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Churpek MM, Carey KA, Snyder A, Winslow CJ, Gilbert E, Shah NS, Patterson BW, Afshar M, Weiss A, Amin DN, Rhodes DJ, Edelson DP. Multicenter Development and Prospective Validation of eCARTv5: A Gradient Boosted Machine Learning Early Warning Score. medRxiv 2024:2024.03.18.24304462. [PMID: 38562803 PMCID: PMC10984051 DOI: 10.1101/2024.03.18.24304462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Rationale Early detection of clinical deterioration using early warning scores may improve outcomes. However, most implemented scores were developed using logistic regression, only underwent retrospective internal validation, and were not tested in important patient subgroups. Objectives To develop a gradient boosted machine model (eCARTv5) for identifying clinical deterioration and then validate externally, test prospectively, and evaluate across patient subgroups. Methods All adult patients hospitalized on the wards in seven hospitals from 2008- 2022 were used to develop eCARTv5, with demographics, vital signs, clinician documentation, and laboratory values utilized to predict intensive care unit transfer or death in the next 24 hours. The model was externally validated retrospectively in 21 hospitals from 2009-2023 and prospectively in 10 hospitals from February to May 2023. eCARTv5 was compared to the Modified Early Warning Score (MEWS) and the National Early Warning Score (NEWS) using the area under the receiver operating characteristic curve (AUROC). Measurements and Main Results The development cohort included 901,491 admissions, the retrospective validation cohort included 1,769,461 admissions, and the prospective validation cohort included 46,330 admissions. In retrospective validation, eCART had the highest AUROC (0.835; 95%CI 0.834, 0.835), followed by NEWS (0.766 (95%CI 0.766, 0.767)), and MEWS (0.704 (95%CI 0.703, 0.704)). eCART's performance remained high (AUROC ≥0.80) across a range of patient demographics, clinical conditions, and during prospective validation. Conclusions We developed eCARTv5, which accurately identifies early clinical deterioration in hospitalized ward patients. Our model performed better than the NEWS and MEWS retrospectively, prospectively, and across a range of subgroups.
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Balk R, Esper AM, Martin GS, Miller RR, Lopansri BK, Burke JP, Levy M, Opal S, Rothman RE, D’Alessio FR, Sidhaye VK, Aggarwal NR, Greenberg JA, Yoder M, Patel G, Gilbert E, Parada JP, Afshar M, Kempker JA, van der Poll T, Schultz MJ, Scicluna BP, Klein Klouwenberg PMC, Liebler J, Blodget E, Kumar S, Navalkar K, Yager TD, Sampson D, Kirk JT, Cermelli S, Davis RF, Brandon RB. Validation of SeptiCyte RAPID to Discriminate Sepsis from Non-Infectious Systemic Inflammation. J Clin Med 2024; 13:1194. [PMID: 38592057 PMCID: PMC10931699 DOI: 10.3390/jcm13051194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/08/2024] [Accepted: 02/18/2024] [Indexed: 04/10/2024] Open
Abstract
(1) Background: SeptiCyte RAPID is a molecular test for discriminating sepsis from non-infectious systemic inflammation, and for estimating sepsis probabilities. The objective of this study was the clinical validation of SeptiCyte RAPID, based on testing retrospectively banked and prospectively collected patient samples. (2) Methods: The cartridge-based SeptiCyte RAPID test accepts a PAXgene blood RNA sample and provides sample-to-answer processing in ~1 h. The test output (SeptiScore, range 0-15) falls into four interpretation bands, with higher scores indicating higher probabilities of sepsis. Retrospective (N = 356) and prospective (N = 63) samples were tested from adult patients in ICU who either had the systemic inflammatory response syndrome (SIRS), or were suspected of having/diagnosed with sepsis. Patients were clinically evaluated by a panel of three expert physicians blinded to the SeptiCyte test results. Results were interpreted under either the Sepsis-2 or Sepsis-3 framework. (3) Results: Under the Sepsis-2 framework, SeptiCyte RAPID performance for the combined retrospective and prospective cohorts had Areas Under the ROC Curve (AUCs) ranging from 0.82 to 0.85, a negative predictive value of 0.91 (sensitivity 0.94) for SeptiScore Band 1 (score range 0.1-5.0; lowest risk of sepsis), and a positive predictive value of 0.81 (specificity 0.90) for SeptiScore Band 4 (score range 7.4-15; highest risk of sepsis). Performance estimates for the prospective cohort ranged from AUC 0.86-0.95. For physician-adjudicated sepsis cases that were blood culture (+) or blood, urine culture (+)(+), 43/48 (90%) of SeptiCyte scores fell in Bands 3 or 4. In multivariable analysis with up to 14 additional clinical variables, SeptiScore was the most important variable for sepsis diagnosis. A comparable performance was obtained for the majority of patients reanalyzed under the Sepsis-3 definition, although a subgroup of 16 patients was identified that was called septic under Sepsis-2 but not under Sepsis-3. (4) Conclusions: This study validates SeptiCyte RAPID for estimating sepsis probability, under both the Sepsis-2 and Sepsis-3 frameworks, for hospitalized patients on their first day of ICU admission.
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Affiliation(s)
- Robert Balk
- Rush Medical College and Rush University Medical Center, Chicago, IL 60612, USA; (J.A.G.); (M.Y.); (G.P.)
| | - Annette M. Esper
- Grady Memorial Hospital and Emory University School of Medicine, Atlanta, GA 30322, USA; (A.M.E.); (G.S.M.); (J.A.K.)
| | - Greg S. Martin
- Grady Memorial Hospital and Emory University School of Medicine, Atlanta, GA 30322, USA; (A.M.E.); (G.S.M.); (J.A.K.)
| | | | - Bert K. Lopansri
- Intermountain Medical Center, Murray, UT 84107, USA; (B.K.L.); (J.P.B.)
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA
| | - John P. Burke
- Intermountain Medical Center, Murray, UT 84107, USA; (B.K.L.); (J.P.B.)
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA
| | - Mitchell Levy
- Warren Alpert Medical School, Brown University, Providence, RI 02912, USA; (M.L.); (S.O.)
| | - Steven Opal
- Warren Alpert Medical School, Brown University, Providence, RI 02912, USA; (M.L.); (S.O.)
| | - Richard E. Rothman
- School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; (R.E.R.); (F.R.D.); (V.K.S.)
| | - Franco R. D’Alessio
- School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; (R.E.R.); (F.R.D.); (V.K.S.)
| | - Venkataramana K. Sidhaye
- School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; (R.E.R.); (F.R.D.); (V.K.S.)
| | - Neil R. Aggarwal
- Anschutz Medical Campus, University of Colorado, Denver, CO 80045, USA;
| | - Jared A. Greenberg
- Rush Medical College and Rush University Medical Center, Chicago, IL 60612, USA; (J.A.G.); (M.Y.); (G.P.)
| | - Mark Yoder
- Rush Medical College and Rush University Medical Center, Chicago, IL 60612, USA; (J.A.G.); (M.Y.); (G.P.)
| | - Gourang Patel
- Rush Medical College and Rush University Medical Center, Chicago, IL 60612, USA; (J.A.G.); (M.Y.); (G.P.)
| | - Emily Gilbert
- Loyola University Medical Center, Maywood, IL 60153, USA; (E.G.); (J.P.P.)
| | - Jorge P. Parada
- Loyola University Medical Center, Maywood, IL 60153, USA; (E.G.); (J.P.P.)
| | - Majid Afshar
- School of Medicine and Public Health, University of Wisconsin, Madison, WI 53705, USA;
| | - Jordan A. Kempker
- Grady Memorial Hospital and Emory University School of Medicine, Atlanta, GA 30322, USA; (A.M.E.); (G.S.M.); (J.A.K.)
| | - Tom van der Poll
- Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (T.v.d.P.); (M.J.S.)
| | - Marcus J. Schultz
- Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (T.v.d.P.); (M.J.S.)
| | - Brendon P. Scicluna
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida MSD 2080, Malta;
- Department of Applied Biomedical Science, Faculty of Health Sciences, Mater Dei Hospital, University of Malta, Msida MSD 2080, Malta
| | | | - Janice Liebler
- Keck Hospital of University of Southern California (USC), Los Angeles, CA 90033, USA; (J.L.); (S.K.)
- Los Angeles General Medical Center, Los Angeles, CA 90033, USA
| | - Emily Blodget
- Keck Hospital of University of Southern California (USC), Los Angeles, CA 90033, USA; (J.L.); (S.K.)
- Los Angeles General Medical Center, Los Angeles, CA 90033, USA
| | - Santhi Kumar
- Keck Hospital of University of Southern California (USC), Los Angeles, CA 90033, USA; (J.L.); (S.K.)
- Los Angeles General Medical Center, Los Angeles, CA 90033, USA
| | - Krupa Navalkar
- Immunexpress Inc., Seattle, DC 98109, USA; (K.N.); (J.T.K.); (S.C.); (R.F.D.)
| | - Thomas D. Yager
- Immunexpress Inc., Seattle, DC 98109, USA; (K.N.); (J.T.K.); (S.C.); (R.F.D.)
| | - Dayle Sampson
- Immunexpress Inc., Seattle, DC 98109, USA; (K.N.); (J.T.K.); (S.C.); (R.F.D.)
| | - James T. Kirk
- Immunexpress Inc., Seattle, DC 98109, USA; (K.N.); (J.T.K.); (S.C.); (R.F.D.)
| | - Silvia Cermelli
- Immunexpress Inc., Seattle, DC 98109, USA; (K.N.); (J.T.K.); (S.C.); (R.F.D.)
| | - Roy F. Davis
- Immunexpress Inc., Seattle, DC 98109, USA; (K.N.); (J.T.K.); (S.C.); (R.F.D.)
| | - Richard B. Brandon
- Immunexpress Inc., Seattle, DC 98109, USA; (K.N.); (J.T.K.); (S.C.); (R.F.D.)
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Oh DS, Kim E, Lu G, Normand R, Shook LL, Lyall A, Jasset O, Demidkin S, Gilbert E, Kim J, Akinwunmi B, Tantivit J, Tirard A, Arnold BY, Slowikowski K, Goldberg MB, Filbin MR, Hacohen N, Nguyen LH, Chan AT, Yu XG, Li JZ, Yonker L, Fasano A, Perlis RH, Pasternak O, Gray KJ, Choi GB, Drew DA, Sen P, Villani AC, Edlow AG, Huh JR. SARS-CoV-2 infection elucidates unique features of pregnancy-specific immunity. medRxiv 2024:2024.02.05.24301794. [PMID: 38370801 PMCID: PMC10871456 DOI: 10.1101/2024.02.05.24301794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Pregnancy is a risk factor for increased severity of SARS-CoV-2 and other respiratory infections. The mechanisms underlying this risk have not been well-established, partly due to a limited understanding of how pregnancy shapes immune responses. To gain insight into the role of pregnancy in modulating immune responses at steady state and upon perturbation, we collected peripheral blood mononuclear cells (PBMC), plasma, and stool from 226 women, including 152 pregnant individuals (n = 96 with SARS-CoV-2 infection and n = 56 healthy controls) and 74 non-pregnant women (n = 55 with SARS-CoV-2 and n = 19 healthy controls). We found that SARS-CoV-2 infection was associated with altered T cell responses in pregnant compared to non-pregnant women. Differences included a lower percentage of memory T cells, a distinct clonal expansion of CD4-expressing CD8 + T cells, and the enhanced expression of T cell exhaustion markers, such as programmed cell death-1 (PD-1) and T cell immunoglobulin and mucin domain-3 (Tim-3), in pregnant women. We identified additional evidence of immune dysfunction in severely and critically ill pregnant women, including a lack of expected elevation in regulatory T cell (Treg) levels, diminished interferon responses, and profound suppression of monocyte function. Consistent with earlier data, we found maternal obesity was also associated with altered immune responses to SARS-CoV-2 infection, including enhanced production of inflammatory cytokines by T cells. Certain gut bacterial species were altered in pregnancy and upon SARS-CoV-2 infection in pregnant individuals compared to non-pregnant women. Shifts in cytokine and chemokine levels were also identified in the sera of pregnant individuals, most notably a robust increase of interleukin-27 (IL-27), a cytokine known to drive T cell exhaustion, in the pregnant uninfected control group compared to all non-pregnant groups. IL-27 levels were also significantly higher in uninfected pregnant controls compared to pregnant SARS-CoV-2-infected individuals. Using two different preclinical mouse models of inflammation-induced fetal demise and respiratory influenza viral infection, we found that enhanced IL-27 protects developing fetuses from maternal inflammation but renders adult female mice vulnerable to viral infection. These combined findings from human and murine studies reveal nuanced pregnancy-associated immune responses, suggesting mechanisms underlying the increased susceptibility of pregnant individuals to viral respiratory infections.
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Schmuhl KK, Nagel S, Tamburro R, Jewell TM, Gilbert E, Gonzalez A, Sullivan DL, Sprague JE. Better together: utilizing an interprofessional course and escape room to educate healthcare students about opioid use disorder. BMC Med Educ 2023; 23:917. [PMID: 38053154 DOI: 10.1186/s12909-023-04899-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/23/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND The aim of the present study was to determine the impact of an innovative interprofessional educational activity on healthcare professional students' learning. The educational activity targeted student knowledge of opioid use disorder (OUD) and perceptions of working with an interprofessional team while caring for patients with OUD. METHODS Students from nursing, pharmacy, physician assistant, dentistry, social work, and medicine programs were recruited to participate in the interprofessional educational activity. The educational experience included seven asynchronous modules and a virtual synchronous escape room. Prior to the educational programming, participants completed a pre-survey that assessed their knowledge and attitudes towards working on an interprofessional team and perceptions of patients with OUD. The asynchronous modules were required in order to participate in the escape room and each module contained its own pre/post quiz to assess student knowledge. RESULTS A total of 402 students participated in the course. Prior to participating in the course, students disagreed that they had extensive educational experience with SUD (2.45 ± 0.79). The students displayed significant improvement in the knowledge based areas after completing the seven asynchronous modules. The largest significant area of knowledge-based improvement was seen in treatment of OUD where on the pre-quiz 65.54 ± 20.21% were answered correctly compared to 95.97 ± 9.61% on the post-quiz. Participation in the escape room significantly changed the students' perceptions of working in interprofessional teams while managing patients with OUD. Of the eleven perception variables assessed, seven showed a significant increase in the post-survey. Following the escape room, participants also strongly agreed that they now would refer patients to colleagues in other disciplines. CONCLUSIONS An interprofessional educational experience including both an asynchronous course and virtual synchronous escape room can increase participant knowledge around OUD and may improve student perceptions of working with an interprofessional team and caring for patients with OUD.
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Affiliation(s)
- Kelsey K Schmuhl
- The Ohio State University College of Pharmacy, Columbus, OH, USA
| | - Steven Nagel
- The Ohio State University College of Pharmacy, Columbus, OH, USA
| | - Ross Tamburro
- The Ohio State University College of Pharmacy, Columbus, OH, USA
| | - T'Bony M Jewell
- The Ohio State University College of Pharmacy, Columbus, OH, USA
| | - Emily Gilbert
- The Ohio State University College of Pharmacy, Columbus, OH, USA
| | - Anthony Gonzalez
- The Ohio State University College of Social Work, Columbus, OH, USA
| | | | - Jon E Sprague
- The Ohio Attorney General's Center for the Future of Forensic Sciences, Bowling Green State University, Bowling Green, OH, USA.
- Office of Ohio Attorney General Dave Yost & Bowling Green State University, Bowling Green, OH, 43403, USA.
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5
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Gilbert E, Rumbold A, Campbell S, Boyle JA, Grzeskowiak L. Management of encounters related to subfertility and infertility in Australian general practice: a focus on Aboriginal and Torres Strait Islander females. BMC Womens Health 2023; 23:410. [PMID: 37542253 PMCID: PMC10403831 DOI: 10.1186/s12905-023-02559-x] [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: 03/22/2023] [Accepted: 07/20/2023] [Indexed: 08/06/2023] Open
Abstract
OBJECTIVE To investigate the management of subfertility and infertility among Aboriginal and Torres Strait Islander females attending Australian general practice. METHODS Cross-sectional study of 1,258,581 women (18-49 years) attending general practice between January 2011 and June 2019, utilising data from NPS MedicineWise MedicineInsight, a national general practice database in Australia. RESULTS The prevalence of subfertility/infertility encounters was lower for Aboriginal and Torres Strait Islander females (12.37 per 1,000) than for non-Indigenous females (16.62 per 1,000). Aboriginal and Torres Strait Islander females with a subfertility/infertility encounter were younger and more likely to live outside Major cities and in areas of socioeconomic disadvantage than non-Indigenous females. Rates of prescribed infertility medications were not different between groups, however Aboriginal and Torres Strait Islander females were more likely to receive a pelvic ultrasound (24.30% vs. 19.90%); tests for luteinizing hormone (31.89% vs. 25.65%); testosterone (14.93% vs. 9.96%) and; glycated haemoglobin (HbA1c) (6.32% vs. 3.41%),but less likely to receive an anti-müllerian hormone test (2.78% vs. 7.04%). CONCLUSIONS Lower encounter rates for infertility/subfertility among Aboriginal and Torres Strait Islander peoples may indicate access issues, preferred use of Aboriginal community-controlled health centres or younger average age at first birth and thus less age-related infertility. IMPLICATIONS FOR PUBLIC HEALTH Future efforts should focus on maximising the inclusiveness of infertility surveillance. There is also a need for further research into the experiences of and preferences for infertility care and associated barriers among Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- E Gilbert
- Faculty of Health, Charles Darwin University, Darwin, NT, Australia.
| | - A Rumbold
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - S Campbell
- Faculty of Health, Charles Darwin University, Darwin, NT, Australia
| | - J A Boyle
- Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - L Grzeskowiak
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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Brunskill A, Gilbert E. Academic libraries' social media posts related to disabilities: A review of libraries' tweets in terms of their content and accessibility. The Journal of Academic Librarianship 2023. [DOI: 10.1016/j.acalib.2023.102684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Gilbert E, Ewald A. "You get past the packaging": young women smokers' resistance to standardized cigarette packaging. Women Health 2023; 63:186-193. [PMID: 36650637 DOI: 10.1080/03630242.2022.2164397] [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: 01/19/2023]
Abstract
We examined how young women construct and experience plain tobacco packaging. Forty-one Australian young women who are current smokers took part in this qualitative interview research. Data was analyzed using constructivist grounded theory, with the core category about the strategic ways young women resist plain tobacco packaging. The majority of women reported that plain packaging was unappealing and that the larger health warnings were shocking and offensive. However, almost all reported being desensitized to the graphic health warnings. The graphic warnings were seen as "fake" or lacking in credibility, and irrelevant to the women's life stage. Importantly, the majority of women engaged in practices to strategically resist and avoid health warnings on the packs as a way to continue smoking. Our findings point to the need to develop health warnings on tobacco products that are gender specific and focus on proximal social consequences to increase salience for young women smokers.
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Affiliation(s)
- E Gilbert
- School of Psychology, Western Sydney University, Penrith, NSW, Australia
| | - A Ewald
- School of Psychology, Western Sydney University, Penrith, NSW, Australia
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Zhang H, Gilbert E, Hussain S, Veldhuizen S, Le Foll B, Selby P, Zawertailo L. Effectiveness of bupropion and varenicline for smokers with baseline depressive symptoms. Nicotine Tob Res 2022; 25:937-944. [PMID: 36520964 DOI: 10.1093/ntr/ntac288] [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: 07/12/2022] [Revised: 11/01/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
Abstract
Introduction
Smokers with concurrent depression are less likely to achieve abstinence, even with pharmacotherapy. The purpose of this secondary data analysis was to evaluate if presence of any depressive symptoms at baseline alters the effectiveness of bupropion and varenicline for smoking cessation.
Methods
Eligible participants were enrolled via the internet and randomized 1:1 to receive a 12-week supply of either bupropion (n=465) or varenicline (n=499). Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-2). Follow-up surveys were conducted at weeks 4, 8, 12, 26 and 52 to assess self-reported quit. Primary outcome was 7-day point prevalence abstinence at 12 weeks follow up (end-of-treatment).
Results
Participants who endorsed any depressive symptoms (PHQ-2 > 0; n=280) were less likely to be quit at end-of-treatment compared to participants who did not endorse any symptoms (PHQ-2 = 0; n=684) (OR= 0.56, 95%CI: 0.38-0.8, p=0.003). Within the varenicline group, quit outcomes did not differ between those with and without depressive symptoms (21.3% vs 26.9% respectively). Within the bupropion group, however, those with symptoms had significant reduced quit rate compared to those without symptoms (7.0% vs 17.3% respectively).
Conclusions
The presence of even one symptom of depression at the start of a quit attempt may adversely affect quit outcomes. Patients should be assessed for depressive symptoms when planning to quit smoking as it may inform the approach to treatment. However, future studies are needed to confirm these findings.
Implications
Findings from the current study illustrate the importance of evaluating baseline sub-clinical depressive symptoms before a quit attempt using first-line pharmacotherapies. This secondary analysis of a large-scale randomized trial suggests that bupropion may be less effective for those with baseline depressive symptoms while varenicline may be equally effective for those with and without depressive symptoms.
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Affiliation(s)
- Helena Zhang
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health , Toronto, Canada
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto , Toronto, Canada
| | - Emily Gilbert
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health , Toronto, Canada
| | - Sarwar Hussain
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health , Toronto, Canada
| | - Scott Veldhuizen
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health , Toronto, Canada
| | - Bernard Le Foll
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto , Toronto, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto , Toronto, Canada
- Department of Psychiatry, University of Toronto , Toronto, Canada
- Acute Care Program, Addiction Division, Centre for Addiction and Mental Health , Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto , Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health , Toronto, Canada
| | - Peter Selby
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health , Toronto, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto , Toronto, Canada
- Department of Psychiatry, University of Toronto , Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto , Toronto, Canada
| | - Laurie Zawertailo
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health , Toronto, Canada
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto , Toronto, Canada
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Izadi Z, Gianfrancesco MA, Aguirre A, Strangfeld A, Mateus EF, Hyrich KL, Gossec L, Carmona L, Lawson‐Tovey S, Kearsley‐Fleet L, Schaefer M, Seet AM, Schmajuk G, Jacobsohn L, Katz P, Rush S, Al‐Emadi S, Sparks JA, Hsu TY, Patel NJ, Wise L, Gilbert E, Duarte‐García A, Valenzuela‐Almada MO, Ugarte‐Gil MF, Ribeiro SLE, de Oliveira Marinho A, de Azevedo Valadares LD, Giuseppe DD, Hasseli R, Richter JG, Pfeil A, Schmeiser T, Isnardi CA, Reyes Torres AA, Alle G, Saurit V, Zanetti A, Carrara G, Labreuche J, Barnetche T, Herasse M, Plassart S, Santos MJ, Rodrigues AM, Robinson PC, Machado PM, Sirotich E, Liew JW, Hausmann JS, Sufka P, Grainger R, Bhana S, Costello W, Wallace ZS, Yazdany J. Development of a Prediction Model for COVID-19 Acute Respiratory Distress Syndrome in Patients With Rheumatic Diseases: Results From the Global Rheumatology Alliance Registry. ACR Open Rheumatol 2022; 4:872-882. [PMID: 35869686 PMCID: PMC9350083 DOI: 10.1002/acr2.11481] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/31/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Some patients with rheumatic diseases might be at higher risk for coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS). We aimed to develop a prediction model for COVID-19 ARDS in this population and to create a simple risk score calculator for use in clinical settings. METHODS Data were derived from the COVID-19 Global Rheumatology Alliance Registry from March 24, 2020, to May 12, 2021. Seven machine learning classifiers were trained on ARDS outcomes using 83 variables obtained at COVID-19 diagnosis. Predictive performance was assessed in a US test set and was validated in patients from four countries with independent registries using area under the curve (AUC), accuracy, sensitivity, and specificity. A simple risk score calculator was developed using a regression model incorporating the most influential predictors from the best performing classifier. RESULTS The study included 8633 patients from 74 countries, of whom 523 (6%) had ARDS. Gradient boosting had the highest mean AUC (0.78; 95% confidence interval [CI]: 0.67-0.88) and was considered the top performing classifier. Ten predictors were identified as key risk factors and were included in a regression model. The regression model that predicted ARDS with 71% (95% CI: 61%-83%) sensitivity in the test set, and with sensitivities ranging from 61% to 80% in countries with independent registries, was used to develop the risk score calculator. CONCLUSION We were able to predict ARDS with good sensitivity using information readily available at COVID-19 diagnosis. The proposed risk score calculator has the potential to guide risk stratification for treatments, such as monoclonal antibodies, that have potential to reduce COVID-19 disease progression.
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Affiliation(s)
| | | | | | | | - Elsa F. Mateus
- Portuguese League Against Rheumatic DiseasesLisbonPortugal
| | - Kimme L. Hyrich
- The University of Manchester and National Institute for Health Research Manchester Biomedical Research Centre, Manchester University and NHS Foundation TrustManchesterUK
| | - Laure Gossec
- INSERM, Sorbonne Universite and Hopital Universitaire Pitie Salpetriere, AP‐HPParisFrance
| | | | - Saskia Lawson‐Tovey
- The University of Manchester and National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust and Manchester Academic Health Science CentreManchesterUK
| | - Lianne Kearsley‐Fleet
- The University of Manchester and Manchester Academic Health Science CentreManchesterUK
| | | | | | - Gabriela Schmajuk
- University of CaliforniaSan Francisco and San Francisco Department of Veterans Affairs Medical Center
| | | | | | | | | | - Jeffrey A. Sparks
- Brigham and Women's Hospital and Harvard Medical SchoolBostonMassachusetts
| | - Tiffany Y‐T Hsu
- Brigham and Women's Hospital and Harvard Medical SchoolBostonMassachusetts
| | - Naomi J. Patel
- Massachusetts General Hospital and Harvard Medical SchoolBoston
| | - Leanna Wise
- University of Southern CaliforniaLos Angeles
| | | | | | | | - Manuel F. Ugarte‐Gil
- Universidad Científica del Sur and Hospital Nacional Guillermo Almenara IrigoyenEsSalud, LimaPeru
| | | | | | | | | | - Rebecca Hasseli
- Justus‐Liebig University Giessen, Campus KerckhoffGiessenGermany
| | | | - Alexander Pfeil
- Jena University Hospital and Friedrich Schiller University JenaJenaGermany
| | - Tim Schmeiser
- Rheumatology im Veedel (Private Practice)CologneGermany
| | | | | | | | | | - Anna Zanetti
- Italian Society for Rheumatology and University of Milano‐BicoccaMilanItaly
| | - Greta Carrara
- Italian Society for Rheumatology and University of Milano‐BicoccaMilanItaly
| | | | - Thomas Barnetche
- FHU ACRONIM, Centre for Autoimmune Systemic Rare Diseases, Bordeaux University HospitalBordeauxFrance
| | - Muriel Herasse
- Filière des Maladies Autoimmunes et Autoinflammatoires Rares, Hôpital Huriez, Centre Hospitalier Universitaire de LilleLilleFrance
| | - Samira Plassart
- Filière des Maladies Autoimmunes et Autoinflammatoires Rares, Hôpital Huriez, Centre Hospitalier Universitaire de LilleLilleFrance
| | - Maria José Santos
- Hospital Garcia de Orta, Almada, Portugal, and Instituto de Medicina Molecular Faculdade Medicina and Rheumatic Diseases Portuguese RegisterLisbonPortugal
| | - Ana Maria Rodrigues
- Rheumatic Diseases Portuguese Register, Sociedade Portuguesa de Reumatologia, Nova Medical School, and Hospital dos LusiadasLisbonPortugal
| | - Philip C. Robinson
- The University of Queensland, Brisbane, Queensland, Australia, and Royal Brisbane and Women's Hospital, Metro North Hospital and Health ServiceHerstonQueenslandAustralia
| | - Pedro M. Machado
- University College London, University College London Hospitals NHS Foundation Trust and Northwick Park Hospital, London North West University Healthcare NHS TrustLondonUK
| | - Emily Sirotich
- McMaster University, Hamilton, Ontario, Canada, and Canadian Arthritis Patient AllianceTorontoOntarioCanada
| | - Jean W. Liew
- Boston University School of MedicineBostonMassachusetts
| | - Jonathan S. Hausmann
- Beth Israel Deaconess Medical Center, Harvard Medical School and Boston Children's HospitalBostonMassachusetts
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Izadi Z, Gianfrancesco MA, Schmajuk G, Jacobsohn L, Katz P, Rush S, Ja C, Taylor T, Shidara K, Danila MI, Wysham KD, Strangfeld A, Mateus EF, Hyrich KL, Gossec L, Carmona L, Lawson-Tovey S, Kearsley-Fleet L, Schaefer M, Al-Emadi S, Sparks JA, Hsu TYT, Patel NJ, Wise L, Gilbert E, Duarte-García A, Valenzuela-Almada MO, Ugarte-Gil MF, Ljung L, Scirè CA, Carrara G, Hachulla E, Richez C, Cacoub P, Thomas T, Santos MJ, Bernardes M, Hasseli R, Regierer A, Schulze-Koops H, Müller-Ladner U, Pons-Estel G, Tanten R, Nieto RE, Pisoni CN, Tissera YS, Xavier R, Lopes Marques CD, Pileggi GCS, Robinson PC, Machado PM, Sirotich E, Liew JW, Hausmann JS, Sufka P, Grainger R, Bhana S, Gore-Massy M, Wallace ZS, Yazdany J. Environmental and societal factors associated with COVID-19-related death in people with rheumatic disease: an observational study. Lancet Rheumatol 2022; 4:e603-e613. [PMID: 35909441 PMCID: PMC9313519 DOI: 10.1016/s2665-9913(22)00192-8] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Differences in the distribution of individual-level clinical risk factors across regions do not fully explain the observed global disparities in COVID-19 outcomes. We aimed to investigate the associations between environmental and societal factors and country-level variations in mortality attributed to COVID-19 among people with rheumatic disease globally. Methods In this observational study, we derived individual-level data on adults (aged 18-99 years) with rheumatic disease and a confirmed status of their highest COVID-19 severity level from the COVID-19 Global Rheumatology Alliance (GRA) registry, collected between March 12, 2020, and Aug 27, 2021. Environmental and societal factors were obtained from publicly available sources. The primary endpoint was mortality attributed to COVID-19. We used a multivariable logistic regression to evaluate independent associations between environmental and societal factors and death, after controlling for individual-level risk factors. We used a series of nested mixed-effects models to establish whether environmental and societal factors sufficiently explained country-level variations in death. Findings 14 044 patients from 23 countries were included in the analyses. 10 178 (72·5%) individuals were female and 3866 (27·5%) were male, with a mean age of 54·4 years (SD 15·6). Air pollution (odds ratio 1·10 per 10 μg/m3 [95% CI 1·01-1·17]; p=0·0105), proportion of the population aged 65 years or older (1·19 per 1% increase [1·10-1·30]; p<0·0001), and population mobility (1·03 per 1% increase in number of visits to grocery and pharmacy stores [1·02-1·05]; p<0·0001 and 1·02 per 1% increase in number of visits to workplaces [1·00-1·03]; p=0·032) were independently associated with higher odds of mortality. Number of hospital beds (0·94 per 1-unit increase per 1000 people [0·88-1·00]; p=0·046), human development index (0·65 per 0·1-unit increase [0·44-0·96]; p=0·032), government response stringency (0·83 per 10-unit increase in containment index [0·74-0·93]; p=0·0018), as well as follow-up time (0·78 per month [0·69-0·88]; p<0·0001) were independently associated with lower odds of mortality. These factors sufficiently explained country-level variations in death attributable to COVID-19 (intraclass correlation coefficient 1·2% [0·1-9·5]; p=0·14). Interpretation Our findings highlight the importance of environmental and societal factors as potential explanations of the observed regional disparities in COVID-19 outcomes among people with rheumatic disease and lay foundation for a new research agenda to address these disparities. Funding American College of Rheumatology and European Alliance of Associations for Rheumatology.
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Affiliation(s)
- Zara Izadi
- Division of Rheumatology, School of Medicine, University of California, San Francisco, CA, USA
| | - Milena A Gianfrancesco
- Division of Rheumatology, School of Medicine, University of California, San Francisco, CA, USA
| | - Gabriela Schmajuk
- Division of Rheumatology, School of Medicine, University of California, San Francisco, CA, USA
- San Francisco VA Medical Center, San Francisco, CA, USA
| | - Lindsay Jacobsohn
- Division of Rheumatology, School of Medicine, University of California, San Francisco, CA, USA
| | - Patricia Katz
- Division of Rheumatology, School of Medicine, University of California, San Francisco, CA, USA
| | - Stephanie Rush
- Division of Rheumatology, School of Medicine, University of California, San Francisco, CA, USA
| | - Clairissa Ja
- Division of Rheumatology, School of Medicine, University of California, San Francisco, CA, USA
| | - Tiffany Taylor
- Division of Rheumatology, School of Medicine, University of California, San Francisco, CA, USA
| | - Kie Shidara
- Division of Rheumatology, School of Medicine, University of California, San Francisco, CA, USA
| | - Maria I Danila
- Division of Clinical Immunology and Rheumatology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Katherine D Wysham
- VA Puget Sound Health Care System and Division of Rheumatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Anja Strangfeld
- German Rheumatism Research Center, Epidemiology and Health Care Research, Berlin, Germany
| | - Elsa F Mateus
- Portuguese League Against Rheumatic Diseases, Lisbon, Portugal
| | - Kimme L Hyrich
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
- National Institute of Health Research Manchester Biomedical Research Centre, University of Manchester-NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Laure Gossec
- INSERM, Sorbonne Universites, Groupe Hopital Universitaire Pitie Salpetriere, AP-HP, Paris, France
- Rheumatology Department, Sorbonne Universites, Groupe Hopital Universitaire Pitie Salpetriere, AP-HP, Paris, France
| | | | - Saskia Lawson-Tovey
- Centre for Genetics and Genomics Versus Arthritis, University of Manchester, Manchester, UK
- Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
- National Institute of Health Research Manchester Biomedical Research Centre, University of Manchester-NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Martin Schaefer
- German Rheumatism Research Center, Epidemiology and Health Care Research, Berlin, Germany
| | | | - Jeffrey A Sparks
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tiffany Y-T Hsu
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Naomi J Patel
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Leanna Wise
- University of Southern California, Los Angeles, CA, USA
| | - Emily Gilbert
- Division of Rheumatology, Mayo Clinic, Jacksonville, FL, USA
| | - Alí Duarte-García
- Division of Rheumatology, Mayo Clinic, Rochester, MN, USA
- Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | | | - Manuel F Ugarte-Gil
- School of Medicine, Universidad Científica del Sur, Lima, Peru
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - Lotta Ljung
- Department of Public Health and Clinical Medicine and Department of Rheumatology, Umeå University, Umeå, Sweden
- Division of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Carlo A Scirè
- Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy
| | - Greta Carrara
- Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy
| | - Eric Hachulla
- INSERM, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France, U1286-INFINITE-Institute for Translational Research in Inflammation, Université de Lille, Lille, France
| | - Christophe Richez
- Department of Rheumatology, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeux, France
- UMR-CNRS 5164, ImmunoConcEpT, Bordeaux University, Bordeaux, France
| | - Patrice Cacoub
- INSERM 959, Sorbonne Universites, Groupe Hopital Universitaire Pitie Salpetriere, AP-HP, Paris, France
| | - Thierry Thomas
- Département de Médecine Interne et Immunologie Clinique, Sorbonne Universites, Groupe Hopital Universitaire Pitie Salpetriere, AP-HP, Paris, France
- Centre National de Références Maladies Autoimmunes systémiques rares, Sorbonne Universites, Groupe Hopital Universitaire Pitie Salpetriere, AP-HP, Paris, France
- Centre National de Références Maladies Autoinflammatoires et Amylose Inflammatoire, Sorbonne Universites, Groupe Hopital Universitaire Pitie Salpetriere, AP-HP, Paris, France
- Inflammation-Immunopathology-Biotherapy Department, Sorbonne Universites, Groupe Hopital Universitaire Pitie Salpetriere, AP-HP, Paris, France
- Department of Rheumatology, Hôpital Nord, Centre Hospitalier Universitaire Saint-Etienne, INSERM U1059, Lyon University, Saint-Etienne, France
| | - Maria J Santos
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal
- Instituto de Medicina Molecular, Faculdade Medicina Lisboa, University of Lisbon, Lisbon, Portugal
| | - Miguel Bernardes
- Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal
- Rheumatology Department, Centro Hospitalar-Universitário de São João, Porto, Portugal
| | - Rebecca Hasseli
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Germany
| | - Anne Regierer
- German Rheumatism Research Center, Epidemiology and Health Care Research, Berlin, Germany
| | - Hendrik Schulze-Koops
- Division of Rheumatology and Clinical Immunology, Department of Medicine IV, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Ulf Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Germany
| | | | - Romina Tanten
- Hospital Francisco Lopez Lima, General Roca, Argentina
| | - Romina E Nieto
- Department of Rheumatology, Grupo Oroño-Centro Regional de Enfermedades Autoinmunes y Reumáticas, Rosario, Santa Fe, Argentina
| | - Cecilia N Pisoni
- Rheumatology and Immunology Section, Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno", Buenos Aires, Argentina
| | - Yohana S Tissera
- Servicio de Clínica Médica, Unidad de Reumatología del Hospital Córdoba and Sanatorio Parque de Córdoba, Córdoba, Argentina
| | - Ricardo Xavier
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Philip C Robinson
- University of Queensland Medical School, Brisbane, QLD, Australia
- Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, QLD, Australia
| | - Pedro M Machado
- University College London, University College London Hospitals NHS Foundation Trust, Northwick Park Hospital, London North-West University Healthcare NHS Trust, London, UK
| | - Emily Sirotich
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Canadian Arthritis Patient Alliance, Toronto, ON, Canada
| | - Jean W Liew
- Boston University School of Medicine, Boston, MA, USA
| | - Jonathan S Hausmann
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
| | | | - Rebecca Grainger
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | | | | | - Zachary S Wallace
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jinoos Yazdany
- Division of Rheumatology, School of Medicine, University of California, San Francisco, CA, USA
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Gilbert E, Figueroa-Parra G, Valenzuela-Almada M, Vallejo S, Neville MR, Patel N, Cook C, Fu X, Hagi R, McDermott G, Di Iorio M, Masto L, Vanni K, Kowalski E, Qian G, Wallace Z, Duarte-Garcia A, Sparks J. OP0251 IMPACT OF INTERSTITIAL LUNG DISEASE ON SEVERE COVID-19 OUTCOMES FOR PATIENTS WITH RHEUMATOID ARTHRITIS: A MULTICENTER STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2973] [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
BackgroundRA has been associated with poor COVID-19 outcomes, but few studies have investigated outcomes in RA features such as interstitial lung disease.ObjectivesTo assess COVID-19 outcomes in patients with RA overall, and those with and without ILD, compared to general population comparators.MethodsA multicenter, retrospective cohort study was conducted at Mayo Clinic (19 hospitals and affiliated outpatient centers in 4 states) and Mass General Brigham (14 hospitals and affiliated outpatient centers in New England). Consecutive patients with RA meeting ACR/EULAR criteria and a positive COVID-19 test from March 1, 2020 through June 6, 2021 were matched 1:5 on age, sex, race, and COVID-19 test date with general population comparators without RA. RA features assessed included: RA-ILD per Bongartz criteria [1], duration, rheumatoid factor (RF), cyclic citrullinated peptide antibody (CCP), bone erosions, and treatments. The primary outcome was a composite of hospitalization or death following COVID-19 diagnosis. We used multivariable Cox regression to investigate the association of RA, and features such as ILD, with COVID-19 outcomes compared to matched comparators.ResultsWe analyzed 582 patients with RA and 2892 comparators without RA, all with COVID-19. Mean age was 62 years, 51% were female, and 79% were White. Mean RA duration was 11 years, 67% were seropositive (52% RF+ and 54% CCP+), 27% had bone erosions, 28% were on steroids, and 79% were on DMARDs. 50/582 (9%) patients with RA had ILD.The COVID-19 hospitalization or death rate for RA patients was higher than comparators (3.0 per 1,000 days [95% CI 2.5-3.6] vs. 1.9 per 1,000 days [95% CI 1.7-2.1], respectively). Overall, RA patients had a 53% higher risk of hospitalization or death than comparators after adjustment (95% CI 1.20-1.94).Among those with RA-ILD, the hospitalization or death rate was significantly higher than comparators (10.9 [95% CI 6.7-15.2] vs. 2.5 per 1,000 days [1.8-3.2], respectively). RA-ILD was associated with nearly 3-fold higher risk for hospitalization or death than comparators (multivariable HR 2.84 [95% CI 1.64-4.91], Table 1). There was a significant interaction between RA/comparator status and presence/absence of ILD for risk of severe COVID-19 (p<0.001, Figure 1). The elevated risk for severe COVID-19 was similar for RA subgroups defined by serostatus or bone erosions.Table 1.Frequencies, proportions, and hazard ratios for COVID-19 outcomes, comparing all RA patients, and subgroups with or without RA-ILD, to matched comparators.COVID-19 OutcomesAll RA Patients (n=582)RA-ILD (n=50)RA Patients without ILD (n=532)Comparators (n=2,892)Hospitalization, n (%)121 (21)24 (48)97 (18)402 (14)Unadjusted HR (95% CI)1.58 (1.27, 1.96)2.65 (1.71, 4.09)1.43 (1.12, 1.82)Ref.Adjusted* HR (95% CI)1.45 (1.14, 1.83)2.35 (1.38, 4.00)1.31 (1.00, 1.70)Ref.Death, n (%)26 (4)9 (18)17 (3)63 (2)Unadjusted HR (95% CI)1.72 (0.98, 3.01)5.88 (2.07, 16.71)1.13 (0.56, 2.29)Ref.Adjusted* HR (95% CI)1.24 (0.66, 2.32)13.94 (4.30, 45.18)0.75 (0.35, 1.63)Ref.Hospitalization or death, n (%)126 (22)25 (50)101 (19)419 (14)Unadjusted HR (95% CI)1.66 (1.33, 2.07)3.01 (1.93, 4.70)1.47 (1.14, 1.89)Ref.Adjusted* HR (95% CI)1.53 (1.20, 1.94)2.84 (1.64, 4.91)1.34 (1.02, 1.77)Ref.*Adjusted for age, sex, race, and smokingFigure 1.Multivariable hazard ratios for the composite outcome of hospitalization or death from COVID-19, comparing all RA and subgroups by serostatus, bone erosions, and ILD to matched comparators without RA.ConclusionWe confirmed that RA was associated with severe COVID-19 outcomes compared to the general population. We found evidence that ILD may be an effect modifier for the relationship between RA and severe COVID-19 outcomes, but RA subgroups defined by serostatus and bone erosions had similarly elevated risk. These findings suggest that ILD or its treatment may be a major contributor to severe COVID-19 outcomes in RA.References[1]Bongartz, T, et al, Arthritis Rheum. 2010 Jun;62(6):1583-91.Disclosure of InterestsNone declared
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McCormack K, Gilbert E. The geopolitics of militarism and humanitarianism. Prog Hum Geogr 2022; 46:179-197. [PMID: 35115737 PMCID: PMC8801667 DOI: 10.1177/03091325211032267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In this article, we trace the interconnections between humanitarianism and militarism. We highlight the significance of a geographical perspective in emphasizing the spatial and multiscalar dimensions of this changing relationship, particularly in Western states. In doing so, we reveal the violent geographies produced through militarized humanitarianism and demonstrate the ways political violence can be obscured through invocations of humanitarianism. We look at five overlapping lines of enquiry: the way humanitarianism is used to modulate war; the rationalization of military intervention as humanitarian; military deployment in response to humanitarian crises; the military take-up of humanitarian-style practices; and weapons development and humanitarianism.
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Affiliation(s)
- Killian McCormack
- Killian McCormack, University of Toronto, 27 King’s College Circle Toronto, Ontario M5S 1A1, Canada.
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13
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Tirmarche M, Apostoaei I, Blanchardon E, Ellis ED, Gilbert E, Harrison JD, Laurier D, Marsh JW, Sokolnikov M, Wakeford R, Zhivin S. ICRP Publication 150: Cancer Risks from Plutonium and Uranium Exposure. Ann ICRP 2021; 50:1-143. [PMID: 34877884 DOI: 10.1177/01466453211028020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Sattui SE, Conway R, Putman MS, Seet AM, Gianfrancesco MA, Beins K, Hill C, Liew D, Mackie SL, Mehta P, Neill L, Gomez G, Salinas MIH, Maldonado FN, Mariz HA, de Sousa Studart SA, Araujo NC, Knight A, Rozza D, Quartuccio L, Samson M, Bally S, Maria AT, Chazerain P, Hasseli R, Müller-Ladner U, Hoyer BF, Voll R, Torres RP, Luis M, Ribeirio SLE, Al-Emadi S, Sparks JA, Hsu TYT, D'Silva KM, Patel NJ, Wise L, Gilbert E, Almada MV, Duarte-García A, Ugarte-Gil M, Jacobsohn L, Izadi Z, Strangfeld A, Mateus EF, Hyrich KL, Gossec L, Carmona L, Lawson-Tovey S, Kearsley-Fleet L, Schaefer M, Sirotich E, Hausmann JS, Sufka P, Bhana S, Liew JW, Grainger R, Machado PM, Wallace ZS, Yazdany J, Robinson PC. Outcomes of COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica from the COVID-19 Global Rheumatology Alliance physician registry: a retrospective cohort study. Lancet Rheumatol 2021; 3:e855-e864. [PMID: 34778843 PMCID: PMC8570701 DOI: 10.1016/s2665-9913(21)00316-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Patients with primary systemic vasculitis or polymyalgia rheumatica might be at a high risk for poor COVID-19 outcomes due to the treatments used, the potential organ damage cause by primary systemic vasculitis, and the demographic factors associated with these conditions. We therefore aimed to investigate factors associated with COVID-19 outcomes in patients with primary systemic vasculitis or polymyalgia rheumatica. Methods In this retrospective cohort study, adult patients (aged ≥18 years) diagnosed with COVID-19 between March 12, 2020, and April 12, 2021, who had a history of primary systemic vasculitis (antineutrophil cytoplasmic antibody [ANCA]-associated vasculitis, giant cell arteritis, Behçet's syndrome, or other vasculitis) or polymyalgia rheumatica, and were reported to the COVID-19 Global Rheumatology Alliance registry were included. To assess COVID-19 outcomes in patients, we used an ordinal COVID-19 severity scale, defined as: (1) no hospitalisation; (2) hospitalisation without supplemental oxygen; (3) hospitalisation with any supplemental oxygen or ventilation; or (4) death. Multivariable ordinal logistic regression analyses were used to estimate odds ratios (ORs), adjusting for age, sex, time period, number of comorbidities, smoking status, obesity, glucocorticoid use, disease activity, region, and medication category. Analyses were also stratified by type of rheumatic disease. Findings Of 1202 eligible patients identified in the registry, 733 (61·0%) were women and 469 (39·0%) were men, and their mean age was 63·8 years (SD 17·1). A total of 374 (31·1%) patients had polymyalgia rheumatica, 353 (29·4%) had ANCA-associated vasculitis, 183 (15·2%) had giant cell arteritis, 112 (9·3%) had Behçet's syndrome, and 180 (15·0%) had other vasculitis. Of 1020 (84·9%) patients with outcome data, 512 (50·2%) were not hospitalised, 114 (11·2%) were hospitalised and did not receive supplemental oxygen, 239 (23·4%) were hospitalised and received ventilation or supplemental oxygen, and 155 (15·2%) died. A higher odds of poor COVID-19 outcomes were observed in patients who were older (per each additional decade of life OR 1·44 [95% CI 1·31-1·57]), were male compared with female (1·38 [1·05-1·80]), had more comorbidities (per each additional comorbidity 1·39 [1·23-1·58]), were taking 10 mg/day or more of prednisolone compared with none (2·14 [1·50-3·04]), or had moderate, or high or severe disease activity compared with those who had disease remission or low disease activity (2·12 [1·49-3·02]). Risk factors varied among different disease subtypes. Interpretation Among patients with primary systemic vasculitis and polymyalgia rheumatica, severe COVID-19 outcomes were associated with variable and largely unmodifiable risk factors, such as age, sex, and number of comorbidities, as well as treatments, including high-dose glucocorticoids. Our results could be used to inform mitigation strategies for patients with these diseases. Funding American College of Rheumatology and the European Alliance of Associations for Rheumatology.
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Affiliation(s)
- Sebastian E Sattui
- Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, New York, NY, USA
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Richard Conway
- Department of Rheumatology, St James's Hospital, Dublin, Ireland
| | | | - Andrea M Seet
- Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, USA
| | - Milena A Gianfrancesco
- Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, USA
| | | | - Catherine Hill
- Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, SA, Australia
- Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - David Liew
- Department of Rheumatology, Austin Health, Melbourne, Australia
- Department of Medicine, University of Melbourne, VIC, Australia
| | - Sarah L Mackie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Puja Mehta
- Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, UK
- Department of Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Lorna Neill
- Polymyalgia Rheumatica and Giant Cell Arteritis Scotland, Perth, Scotland, UK
| | - Gimena Gomez
- Research Unit Argentine Society of Rheumatology, Buenos Aires, Argentina
| | | | | | | | | | - Nafice Costa Araujo
- Instituto de Assistencia Medica ao Servidor Publico Estadual de Sao Paulo, Sao Paulo, Brazil
| | - Ann Knight
- Rheumatology, Institute of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Davide Rozza
- Epidemiology Research Unit, Italian Society for Rheumatology, Milan, Italy
| | - Luca Quartuccio
- Clinic of Rheumatology, Department of Medicine, University of Udine, School of Rheumatology, Santa Maria della Misericordia Academic Hospital, Udine, Italy
| | - Maxime Samson
- Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France
| | - Stéphane Bally
- Nephrology and Dialysis Service, Metropole Savoie Hospital Center, Chambery, France
| | - Alexandre Tj Maria
- Department of Internal Medicine and Multi-Organic Diseases, Saint-Eloi University Hospital of Montpellier, Montpellier, France
| | - Pascal Chazerain
- Department of Rheumatology and Internal Medicine, Diaconesses Croix Saint Simon Hospital, Paris, France
| | - Rebecca Hasseli
- Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus Liebig University Giessen, Bad Nauheim, Germany
| | - Ulf Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus Liebig University Giessen, Bad Nauheim, Germany
| | - Bimba F Hoyer
- Department of Rheumatology and Clinical Immunology, Clinic for Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Reinhard Voll
- Department of Rheumatology and Clinical Immunology, University Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Germany
| | - Rita Pinheiro Torres
- CEDOC, Nova Medical School, Lisbon, Portugal
- Rheumatology Service, Egas Moniz Hospital, Lisboa Occidental Hospital Centre, Lisbon, Portugal
| | - Mariana Luis
- Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- School of Medicine, Universidade de Coimbra, Coimbra, Portugal
| | | | | | - Jeffrey A Sparks
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tiffany Y-T Hsu
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kristin M D'Silva
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Naomi J Patel
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Leanna Wise
- Los Angeles County Hospital, Los Angeles, CA, USA
- University of South California Medical Center, Los Angeles, CA, USA
| | - Emily Gilbert
- Division of Rheumatology, Mayo Clinic Health System, Jacksonville, FL, USA
| | | | - Alí Duarte-García
- Division of Rheumatology, Mayo Clinic Health System, Rochester, MN, USA
| | - Manuel Ugarte-Gil
- School of Medicine, University Cientifica del Sur, Lima, Peru
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - Lindsay Jacobsohn
- Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, USA
| | - Zara Izadi
- Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, USA
| | - Anja Strangfeld
- German Rheumatism Research Center, Epidemiology and Health Care Research, Berlin, Germany
| | - Elsa F Mateus
- Portuguese League Against Rheumatic Diseases, Lisbon, Portugal
| | - Kimme L Hyrich
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- National Institute of Health Research Manchester Biomedical Research Centre, University of Manchester, Manchester, UK
- National Institute of Health Research Manchester Biomedical Research Centre, Manchester University NHS Trust, Manchester, UK
| | - Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris France
- Department of Rheumatology, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France
| | | | - Saskia Lawson-Tovey
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | | | - Martin Schaefer
- German Rheumatism Research Center, Epidemiology and Health Care Research, Berlin, Germany
| | - Emily Sirotich
- McMaster University, Hamilton, ON, Canada
- Canadian Arthritis Patient Alliance, Toronto, ON, Canada
| | - Jonathan S Hausmann
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
| | | | | | - Jean W Liew
- Boston University School of Medicine, Boston, MA, USA
| | | | - Pedro M Machado
- Centre for Rheumatology and Department of Neuromuscular Diseases, University College London, UK
- National Institute for Health Research, University College London Hospitals Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
- Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | - Zachary S Wallace
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jinoos Yazdany
- Department of Medicine, Division of Rheumatology, University of California, San Francisco, CA, USA
| | - Philip C Robinson
- University of Queensland, Brisbane, QLD, Australia
- Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, QLD, Australia
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15
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Brian A, Starrett A, Ross R, Pennell A, Gilbert E, Miedema ST, Casner C, Lieberman LJ. The Psychometric Properties for the Test of Perceived Physical Competence for Youths with Visual Impairments. Journal of Visual Impairment & Blindness 2021. [DOI: 10.1177/0145482x211046700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Limited inquiries exist for perceptions of physical competence for people with visual impairments, since there are no specific, psychometrically tested scales. The purpose of this study was to establish the psychometric properties of the Test of Perceived Physical Competence (TPPC) for individuals with visual impairments aged 9–19 years. Methods: Experts ( N = 12) provided feedback for content and face validity. Then, after assessing 179 individuals with visual impairments, McDonald’s Omega, and Confirmatory Factor Analyses were used to evaluate the internal consistency and structure. Finally, results of the TPPC were compared with the Self-Perception Profiles for Children/Adolescents for divergent validity. Results: The standardized root mean square residual result of 0.053 and the Comparative Fit Index result of 0.95 indicated acceptable fit. The percent of variation in each item explained by the factor varied from 44% (item 3) to 63% (item 6). McDonald’s Omega for the one-factor scale is 0.987, and the perceived physical competence subscale of the Self-Perception Profiles for Children and TPPC have a Spearman correlation coefficient of 0.469 (95% confidence interval = 0.269–0.630). Discussion: Having a psychometrically strong scale to measure perceived physical competence of individuals with visual impairments is the first step in being able to replicate current, seminal research among this unique population. This adaptation of Harter’s perceived physical competence subscale uniquely assesses the child’s perceptions of physical competence among peers with visual impairments. This measure, coupled with the power to examine its predictive abilities, is important for children and adolescents with visual impairments, since they possess great tendencies for obesity and sedentary behavior. Implications for practitioners: If practitioners would like to change tendencies for obesity and sedentary behavior, then, they must include perceptions of physical competence as a latent construct. Now, practitioners can feel confident to do so for this highly vulnerable population.
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Affiliation(s)
- Ali Brian
- Department of Physical Education, University of South Carolina, Columbia, SC, USA
| | - Angela Starrett
- Child Development Research Center, University of South Carolina, Columbia, SC, USA
| | - Robbie Ross
- Department of Educational Studies, University of South Carolina, Columbia, SC, USA
| | - Adam Pennell
- Natural Science Division, Pepperdine University, Malibu, CA, USA
| | - Emily Gilbert
- Department of Physical Education, University of South Carolina, Columbia, SC, USA
| | | | - Chandler Casner
- Department of Physical Education, University of South Carolina, Columbia, SC, USA
| | - Lauren J. Lieberman
- Department of Kinesiology, Sports Studies, and Physical Education, The State University of New York’s College at Brockport, Brockport, NY, USA
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16
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Sondhi A, Leidi A, Gilbert E. A Small Area Estimation Method for Investigating the Relationship between Public Perception of Drug Problems with Neighborhood Prognostics: Trends in London between 2012 and 2019. Int J Environ Res Public Health 2021; 18:ijerph18179016. [PMID: 34501603 PMCID: PMC8430465 DOI: 10.3390/ijerph18179016] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/16/2021] [Accepted: 08/21/2021] [Indexed: 11/19/2022]
Abstract
The correlation of the public’s perception of drug problems with neighborhood characteristics has rarely been studied. The aim of this study was to investigate factors that correlate with public perceptions in London boroughs using the Mayor’s Office for Policing and Crime (MOPAC) Public Attitude Survey between 2012 and 2019. A subject-specific random effect deploying a Generalized Linear Mixed Model (GLMM) using an Adaptive Gaussian Quadrature method with 10 integration points was applied. To obtain time trends across inner and outer London areas, the GLMM was fitted using a Restricted Marginal Pseudo Likelihood method. The perception of drug problems increased with statistical significance in 17 out of 32 London boroughs between 2012 and 2019. These boroughs were geographically clustered across the north of London. Levels of deprivation, as measured by the English Index of Multiple Deprivation, as well as the percentage of local population who were non-UK-born and recorded vehicle crime rates were shown to be positively associated with the public’s perception of drug problems. Conversely, recorded burglary rate was negatively associated with the public’s perception of drug problems in their area. The public are influenced in their perception of drug problems by neighborhood factors including deprivation and visible manifestations of antisocial behavior.
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Affiliation(s)
- Arun Sondhi
- Therapeutic Solutions (Addictions), London W1K 1QW, UK
- Correspondence:
| | | | - Emily Gilbert
- Evidence and Insight, London Mayor’s Office for Policing and Crime, London SE1 2AA, UK;
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17
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Brian AS, Starrett A, Pennell A, Beach PH, Miedema ST, Stribing A, Gilbert E, Patey M, Lieberman LJ. The Brief Form of the Test of Gross Motor Development-3 for Individuals with Visual Impairments. Int J Environ Res Public Health 2021; 18:7962. [PMID: 34360265 PMCID: PMC8345496 DOI: 10.3390/ijerph18157962] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 12/04/2022]
Abstract
Children with visual impairments (VI) tend to struggle with their fundamental motor skills (FMS), and these difficulties often persist across the lifespan, requiring frequent assessment. The Test of Gross Motor Development (TGMD) shows robust psychometric properties for children with VI. The TGMD, which includes 13 skills, is time-consuming to administer and score, warranting the need to explore brief versions. Therefore, the purpose of this study was to explore the psychometric properties of three, six-skill versions of the TGMD-3 with children with VI. Children (n = 302; Boys = 58%, Girls = 42%; Mage = 13.00, SD = 2.50 years) with VI (B1 = 27%, B2 = 20%, B3 = 38%, B4 = 15%) participated in this study. We examined three different models using confirmatory factor analyses on the relationships between the motor skills and latent traits across the models. Scores from all three brief versions had acceptable global fit. Although further research should be conducted, practitioners can adopt a brief version of the TGMD to assess children with VI.
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Affiliation(s)
- Ali S. Brian
- Department of Physical Education, University of South Carolina, Columbia, SC 29208, USA; (S.T.M.); (A.S.)
| | - Angela Starrett
- Child Development Research Center, University of South Carolina, Columbia, SC 29208, USA;
| | - Adam Pennell
- Natural Science Division, Pepperdine University, Malibu, CA 90263, USA;
| | - Pamela Haibach Beach
- SUNY-Brockport, Kinesiology, Sport Studies, and Physical Education, Brockport, NY 14420, USA; (P.H.B.); (L.J.L.)
| | - Sally Taunton Miedema
- Department of Physical Education, University of South Carolina, Columbia, SC 29208, USA; (S.T.M.); (A.S.)
| | - Alexandra Stribing
- Department of Physical Education, University of South Carolina, Columbia, SC 29208, USA; (S.T.M.); (A.S.)
| | - Emily Gilbert
- SUNY-Cortland, Physical Education Department, Cortland, NY 13045, USA;
| | - Matthew Patey
- Department of Movement Arts, Health Promotion, and Leisure Studies, Bridgewater State University, Bridgewater, MA 02324, USA;
| | - Lauren J. Lieberman
- SUNY-Brockport, Kinesiology, Sport Studies, and Physical Education, Brockport, NY 14420, USA; (P.H.B.); (L.J.L.)
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18
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Gilbert E, Walker R, Simon D, Derkenne R, Rumbold A, Campbell S, Boyle JA. "We are only looking at the tip of the iceberg in infertility": perspectives of health providers about fertility issues and management among Aboriginal and Torres Strait Islander people. BMC Health Serv Res 2021; 21:704. [PMID: 34271914 PMCID: PMC8285865 DOI: 10.1186/s12913-021-06714-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/01/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Aboriginal and Torres Strait Islander women and men are disproportionately affected by a range of risk factors for infertility. However, remarkably little is known about the prevalence of infertility in this group, or how Aboriginal and Torres Strait Islander people access fertility treatments including assisted reproductive technology (ART). This qualitative study aims to explore health care provider (HCP) perspectives on the health burden of infertility among Aboriginal and Torres Strait Islander people, as well as factors that may affect access to infertility treatment for this group. METHOD Semi-structured interviews were conducted with HCPs (8 doctors; 3 nurses and 1 Aboriginal Health Practitioner) working in fertility care in the Northern Territory, Australia. Transcribed interviews were analysed using an iterative thematic approach using the NVivo-9 software package. RESULTS Providers perceive infertility as an underestimated health issue in this patient population, reporting a high prevalence of infertility-related risk factors but fewer clinical encounters of diagnosis and treatment. Perceived barriers to accessing fertility care included cultural differences such as the shame and stigma associated with reproductive health and the separation of men's business and women's business; service-related barriers such as limited timely and affordable access to specialist health services and; a lack of culturally responsive and appropriate fertility services. Providers had mixed opinions on their role in ameliorating inequities of access, and hence a range of strategies to address barriers were suggested. These included a greater patient education, ongoing patient support and providing a culturally safe environment. CONCLUSION The current study adds to the understanding of how Aboriginal and Torres Strait Islander people access fertility treatments. There is a need for further research to quantify infertility in Aboriginal and Torres Strait Islander people, investigate community perceptions towards infertility and identify community-driven priorities to improve access to fertility care for this population.
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Affiliation(s)
- Emily Gilbert
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, VIC, Melbourne, Australia
| | - Ruth Walker
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, VIC, Melbourne, Australia
| | - David Simon
- Top End Health Service, NT, Casuarina, Australia
| | | | - Alice Rumbold
- South Australian Health and Medical Research Institute, SA, Adelaide, Australia
| | - Sandra Campbell
- Molly Wardaguga Research Centre, School of Nursing and Midwifery, Charles Darwin University, QLD, Brisbane City, Australia
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, VIC, Melbourne, Australia.
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19
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Gilbert E, Avery J, Bartlett R, Campbell S, Joham A, Rumbold A, Boyle J. The Prevalence of Clinical Characteristics of Polycystic Ovary Syndrome among Indigenous Women: A Systematic Search and Review of the Literature. Semin Reprod Med 2021; 39:78-93. [PMID: 34273900 DOI: 10.1055/s-0041-1730021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged women; however, to date there has been no synthesis of the burden of PCOS specifically among indigenous women. We aimed to systematically identify and collate studies reporting prevalence and clinical features of PCOS among indigenous women worldwide. We performed a comprehensive search of six databases (Ovid MEDLINE, MEDLINE In Process & Other Non-Indexed Citations, EMBASE, EBM reviews, CINAHL, and SCOPUS) supplemented by gray literature searches and the screening of reference lists. A narrative synthesis was conducted. Fourteen studies met inclusion criteria; however, one was excluded as it assessed only children and adolescents younger than 15 years, with limited clinical relevance. Studies examined indigenous women from Australia, Sri Lanka, New Zealand, and the United States. Prevalence of PCOS was reported in only four studies and ranged from 3.05% for women in Sri Lanka to 26% for women in Australia. All included studies reported on at least one clinical feature of PCOS. Of the studies that reported on a comparison group from the same country, there was evidence of more severe features in indigenous women from New Zealand and the United States. The limited evidence available warrants further investigation of the burden of PCOS in indigenous women to build the knowledge base for effective and culturally relevant management of this condition.
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Affiliation(s)
- Emily Gilbert
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
| | - Jodie Avery
- Adelaide Medical School, The University of Adelaide, South Australia, Australia
| | - Rebeccah Bartlett
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
| | - Sandra Campbell
- Molly Wardaguga Research Centre, School of Nursing and Midwifery, Charles Darwin University, Queensland, Australia
| | - Anju Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
| | - Alice Rumbold
- South Australian Health and Medical Research Institute, South Australia, Australia
| | - Jacqueline Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
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20
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Fitzsimons E, Moulton V, Hughes DA, Neaves S, Ho K, Hemani G, Timpson N, Calderwood L, Gilbert E, Ring S. Collection of genetic data at scale for a nationally representative population: the UK Millennium Cohort Study. Longit Life Course Stud 2021; 13:169-187. [PMID: 35920643 DOI: 10.1332/175795921x16223668101602] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A DNA bank has been created from the Millennium Cohort Study (MCS) saliva samples. A total of 23,336 samples are available, from 9,259 cohort members (4,630 males and 4,629 females), 8,898 mothers and 5,179 fathers. There are 4,533 mother, child, father 'triads'. This paper describes the collection of the saliva samples from cohort members and their biological parents in the MCS. It analyses response rates and predictors of response, and details the DNA extraction, genotyping and imputation procedures performed on the data.
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Affiliation(s)
- Emla Fitzsimons
- University College London, UK
- Institute for Fiscal Studies, London,UK
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21
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Ugarte-Gil MF, Alarcon GS, Seet A, Izadi Z, Reategui Sokolova C, Clarke AE, Wise L, Pons-Estel G, Santos MJ, Bernatsky S, Mathias L, Lim N, Sparks J, Wallace Z, Hyrich K, Strangfeld A, Gossec L, Carmona L, Mateus E, Lawson-Tovey S, Trupin L, Rush S, Schmajuk G, Katz P, Jacobsohn L, Al Emadi S, Gilbert E, Duarte-Garcia A, Valenzuela-Almada M, Hsu T, D’silva K, Serling-Boyd N, Dieudé P, Nikiphorou E, Kronzer V, Singh N, Wallace B, Akpabio A, Thomas R, Bhana S, Costello W, Grainger R, Hausmann J, Liew J, Sirotich E, Sufka P, Robinson P, Machado P, Gianfrancesco M, Yazdany J. OP0286 CHARACTERISTICS ASSOCIATED WITH SEVERE COVID-19 OUTCOMES IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE): RESULTS FROM THE COVID-19 GLOBAL RHEUMATOLOGY ALLIANCE (COVID-19 GRA). Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Background:An increased risk of severe COVID-19 outcomes may be seen in patients with autoimmune diseases on moderate to high daily doses of glucocorticoids, as well as in those with comorbidities. However, specific information about COVID-19 outcomes in SLE is scarce.Objectives:To determine the characteristics associated with severe COVID-19 outcomes in a multi-national cross-sectional registry of COVID-19 patients with SLE.Methods:SLE adult patients from a physician-reported registry of the COVID-19 GRA were studied. Variables collected at COVID-19 diagnosis included age, sex, race/ethnicity, region, comorbidities, disease activity, time period of COVID-19 diagnosis, glucocorticoid (GC) dose, and immunomodulatory therapy. Immunomodulatory therapy was categorized as: antimalarials only, no SLE therapy, traditional immunosuppressive (IS) drug monotherapy, biologics/targeted synthetic IS drug monotherapy, and biologic and traditional IS drug combination therapy. We used an ordinal COVID-19 severity outcome defined as: not hospitalized/hospitalized without supplementary oxygen; hospitalized with non-invasive ventilation; hospitalized with mechanical ventilation/extracorporeal membrane oxygenation; and death. An ordinal logistic regression model was constructed to assess the association between demographic characteristics, comorbidities, medications, disease activity and COVID-19 severity. This assumed that the relationship between each pair of outcome groups is of the same direction and magnitude.Results:Of 1069 SLE patients included, 1047 (89.6%) were female, with a mean age of 44.5 (SD: 14.1) years. Patient outcomes included 815 (78.8%) not hospitalized/hospitalized without supplementary oxygen; 116 (11.2) hospitalized with non-invasive ventilation, 25 (2.4%) hospitalized with mechanical ventilation/extracorporeal membrane oxygenation and 78 (7.5%) died. In a multivariate model (n=804), increased age [OR=1.03 (1.01, 1.04)], male sex [OR =1.93 (1.21, 3.08)], COVID-19 diagnosis between June 2020 and January 2021 (OR =1.87 (1.17, 3.00)), no IS drug use [OR =2.29 (1.34, 3.91)], chronic renal disease [OR =2.34 (1.48, 3.70)], cardiovascular disease [OR =1.93 (1.34, 3.91)] and moderate/high disease activity [OR =2.24 (1.46, 3.43)] were associated with more severe COVID-19 outcomes. Compared with no use of GC, patients using GC had a higher odds of poor outcome: 0-5 mg/d, OR =1.98 (1.33, 2.96); 5-10 mg/d, OR =2.88 (1.27, 6.56); >10 mg/d, OR =2.01 (1.26, 3.21) (Table 1).Table 1.Characteristics associated with more severe COVID-19 outcomes in SLE. (N=804)OR (95% CI)Age, years1.03 (1.01, 1.04)Sex, Male1.93 (1.21, 3.08)Race/Ethnicity, Non-White vs White1.47 (0.87, 2.50)RegionEuropeRef.North America0.67 (0.29, 1.54)South America0.67 (0.29, 1.54)Other1.93 (0.85, 4.39)Season, June 16th 2020-January 8th 2021 vs January-June 15th 20201.87 (1.17, 3.00)Glucocorticoids0 mg/dayRef.0-5 mg/day1.98 (1.33, 2.96)5-10 mg/day2.88 (1.27, 6.56)=>10 mg/day2.01 (1.26, 3.21)Medication CategoryAntimalarial onlyRef.No IS drugs2.29 (1.34, 3.91)Traditional IS drugs as monotherapy1.17 (0.77, 1.77)b/ts IS drugs as monotherapy1.00 (0.37, 2.71)Combination of traditional and b/ts IS1.00 (0.55, 1.82)Comorbidity BurdenNumber of Comorbidities (excluding renal and cardiovascular disease)1.39 (0.97, 1.99)Chronic renal disease2.34 (1.48, 3.70)Cardiovascular disease1.93 (1.34, 3.91)Disease Activity, Moderate/ high vs Remission/ low 2.24 (1.46, 3.43)IS: immunosuppressive. b/ts: biologics/targeted syntheticsConclusion:Increased age, male sex, glucocorticoid use, chronic renal disease, cardiovascular disease and moderate/high disease activity at time of COVID-19 diagnosis were associated with more severe COVID-19 outcomes in SLE. Potential limitations include possible selection bias (physician reporting), the cross-sectional nature of the data, and the assumptions underlying the outcomes modelling.Acknowledgements:The views expressed here are those of the authors and participating members of the COVID-19 Global Rheumatology Alliance and do not necessarily represent the views of the ACR, EULAR) the UK National Health Service, the National Institute for Health Research (NIHR), or the UK Department of Health, or any other organization.Disclosure of Interests:Manuel F. Ugarte-Gil Grant/research support from: Pfizer, Janssen, Graciela S Alarcon: None declared, Andrea Seet: None declared, Zara Izadi: None declared, Cristina Reategui Sokolova: None declared, Ann E Clarke Consultant of: AstraZeneca, BristolMyersSquibb, GlaxoSmithKline, Exagen Diagnostics, Leanna Wise: None declared, Guillermo Pons-Estel: None declared, Maria Jose Santos: None declared, Sasha Bernatsky: None declared, Lauren Mathias: None declared, Nathan Lim: None declared, Jeffrey Sparks Consultant of: Bristol-Myers Squibb, Gilead, Inova, Janssen, and Optum unrelated to this work., Grant/research support from: Amgen and Bristol-Myers Squibb, Zachary Wallace Consultant of: Viela Bio and MedPace, Grant/research support from: Bristol-Myers Squibb and Principia/Sanofi, Kimme Hyrich Speakers bureau: Abbvie, Grant/research support from: MS, UCB, and Pfizer, Anja Strangfeld Speakers bureau: AbbVie, MSD, Roche, BMS, Pfizer, Grant/research support from: AbbVie, BMS, Celltrion, Fresenius Kabi, Lilly, Mylan, Hexal, MSD, Pfizer, Roche, Samsung, Sanofi-Aventis, and UCB, Laure Gossec Consultant of: Abbvie, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sanofi-Aventis, UCB, Grant/research support from: Lilly, Mylan, Pfizer, Loreto Carmona: None declared, Elsa Mateus Grant/research support from: Pfizer, Abbvie, Novartis, Janssen-Cilag, Lilly Portugal, Sanofi, Grünenthal S.A., MSD, Celgene, Medac, Pharmakern, GAfPA, Saskia Lawson-Tovey: None declared, Laura Trupin: None declared, Stephanie Rush: None declared, Gabriela Schmajuk: None declared, Patti Katz: None declared, Lindsay Jacobsohn: None declared, Samar Al Emadi: None declared, Emily Gilbert: None declared, Ali Duarte-Garcia: None declared, Maria Valenzuela-Almada: None declared, Tiffany Hsu: None declared, Kristin D’Silva: None declared, Naomi Serling-Boyd: None declared, Philippe Dieudé Consultant of: Boerhinger Ingelheim, Bristol-Myers Squibb, Lilly, Sanofi, Pfizer, Chugai, Roche, Janssen unrelated to this work, Grant/research support from: Bristol-Myers Squibb, Chugaii, Pfizer, unrelated to this work, Elena Nikiphorou: None declared, Vanessa Kronzer: None declared, Namrata Singh: None declared, Beth Wallace: None declared, Akpabio Akpabio: None declared, Ranjeny Thomas: None declared, Suleman Bhana Consultant of: AbbVie, Horizon, Novartis, and Pfizer (all <$10,000) unrelated to this work, Wendy Costello: None declared, Rebecca Grainger Speakers bureau: Abbvie, Janssen, Novartis, Pfizer, Cornerstones, Jonathan Hausmann Consultant of: Novartis, Sobi, Biogen, all unrelated to this work (<$10,000), Jean Liew Grant/research support from: Pfizer outside the submitted work, Emily Sirotich Grant/research support from: Board Member of the Canadian Arthritis Patient Alliance, a patient run, volunteer based organization whose activities are largely supported by independent grants from pharmaceutical companies, Paul Sufka: None declared, Philip Robinson Speakers bureau: Abbvie, Eli Lilly, Janssen, Novartis, Pfizer and UCB (all < $10,000), Consultant of: Abbvie, Eli Lilly, Janssen, Novartis, Pfizer and UCB (all < $10,000), Pedro Machado Speakers bureau: Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche and UCB, all unrelated to this study (all < $10,000)., Consultant of: Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche and UCB, all unrelated to this study (all < $10,000), Milena Gianfrancesco: None declared, Jinoos Yazdany Consultant of: Eli Lilly and AstraZeneca unrelated to this project
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22
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Izadi Z, Gianfrancesco M, Hyrich K, Strangfeld A, Gossec L, Carmona L, Mateus E, Lawson-Tovey S, Trupin L, Rush S, Schmajuk G, Jacobsohn L, Katz P, Al Emadi S, Wise L, Gilbert E, Valenzuela-Almada M, Duarte-Garcia A, Sparks J, Hsu T, D’silva K, Serling-Boyd N, Bhana S, Costello W, Grainger R, Hausmann J, Liew J, Sirotich E, Sufka P, Wallace Z, Machado P, Robinson P, Yazdany J. OP0288 MACHINE LEARNING ALGORITHMS TO PREDICT COVID-19 ACUTE RESPIRATORY DISTRESS SYNDROME IN PATIENTS WITH RHEUMATIC DISEASES: RESULTS FROM THE GLOBAL RHEUMATOLOGY ALLIANCE PROVIDER REGISTRY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.446] [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
Background:Acute Respiratory Distress Syndrome (ARDS) is a life-threatening complication of COVID-19 and has been reported in approximately one-third of hospitalized patients with COVID-191. Risk factors associated with the development of ARDS include older age and diabetes2. However, little is known about factors associated with ARDS in the setting of COVID-19, in patients with rheumatic disease or those receiving immunosuppressive medications. Prediction algorithms using traditional regression methods perform poorly with rare outcomes, often yielding high specificity but very low sensitivity. Machine learning algorithms optimized for rare events are an alternative approach with potentially improved sensitivity for rare events, such as ARDS in COVID-19 among patients with rheumatic disease.Objectives:We aimed to develop a prediction model for ARDS in people with COVID-19 and pre-existing rheumatic disease using a series of machine learning algorithms and to identify risk factors associated with ARDS in this population.Methods:We used data from the COVID-19 Global Rheumatology Alliance (GRA) Registry from March 24 to Nov 1, 2020. ARDS diagnosis was indicated by the reporting clinician. Five machine learning algorithms optimized for rare events predicted ARDS using 42 variables covering patient demographics, rheumatic disease diagnoses, medications used at the time of COVID-19 diagnosis, and comorbidities. Model performance was assessed using accuracy, area under curve, sensitivity, specificity, positive predictive value, and negative predictive value. Adjusted odds ratios corresponding to the 10 most influential predictors from the best performing model were derived using hierarchical multivariate mixed-effects logistic regression that accounted for within-country correlations.Results:A total of 5,931 COVID-19 cases from 67 countries were included in the analysis. Mean (SD) age was 54.9 (16.0) years, 4,152 (70.0%) were female, and 2,399 (40.5%) were hospitalized. ARDS was reported in 388 (6.5% of total and 15.6% of hospitalized) cases. Statistically significant differences in the risk of ARDS were observed by demographics, diagnoses, medications, and comorbidities using unadjusted univariate comparisons (data not shown). Gradient boosting machine (GBM) had the highest sensitivity (0.81) and was considered the best performing model (Table 1). Hypertension, interstitial lung disease, kidney disease, diabetes, older age, glucocorticoids, and anti-CD20 monoclonal antibodies were associated with the development of ARDS while tumor necrosis factor inhibitors were associated with a protective effect (Figure 1).Table 1.Performance of machine learning algorithms.GBMSVMGLMNETNNETRFAccuracy0.790.680.660.660.67AUC0.750.700.740.580.74Sensitivity0.810.680.650.680.67Specificity0.490.600.730.480.68PPV0.960.960.970.950.97NPV0.160.120.130.090.13GBM: Gradient Boosting Machine, SVM: Support vector machines, GLMNET: Lasso and Elastic-Net Regularized Generalized Linear Models, NNET: Neural Networks, RF: Random Forest. AUC: Area Under Curve; PPV: Positive Predictive Value; NPV: Negative Predictive Value.Conclusion:In this global cohort of patients with rheumatic disease, a machine learning model, GBM, predicted the onset of ARDS with 81% sensitivity using baseline information obtained at the time of COVID-19 diagnosis. These results identify patients who may be at higher risk of severe COVID-19 outcomes. Further studies are necessary to validate the proposed prediction model in external cohorts and to evaluate its clinical utility. Disclaimer: The views expressed here are those of the authors and participating members of the COVID-19 Global Rheumatology Alliance, and do not necessarily represent the views of the ACR, NIH, (UK) NHS, NIHR, or the department of Health.References:[1]Tzotzos SJ, Fischer B, Fischer H, Zeitlinger M. 2020;24(1):516.[2]Wu C, Chen X, Cai Y, et al. JAMA Intern Med. 2020;180(7):934-943.Acknowledgements:The COVID-19 Global Rheumatology Alliance.Disclosure of Interests:Zara Izadi: None declared, Milena Gianfrancesco: None declared, Kimme Hyrich Speakers bureau: Abbvie and grant income from BMS, UCB, and Pfizer, all unrelated to this study., Anja Strangfeld Speakers bureau: AbbVie, MSD, Roche, BMS, Pfizer, outside the submitted work., Grant/research support from: A consortium of 13 companies (among them AbbVie, BMS, Celltrion, Fresenius Kabi, Lilly, Mylan, Hexal, MSD, Pfizer, Roche, Samsung, Sanofi-Aventis, and UCB) supporting the German RABBIT register., Laure Gossec Consultant of: Abbvie, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sanofi-Aventis, UCB., Grant/research support from: Lilly, Mylan, Pfizer, all unrelated to this study., Loreto Carmona Consultant of: Loreto Carmona’s institute works by contract for laboratories among other institutions, such as Abbvie Spain, Eisai, Gebro Pharma, Merck Sharp & Dohme España, S.A., Novartis, Farmaceutica, Pfizer, Roche Farma, Sanofi Aventis, Astellas Pharma, Actelion Pharmaceuticals España, Grünenthal GmbH, and UCB Pharma., Elsa Mateus Grant/research support from: LPCDR received grants from Abbvie, Novartis, Janssen-Cilag, Lilly Portugal, Sanofi, Grünenthal S.A., MSD, Celgene, Medac, Pharmakern, GAfPA and Pfizer., Saskia Lawson-Tovey: None declared, Laura Trupin: None declared, Stephanie Rush: None declared, Gabriela Schmajuk: None declared, Lindsay Jacobsohn: None declared, Patti Katz: None declared, Samar Al Emadi: None declared, Leanna Wise: None declared, Emily Gilbert: None declared, Maria Valenzuela-Almada: None declared, Ali Duarte-Garcia: None declared, Jeffrey Sparks Consultant of: Bristol-Myers Squibb, Gilead, Inova, Janssen, and Optum unrelated to this work., Grant/research support from: Amgen and Bristol-Myers Squibb., Tiffany Hsu: None declared, Kristin D’Silva: None declared, Naomi Serling-Boyd: None declared, Suleman Bhana Employee of: Suleman Bhana reports non-branded marketing campaigns for Novartis (<$10,000)., Wendy Costello: None declared, Rebecca Grainger Speakers bureau: Abbvie, Janssen, Novartis, Pfizer, Cornerstones and travel assistance from Pfizer (all < $10,000)., Jonathan Hausmann Consultant of: Novartis, unrelated to this work (<$10,000)., Jean Liew Grant/research support from: Pfizer, outside the submitted work., Emily Sirotich Grant/research support from: Emily Sirotich is a Board Member of the Canadian Arthritis Patient Alliance, a patient run, volunteer-based organization whose activities are largely supported by independent grants from pharmaceutical companies., Paul Sufka: None declared, Zachary Wallace Consultant of: Viela Bio and MedPace, outside the submitted work., Grant/research support from: Bristol-Myers Squibb and Principia/Sanofi., Pedro Machado Speakers bureau: Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche and UCB, all unrelated to this study (all < $10,000)., Philip Robinson Consultant of: Abbvie, Eli Lilly, Janssen, Novartis, Pfizer and UCB and travel assistance from Roche (all < $10,000)., Jinoos Yazdany Consultant of: Eli Lilly and Astra Zeneca, unrelated to this project.
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Sparks J, Wallace Z, Seet A, Gianfrancesco M, Izadi Z, Hyrich K, Strangfeld A, Gossec L, Carmona L, Mateus E, Lawson-Tovey S, Trupin L, Rush S, Schmajuk G, Katz P, Jacobsohn L, Al Emadi S, Wise L, Gilbert E, Duarte-Garcia A, Valenzuela-Almada M, Hsu T, D’silva K, Serling-Boyd N, Dieudé P, Nikiphorou E, Kronzer V, Singh N, Ugarte-Gil MF, Wallace B, Akpabio A, Thomas R, Bhana S, Costello W, Grainger R, Hausmann J, Liew J, Sirotich E, Sufka P, Robinson P, Machado P, Yazdany J. OP0006 ASSOCIATIONS OF BASELINE USE OF BIOLOGIC OR TARGETED SYNTHETIC DMARDS WITH COVID-19 SEVERITY IN RHEUMATOID ARTHRITIS: RESULTS FROM THE COVID-19 GLOBAL RHEUMATOLOGY ALLIANCE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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
Background:Targeted DMARDs may dampen the inflammatory response in COVID-19, perhaps leading to a less severe clinical course. However, some DMARD targets may impair viral immune defenses. Due to sample size limitations, previous studies of DMARD use and COVID-19 outcomes have combined several heterogeneous rheumatic diseases and medications, investigating a single outcome (e.g., hospitalization).Objectives:To investigate the associations of baseline use of biologic or targeted synthetic (b/ts) DMARDs with a range of poor COVID-19 outcomes in rheumatoid arthritis (RA).Methods:We analyzed voluntarily reported cases of COVID-19 in patients with rheumatic diseases in the COVID-19 Global Rheumatology Alliance physician registry (March 12, 2020 - January 6, 2021). We investigated RA treated with b/tsDMARD at the clinical onset of COVID-19 (baseline): abatacept (ABA), rituximab (RTX), Janus kinase inhibitors (JAK), interleukin-6 inhibitors (IL6i), or tumor necrosis factor inhibitors (TNFi). The outcome was an ordinal scale (1-4) for COVID-19 severity: 1) no hospitalization, 2) hospitalization without oxygen need, 3) hospitalization with any oxygen need or ventilation, or 4) death. Baseline covariates including age, sex, smoking, obesity, comorbidities (e.g., cardiovascular disease, cancer, interstitial lung disease [ILD]), concomitant non-biologic DMARD use, glucocorticoid use/dose, RA disease activity, country, and calendar time were used to estimate propensity scores (PS) for b/tsDMARD. The primary analysis used PS matching to compare each drug class to TNFi. Ordinal logistic regression estimated ORs for the COVID-19 severity outcome. In a sensitivity analysis, we used traditional multivariable ordinal logistic regression adjusting for covariates without matching.Results:Of the 1,673 patients with RA on b/tsDMARDs at the onset of COVID-19, (mean age 56.7 years, 79.6% female) there were n=154 on ABA, n=224 on RTX, n=306 on JAK, n=180 on IL6i, and n=809 on TNFi. Overall, 498 (34.3%) were hospitalized and 112 (6.7%) died. Among all patients, 353 (25.3%) were ever smokers, 197 (11.8%) were obese, 462 (27.6%) were on glucocorticoids, 1,002 (59.8%) were on concomitant DMARDs, and 299 (21.7%) had moderate/high RA disease activity. RTX users were more likely than TNFi users to have ILD (11.6% vs. 1.7%) and history of cancer (7.1% vs. 2.0%); JAK users were more likely than TNFi users to be obese (17.3% vs. 9.0%). After propensity score matching, RTX was strongly associated with greater odds of having a worse outcome compared to TNFi (OR 3.80, 95% CI 2.47, 5.85; Figure). Among RTX users, 42 (18.8%) died compared to 27 (3.3%) of TNFi users (Table). JAK use was also associated with greater odds of having a worse COVID-19 severity (OR 1.52, 95%CI 1.02, 2.28). ABA or IL6i use were not associated with COVID-19 severity compared to TNFi. Results were similar in the sensitivity analysis and after excluding cancer or ILD.Table 1.Frequencies for the ordinal COVID-19 severity outcome for patients with RA on biologic or targeted synthetic DMARDs (n=1673).COVID-19 outcomes by severity scale (n,%)ABAn=154RTXn=224JAKn=306IL6in=180TNFi n=8091)Not hospitalized113 (73.3%)121 (54.0%)220 (71.9%)150 (83.3%)666 (82.3%)2)Hospitalization without oxygenation10 (6.5%)14 (6.2%)11 (3.6%)9 (5.0%)53 (6.5%)3)Hospitalization with any oxygenation or ventilation16 (10.4%)47 (21.0%)52 (17.0%)16 (8.9%)63 (7.8%)4)Death15 (9.7%)42 (18.8%)23 (7.5%)5 (2.8%)27 (3.3%)Conclusion:In this large global registry of patients with RA and COVID-19, baseline use of RTX or JAK was associated with worse severity of COVID-19 compared to TNFi use. The very elevated odds for poor COVID-19 outcomes in RTX users highlights the urgent need for risk-mitigation strategies, such as the optimal timing of vaccination. The novel association of JAK with poor COVID-19 outcomes requires replication.Acknowledgements:The views expressed here are those of the authors and participating members of the COVID-19 Global Rheumatology Alliance and do not necessarily represent the views of the ACR, EULAR, the UK National Health Service, the National Institute for Health Research, the UK Department of Health, or any other organization.Disclosure of Interests:Jeffrey Sparks Consultant of: Bristol-Myers Squibb, Gilead, Inova, Janssen, and Optum, unrelated to this work, Grant/research support from: Amgen and Bristol-Myers Squibb, unrelated to this work, Zachary Wallace Consultant of: Viela Bio and MedPace, outside the submitted work., Grant/research support from: Bristol-Myers Squibb and Principia/Sanofi, Andrea Seet: None declared, Milena Gianfrancesco: None declared, Zara Izadi: None declared, Kimme Hyrich Speakers bureau: Abbvie unrelated to this study, Grant/research support from: BMS, UCB, and Pfizer, all unrelated to this study, Anja Strangfeld Paid instructor for: AbbVie, MSD, Roche, BMS, Pfizer, outside the submitted work, Grant/research support from: grants from a consortium of 13 companies (among them AbbVie, BMS, Celltrion, Fresenius Kabi, Lilly, Mylan, Hexal, MSD, Pfizer, Roche, Samsung, Sanofi-Aventis, and UCB) supporting the German RABBIT register, outside the submitted work, Laure Gossec Consultant of: Abbvie, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sanofi-Aventis, UCB, unrelated to this study, Grant/research support from: Lilly, Mylan, Pfizer, all unrelated to this study, Loreto Carmona: None declared, Elsa Mateus Grant/research support from: grants from Abbvie, Novartis, Janssen-Cilag, Lilly Portugal, Sanofi, Grünenthal S.A., MSD, Celgene, Medac, Pharmakern, GAfPA; grants and non-financial support from Pfizer, outside the submitted work, Saskia Lawson-Tovey: None declared, Laura Trupin: None declared, Stephanie Rush: None declared, Gabriela Schmajuk: None declared, Patti Katz: None declared, Lindsay Jacobsohn: None declared, Samar Al Emadi: None declared, Leanna Wise: None declared, Emily Gilbert: None declared, Ali Duarte-Garcia: None declared, Maria Valenzuela-Almada: None declared, Tiffany Hsu: None declared, Kristin D’Silva: None declared, Naomi Serling-Boyd: None declared, Philippe Dieudé Consultant of: Boerhinger Ingelheim, Bristol-Myers Squibb, Lilly, Sanofi, Pfizer, Chugai, Roche, Janssen unrelated to this work, Grant/research support from: Bristol-Myers Squibb, Chugaii, Pfizer, unrelated to this work, Elena Nikiphorou: None declared, Vanessa Kronzer: None declared, Namrata Singh: None declared, Manuel F. Ugarte-Gil Grant/research support from: Janssen and Pfizer, Beth Wallace: None declared, Akpabio Akpabio: None declared, Ranjeny Thomas: None declared, Suleman Bhana Consultant of: AbbVie, Horizon, Novartis, and Pfizer (all <$10,000) unrelated to this work, Wendy Costello: None declared, Rebecca Grainger Speakers bureau: Abbvie, Janssen, Novartis, Pfizer, Cornerstones, Jonathan Hausmann Consultant of: Novartis, Sobi, Biogen, all unrelated to this work (<$10,000), Jean Liew Grant/research support from: Yes, I have received research funding from Pfizer outside the submitted work., Emily Sirotich Grant/research support from: Board Member of the Canadian Arthritis Patient Alliance, a patient run, volunteer based organization whose activities are largely supported by independent grants from pharmaceutical companies, Paul Sufka: None declared, Philip Robinson Speakers bureau: Abbvie, Eli Lilly, Janssen, Novartis, Pfizer and UCB (all < $10,000), Consultant of: Abbvie, Eli Lilly, Janssen, Novartis, Pfizer and UCB (all < $10,000), Pedro Machado Speakers bureau: Yes, I have received consulting/speaker’s fees from Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche and UCB, all unrelated to this study (all < $10,000)., Consultant of: Yes, I have received consulting/speaker’s fees from Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer, Roche and UCB, all unrelated to this study (all < $10,000)., Jinoos Yazdany Consultant of: Eli Lilly and AstraZeneca unrelated to this project
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Gilbert E, Kehtari T, Morshead C. Metformin Activates Resident Neural Stem and Progenitor Cells, Reduces Inflammation and Improves Functional Recovery Following Spinal Cord Injury. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.01747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Gilbert E, Ewald A. Fresher with flavour: young women smokers' constructions and experiences of menthol capsule cigarettes and regular cigarettes. BMC Womens Health 2021; 21:155. [PMID: 33863322 PMCID: PMC8051088 DOI: 10.1186/s12905-021-01297-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/23/2021] [Indexed: 11/23/2022]
Abstract
Background Flavour capsule cigarettes are one of the fastest growing segments of the tobacco market, and there is evidence that Australian young people are increasingly using menthol flavoured capsule cigarettes. This qualitative research examines how young women construct and experience menthol flavour capsule cigarettes as part of their smoking practices, and explores the perceived differences between menthol capsule cigarettes and regular cigarettes. Semi-structured face-to-face in-depth interviews were conducted with 41 Australian young women smokers, using a constructivist grounded theory approach. Results Findings reveal that the perceived fresh and improved taste of menthol and the ability to customise the smoking process positively contributed to young women’s experiences of smoking menthol capsule cigarettes. In particular, menthol capsule flavour cigarettes were constructed by the young women as “fresh”, “light” and “minty”, and “popping” the menthol capsule allowed the young women to personalise their smoking experience. Conclusion These results indicate that specific public health campaigns and legislation should be developed to counter the powerfully alluring effects and the innovative appeal of menthol capsule cigarettes. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01297-2.
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Affiliation(s)
- E Gilbert
- School of Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - A Ewald
- School of Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
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Yin M, Ishihara S, Anderson T, Stehlik J, McKellar S, Dranow E, Gilbert E, Selzman C, Fang J, Drakos S, Wever-Pinzon O. Improving Prediction of Acute Right Ventricular Failure in Patients Undergoing Left Ventricular Assist Devices Using Novel Comprehensive Eighteen-Segment Echocardiographic Strain Analysis. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.502] [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: 11/24/2022] Open
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Zhang Y, Zhang Y, Xu L, Wang H, Shao F, Yu J, Gilbert E, Gu Z. Molecular cloning, tissue expression and polymorphism analysis of the Caveolin-3 gene in ducks. Br Poult Sci 2020; 62:17-24. [PMID: 32873059 DOI: 10.1080/00071668.2020.1817324] [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: 10/23/2022]
Abstract
1. Duck meat is considered a delicacy, but choosing the best meat is problematic. Caveolin-3 (CAV-3) is a muscle-specific protein marker in animals. The goal of the current study was to detect the characteristics of CAV-3 gene in ducks. 2. Full-length CAV-3 was acquired from ducks (Anas platyrhynchos) using reverse transcriptase PCR and rapid amplification of cDNA ends. DNAMAN software was used for homology comparisons. Quantitative reverse transcription-PCR, PCR-single-strand conformation polymorphism, and sequencing were used to determine CAV-3 expression and polymorphism of a single nucleotide, respectively. The study examined four types of ducks, including Jinding, Chaohu, Cherry Valley, and Gaoyou ducks. 3. The study acquired 1066 bp of CAV-3 cDNA sequences, including a 456 bp complete open reading frame encoding 151 amino acids. Both coding sequences (CDSs) and translated amino acids exhibited highest homology with Gallus gallus (CDS homology 91.67%, amino acids 94.04%), followed by mammalian species (CDS homology 79.0%, amino acids 78.0%). Single nucleotide polymorphism analysis revealed five mutations in exons (A489G, G501A, A557G, T563A, and A602G), and a C805T mutation in an intron. Among amplified polymorphic loci detected using primer 2, allele frequency was higher for A (489A501G507A563T602A) than B (489G501G507G563T602C) or C (489G501A507G563A602C). The highest occurred in Cherry Valley ducks (0.7587). Using primer 4, the M allele frequency was higher than that of the N allele. CAV-3 was most highly expressed in the heart, followed by skeletal muscles. Additionally, CAV-3 had higher expression in heart and breast muscle of overfed Muscovy ducks than control ducks, but no difference was seen in thigh muscle. 4. CAV-3 in ducks had the highest homology with Gallus gallus CAV-3, and it could be used as a marker for muscle quality in ducks.
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Affiliation(s)
- Y Zhang
- School of Biology and Food Engineering, Changshu Institute of Technology , Changshu, PR China
| | - Y Zhang
- School of Biology and Food Engineering, Changshu Institute of Technology , Changshu, PR China
| | - L Xu
- School of Biology and Food Engineering, Changshu Institute of Technology , Changshu, PR China
| | - H Wang
- School of Biology and Food Engineering, Changshu Institute of Technology , Changshu, PR China
| | - F Shao
- School of Biology and Food Engineering, Changshu Institute of Technology , Changshu, PR China
| | - J Yu
- School of Biology and Food Engineering, Changshu Institute of Technology , Changshu, PR China
| | - E Gilbert
- Department of Animal and Poultry Science, Virginia Polytechnic Institute and State University , Blacksburg, VA, USA
| | - Z Gu
- School of Biology and Food Engineering, Changshu Institute of Technology , Changshu, PR China
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Hamer M, Stamatakis E, Chastin S, Pearson N, Brown M, Gilbert E, Sullivan A. Feasibility of Measuring Sedentary Time Using Data From a Thigh-Worn Accelerometer. Am J Epidemiol 2020; 189:963-971. [PMID: 32219368 PMCID: PMC7443760 DOI: 10.1093/aje/kwaa047] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 03/18/2020] [Accepted: 03/20/2020] [Indexed: 12/24/2022] Open
Abstract
In large-scale cohort studies, sedentary behavior has been routinely measured using self-reports or devices that apply a count-based threshold. We employed a gold standard postural allocation technique using thigh inclination and acceleration to capture free-living sedentary behavior. Participants aged 46.8 (standard deviation (SD), 0.7) years (n = 5,346) from the 1970 British Cohort Study (United Kingdom) were fitted with a waterproofed thigh-mounted accelerometer device (activPAL3 micro; PAL Technologies Ltd., Glasgow, United Kingdom) worn continuously over 7 days; data were collected in 2016-2018. Usable data were retrieved from 83.0% of the devices fitted, with 79.6% of the sample recording at least 6 full days of wear (at least 10 waking hours). Total daily sitting time (average times were 9.5 (SD, 2.0) hours/day for men and 9.0 (SD, 2.0) hours/day for women) accounted for 59.4% and 57.3% of waking hours in men and women, respectively; 73.8% of sample participants recorded ≥8 hours/day of sitting. Sitting in prolonged bouts of 60 continuous minutes or more accounted for 25.3% and 24.4% of total daily sitting in men and women, respectively. In mutually adjusted models, male sex, underweight, obesity, education, poor self-rated health, television-viewing time, and having a sedentary occupation were associated with higher device-measured sitting times. Thigh-worn accelerometry was feasibly deployed and should be considered for larger-scale national surveys.
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Affiliation(s)
- Mark Hamer
- Correspondence to Prof. Mark Hamer, Institute of Sport, Exercise and Health, University College London, 170 Tottenham Court Road, London WC1E 6BT, United Kingdom (e-mail: )
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Gilbert E, Collins R, Webster V, Boyd N, Maple-Brown L, Boyle J, Smith-Vaughan H. Using co-design to develop a culturally responsive reproductive health learning resource for Aboriginal and Torres Strait Islander youth. Health Promot J Austr 2020; 32 Suppl 1:179-185. [PMID: 32726480 DOI: 10.1002/hpja.392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 07/21/2020] [Indexed: 11/12/2022] Open
Abstract
ISSUE ADDRESSED Healthy behaviours prior to conception can improve pregnancy outcomes and intergenerational health. Adolescence is an important period to promote preconception health, but education resources need to be age and culturally appropriate. Few studies have addressed preconception awareness and knowledge among Aboriginal and Torres Strait Islander youth, and few culturally appropriate resources exist. METHODS A mixed methods, co-design process engaging Aboriginal and Torres Strait Islander youth and an Indigenous Reference Group (IRG). Additionally, a survey was carried out to identify preconception health awareness and interest among a broader youth audience. RESULTS Several main themes emerged from consultation meetings with youth reflecting an awareness of preconception health, but limited understanding. Youth revealed an interest in fertility, and a need for more information on lifestyle factors associated with infertility. Preconception information related to the opposite sex was seen as important as well as information incorporating current local knowledge and world views. Among the survey respondents, 46% (11/24) had a pre-existing understanding of preconception health. Optimising lifestyle behaviours prior to pregnancy was perceived as important for women (21/24; 88%), but less so for men (16/24; 67%), highlighting a gap in knowledge regarding the importance of preconception health for men. CONCLUSION The co-designed resource "Getting healthy before pregnancy" is available in print and electronically, with illustrations and synchronised audio overlay in Aboriginal English or East-side Kriol. The resource includes information on preconception health and behavioural risk factors. SO WHAT We present a co-designed preconception health resource for evaluation with Aboriginal and Torres Strait Islander youth.
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Affiliation(s)
- Emily Gilbert
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia
| | | | - Vanya Webster
- Menzies School of Health Research, Casuarina, NT, Australia
| | - Nicole Boyd
- Menzies School of Health Research, Casuarina, NT, Australia
| | - Louise Maple-Brown
- Menzies School of Health Research, Casuarina, NT, Australia.,Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Jacqueline Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia
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Plavchan P, Barclay T, Gagné J, Gao P, Cale B, Matzko W, Dragomir D, Quinn S, Feliz D, Stassun K, Crossfield IJM, Berardo DA, Latham DW, Tieu B, Anglada-Escudé G, Ricker G, Vanderspek R, Seager S, Winn JN, Jenkins JM, Rinehart S, Krishnamurthy A, Dynes S, Doty J, Adams F, Afanasev DA, Beichman C, Bottom M, Bowler BP, Brinkworth C, Brown CJ, Cancino A, Ciardi DR, Clampin M, Clark JT, Collins K, Davison C, Foreman-Mackey D, Furlan E, Gaidos EJ, Geneser C, Giddens F, Gilbert E, Hall R, Hellier C, Henry T, Horner J, Howard AW, Huang C, Huber J, Kane SR, Kenworthy M, Kielkopf J, Kipping D, Klenke C, Kruse E, Latouf N, Lowrance P, Mennesson B, Mengel M, Mills SM, Morton T, Narita N, Newton E, Nishimoto A, Okumura J, Palle E, Pepper J, Quintana EV, Roberge A, Roccatagliata V, Schlieder JE, Tanner A, Teske J, Tinney CG, Vanderburg A, von Braun K, Walp B, Wang J, Wang SX, Weigand D, White R, Wittenmyer RA, Wright DJ, Youngblood A, Zhang H, Zilberman P. A planet within the debris disk around the pre-main-sequence star AU Microscopii. Nature 2020; 582:497-500. [PMID: 32581383 PMCID: PMC7323865 DOI: 10.1038/s41586-020-2400-z] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 03/17/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Peter Plavchan
- Department of Physics and Astronomy, George Mason University, Fairfax, VA, USA.
| | - Thomas Barclay
- Center for Space Sciences and Technology, University of Maryland Baltimore County (UMBC), Baltimore, MD, USA.,Exoplanets and Stellar Astrophysics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Jonathan Gagné
- Institute for Research on Exoplanets, Département de Physique, Université de Montréal, Montréal, Quebec, Canada
| | - Peter Gao
- Department of Astronomy, University of California, Berkeley, CA, USA
| | - Bryson Cale
- Department of Physics and Astronomy, George Mason University, Fairfax, VA, USA
| | - William Matzko
- Department of Physics and Astronomy, George Mason University, Fairfax, VA, USA
| | - Diana Dragomir
- Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics and Astronomy, University of New Mexico, Albuquerque, NM, USA
| | - Sam Quinn
- Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA
| | - Dax Feliz
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN, USA
| | - Keivan Stassun
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN, USA
| | - Ian J M Crossfield
- Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Physics and Astronomy, University of Kansas, Lawrence, KS, USA
| | | | - David W Latham
- Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA
| | - Ben Tieu
- Department of Physics and Astronomy, George Mason University, Fairfax, VA, USA
| | | | - George Ricker
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Sara Seager
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Joshua N Winn
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA
| | | | - Stephen Rinehart
- Exoplanets and Stellar Astrophysics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | | | - Scott Dynes
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - John Doty
- Exoplanets and Stellar Astrophysics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Fred Adams
- Department of Astronomy, University of Michigan, Ann Arbor, MI, USA
| | - Dennis A Afanasev
- Exoplanets and Stellar Astrophysics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Chas Beichman
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA.,NASA Exoplanet Science Institute, California Institute of Technology, Pasadena, CA, USA
| | - Mike Bottom
- Institute for Astronomy, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Brendan P Bowler
- Department of Astronomy, University of Texas at Austin, Austin, TX, USA
| | | | - Carolyn J Brown
- University of Southern Queensland, Centre for Astrophysics, Toowoomba, Queensland, Australia
| | - Andrew Cancino
- Department of Physics, Astronomy and Materials Science, Missouri State University, Springfield, MO, USA
| | - David R Ciardi
- NASA Exoplanet Science Institute, California Institute of Technology, Pasadena, CA, USA
| | - Mark Clampin
- Exoplanets and Stellar Astrophysics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Jake T Clark
- University of Southern Queensland, Centre for Astrophysics, Toowoomba, Queensland, Australia
| | - Karen Collins
- Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA
| | - Cassy Davison
- Department of Physics and Astronomy, Georgia State University, Atlanta, GA, USA
| | | | - Elise Furlan
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - Eric J Gaidos
- Department of Earth Sciences, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Claire Geneser
- Department of Physics and Astronomy, Mississippi State University, Starkville, MS, USA
| | - Frank Giddens
- Department of Physics, Astronomy and Materials Science, Missouri State University, Springfield, MO, USA
| | - Emily Gilbert
- Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL, USA
| | - Ryan Hall
- Department of Physics and Astronomy, Georgia State University, Atlanta, GA, USA
| | | | | | - Jonathan Horner
- University of Southern Queensland, Centre for Astrophysics, Toowoomba, Queensland, Australia
| | - Andrew W Howard
- Department of Astronomy, California Institute of Technology, Pasadena, CA, USA
| | - Chelsea Huang
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Joseph Huber
- Department of Physics, Astronomy and Materials Science, Missouri State University, Springfield, MO, USA
| | - Stephen R Kane
- Department of Earth and Planetary Sciences, University of California, Riverside, CA, USA
| | | | - John Kielkopf
- Department of Physics and Astronomy, University of Louisville, Louisville, KY, USA
| | - David Kipping
- Department of Astronomy, Columbia University, New York, NY, USA
| | - Chris Klenke
- Department of Physics, Astronomy and Materials Science, Missouri State University, Springfield, MO, USA
| | - Ethan Kruse
- Exoplanets and Stellar Astrophysics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Natasha Latouf
- Department of Physics and Astronomy, George Mason University, Fairfax, VA, USA
| | | | - Bertrand Mennesson
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - Matthew Mengel
- University of Southern Queensland, Centre for Astrophysics, Toowoomba, Queensland, Australia
| | - Sean M Mills
- Department of Astronomy, California Institute of Technology, Pasadena, CA, USA
| | - Tim Morton
- Astronomy Department, University of Florida, Gainesville, FL, USA
| | - Norio Narita
- Department of Astronomy, The University of Tokyo, Tokyo, Japan.,JST, PRESTO, Tokyo, Japan.,Astrobiology Center, NINS, Tokyo, Japan.,National Astronomical Observatory of Japan, NINS, Tokyo, Japan.,Instituto de Astrofisica de Canarias (IAC), La Laguna, Tenerife, Spain
| | - Elisabeth Newton
- Department of Physics and Astronomy, Dartmouth College, Hanover, NH, USA
| | - America Nishimoto
- Department of Physics, Astronomy and Materials Science, Missouri State University, Springfield, MO, USA
| | - Jack Okumura
- University of Southern Queensland, Centre for Astrophysics, Toowoomba, Queensland, Australia
| | - Enric Palle
- Instituto de Astrofisica de Canarias (IAC), La Laguna, Tenerife, Spain
| | - Joshua Pepper
- Department of Physics, Lehigh University, Bethlehem, PA, USA
| | - Elisa V Quintana
- Exoplanets and Stellar Astrophysics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Aki Roberge
- Exoplanets and Stellar Astrophysics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Veronica Roccatagliata
- Dipartimento di Fisica "Enrico Fermi", Universita' di Pisa, Pisa, Italy.,INAF-Osservatorio Astrofisico di Arcetri, Firenze, Italy.,INFN, Sezione di Pisa, Pisa, Italy
| | - Joshua E Schlieder
- Exoplanets and Stellar Astrophysics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Angelle Tanner
- Department of Physics and Astronomy, Mississippi State University, Starkville, MS, USA
| | - Johanna Teske
- Observatories of the Carnegie Institution for Science, Pasadena, CA, USA
| | - C G Tinney
- Exoplanetary Science at UNSW, School of Physics, UNSW Sydney, New South Wales, Australia
| | - Andrew Vanderburg
- Department of Astronomy, University of Texas at Austin, Austin, TX, USA
| | | | - Bernie Walp
- NASA Infrared Telescope Facility, Hilo, HI, USA
| | - Jason Wang
- Department of Astronomy, University of California, Berkeley, CA, USA.,Department of Astronomy, California Institute of Technology, Pasadena, CA, USA
| | | | - Denise Weigand
- Department of Physics, Astronomy and Materials Science, Missouri State University, Springfield, MO, USA
| | - Russel White
- Department of Physics and Astronomy, Georgia State University, Atlanta, GA, USA
| | - Robert A Wittenmyer
- University of Southern Queensland, Centre for Astrophysics, Toowoomba, Queensland, Australia
| | - Duncan J Wright
- University of Southern Queensland, Centre for Astrophysics, Toowoomba, Queensland, Australia
| | - Allison Youngblood
- Exoplanets and Stellar Astrophysics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Hui Zhang
- School of Astronomy and Space Science, Key Laboratory of Ministry of Education, Nanjing University, Nanjing, China
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Gilbert E, Livingston J, Khan M, Kandavel H, Kehtari T, Morshead C. Activating Resident Neural Precursor Cells in the Spinal Cord to Promote Neural Repair. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.05449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Villela MA, Taleb I, Selzman C, Stehlik J, Dranow E, Wever-Pinzon O, Nativi-Nicolau J, McKellar S, Kemeyou L, Gilbert E, Koliopoulou A, Drakos S. Efficacy of Left Ventricular Assist Device Therapy in Cold and Dry Chronic Heart Failure Patients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Livingston J, Gilbert E, Syeda T, Christie T, Morshead C. Delayed delivery of metformin promotes functional recovery in a model of neonatal stroke. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.05684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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34
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Green B, Wong E, Andrews S, Hampshire-Jones K, McKinnon S, Brooks C, McAdam R, Gray S, Vickers C, Blake Y, Sekhon G, Merrick S, Faerber J, Mather P, Gilbert E, McBride R, Coombes A, Walker M, Owen A, Davies J, Richardson S, Carr S, Mapson R, Spivey J, Draper S, Kendall F, Hubbard G, Stratton R. Increased protein intake is associated with improved hand grip strength and quality of life in home enterally tube fed adults using a high-energy, high-protein feed. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2019.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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35
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Lonjers Z, Bhavani S, Carey K, Gilbert E, Afshar M, Churpek M. PREDICTING BACTEREMIA USING ELECTRONIC HEALTH RECORD DATA. Chest 2019. [DOI: 10.1016/j.chest.2019.08.1414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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36
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Miller RR, Lopansri BK, Burke JP, Levy M, Opal S, Rothman RE, D'Alessio FR, Sidhaye VK, Aggarwal NR, Balk R, Greenberg JA, Yoder M, Patel G, Gilbert E, Afshar M, Parada JP, Martin GS, Esper AM, Kempker JA, Narasimhan M, Tsegaye A, Hahn S, Mayo P, van der Poll T, Schultz MJ, Scicluna BP, Klein Klouwenberg P, Rapisarda A, Seldon TA, McHugh LC, Yager TD, Cermelli S, Sampson D, Rothwell V, Newman R, Bhide S, Fox BA, Kirk JT, Navalkar K, Davis RF, Brandon RA, Brandon RB. Validation of a Host Response Assay, SeptiCyte LAB, for Discriminating Sepsis from Systemic Inflammatory Response Syndrome in the ICU. Am J Respir Crit Care Med 2019; 198:903-913. [PMID: 29624409 DOI: 10.1164/rccm.201712-2472oc] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
RATIONALE A molecular test to distinguish between sepsis and systemic inflammation of noninfectious etiology could potentially have clinical utility. OBJECTIVES This study evaluated the diagnostic performance of a molecular host response assay (SeptiCyte LAB) designed to distinguish between sepsis and noninfectious systemic inflammation in critically ill adults. METHODS The study employed a prospective, observational, noninterventional design and recruited a heterogeneous cohort of adult critical care patients from seven sites in the United States (n = 249). An additional group of 198 patients, recruited in the large MARS (Molecular Diagnosis and Risk Stratification of Sepsis) consortium trial in the Netherlands ( www.clinicaltrials.gov identifier NCT01905033), was also tested and analyzed, making a grand total of 447 patients in our study. The performance of SeptiCyte LAB was compared with retrospective physician diagnosis by a panel of three experts. MEASUREMENTS AND MAIN RESULTS In receiver operating characteristic curve analysis, SeptiCyte LAB had an estimated area under the curve of 0.82-0.89 for discriminating sepsis from noninfectious systemic inflammation. The relative likelihood of sepsis versus noninfectious systemic inflammation was found to increase with increasing test score (range, 0-10). In a forward logistic regression analysis, the diagnostic performance of the assay was improved only marginally when used in combination with other clinical and laboratory variables, including procalcitonin. The performance of the assay was not significantly affected by demographic variables, including age, sex, or race/ethnicity. CONCLUSIONS SeptiCyte LAB appears to be a promising diagnostic tool to complement physician assessment of infection likelihood in critically ill adult patients with systemic inflammation. Clinical trial registered with www.clinicaltrials.gov (NCT01905033 and NCT02127502).
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Affiliation(s)
- Russell R Miller
- 1 Intermountain Medical Center, Murray, Utah.,2 University of Utah School of Medicine, Salt Lake City, Utah
| | - Bert K Lopansri
- 1 Intermountain Medical Center, Murray, Utah.,2 University of Utah School of Medicine, Salt Lake City, Utah
| | - John P Burke
- 1 Intermountain Medical Center, Murray, Utah.,2 University of Utah School of Medicine, Salt Lake City, Utah
| | | | - Steven Opal
- 3 Brown University, Providence, Rhode Island
| | | | | | | | - Neil R Aggarwal
- 4 Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert Balk
- 5 Rush Medical College and Rush University Medical Center, Chicago, Illinois
| | - Jared A Greenberg
- 5 Rush Medical College and Rush University Medical Center, Chicago, Illinois
| | - Mark Yoder
- 5 Rush Medical College and Rush University Medical Center, Chicago, Illinois
| | - Gourang Patel
- 5 Rush Medical College and Rush University Medical Center, Chicago, Illinois
| | - Emily Gilbert
- 6 Loyola University Medical Center, Maywood, Illinois
| | - Majid Afshar
- 6 Loyola University Medical Center, Maywood, Illinois
| | | | - Greg S Martin
- 7 Grady Memorial Hospital and Emory University School of Medicine, Atlanta, Georgia
| | - Annette M Esper
- 7 Grady Memorial Hospital and Emory University School of Medicine, Atlanta, Georgia
| | - Jordan A Kempker
- 7 Grady Memorial Hospital and Emory University School of Medicine, Atlanta, Georgia
| | | | | | - Stella Hahn
- 8 Northwell Healthcare, New Hyde Park, New York
| | - Paul Mayo
- 8 Northwell Healthcare, New Hyde Park, New York
| | | | | | | | - Peter Klein Klouwenberg
- 10 Department of Intensive Care, University Medical Center Utrecht, Utrecht, the Netherlands; and
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Diakos N, Taleb I, Pinzon O, Javan H, Kfoury A, Stehlik J, Caine W, Nativi J, Koliopoulou A, Yin M, McCreath L, Thodou A, Sankar T, Gilbert E, Selzman C, Drakos S. BIUx2x2. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Eguia E, Cobb AN, Baker MS, Joyce C, Gilbert E, Gonzalez R, Afshar M, Churpek MM. Risk factors for infection and evaluation of Sepsis-3 in patients with trauma. Am J Surg 2019; 218:851-857. [PMID: 30885453 DOI: 10.1016/j.amjsurg.2019.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/01/2019] [Accepted: 03/06/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND We aim to examine the risk factors associated with infection in trauma patients and the Sepsis-3 definition. METHODS This was a retrospective cohort study of adult trauma patients admitted to a Level I trauma center between January 2014 and January 2016. RESULTS A total of 1499 trauma patients met inclusion criteria and 15% (n = 232) had an infection. Only 19.8% (n = 46) of infected patients met criteria for Sepsis-3, with the majority (43%) of infected cases having a Sequential Organ Failure Assessment (SOFA) score greater on admission compared to the time of suspected infection. In-hospital death was 7% vs 9% (p = 0.65) between Sepsis-3 and infected patients, respectively. Risk factors associated with infection were female sex, admission SOFA score, Elixhauser score, and severe injury (P < 0.05). CONCLUSION Patients with trauma often arrive with organ dysfunction, which adds complexity and inaccuracy to the operational definition of Sepsis-3 using changes in SOFA scores. Injury severity score, comorbidities, SOFA score, and sex are risk factors associated with developing an infection after trauma.
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Affiliation(s)
- Emanuel Eguia
- Loyola University Chicago Burn Shock Trauma Research Institute, Maywood, IL, USA; Department of Surgery, Acute Care Surgery Division, Loyola University Chicago, Maywood, IL, USA.
| | - Adrienne N Cobb
- Loyola University Chicago Burn Shock Trauma Research Institute, Maywood, IL, USA; Department of Surgery, Acute Care Surgery Division, Loyola University Chicago, Maywood, IL, USA
| | - Marshall S Baker
- Department of Surgery, Acute Care Surgery Division, Loyola University Chicago, Maywood, IL, USA
| | - Cara Joyce
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA
| | - Emily Gilbert
- Division of Pulmonary and Critical Care Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Richard Gonzalez
- Loyola University Chicago Burn Shock Trauma Research Institute, Maywood, IL, USA; Department of Surgery, Acute Care Surgery Division, Loyola University Chicago, Maywood, IL, USA
| | - Majid Afshar
- Loyola University Chicago Burn Shock Trauma Research Institute, Maywood, IL, USA; Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA; Division of Pulmonary and Critical Care Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Matthew M Churpek
- Division of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, USA
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Lopansri BK, Miller Iii RR, Burke JP, Levy M, Opal S, Rothman RE, D'Alessio FR, Sidhaye VK, Balk R, Greenberg JA, Yoder M, Patel GP, Gilbert E, Afshar M, Parada JP, Martin GS, Esper AM, Kempker JA, Narasimhan M, Tsegaye A, Hahn S, Mayo P, McHugh L, Rapisarda A, Sampson D, Brandon RA, Seldon TA, Yager TD, Brandon RB. Physician agreement on the diagnosis of sepsis in the intensive care unit: estimation of concordance and analysis of underlying factors in a multicenter cohort. J Intensive Care 2019; 7:13. [PMID: 30828456 PMCID: PMC6383290 DOI: 10.1186/s40560-019-0368-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 01/28/2019] [Indexed: 02/07/2023] Open
Abstract
Background Differentiating sepsis from the systemic inflammatory response syndrome (SIRS) in critical care patients is challenging, especially before serious organ damage is evident, and with variable clinical presentations of patients and variable training and experience of attending physicians. Our objective was to describe and quantify physician agreement in diagnosing SIRS or sepsis in critical care patients as a function of available clinical information, infection site, and hospital setting. Methods We conducted a post hoc analysis of previously collected data from a prospective, observational trial (N = 249 subjects) in intensive care units at seven US hospitals, in which physicians at different stages of patient care were asked to make diagnostic calls of either SIRS, sepsis, or indeterminate, based on varying amounts of available clinical information (clinicaltrials.gov identifier: NCT02127502). The overall percent agreement and the free-marginal, inter-observer agreement statistic kappa (κfree) were used to quantify agreement between evaluators (attending physicians, site investigators, external expert panelists). Logistic regression and machine learning techniques were used to search for significant variables that could explain heterogeneity within the indeterminate and SIRS patient subgroups. Results Free-marginal kappa decreased between the initial impression of the attending physician and (1) the initial impression of the site investigator (κfree 0.68), (2) the consensus discharge diagnosis of the site investigators (κfree 0.62), and (3) the consensus diagnosis of the external expert panel (κfree 0.58). In contrast, agreement was greatest between the consensus discharge impression of site investigators and the consensus diagnosis of the external expert panel (κfree 0.79). When stratified by infection site, κfree for agreement between initial and later diagnoses had a mean value + 0.24 (range − 0.29 to + 0.39) for respiratory infections, compared to + 0.70 (range + 0.42 to + 0.88) for abdominal + urinary + other infections. Bioinformatics analysis failed to clearly resolve the indeterminate diagnoses and also failed to explain why 60% of SIRS patients were treated with antibiotics. Conclusions Considerable uncertainty surrounds the differential clinical diagnosis of sepsis vs. SIRS, especially before organ damage has become highly evident, and for patients presenting with respiratory clinical signs. Our findings underscore the need to provide physicians with accurate, timely diagnostic information in evaluating possible sepsis. Electronic supplementary material The online version of this article (10.1186/s40560-019-0368-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bert K Lopansri
- 1Division of Infectious Diseases and Clinical Epidemiology, Intermountain Medical Center, Murray, UT 84107 USA.,2Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT 84132 USA
| | - Russell R Miller Iii
- 3Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Murray, UT 84107 USA.,4Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132 USA
| | - John P Burke
- 1Division of Infectious Diseases and Clinical Epidemiology, Intermountain Medical Center, Murray, UT 84107 USA.,2Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT 84132 USA
| | | | | | - Richard E Rothman
- 6Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
| | | | | | - Robert Balk
- 7Rush Medical College and Rush University Medical Center, Chicago, IL 60612 USA
| | - Jared A Greenberg
- 7Rush Medical College and Rush University Medical Center, Chicago, IL 60612 USA
| | - Mark Yoder
- 7Rush Medical College and Rush University Medical Center, Chicago, IL 60612 USA
| | - Gourang P Patel
- 7Rush Medical College and Rush University Medical Center, Chicago, IL 60612 USA
| | - Emily Gilbert
- 8Loyola University Medical Center, Maywood, IL 60153 USA
| | - Majid Afshar
- 8Loyola University Medical Center, Maywood, IL 60153 USA
| | - Jorge P Parada
- 8Loyola University Medical Center, Maywood, IL 60153 USA
| | - Greg S Martin
- 9Grady Memorial Hospital and Emory University School of Medicine, Atlanta, GA 30303 USA
| | - Annette M Esper
- 9Grady Memorial Hospital and Emory University School of Medicine, Atlanta, GA 30303 USA
| | - Jordan A Kempker
- 9Grady Memorial Hospital and Emory University School of Medicine, Atlanta, GA 30303 USA
| | | | - Adey Tsegaye
- Northwell Healthcare, New Hyde Park, NY 11042 USA
| | - Stella Hahn
- Northwell Healthcare, New Hyde Park, NY 11042 USA
| | - Paul Mayo
- Northwell Healthcare, New Hyde Park, NY 11042 USA
| | - Leo McHugh
- Immunexpress Inc, 425 Pontius Avenue North, Suite 430, Seattle, WA 98109 USA
| | - Antony Rapisarda
- Immunexpress Inc, 425 Pontius Avenue North, Suite 430, Seattle, WA 98109 USA
| | - Dayle Sampson
- Immunexpress Inc, 425 Pontius Avenue North, Suite 430, Seattle, WA 98109 USA
| | - Roslyn A Brandon
- Immunexpress Inc, 425 Pontius Avenue North, Suite 430, Seattle, WA 98109 USA
| | - Therese A Seldon
- Immunexpress Inc, 425 Pontius Avenue North, Suite 430, Seattle, WA 98109 USA
| | - Thomas D Yager
- Immunexpress Inc, 425 Pontius Avenue North, Suite 430, Seattle, WA 98109 USA
| | - Richard B Brandon
- Immunexpress Inc, 425 Pontius Avenue North, Suite 430, Seattle, WA 98109 USA
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Marin-Acevedo J, Gilbert E, Rivera C, Gonzalez-Estrada A. A CASE OF IDIOPATHIC ANAPHYLAXIS: A 4-YEAR ODYSSEY. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Boyle JA, Xu R, Gilbert E, Kuczynska-Burggraf M, Tan B, Teede H, Vincent A, Gibson-Helm M. Ask PCOS: Identifying Need to Inform Evidence-Based App Development for Polycystic Ovary Syndrome. Semin Reprod Med 2018; 36:59-65. [PMID: 30189452 DOI: 10.1055/s-0038-1667187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND People are increasingly seeking health information and managing their health through electronic technologies. We aimed to determine if women with polycystic ovary syndrome (PCOS) identified a need for PCOS-related mobile health apps and to evaluate related apps currently available. DESIGN A national survey of women and a review of apps available on the iOS and Android platforms. SETTING Community recruitment in Australia in 2016 and review of mobile apps available in 2017. SAMPLE The survey received 264 responses. Sixteen apps related to PCOS were evaluated. MAIN OUTCOME MEASURES Survey: Women's likeliness to use mobile health apps, specifically a PCOS-related app and preferred features of apps. App review: Mapping of available apps and evaluation using the Mobile Application Rating Scale (MARS). RESULTS Of 264 respondents, almost all women had a smartphone (98%), 72% had previously used an app to manage their health, and most (91%) would use a PCOS-specific app if available. The most important feature was the availability of current, evidence-based information. Current apps on PCOS lack provision of quality information. CONCLUSION Women with PCOS would use a PCOS-specific app of good quality that responds to their needs and facilitates self-care; however, currently available apps are unlikely to meet their information needs.
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Affiliation(s)
- Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.,Department of Obstetrics and Gynaecology, Monash Health, Clayton, Victoria, Australia
| | - Rebecca Xu
- Monash University, Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Emily Gilbert
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Millicent Kuczynska-Burggraf
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Bryan Tan
- Monash Health, Clayton, Victoria, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.,Department of Endocrinology, Monash Health, Clayton, Victoria, Australia
| | - Amanda Vincent
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.,Department of Endocrinology, Monash Health, Clayton, Victoria, Australia
| | - Melanie Gibson-Helm
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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Yin M, Ruckel S, McKellar S, Elmer A, Koliopoulou A, Dranow L, Harry J, Davis E, Gilbert E, Nativi-Nicolau J, Stehlik J, Reid B, Fang J, Drakos S, Kfoury A, Selzman C, Wever-Pinzon O. A Novel Predictive Risk Score for Gastrointestinal Bleed Following Implantation of Continuous Flow Left Ventricular Assist Device. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Taleb I, Koliopoulou A, Tandar A, McKellar S, Nativi-Nicolau J, Wever-Pinzon O, Gilbert E, Fang J, Stehlik J, Tonna J, Morshedzadeh J, ko B, Owan T, Ibrahim H, Selzman C, Welt F, Drakos S. Feasibility and Effectiveness of a Shock Team Approach in Refractory Cardiogenic Shock: Preliminary Results. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Chatzitheochari S, Fisher K, Gilbert E, Calderwood L, Huskinson T, Cleary A, Gershuny J. Using New Technologies for Time Diary Data Collection: Instrument Design and Data Quality Findings from a Mixed-Mode Pilot Survey. Soc Indic Res 2017; 137:379-390. [PMID: 29651193 PMCID: PMC5884889 DOI: 10.1007/s11205-017-1569-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/16/2017] [Indexed: 06/08/2023]
Abstract
Recent years have witnessed a steady growth of time-use research, driven by the increased research and policy interest in population activity patterns and their associations with long-term outcomes. There is recent interest in moving beyond traditional paper-administered time diaries to use new technologies for data collection in order to reduce respondent burden and administration costs, and to improve data quality. This paper presents two novel diary instruments that were employed by a large-scale multi-disciplinary cohort study in order to obtain information on the time allocation of adolescents in the United Kingdom. A web-administered diary and a smartphone app were created, and a mixed-mode data collection approach was followed: cohort members were asked to choose between these two modes, and those who were unable or refused to use the web/app modes were offered a paper diary. Using data from a pilot survey of 86 participants, we examine diary data quality indicators across the three modes. Results suggest that the web and app modes yield an overall better time diary data quality than the paper mode, with a higher proportion of diaries with complete activity and contextual information. Results also show that the web and app modes yield a comparable number of activity episodes to the paper mode. These results suggest that the use of new technologies can improve diary data quality. Future research using larger samples should systematically investigate selection and measurement effects in mixed-mode time-use survey designs.
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Affiliation(s)
| | - Kimberly Fisher
- Center for Time Use Research, University of Oxford, 74 Woodstock Road, Oxford, OX2 6HP UK
| | - Emily Gilbert
- Centre for Longitudinal Studies, UCL Institute of Education, 20 Bedford Way, London, WC1H 0AL UK
| | - Lisa Calderwood
- Centre for Longitudinal Studies, UCL Institute of Education, 20 Bedford Way, London, WC1H 0AL UK
| | - Tom Huskinson
- Ipsos MORI, 3 Thomas More Square, London, E1W 1YW UK
| | - Andrew Cleary
- Ipsos MORI, 3 Thomas More Square, London, E1W 1YW UK
| | - Jonathan Gershuny
- Center for Time Use Research, University of Oxford, 74 Woodstock Road, Oxford, OX2 6HP UK
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Elsäßer W, Gilbert E, Eberle SH. Beitrag zur Charakterisierung und Identifizierung organischer Stoffe niederer molarer Massen in biologischen Kläranlagenabläufen. ACTA ACUST UNITED AC 2016. [DOI: 10.1002/aheh.19920200203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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46
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Tabachnick D, Stehlik J, Gilbert E, Nativi-Nicolau J, Fang J, Wever-Pinzon O, Drakos S, Budge D, Kfoury B, Alharethi R, Caine W, Selzman C, McKellar S. Characteristics and Co-Morbidities in Heart Transplant Recipients Who Survive into Their Eighties. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.594] [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: 11/27/2022] Open
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47
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48
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Gilbert E, Vickaryous M. Neural Stem/Progenitor Cells of the Spinal Cord are Activated in Response to Tail Loss in the Leopard Gecko. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.346.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Emily Gilbert
- Biomedical Science University of GuelphGuelphOntarioCanada
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49
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Kfoury A, Miller D, Snow G, Afshar K, Stehlik J, Budge D, Caine W, McKellar S, Everitt M, Alharethi R, Fang J, Drakos S, Gilbert E, Hammond E. Mixed Cellular and Antibody-Mediated Rejection in Heart Transplantation: A Distinct Entity or Simply the Sum of Two? J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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50
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Wever-Pinzon J, Al-Sarie M, Catino A, McCubrey R, Stehlik J, Kfoury A, Reid B, Wever-Pinzon O, Alharethi R, Wright S, Li D, Gilbert E, Mckellar S, Barney J, Fang J, Selzman C, Drakos S. Structural and Functional Myocardial Improvement Following Continuous-Flow Mechanical Unloading in Chronic Ischemic and Non-Ischemic Cardiomyopathy. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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