | - D. A. Abanin
- Google Research, Mountain View, CA, USA
- Department of Theoretical Physics, University of Geneva, Geneva, Switzerland
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Jones C, Okano I, Arzani A, Dodo Y, Moser M, Reisener MJ, Chiapparelli E, Adl Amini D, Shue J, Sama AA, Cammisa FP, Girardi FP, Hughes AP. The predictive value of a novel site-specific MRI-based bone quality assessment, endplate bone quality (EBQ), for severe cage subsidence among patients undergoing standalone lateral lumbar interbody fusion. Spine J 2022; 22:1875-1883. [PMID: 35843534 DOI: 10.1016/j.spinee.2022.07.085] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/18/2022] [Accepted: 07/11/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Studies have shown that site-specific bone density measurements had more predictive value for complications than standard whole-region measurements. Recently, MRI-based assessments of vertebral bone quality (VBQ) were introduced. However, there have been few studies that investigate the association between site-specific MRI bone assessment and osteoporosis-related complications in patients undergoing lumbar interbody fusion. In this work, we created a novel site-specific MRI-based assessment of the endplate bone quality (EBQ) and assessed its predictive value for severe cage subsidence following standalone lateral lumbar interbody fusion (SA-LLIF). PURPOSE To investigate the predictive value of a novel MRI-based bone assessment for severe cage subsidence after SA-LLIF. STUDY DESIGN/SETTING Retrospective cohort study. PATIENT SAMPLE Patients who underwent SA-LLIF from 2008 to 2019 at a single, academic institution with available preoperative lumbar CT and T1-weighted MRIs. OUTCOME MEASURES Association between EBQ and severe subsidence after SA-LLIF. METHODS We retrospectively reviewed the records of SA-LLIF patients treated between 2008 and 2019. EBQ was measured using preoperative non-contrast T1-weighted MRIs of the lumbar spine. EBQ was defined as the average value of signal intensity of both endplates divided by that of the cerebrospinal fluid space at the level of L3. Bivariate and multivariable analyses with generalized linear mixed models were performed and set binary severe subsidence as the outcome. RESULTS Two hundred five levels in 89 patients were included. Fifty levels (24.4%) demonstrated severe subsidence. Bone mineral density measured by quantitative computed tomography was significantly lower in the subsidence group. Both VBQ and EBQ were significantly higher in the subsidence group. The EBQ plus Modic change (MC) model demonstrated that the effect of EBQ was independent of MC. In multivariate analyses adjusted with QCT-vBMD, EBQ showed a significant association with cage subsidence whereas VBQ only showed a marginal trend. The EBQ-based prediction model for severe subsidence showed better goodness of fit compared to the VBQ-based model. CONCLUSIONS High EBQ was an independent factor for severe cage subsidence after SA-LLIF and the EBQ-based model showed better goodness of fit compared to VBQ- or MC-based models. EBQ assessment before SA-LLIF may provide insight into a patient's risk for severe subsidence.
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Affiliation(s)
- Conor Jones
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
| | - Ichiro Okano
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA; Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666 Japan
| | - Artine Arzani
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
| | - Yusuke Dodo
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA; Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666 Japan
| | - Manuel Moser
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
| | | | - Erika Chiapparelli
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
| | - Dominik Adl Amini
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
| | - Jennifer Shue
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
| | - Andrew A Sama
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
| | - Frank P Cammisa
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
| | - Federico P Girardi
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
| | - Alexander P Hughes
- Spine Care Institute, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
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34
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Guidoboni G, Nunez R, Keller J, Wikle C, Robinson EL, Verticchio Vercellin AC, Siesky B, Oddone F, Quaranta L, Wirostko B, Topouzis F, Cheng CY, Januleviciene I, Wegner A, Antman G, Jones C, Harris A. Precision medicine and glaucoma management: how mathematical modeling and artificial intelligence help in clinical practice. Expert Rev Ophthalmol 2022; 17:299-301. [PMID: 36545014 PMCID: PMC9762696 DOI: 10.1080/17469899.2022.2130249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/26/2022] [Indexed: 12/26/2022]
Affiliation(s)
- G Guidoboni
- Electrical Engineering Computer Science, University of Missouri, Columbia, MO, United States
| | - R Nunez
- Electrical Engineering Computer Science, University of Missouri, Columbia, MO, United States
| | - J Keller
- Electrical Engineering Computer Science, University of Missouri, Columbia, MO, United States
| | - C Wikle
- Statistics, University of Missouri, Columbia, MO, United States
| | - EL Robinson
- School of Social Work, University of Missouri System, Columbia, MO, United States
| | | | - B Siesky
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - F Oddone
- IRCCS Fondazione Bietti, Rome, Italy
| | - L Quaranta
- Centro Oculistico Italiano, Brescia, Italy
| | - B Wirostko
- Moran Eye Center, Salt Lake City, UT, United States
| | - F Topouzis
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C-Y Cheng
- Singapore Eye Research Institute, Singapore, Singapore
| | | | - A Wegner
- Institute for Refractive and Ophthalmic Surgery, Zürich, Switzerland
| | - G Antman
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Rabin Medical Center, Petah Tikva, Israel
| | - C Jones
- Mathematics, University of Missouri, Columbia, MO, United States
| | - A Harris
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
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35
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Anandkumar D, Whitehead N, Agarwala R, Tomlinson J, Pencavel T, Jones C, Aggarwal G. Development of an ERAS laparoscopic liver resection pathway. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.06.054] [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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Khosla S, Ike C, Walker D, Derbyshire S, Jones C. Evaluating the implementation of enhanced recovery after transoral robotic surgery for oropharyngeal cancer. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.06.085] [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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Bakr D, Reid A, Flaherty K, Holdich A, Jones C, Tarrant R, Cox A, Goodwill L, Lewis J, Girardi M, Whittaker S, Mitchell T. POT1 gene dysfunction in primary cutaneous T-cell lymphoma. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00551-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chen L, Zheng M, Chen Z, Peng Y, Jones C, Graves S, Chen P, Ruan R, Papadimitriou J, Carey-Smith R, Leys T, Mitchell C, Huang YG, Wood D, Bulsara M, Zheng MH. The burden of end-stage osteoarthritis in Australia: a population-based study on the incidence of total knee replacement attributable to overweight/obesity. Osteoarthritis Cartilage 2022; 30:1254-1262. [PMID: 34890810 DOI: 10.1016/j.joca.2021.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/11/2021] [Accepted: 10/27/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To determine the risk of total knee replacement (TKR) for primary osteoarthritis (OA) associated with overweight/obesity in the Australian population. METHODS This population-based study analyzed 191,723 cases of TKR collected by the Australian Orthopaedic Association National Joint Registry and population data from the Australian Bureau of Statistics. The time-trend change in incidence of TKR relating to BMI was assessed between 2015 and 2018. The influence of obesity on the incidence of TKR in different age and gender groups was determined. The population attributable fraction (PAF) was then calculated to estimate the effect of obesity reduction on TKR incidence. RESULTS The greatest increase in incidence of TKR was seen in patients from obese class III. The incidence rate ratio for having a TKR for obesity class III was 28.683 at those aged 18-54 years but was 2.029 at those aged >75 years. Females in obesity class III were 1.7 times more likely to undergo TKR compared to similarly classified males. The PAFs of TKR associated with overweight or obesity was 35%, estimating 14,287 cases of TKR attributable to obesity in 2018. The proportion of TKRs could be reduced by 20% if overweight and obese population move down one category. CONCLUSIONS Obesity has resulted in a significant increase in the incidence of TKR in the youngest population in Australia. The impact of obesity is greatest in the young and the female population. Effective strategies to reduce the national obese population could potentially reduce 35% of the TKR, with over 10,000 cases being avoided.
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Affiliation(s)
- L Chen
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - M Zheng
- Institute for Health Research, Medical School, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Z Chen
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Y Peng
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia; Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, South Australia, Australia
| | - C Jones
- Department of Orthopaedic Surgery, Fiona Stanley Hospital Group, Perth, Western Australia, Australia
| | - S Graves
- Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, South Australia, Australia
| | - P Chen
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - R Ruan
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - J Papadimitriou
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia; Pathwest Laboratories, Perth, Western Australia, Australia
| | - R Carey-Smith
- Department of Orthopaedic Surgery, Sir Charles Gardner Hospital, Perth, Western Australia, Australia
| | - T Leys
- Department of Orthopaedic Surgery, Sir Charles Gardner Hospital, Perth, Western Australia, Australia
| | - C Mitchell
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Y G Huang
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - D Wood
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - M Bulsara
- Institute for Health Research, Medical School, University of Notre Dame Australia, Fremantle, Western Australia, Australia.
| | - M H Zheng
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia; Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia.
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Abstract
This paper presents an overview of the importance of mental health services for unaccompanied asylum-seeking children in the United Kingdom. It reviews what mental health support appears to be available in the United Kingdom following an on-line search which took place in Spring 2021 and using information gathered through 22 interviews and focus groups with stakeholders. The latter group are defined as people working with asylum-seeking children. The primary stakeholders were local authority staff, although interviews were also conducted with local government associations (London Councils, the Local Government Association), NHS bodies and the voluntary sector. Often, further relevant stakeholders were identified during interviews. The report details the aims, methodology and context, before the findings are presented which is followed by recommendations for improving mental and social care provision for unaccompanied asylum-seeking children in the United Kingdom.
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Affiliation(s)
- A Dubs
- House of Lords, United Kingdom of Great Britain and Northern Ireland
| | - K Hay
- NHS, United Kingdom of Great Britain and Northern Ireland
| | - C Jones
- House of Lords, United Kingdom of Great Britain and Northern Ireland
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Casha G, Jones C. Intercostal thoracotomy for surgical attenuation of portoazygos extrahepatic portosystemic shunts in three dogs: surgical technique and short-term outcomes. N Z Vet J 2022; 70:332-339. [PMID: 35924343 DOI: 10.1080/00480169.2022.2108153] [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] [Indexed: 10/16/2022]
Abstract
CASE HISTORIES The medical records of three dogs, presenting to the surgery department at a tertiary private referral hospital (Cork, Republic of Ireland), were retrospectively reviewed. The patients presented for investigation of a 3-day history of progressive lethargy, decreased appetite and hindlimb weakness (Case 1); brachycephalic obstructive airway syndrome and the development of abnormal licking behaviours (Case 2); and a 2-month history of increased thirst with elevated alanine aminotransferase in serum (Case 3). CLINICAL FINDINGS Case 1 presented with tachycardia, hindlimb paraparesis and neck pain, while Case 2 presented with facial conformation abnormalities consistent with brachycephalic obstructive airway syndrome. General physical examination and neurological assessment were within normal limits for Case 3. Baseline serum biochemistry measurements, in all three patients, indicated elevated activities of alanine aminotransferase and alkaline phosphatase, as well as elevated concentrations of resting bile acids (BA), suggestive of an extrahepatic portosystemic shunt. Abdominal computed tomography (CT) angiography was performed, for each dog, which revealed the presence of a portoazygous shunt (PAS) with final insertion into the caudal azygos vein within the thorax. TREATMENT AND OUTCOME Abdominal CT angiography images were used for surgical planning and a right-sided intercostal thoracotomy was performed. The location of the thoracotomy was patient-specific and located cranial to the diaphragm, either at the point of PAS insertion into the azygos vein or one rib-space caudal to the insertion, as determined by pre-operative CT images. The intercostal thoracotomy provided good visualisation of the PAS and an appropriate surgical field for placement of a thin film band around the PAS. No surgical complications or post-attenuation seizures were observed. All patients appeared comfortable on oral analgesia and were discharged from the hospital by 48 hours after surgery. All patients demonstrated a clinical improvement when reassessed 6-8 weeks after surgery, and Cases 2 and 3 demonstrated a reduction of resting BA concentrations to within normal limits. The third patient (Case 1) had a considerable reduction in the concentration of resting BA from >140 µmol/L to 20 µmol/L (reference range 0-10 µmol/L) 6-8 weeks after surgery. CLINICAL RELEVANCE A right-sided intercostal thoracotomy can be considered for surgical management of PAS in dogs. While both intraoperative and short-term results appear promising, further prospective studies are required before this approach can be recommended as the preferred approach for PAS attenuation.
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Affiliation(s)
- G Casha
- Gilabbey Veterinary Hospital, Cork, Republic of Ireland
| | - C Jones
- Gilabbey Veterinary Hospital, Cork, Republic of Ireland
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Salzmann SN, Okano I, Jones C, Zhu J, Lu S, Onyekwere I, Balaji V, Reisener MJ, Chiapparelli E, Shue J, Carrino JA, Girardi FP, Cammisa FP, Sama AA, Hughes AP. Preoperative MRI-based vertebral bone quality (VBQ) score assessment in patients undergoing lumbar spinal fusion. Spine J 2022; 22:1301-1308. [PMID: 35342015 DOI: 10.1016/j.spinee.2022.03.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 02/14/2022] [Accepted: 03/17/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The importance of bone status assessment in spine surgery is well recognized. The current gold standard for assessing bone mineral density is dual-energy X-ray absorptiometry (DEXA). However, DEXA has been shown to overestimate BMD in patients with spinal degenerative disease and obesity. Consequently, alternative radiographic measurements using data routinely gathered during preoperative evaluation have been explored for the evaluation of bone quality and fracture risk. Opportunistic quantitative computed tomography (QCT) and more recently, the MRI-based vertebral bone quality (VBQ) score, have both been shown to correlate with DEXA T-scores and predict osteoporotic fractures. However, to date the direct association between VBQ and QCT has not been studied. PURPOSE The objective of this study was to evaluate the correlation between VBQ and spine QCT BMD measurements and assess whether the recently described novel VBQ score can predict the presence of osteopenia/osteoporosis diagnosed with QCT. STUDY DESIGN/SETTING Cross-sectional study using retrospectively collected data. PATIENT SAMPLE Patients undergoing lumbar fusion from 2014-2019 at a single, academic institution with available preoperative lumbar CT and T1-weighted MRIs were included. OUTCOME MEASURES Correlation of the VBQ score with BMD measured by QCT, and association between VBQ score and presence of osteopenia/osteoporosis. METHODS Asynchronous QCT measurements were performed. The average L1-L2 BMD was calculated and patients were categorized as either normal BMD (>120 mg/cm3) or osteopenic/osteoporotic (≤120 mg/cm3). The VBQ score was calculated by dividing the median signal intensity of the L1-L4 vertebral bodies by the signal intensity of the cerebrospinal fluid on midsagittal T1-weighted MRI images. Inter-observer reliability testing of the VBQ measurements was performed. Demographic data and the VBQ score were compared between the normal and osteopenic/osteoporotic group. To determine the area-under-curve (AUC) of the VBQ score as a predictor of osteopenia/osteoporosis receiver operating characteristic (ROC) analysis was performed. VBQ scores were compared with QCT BMD using the Pearson's correlation. RESULTS A total of 198 patients (53% female) were included. The mean age was 62 years and the mean BMI was 28.2 kg/m2. The inter-observer reliability of the VBQ measurements was excellent (ICC of 0.90). When comparing the patients with normal QCT BMD to those with osteopenia/osteoporosis, the patients with osteopenia/osteoporosis were significantly older (64.9 vs. 56.7 years, p<.0001). The osteopenic/osteoporotic group had significantly higher VBQ scores (2.6 vs. 2.2, p<.0001). The VBQ score showed a statistically significant negative correlation with QCT BMD (correlation coefficient = -0.358, 95% CI -0.473 - -0.23, p<.001). Using a VBQ score cutoff value of 2.388, the categorical VBQ score yielded a sensitivity of 74.3% and a specificity of 57.0% with an AUC of 0.7079 to differentiate patients with osteopenia/osteoporosis and with normal BMD. CONCLUSIONS We found that the VBQ score showed moderate diagnostic ability to differentiate patients with normal BMD versus osteopenic/osteoporotic BMD based on QCT. VBQ may be an interesting adjunct to clinically performed bone density measurements in the future.
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Affiliation(s)
- Stephan N Salzmann
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Ichiro Okano
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Conor Jones
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Jiaqi Zhu
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Shuting Lu
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Ikenna Onyekwere
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Venkatesh Balaji
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Marie-Jacqueline Reisener
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Erika Chiapparelli
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Jennifer Shue
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - John A Carrino
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Federico P Girardi
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Frank P Cammisa
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Andrew A Sama
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA
| | - Alexander P Hughes
- Hospital for Special Surgery, Weill Cornell Medicine, Spine Care Institute, 535 East 70th St, New York, NY 10021, USA.
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Uy M, Millan B, Jones C, Sands D, Matsumoto E, Bay B, Shayegan B. Successful Same-Day Discharge for Robot-Assisted Radical Prostatectomy: A Systematic Review and Meta-Analysis. Urol Pract 2022; 9:294-305. [PMID: 37145778 DOI: 10.1097/upj.0000000000000305] [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: 02/14/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Same-day discharge (SDD) following robot-assisted radical prostatectomy (RARP) is emerging as the standard of care. We conducted a systematic review and meta-analysis to evaluate the differences in perioperative characteristics, complication/readmissions rates and satisfaction/cost data between inpatient (IP) RARP and SDD RARP. METHODS This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was prospectively registered with PROSPERO (CRD42021258848). A comprehensive search of PubMed®, Embase®, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and conference abstract publications was performed. A leave-one-out sensitivity analysis was performed to control for heterogeneity and risk of bias. RESULTS A total of 14 studies were included with a pooled population of 3,795 patients, including 2,348 (61.9%) IP RARPs and 1,447 (38.1%) SDD RARPs. SDD pathways varied, though many commonalities were present in patient selection, perioperative recommendations and postoperative management. When compared to IP RARP, SDD RARP had no differences in ≥grade 3 Clavien-Dindo complications (RR: 0.4, 95% CI 0.2, 1.1, p=0.07), 90-day readmission rates (RR: 0.6, 95% CI 0.3, 1.1, p=0.10) or unscheduled emergency department visits (RR: 1.0, 95% CI 0.3, 3.1, p=0.97). Cost savings per patient ranged between $367 and $2,109, and overall satisfaction was high at 87.5%-100%. CONCLUSIONS SDD following RARP is both feasible and safe, while potentially offering health care cost savings with high patient satisfaction rates. Data from this study will inform the uptake and development of future SDD pathways in contemporary urological care such that it may be offered to a broader patient population.
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Affiliation(s)
- Michael Uy
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Braden Millan
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Conor Jones
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - David Sands
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Edward Matsumoto
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Urology, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Benjamin Bay
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Urology, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Bobby Shayegan
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Urology, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, Low Z, May C, Musto L, Nagi S, Nur S, Salau E, Shabbir S, Thomas MC, Uthayanan L, Vig S, Zaheer M, Zeng G, Ashcroft-Quinn S, Brown R, Hayes J, McConville R, French R, Gilliam A, Sheetal S, Shehzad MU, Bani W, Christie I, Franklyn J, Khan M, Russell J, Smolarek S, Varadarassou R, Ahmed SK, Narayanaswamy S, Sealy J, Shah M, Dodhia V, Manukyan A, O'Hare R, Orbell J, Chung I, Forenc K, Gupta A, Agarwal A, Al Dabbagh A, Bennewith R, Bottomley J, Chu TSM, Chu YYA, Doherty W, Evans B, Hainsworth P, Hosfield T, Li CH, McCullagh I, Mehta A, Thaker A, Thompson B, Virdi A, Walker H, Wilkins E, Dixon C, Hassan MR, Lotca N, Tong KS, Batchelor-Parry H, Chaudhari S, Harris T, Hooper J, Johnson C, Mulvihill C, Nayler J, Olutobi O, Piramanayagam B, Stones K, Sussman M, Weaver C, Alam F, Al Rawi M, Andrew F, Arrayeh A, Azizan N, Hassan A, Iqbal Z, John I, Jones M, Kalake O, Keast M, Nicholas J, Patil A, Powell K, Roberts P, Sabri A, Segue AK, Shah A, Shaik Mohamed SA, Shehadeh A, Shenoy S, Tong A, 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Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Uy M, Millan B, Jones C, Sands D, Matsumoto E, Bay B, Shayegan B. Reply by Authors. Urol Pract 2022; 9:304-305. [PMID: 37145792 DOI: 10.1097/upj.0000000000000305.04] [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] [Accepted: 03/11/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Michael Uy
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Braden Millan
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Conor Jones
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - David Sands
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Edward Matsumoto
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Urology, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Benjamin Bay
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Urology, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Bobby Shayegan
- Division of Urology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Urology, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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Jones C, Zadeh S, Jadva V, Golombok S. O-212 Single fathers by choice: experiences of surrogacy and thoughts and feelings about disclosure. Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
What are the experiences of single men regarding (i) the process of surrogacy (ii) their relationship with the surrogate (iii) disclosing surrogacy to their child?
Summary answer
The fathers reported a variety of experiences of surrogacy and all fathers had either disclosed or intended to disclose using surrogacy to their child.
What is known already
Very little is known about single men’s experiences of surrogacy arrangements and how they think and feel about disclosing their use of surrogacy and egg donation to their child. Studies have focused on the decision-making process of using surrogacy as a single man and family functioning once these families are formed. Yet questions remain about how fathers experience and navigate the process of surrogacy as a single man and how they communicate to their child about their surrogacy story.
Study design, size, duration
The study is an international, multi-disciplinary, qualitative study of fathers who chose to begin a family and parent alone. Data were collected by two researchers between 2018 and 2021 and form part of a larger study of single fathers by choice with different routes to parenthood. The present study reports on twenty-one fathers who used surrogacy and egg donation to begin their family. The children were aged between 0-6 years.
Participants/materials, setting, methods
Purposive sampling was used to recruit participants. In-depth semi-structured interviews were conducted with the single fathers. The interview topics covered fathers’ motivations for pursuing single parenthood, experiences of the process of using egg donation and surrogacy, surrogacy arrangements including location, navigating the relationship with the surrogate, and fathers' decisions around disclosing their route to parenthood to their child. The audio-recorded interviews mostly lasted around two hours and verbatim transcripts were produced afterwards.
Main results and the role of chance
Data were analysed using reflexive thematic analysis and qualitative content analysis. Preliminary analysis indicated that the fathers reported a variety of experiences of surrogacy and had differing experiences in terms of the length of time it took to begin the surrogacy journey and the ease with which arrangements were made. Many of the fathers had remained in contact with the surrogate, but to differing degrees. Clinics were placed as both facilitators and gatekeepers of the process, pointing to the complexities of the surrogacy process.
Regarding disclosure, it was found that the fathers thought more about when to disclose, rather than whether to disclose. All the fathers stated an intention to tell their child about their surrogacy story, but carefully considered which age was best and wanted to use child-led methods of disclosure. The fathers reported that it was hard to hide their route to parenthood and expressed a motivation to talk openly to their children about the way in which they built their family. Many fathers described either using books or creating their own book as a disclosure aid for their child.
Limitations, reasons for caution
Due to the variation between different countries regarding laws on surrogacy, the findings may not be representative of experiences of surrogacy in different contexts from the ones studied. The sample size was relatively small; however, the research provides new insights into an area with little academic literature.
Wider implications of the findings
The study findings contribute a new understanding of the experiences of single fathers who use surrogacy to begin a family. The disclosure findings largely reflect those of studies of single mothers through sperm donation showing that single parents are very likely to disclose and many disclose at an early age.
Trial registration number
N / A
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Affiliation(s)
- C Jones
- University of Cambridge, Centre for Family Research , Cambridge, United Kingdom
| | - S Zadeh
- University College London, Thomas Coram Research Unit , London, United Kingdom
| | - V Jadva
- University College London, Institute for Women's Health , London, United Kingdom
| | - S Golombok
- University of Cambridge, Centre for Family Research , Cambridge, United Kingdom
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Arnold J, Dass S, Twigg S, Jones C, Rhodes B, Hewins P, Chakravorty M, Courtney P, Ehrenstein M, Md. Yusof MY, Vital E. AB0434 EFFICACY AND SAFETY OF OBINUTUZUMAB IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS WITH SECONDARY NON-RESPONSE TO RITUXIMAB. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSecondary inefficacy characterized by infusion reactions and anti-drug antibodies occur in 14% of SLE patients treated with repeat rituximab courses(1). Obinutuzumab is a next-generation humanized type-2 anti-CD20 therapy licensed for hematological malignancies which may overcome this issue(2).ObjectivesWe set out to evaluate the clinical efficacy and safety of obinutuzumab in a cohort of rituximab resistant SLE patients.MethodsWe collated data from SLE patients receiving obinutuzumab for secondary non-response to rituximab in BILAG centres. Disease activity was assessed using BILAG-2004, SLEDAI-2K and serology before, and 6 months after, obinutuzumab 2x1000mg infusions alongside methylprednisolone 100mg. Flow cytometry where possible was carried out using a multiple gating highly sensitive strategy.ResultsAll 9 patients included in the study received obinutuzumab alongside concomitant oral immunosuppression. At 6 months post-obinutuzumab, there were significant reductions in median SLEDAI-2K from 12 to 6 (p=0.014) and total BILAG-2004 score from 21 to 2 (p=0.009). Complement C3 and dsDNA titres improved significantly (both p=0.04). Non statistically significant numerical improvements were seen in C4 levels.Of 8/9 patients receiving concomitant oral prednisolone at baseline (all >10mg/day), 5/9 had their dose reduced at 6 months; 4/8 were on 5mg/day and were in Lupus Low Disease Activity State. After obinutuzumab, 6/9 patients with peripheral B-cell data achieved complete depletion including 4/4 assessed with highly sensitive assays. 1/9 obinutuzumab non-responder required cyclophosphamide therapy. 1 unvaccinated patient died from COVID-19.Table 1.Baseline characteristics, disease activity and steroid doses before and after last obinutuzumab/rituximab.PatientEthnicityDisease duration (Years)Age (Years)Total BILAG-2004 before ObiTotal BILAG-2004 after ObiSLEDAI-2K before ObiSLEDAI-2K after ObiPrednisolone before Obi (mg)Prednisolone after Obi (mg)1South Asian10.836.41821481052South Asian6.324.424212430103South Asian11.934.829110410104South Asian8.241.92116015155South Asian6.829.43221181450606White European17.537.0128881557White European16.930.01211281058Caribbean6.244.225213010159Caribbean2.621.092166105Median (Q1, Q3)NA8.2 (6, 12)34.8 (29,37)21 (12, 25)2 (1, 2)12 (10, 14)6 (4, 8)10 (10, 15)10 (5, 15)ConclusionObinutuzumab appears to be effective and steroid-sparing in renal and non-renal SLE patients with secondary non-response to rituximab. Obinutuzumab was shown to be effective in patients with severe renal and non-renal disease. Therefore, in those with previous responsiveness to B-cell depletion, switching to humanised type-2 anti-CD20 therapy is a logical approach following loss off efficacy.References[1]Vital EM, Dass S, Buch MH, Henshaw K, Pease CT, Martin MF, et al. B cell biomarkers of rituximab responses in systemic lupus erythematosus. Arthritis Rheum [Internet]. 2011 Oct [cited 2020 Oct 12];63(10):3038–47. Available from: https://pubmed.ncbi.nlm.nih.gov/21618204/[2]Hassan SU, Md Yusof MY, Emery P, Dass S, Vital EM. Biologic Sequencing in Systemic Lupus Erythematosus: After Secondary Non-response to Rituximab, Switching to Humanised Anti-CD20 Agent Is More Effective Than Belimumab. Front Med [Internet]. 2020 Aug 27 [cited 2020 Sep 2];7:498. Available from: https://www.frontiersin.org/article/10.3389/fmed.2020.00498/fullDisclosure of InterestsJack Arnold: None declared, Shouvik Dass Consultant of: Roche, Abbvie, UCB & Chugai, Employee of: Honoraria from Roche, Abbvie, UCB & Chugai, Sarah Twigg: None declared, Colin Jones: None declared, Benjamin Rhodes: None declared, Peter Hewins: None declared, Mithun Chakravorty: None declared, Philip Courtney: None declared, Michael Ehrenstein Grant/research support from: GSK, Employee of: Has received honoraria from GSK, Md Yuzaiful Md Yusof: None declared, Edward Vital Employee of: Has received honoraria from Roche
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Ducker G, Mills K, Yong C, Jones C, Mukhtyar C. POS0793 IMPROVED RELAPSE-FREE SURVIVAL WITH THE NORWICH PREDNISOLONE REGIMEN FOR GIANT CELL ARTERITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundGlucocorticoid therapy is the mainstay treatment for GCA. There is no consensus on the dose of prednisolone to be used. Prednisolone regimens used in clinical trials have reported relapse rates of 66 to 92%. The long-term follow-up of Tocilizumab and prednisolone for 1-year showed a relapse rate of 74% at 2 years. The Norwich Regimen is a bespoke prednisolone plan with an initial dose of 1mg/kg of lean body mass. It delivers 164.64 mg/kg of lean body mass in a logarithmic taper over 100 weeks. It was devised to reduce the risk of relapse and allow patients to be in control of their prednisolone reduction.ObjectivesTo document drug-free survival at 150 weeks of people with GCA treated with a bespoke prednisolone taperMethodsAll patients were diagnosed by biopsy, ultrasonography or PET scan and provided with a printed prednisolone plan at diagnosis. All individuals were assessed at approximately 3-6 monthly intervals in addition to suspected relapse, toxicity or other need for course correction. Relapses were confirmed objectively using a modification of the Kerr criteria. Relapse free survival was recorded at 100 weeks. Patients were given an open invite to contact us in the event of a suspected relapse after coming off prednisolone. A notes review was done to record events at 150 weeks.Results150 consecutive people with objectively diagnosed GCA (mean age 74) since 10/01/2012 have completed 150 weeks since starting prednisolone. Drug-free, relapse-free survival at 100 weeks was met by 133/150 (89%). 7 individuals died and 20 relapsed. A further 5 died and 15 relapsed by week 150; 103/150 (69%) survivors were in prednisolone-free remission. Of the 12 deaths – 6 died of cancer, 1 subdural haemorrhage, 1 ischaemic bowel, 1 septicaemia, 1 general decline (aged 93). The cause of death was not available for 2 individuals who died in the community. The median time to relapse for the 35 individuals was 80 weeks (IQR 64,109).ConclusionWe report the first results of a bespoke prednisolone taper to be used in real life. The Norwich Regimen for the treatment of GCA results in drug-free relapse-free survival of 89% at 100 weeks and 69% at 150 weeks, which is superior to all other reports published so far.References[1]Mukhtyar, C, Cate, H, Graham, C, Merry, P, Mills, K, and Misra, A, 2019, ‘Development of an evidence-based regimen of prednisolone to treat giant cell arteritis – the Norwich regimen’ Rheumatology Advances in Practice, Volume 3, Issue 1, 2019, rkz001, https://doi.org/10.1093/rap/rkz001[2]Hellmich B, Agueda A, Monti S, et al2018 Update of the EULAR recommendations for the management of large vessel vasculitis Annals of the Rheumatic Diseases 2020;79:19-30.Disclosure of InterestsNone declared
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Mansfield-Smith S, Al-Hashimi M, Jones C, Mukhtyar C. POS0810 FREQUENCY OF VISUAL MANIFESTATIONS IN GIANT CELL ARTERITIS IN NORFOLK. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe ophthalmic features of giant cell arteritis (GCA) involve a spectrum of severity from transient symptoms to bilateral visual loss from anterior ischaemic optic neuropathy or less commonly central retinal or cilioretinal artery occlusion. Reported ocular involvement varies between 10-70%.1,2. At the Norfolk and Norwich University Hospital an interdisciplinary fast track service is provided for potential GCA patients. This report aims provides a complete picture of the frequency and nature of ocular involvement in GCA.Objectives350 records of consecutive patients diagnosed objectively with GCA based on biopsy or imaging were reviewed. In our centre, the hospital pathway mandates all suspected GCA cases to have a formal ophthalmology assessment including visual acuity, pupil exam and full-dilated fundus assessment. Systemic and Ophthalmic symptoms and signs were recorded.MethodsFrom January 2012 to September 2021, 350 individuals were diagnosed with GCA by biopsy, ultrasonography or positron emission tomography. The mean age was 74 ± 7.7 years. 235 (67%) of patients were females. 101 (29%) presenting with GCA had visual symptoms and/or signs. 42 of them had mono-ocular and 5 had binocular loss of vision. A summary of the key visual symptoms and signs are shown in Table 1. Only 6 patients with visual symptoms did not have any symptoms commonly associated with GCA.Table 1.Visual Symptoms and Signs (N=350 patients)Visual Symptoms101Blurred Vision36Loss of vision47Double Vision27Ocular SignsRight CRAO11Left CRAO110Right AION219Left AION223Right extraocular muscle weakness6Left extraocular muscle weakness41 Central retinal artery occlusion 2 Anterior ischaemic optic neuropathyResultsFrom January 2012 to September 2021, 350 individuals were diagnosed with GCA by biopsy, ultrasonography or positron emission tomography. The mean age was 74 ± 7.7 years. 235 (67%) of patients were females. 101 (29%) presenting with GCA had visual symptoms and/or signs. 42 of them had mono-ocular and 5 had binocular loss of vision. A summary of the key visual symptoms and signs are shown in Table 1. Only 6 patients with visual symptoms did not have any extra-ocular symptoms commonly associated with GCA.ConclusionWe report the frequency of visual involvement in one of the largest cohorts of individuals with GCA. 29% have ocular symptoms. Partial or total field loss occurred in 13% of cases. 2% of patients presented with visual manifestations as the only feature of GCA. Rarely, permanent visual loss may occur without any other manifestation of GCA.References[1]Ivana Vodopivec, Joseph F Rizzo, III, Ophthalmic manifestations of giant cell arteritis, Rheumatology, Volume 57, Issue suppl_2, February 2018, Pages ii63–ii72.[2]Saleh M, Turesson C, Englund M, Merkel PA, Mohammad AJ. Visual Complications in Patients with Biopsy-proven Giant Cell Arteritis: A Population-based Study. J Rheumatol. 2016;43(8):1559-1565.Disclosure of InterestsNone declared
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Jones C, Trickey J. POS1523-HPR PATIENT SATISFACTION SURVEY OF A SPECIALIST PHARMACIST RUN RHEUMATOLOGY BIOLOGIC AND JAK INHIBITOR CLINIC. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundHereford Rheumatology Department, UK, treats over 850 patients on biologic disease-modifying anti-rheumatic drugs (bDMARDs) and JAK inhibitors (JAKi). The multidisciplinary team (MDT) includes a Specialist Rheumatology Pharmacist running clinics for all adult Rheumatology patients who have been identified for bDMARD or JAKi initiation or switch by their responsible Consultant. Patients can feel anxious during the pre-treatment screening process and require reassurance about medication safety. This innovative role has been a well-received asset to the Rheumatology MDT, but patients’ perceptions of the role are unknown. To our knowledge, there is no similar study within British Rheumatology practice.ObjectivesThe survey aims to gauge patient satisfaction of the consultation from a pharmacist-run bDMARD and JAKi initiation and switch clinic.MethodsA generic patient satisfaction survey was piloted with positive results. Following this, a bespoke survey was developed, specifically enquiring about patients’ perceptions of the consultation skills, clarity, education and reassurance provided by the pharmacist. A Likert scale was used where appropriate and a space for free text was included. The Trust’s Patient Experience Team was consulted to ensure clarity for patients. In consecutive weekly clinics from July 2021 to January 2022, the survey was given to all patients immediately following Specialist Rheumatology Pharmacist clinic. The majority of patients were seen face-to-face however the survey was posted to the patient if telephone consultation was necessary. Clinic staff collected the completed surveys to ensure patient anonymity.Results57 of 58 patients completed the survey, with 100% stating they were pleased to receive counselling from a pharmacist. Patients were asked to score their knowledge of the medication out of 10, before and after the consultation; they reported a mean increase in knowledge of 3.9/10. The remaining survey results show mostly positive feedback (Table 1).Table 1.Patient rating of experience in pharmacist clinic.StatementNo answerStrongly disagreeDisagreeNeitherAgreeStrongly agreeThe pharmacist put me at ease00001146The information provided was easy for me to understand.10011342The pharmacist listened to what I had to say.0000948The pharmacist showed care and sensitivity to my Rheumatological condition.00001146The pharmacist appeared knowledgeable about the medication to be started.0000849I feel that the medication I am starting has been chosen for me as an individual.10011738I understand why we are starting the new medication.00021045I have been told about the side effects the medication could cause.00001146I feel that it is safe to start the new medication.10161534I was able to discuss my concerns and ask questions about the new medication.00001146I felt included in the decision to start or change to new medication.10021143Overall, my experience in the pharmacist clinic today was a positive one*40001043*Statement excludes results from 4 patients who did not complete the second page of the survey.ConclusionThe results demonstrate the high level of patient satisfaction attained from the Specialist Pharmacist clinic. A small number of patients remain sceptical about medication safety, despite discussion. Inclusion of a pharmacist is especially useful to manage the increasing number of patients starting these medications, maintaining excellent patient experience, reducing the workload for other Rheumatology staff, and ensuring a robust MDT.ReferencesNot applicable.Disclosure of InterestsClaire Jones Speakers bureau: Presented to rheumatology pharmacists at King’s College hospital London, Dec 2017. Purpose: to share my role to aid their development. Paid by UCB: £1000., Consultant of: Focus group for Fresenius Kabi Sept 2021. Received £500 honorarium, Jeanette Trickey: None declared
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Van Veelen N, Boonekamp R, Schoonderwoerd T, Emmerik M, Nijdam M, Bruinsma B, Geuze E, Jones C, Vermetten E. Tailored Immersion: Implementing Personalized Components Into Virtual Reality for Veterans With Post-Traumatic Stress Disorder. Eur Psychiatry 2022. [PMCID: PMC9567913 DOI: 10.1192/j.eurpsy.2022.1737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction With the application of virtual reality (VR), tailored interventions can be created that mirror the traumatic experiences of veterans with post-traumatic stress disorder (PTSD). Visual elements can be mimicked, and auditory and other senses stimulated. In doing so, the degree of immersion can be adjusted to optimize the therapeutic process. Objectively measuring the sensory immersion is key to keep subjects within their personal window of tolerance. Based on this information the therapist can decide manipulate the sensory stimulation embedded in the treatment. Objectives The objectives of this study are to explore the different immersive design aspects of VRET that can be modified to influence the experienced presence in veterans with PTSD, and to discuss possible methods of measuring the emotional response facilitated by immersive design aspects and experienced presence. Methods Four design aspects are discussed: system, sensory cues, narrative and challenge. We also report on a user experiment in three veterans that informed on quality and depth of immersion. Results Believability of the neutral virtual environment was important for maintaining the veterans’ presence within the VR experience. The immersive design aspects that were personalized and supportive in the narrative of the veteran such as music and self-selected images appeared to have a strong influence on recall and reliving of the traumatic events. Conclusions Finally, in order to increase the therapeutic effect in veterans with PTSD, the highlighted design aspects should be recognized and tailored to maximize immersion in virtual reality exposure therapy. Disclosure No significant relationships.
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