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Hybrid delivery of cluster-set resistance training for individuals previously treated for lung cancer: the results of a single-arm feasibility trial. Pilot Feasibility Stud 2023; 9:177. [PMID: 37848969 PMCID: PMC10580552 DOI: 10.1186/s40814-023-01405-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/06/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Individuals with non-small cell lung cancer (NSCLC) are burdened by long-lasting symptoms (e.g., dyspnea and fatigue) post-treatment. These symptoms often reduce physical activity levels and increase the risk of functional decline. Though we have previously proposed cluster-set resistance training to mitigate symptom burden in lung cancer, there is currently no data on the feasibility or acceptability of this mode of exercise in cancer. Therefore, the purpose of this study was to investigate the feasibility and acceptability of a hybrid-delivery home-based cluster-set resistance training program in individuals with NSCLC stages I-III (i.e., early stage). METHODS This study aimed to recruit individuals with NSCLC stages I-III post-treatment to participate in 8 weeks of home-based resistance training, 3 days per week. The program included supervised sessions in the participants' homes and virtual supervision via videoconferencing. The primary outcome measure of feasibility was evaluated through recruitment, retention, and intervention fidelity (i.e., proportion of exercise completed, relative to what was prescribed). Intervention acceptability (i.e., ease and quality of virtual delivery, level of difficulty, and home-based approach) was assessed using a 4-point Likert-type scale from "strongly disagree" to "strongly agree". RESULTS Fourteen participants were recruited over a 6-month period, with 11 completing the intervention (2 withdrew due to unrelated illness, 1 withdrew due to requiring active treatment), yielding a retention rate of 79%. Characteristics of the participants who completed the intervention (n = 11) were as follows: mean age: 71 ± 10 years, mean BMI: 29.1 ± 6.5, and average time since diagnosis was 62 ± 51 months. Of completers, 27% were male, and 36% were Black; 10 were stage I (91%), and one was stage II (9%). Mean session attendance was 86.4 ± 9.5%. Mean intervention fidelity was 83.1 ± 13.1%. With regard to acceptability, > 90% of participants positively rated all aspects of the intervention delivery. No adverse events related to exercise were recorded. CONCLUSIONS The hybrid delivery of a home-based resistance exercise program for individuals previously treated for early-stage NSCLC was found to be safe and feasible. Adaptations to the program for future interventions are required, particularly surrounding resistance exercise programming, and intervention delivery with home visits. TRIAL REGISTRATION ClinicalTrials.gov: NCT05014035 . Registered January 20, 2021.
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The impact of signposting and group support pathways on a community-based physical activity intervention grounded in motivational interviewing. J Public Health (Oxf) 2022; 44:851-862. [PMID: 34121114 DOI: 10.1093/pubmed/fdab198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 05/07/2021] [Accepted: 05/26/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Brief advice is recommended to increase physical activity (PA) within primary care. This study assessed change in PA levels and mental well-being after a motivational interviewing (MI) community-based PA intervention and the impact of signposting (SP) and social action (SA) (i.e. weekly group support) pathways. METHODS Participants (n = 2084) took part in a community-based, primary care PA programme using MI techniques. Self-reported PA and mental well-being data were collected at baseline (following an initial 30-min MI appointment), 12 weeks, 6 months and 12 months. Participants were assigned based upon the surgery they attended to the SP or SA pathway. Multilevel models derived point estimates and 95% confidence intervals for outcomes at each time point and change scores. RESULTS Participants increased PA and mental well-being at each follow-up time point through both participant pathways and with little difference between pathways. Retention was similar between pathways at 12 weeks, but the SP pathway retained more participants at 6 and 12 months. CONCLUSIONS Both pathways produced similar improvements in PA and mental well-being; however, the addition of a control would have provided further insight as to the effectiveness. Due to lower resources yet similar effects, the SP pathway could be incorporated to support PA in primary care settings.
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The impact of signposting and group support pathways on a community-based physical activity intervention grounded in motivational interviewing. J Public Health (Oxf) 2022. [PMID: 34121114 DOI: 10.31236/osf.io/gq78r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Brief advice is recommended to increase physical activity (PA) within primary care. This study assessed change in PA levels and mental well-being after a motivational interviewing (MI) community-based PA intervention and the impact of signposting (SP) and social action (SA) (i.e. weekly group support) pathways. METHODS Participants (n = 2084) took part in a community-based, primary care PA programme using MI techniques. Self-reported PA and mental well-being data were collected at baseline (following an initial 30-min MI appointment), 12 weeks, 6 months and 12 months. Participants were assigned based upon the surgery they attended to the SP or SA pathway. Multilevel models derived point estimates and 95% confidence intervals for outcomes at each time point and change scores. RESULTS Participants increased PA and mental well-being at each follow-up time point through both participant pathways and with little difference between pathways. Retention was similar between pathways at 12 weeks, but the SP pathway retained more participants at 6 and 12 months. CONCLUSIONS Both pathways produced similar improvements in PA and mental well-being; however, the addition of a control would have provided further insight as to the effectiveness. Due to lower resources yet similar effects, the SP pathway could be incorporated to support PA in primary care settings.
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Footwear profiles and foot-related problems of male netball players. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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1166P Social determinants of lung cancer in East London. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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O-028 Small extracellular vesicles (sEV) in peritoneal fluid and peripheral blood as biomarkers of endometriosis. Hum Reprod 2022. [DOI: 10.1093/humrep/deac104.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Can we identify lesion-derived endometriosis-specific sEV cargo in peritoneal fluid of women with endometriosis, and detect the same endometriosis-specific cargo in sEV from peripheral blood?
Summary answer
Endometriosis-specific sEV are present in PF. Identification in peripheral blood is challenging due to low abundance in comparison to blood-borne sEV.
What is known already
Endometriosis is characterised by intraperitoneal lesions of endometrial tissue. Although ultrasound detection of severe endometriosis is possible, the final diagnosis currently relies on invasive laparoscopy as the gold standard, which leads to a delay of 8-10 years after women first present to their GPs with symptoms.
We have previously shown that the peritoneal fluid (PF) of women with endometriosis contains endometriosis-specific sEV. If these can be traced in blood samples, endometriosis-specific sEV could serve as biomarkers of endometriosis, particularly for stages I and II, which are difficult to detect by ultrasound.
Study design, size, duration
This is an observational pilot study of 29 patients in total. From March 2021 until August 2021, we collected PF samples from 11 controls and 16 endometriosis cases and blood samples from 12 controls and 11 endometriosis cases. Of these, 19 were paired samples (blood and PF from the same participant).
Participants/materials, setting, methods
Women >18 years of age undergoing laparoscopic surgery for endometriosis or unrelated conditions were invited to participate (HREC 08078B/HREC 10148B). Exclusion criteria were pregnancy, malignancy, and menopause. Purified, validated sEV were analysed by label based quantitative proteomics Tandem Mass Tag (TMT). Data analysis was performed using Proteome Discoverer v2.4 (Thermo Fisher), statistical analysis using the R (LIMMA), with a protein false discovery rate of 1% and a quantitative threshold of an adjusted p-value <0.05.
Main results and the role of chance
We ascertained the identity of sEV by TEM and NTA (mode size 121.8 ± 18.0 nm (blood, n = 5) and 155.9 ± 37.2 (PF, n = 6)), and signals for syntenin and ALIX in immunoblots as well as expression of CD9, CD63 and CD81 in capture bead-flow cytometry. Proteomics analysis identified 9145 proteins groups across all sample groups, of these proteins 5,429 are consistently quantifiable, with 602 significantly different between comparisons (adjusted P-value <0.05). PCA showed separation of samples by type rather than batch. Fractionated analysis by SPS-MS3 methodology identified 7064 protein groups, with 3408 proteins consistently quantified across sample groups. Of these, 602 were found to differ significantly across all comparisons. In PF, 533 proteins changed significantly in abundance (245 up and 288 down), while in blood, four proteins changed in abundance.
Limitations, reasons for caution
The main limitation of the study is in its small sample size, which meant that we could not stratify data according to endometriosis stage. Due to limited amount of protein within sEV samples, not all assays could be done on all samples.
Wider implications of the findings
Our findings suggest that our methodology makes it feasible to define a protein signature of endometriosis based on sEV cargoes drawn from blood samples. This would represent a non-invasive biomarker of endometriosis and could help diagnose the condition, or rule out endometriosis as the origin of symptoms in the future.
Trial registration number
not applicable
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Study protocol: investigating the feasibility of a hybrid delivery of home-based cluster set resistance training for individuals previously treated for lung cancer. Pilot Feasibility Stud 2022; 8:102. [PMID: 35585562 PMCID: PMC9114285 DOI: 10.1186/s40814-022-01065-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/06/2022] [Indexed: 11/29/2022] Open
Abstract
Background Symptom burden remains a critical concern for individuals with non-small cell lung cancer (NSCLC) following the completion of treatment. The most common symptom clusters, dyspnea (shortness of breath) and fatigue, can contribute to physical decline, reductions in quality of life, and a higher risk of comorbidities and mortality. Dyspnea is a primary limiter of exercise capacity in individuals with lung cancer, resulting in exercise avoidance and an accelerated physical decline. As such, designing resistance training with cluster sets to mitigate symptoms of dyspnea and fatigue may result in improved exercise tolerance. Thus, maintaining the exercise stimulus via cluster sets, combined with improved tolerance of the exercise, could result in the maintenance of physical function and quality of life. The purpose of this study is to investigate the feasibility and preliminary efficacy of a hybrid-delivery home-based cluster-set resistance training program in individuals with NSCLC. Methods Individuals with NSCLC (n = 15), within 12 months of completion of treatment, will be recruited to participate in this single-arm feasibility trial. Participants will complete 8 weeks of home-based resistance training designed to minimize dyspnea and fatigue. The hybrid delivery of the program will include supervised sessions in the participants’ home and virtual supervision via video conferencing. The primary outcome of feasibility will be quantified by recruitment rates, retention, acceptability, and intervention fidelity. Exploratory outcomes (dyspnea, fatigue, quality of life, physical function, and body composition) will be assessed pre- and post-intervention. Discussion This study will provide important data on the feasibility of delivering this intervention and inform procedures for a future randomized controlled trial. Trial registration Record not yet public
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Determining the appropriate use of Technology Enabled Care Services (TECS) to manage upper limb trauma injuries during the COVID-19 pandemic: A multicentre retrospective observational study. J Plast Reconstr Aesthet Surg 2022; 75:2127-2134. [PMID: 35367161 PMCID: PMC8855640 DOI: 10.1016/j.bjps.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 02/14/2022] [Indexed: 10/25/2022]
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Deficits in muscle cross-sectional area and maximal isometric force following a shark bite injury are not reflected in jumping performance. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Do the adverse physical effects of breast cancer surgery affect participation in physical activity and sport? J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Structural development of cortical lobes during the first 6 months of life in infant macaques. Dev Cogn Neurosci 2021; 48:100906. [PMID: 33465553 PMCID: PMC7815644 DOI: 10.1016/j.dcn.2020.100906] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/06/2020] [Accepted: 12/17/2020] [Indexed: 12/20/2022] Open
Abstract
This study mapped the developmental trajectories of cortical regions in comparison to overall brain growth in typically developing, socially-housed infant macaques. Volumetric changes of cortical brain regions were examined longitudinally between 2-24 weeks of age (equivalent to the first 2 years in humans) in 21 male rhesus macaques. Growth of the prefrontal, frontal, parietal, occipital, and temporal cortices (visual and auditory) was examined using MRI and age-specific infant macaque brain atlases developed by our group. Results indicate that cortical volumetric development follows a cubic growth curve, but maturational timelines and growth rates are region-specific. Total intracranial volume (ICV) increased significantly during the first 5 months of life, leveling off thereafter. Prefrontal and temporal visual cortices showed fast volume increases during the first 16 weeks, followed by a plateau, and significant growth again between 20-24 weeks. Volume of the frontal and temporal auditory cortices increased substantially between 2-24 weeks. The parietal cortex showed a significant volume increase during the first 4 months, whereas the volume of the occipital lobe increased between 2-12 weeks and plateaued thereafter. These developmental trajectories show similarities to cortical growth in human infants, providing foundational information necessary to build nonhuman primate (NHP) models of human neurodevelopmental disorders.
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Defining clinical decision making in the provision of audio-visual outpatient care for acute upper limb trauma services: A review of practice. J Plast Reconstr Aesthet Surg 2020; 74:407-447. [PMID: 32978111 PMCID: PMC7502177 DOI: 10.1016/j.bjps.2020.08.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/01/2020] [Indexed: 11/26/2022]
Abstract
The Covid-19 pandemic has accelerated the widespread adoption of technology-enabled care in the NHS.1 Moving into phase two of the response, the continuing use of audio-visual technology is expected, where appropriate, to be integral in the provision of safe, quality patient care.2 A clinical need therefore exists to identify when care can be safely delivered remotely using audio-visual technology and when there is a need for in-person contact. At Salisbury Foundation Trust (SFT), during phase one of the NHS response to Covid-19, the decision to treat upper limb trauma patients in-person or remotely was made using clinical screening criteria. For many patients, audio-visual appointments offered a practical, time efficient way of accessing their reconstructive team for assessment, advice and post-operative care. However, a subset of patients was identified by the team as requiring at least one in-person consultation to minimize perceived clinical risk and to optimize quality outcomes. In order to understand more fully the challenges and successes of technology-enabled care to date, a national survey of practice across hand units in the UK was conducted. We present here some of our key findings and propose the need to develop nationally agreed screening criteria to determine how and when technology enabled outpatient care can be used in the management of acute upper limb trauma. The results of this survey forms part of a series of projects currently underway looking at the efficacy of audio-visual care in upper limb trauma, including a multicentre observational study.
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Estimates of Stress Between the Hamstring Muscles. Muscles Ligaments Tendons J 2020. [DOI: 10.32098/mltj.03.2020.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Upskilling the surgical workforce for vascular access provision during the COVID-19 pandemic - The Salisbury experience. J Plast Reconstr Aesthet Surg 2020; 74:407-447. [PMID: 33051174 PMCID: PMC7449121 DOI: 10.1016/j.bjps.2020.08.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 08/01/2020] [Indexed: 12/01/2022]
Abstract
A vascular access device is defined as a catheter inserted into veins allowing fluids and medicines to be delivered intravenously1. The need for such devices in acutely unwell patients has remained steady throughout the COVID-19 pandemic. We describe here our experience of up-skilling the resident plastic surgery and maxillofacial surgical registrars to provide a vascular access service to reduce the workload on our intensive care colleagues. We hope that our practice and an ‘all hands on deck’ approach to the utilisation of baseline skills within the existing workforce will inform other departments to help ease the burden on critical care departments as we progress through the next stages of the COVID-19 pandemic.
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Early Developmental Trajectories of Functional Connectivity Along the Visual Pathways in Rhesus Monkeys. Cereb Cortex 2020; 29:3514-3526. [PMID: 30272135 DOI: 10.1093/cercor/bhy222] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 07/23/2018] [Accepted: 08/19/2018] [Indexed: 12/30/2022] Open
Abstract
Early social interactions shape the development of social behavior, although the critical periods or the underlying neurodevelopmental processes are not completely understood. Here, we studied the developmental changes in neural pathways underlying visual social engagement in the translational rhesus monkey model. Changes in functional connectivity (FC) along the ventral object and motion pathways and the dorsal attention/visuo-spatial pathways were studied longitudinally using resting-state functional MRI in infant rhesus monkeys, from birth through early weaning (3 months), given the socioemotional changes experienced during this period. Our results revealed that (1) maturation along the visual pathways proceeds in a caudo-rostral progression with primary visual areas (V1-V3) showing strong FC as early as 2 weeks of age, whereas higher-order visual and attentional areas (e.g., MT-AST, LIP-FEF) show weak FC; (2) functional changes were pathway-specific (e.g., robust FC increases detected in the most anterior aspect of the object pathway (TE-AMY), but FC remained weak in the other pathways (e.g., AST-AMY)); (3) FC matures similarly in both right and left hemispheres. Our findings suggest that visual pathways in infant macaques undergo selective remodeling during the first 3 months of life, likely regulated by early social interactions and supporting the transition to independence from the mother.
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3:36 PM Abstract No. 277 First-in-human evaluation of an absorbable vena cava filter for the prevention of pulmonary embolism. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Experimental estimates of compression heating and decompression cooling in ethylene glycol. MAGNETIC RESONANCE IN CHEMISTRY : MRC 2020; 58:163-169. [PMID: 31671221 PMCID: PMC6980274 DOI: 10.1002/mrc.4961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/17/2019] [Accepted: 10/23/2019] [Indexed: 06/10/2023]
Abstract
The chemical shift difference, Δσ, between the methylene and hydroxyl protons in the high resolution 1 H nuclear magnetic resonance spectrum of ethylene glycol is shown to be pressure dependent. The equilibrium Δσ values for ethylene glycol are reported as a function of temperature and pressure between ambient conditions, 323 K and 2 kbar, respectively. This surface is used along with Δσ values measured in response to a rapid pressure increase to calculate a temperature rise that is used to infer a temperature change for water that is consistent with theoretical estimates. This work implies that compression heating and decompression cooling are not significant enough to interfere with pressure induced protein folding studies.
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Does tibial bone mineral status quality differ between medial tibial stress syndrome symptomatic and asymptomatic long-distance runners? J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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MA05.01 Second or Third Line Anti-PD-1 Therapy After Multimodality Therapy Including Total Pleurectomy in Malignant Pleural Mesothelioma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Short-term effects of anti-pronation taping on foot mobility and pain in female netball athletes with medial tibial stress syndrome. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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P2.06-05 Multimodality Therapy Using Total Pleurectomy in Malignant Pleural Mesothelioma: Long-Term Outcomes in 150 Consecutive Cases. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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OR58: Is Bowel Lengthening a Step Towards Enteral Autonomy? Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32530-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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216PD Should radical surgery be performed in non-epithelioid malignant pleural mesothelioma? J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30489-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract No. 608 Value of performing outpatient CT-guided percutaneous lung biopsy at a large, tertiary care center after unsuccessful outside hospital biopsy attempt. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Exploring the high-resolution mapping of gender-disaggregated development indicators. J R Soc Interface 2017; 14:20160825. [PMID: 28381641 PMCID: PMC5414904 DOI: 10.1098/rsif.2016.0825] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/13/2017] [Indexed: 11/22/2022] Open
Abstract
Improved understanding of geographical variation and inequity in health status, wealth and access to resources within countries is increasingly being recognized as central to meeting development goals. Development and health indicators assessed at national or subnational scale can often conceal important inequities, with the rural poor often least well represented. The ability to target limited resources is fundamental, especially in an international context where funding for health and development comes under pressure. This has recently prompted the exploration of the potential of spatial interpolation methods based on geolocated clusters from national household survey data for the high-resolution mapping of features such as population age structures, vaccination coverage and access to sanitation. It remains unclear, however, how predictable these different factors are across different settings, variables and between demographic groups. Here we test the accuracy of spatial interpolation methods in producing gender-disaggregated high-resolution maps of the rates of literacy, stunting and the use of modern contraceptive methods from a combination of geolocated demographic and health surveys cluster data and geospatial covariates. Bayesian geostatistical and machine learning modelling methods were tested across four low-income countries and varying gridded environmental and socio-economic covariate datasets to build 1×1 km spatial resolution maps with uncertainty estimates. Results show the potential of the approach in producing high-resolution maps of key gender-disaggregated socio-economic indicators, with explained variance through cross-validation being as high as 74-75% for female literacy in Nigeria and Kenya, and in the 50-70% range for many other variables. However, substantial variations by both country and variable were seen, with many variables showing poor mapping accuracies in the range of 2-30% explained variance using both geostatistical and machine learning approaches. The analyses offer a robust basis for the construction of timely maps with levels of detail that support geographically stratified decision-making and the monitoring of progress towards development goals. However, the great variability in results between countries and variables highlights the challenges in applying these interpolation methods universally across multiple countries, and the importance of validation and quantifying uncertainty if this is undertaken.
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180 Medical Screening Exam Utilized to Manage Emergent and Non-emergent Patients Presenting to the Emergency Department. Ann Emerg Med 2016. [DOI: 10.1016/j.annemergmed.2016.08.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Are We All Equal When We Smile? PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.05.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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123 Evaluation of the Motor Vehicle Crash Scene to Improve Patient Outcome. Ann Emerg Med 2016. [DOI: 10.1016/j.annemergmed.2016.08.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Self-management in temporomandibular disorders: a systematic review of behavioural components. J Oral Rehabil 2016; 43:759-70. [DOI: 10.1111/joor.12422] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2016] [Indexed: 12/21/2022]
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A comparison of low volume 'high-intensity-training' and high volume traditional resistance training methods on muscular performance, body composition, and subjective assessments of training. Biol Sport 2016; 33:241-9. [PMID: 27601778 PMCID: PMC4993139 DOI: 10.5604/20831862.1201813] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 01/19/2016] [Accepted: 04/19/2016] [Indexed: 11/13/2022] Open
Abstract
Most studies of resistance training (RT) examine methods that do not resemble typical training practices of persons participating in RT. Ecologically valid RT programs more representative of such practices are seldom compared. This study compared two such approaches to RT. Thirty participants (males, n = 13; females, n = 17) were randomised to either a group performing low volume 'High Intensity Training' (HIT; n = 16) or high volume 'Body-building' (3ST; n = 14) RT methods 2x/week for 10 weeks. Outcomes included muscular performance, body composition, and participant's subjective assessments. Both HIT and 3ST groups improved muscular performance significantly (as indicated by 95% confidence intervals) with large effect sizes (ES; 0.97 to 1.73 and 0.88 to 1.77 respectively). HIT had significantly greater muscular performance gains for 3 of 9 tested exercises compared with 3ST (p < 0.05) and larger effect sizes for 8 of 9 exercises. Body composition did not significantly change in either group. However, effect sizes for whole body muscle mass changes were slightly more favourable in the HIT group compared with the 3ST group (0.27 and -0.34 respectively) in addition to whole body fat mass (0.03 and 0.43 respectively) and whole body fat percentage (-0.10 and -0.44 respectively). Significant muscular performance gains can be produced using either HIT or 3ST. However, muscular performance gains may be greater when using HIT. Future research should look to identify which components of ecologically valid RT programs are primarily responsible for these differences in outcome.
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Preliminary safety and efficacy of an absorbable vena cava filter in a porcine model. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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P154 Evaluation of Inhaler Technique Mastery for Budesonide Formoterol Spiromax® Compared with Symbicort Turbohaler® in Adult Patients with Asthma: Primary Results From the Easy Low Instruction Over Time [ELIOT] Study: Abstract P154 Table 1. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Resistance training can reverse sarcopenia in older foot muscles. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Posters 159Misdiagnosed, misbelieved and misdirected; largest uk study casts doubt on some long held but poorly validated assumptions about the pots population and suggests improvements in care pathways and service provision60An acute comparison of different strategies for targeting the left ventricular lead for cardiac resynchronisation therapy61Relationship of phase singularities and high dominant frequency regions during persistent atrial fibrillation in humans62Restoration of sinus rhythm results in early and late improvements in the functional reserve of the heart following direct current cardioversion of persistent af: fresh-af63Non-concomitant hybrid ablation using the estech cobra device for the treatment of longstanding persistent atrial fibrillation: an initial single-centre experience64Artificial intelligence outperforms manual ecg scoring in the detection of arrhythmia substrate65Single centre experience and outcome of persistent af ablation using nmarq catheter: 2 year follow up66The growing burden of atrial fibrillation and management at a typical district general hospital67Haemodynamic effects of single-vein, simultaneous, multipoint pacing compared with bipolar pacing in patients undergoing cardiac resynchronisation therapy68Is multisite pacing of interest in cardiac resynchronization therapy? teachings from a long-term follow-up of a cohort of patients implanted with triventricular pacing systems69Differences in fractionated electrogram detection: a direct quantitative comparison between navx and carto: Table 1. Europace 2015. [DOI: 10.1093/europace/euv329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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MO-F-304-02. Med Phys 2015. [DOI: 10.1118/1.4925394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Biodegradable silicon nanoneedles delivering nucleic acids intracellularly induce localized in vivo neovascularization. NATURE MATERIALS 2015; 14:532-9. [PMID: 25822693 PMCID: PMC4538992 DOI: 10.1038/nmat4249] [Citation(s) in RCA: 270] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 02/11/2015] [Indexed: 04/14/2023]
Abstract
The controlled delivery of nucleic acids to selected tissues remains an inefficient process mired by low transfection efficacy, poor scalability because of varying efficiency with cell type and location, and questionable safety as a result of toxicity issues arising from the typical materials and procedures employed. High efficiency and minimal toxicity in vitro has been shown for intracellular delivery of nuclei acids by using nanoneedles, yet extending these characteristics to in vivo delivery has been difficult, as current interfacing strategies rely on complex equipment or active cell internalization through prolonged interfacing. Here, we show that a tunable array of biodegradable nanoneedles fabricated by metal-assisted chemical etching of silicon can access the cytosol to co-deliver DNA and siRNA with an efficiency greater than 90%, and that in vivo the nanoneedles transfect the VEGF-165 gene, inducing sustained neovascularization and a localized sixfold increase in blood perfusion in a target region of the muscle.
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USAID RESPOND project's global one health core competencies and one
health modules. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abstract
Oral health inequalities associated with socioeconomic status are widely observed but may depend on the way that both oral health and socioeconomic status are measured. Our aim was to investigate inequalities using diverse indicators of oral health and 4 socioeconomic determinants, in the context of age and cohort. Multiple linear or logistic regressions were estimated for 7 oral health measures representing very different outcomes (2 caries prevalence measures, decayed/missing/filled teeth, 6-mm pockets, number of teeth, anterior spaces, and excellent oral health) against 4 socioeconomic measures (income, education, Index of Multiple Deprivation, and occupational social class) for adults aged ≥21 y in the 2009 UK Adult Dental Health Survey data set. Confounders were adjusted and marginal effects calculated. The results showed highly variable relationships for the different combinations of variables and that age group was critical, with different relationships at different ages. There were significant income inequalities in caries prevalence in the youngest age group, marginal effects of 0.10 to 0.18, representing a 10- to 18-percentage point increase in the probability of caries between the wealthiest and every other quintile, but there was not a clear gradient across the quintiles. With number of teeth as an outcome, there were significant income gradients after adjustment in older groups, up to 4.5 teeth (95% confidence interval, 2.2-6.8) between richest and poorest but none for the younger groups. For periodontal disease, income inequalities were mediated by other socioeconomic variables and smoking, while for anterior spaces, the relationships were age dependent and complex. In conclusion, oral health inequalities manifest in different ways in different age groups, representing age and cohort effects. Income sometimes has an independent relationship, but education and area of residence are also contributory. Appropriate choices of measures in relation to age are fundamental if we are to understand and address inequalities.
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Effect of sodium, potassium, magnesium, and calcium salt cations on pH, proteolysis, organic acids, and microbial populations during storage of full-fat Cheddar cheese. J Dairy Sci 2014; 97:4780-98. [DOI: 10.3168/jds.2014-8071] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 04/25/2014] [Indexed: 12/20/2022]
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Abstract
Various interventions have been used for the management of patients with temporomandibular joint (TMJ) disc displacement without reduction (DDwoR), but their clinical effectiveness remains unclear. This systematic review investigated the effects of these interventions and is reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic and manual searches up to November 1, 2013, were conducted for English-language, peer-reviewed, publications of randomized clinical trials comparing any form of conservative or surgical interventions for patients with clinical and/or radiologic diagnosis of acute or chronic DDwoR. Two primary outcomes (TMJ pain intensity and maximum mouth opening) and a number of secondary outcomes were examined. Two reviewers performed data extraction and risk of bias assessment. Data collection and analysis were performed according to Cochrane recommendations. Twenty studies involving 1,305 patients were included. Data analysis involved 21 comparisons between a variety of interventions, either between interventions, or between intervention and placebo or no intervention. Meta-analysis on homogenous groups was conducted in 4 comparisons. In most comparisons made, there were no statistically significant differences between interventions relative to primary outcomes at short- or long-term follow-up (p > .05). In a separate analysis, however, the majority of reviewed interventions reported significantly improved primary outcome measures from their baseline levels over time (p < .05). Evidence levels, however, are currently insufficient for definitive conclusions, because the included studies were too heterogeneous and at an unclear to high risk of bias. In view of the comparable therapeutic effects, paucity of high-quality evidence, and the greater risks and costs associated with more complex interventions, patients with symptomatic DDwoR should be initially treated by the simplest and least invasive intervention.
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WE-G-19A-01: Radiologists and Medical Physicists: Working Together to Achieve Common Goals. Med Phys 2014. [DOI: 10.1118/1.4889475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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JUMP HEIGHT IS THE CRITICAL FACTOR AFFECTING BETWEEN-SEX DIFFERENCES IN PATELLAR TENDON LOADING DURING LANDING IN VOLLEYBALL. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Timing interventions in relation to temporomandibular joint closed lock duration: a systematic review of 'locking duration'. J Oral Rehabil 2014; 41:24-58. [PMID: 24393132 DOI: 10.1111/joor.12126] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2013] [Indexed: 11/30/2022]
Abstract
Temporomandibular joint (TMJ) 'closed lock' (CL) is a clinical condition causing TMJ pain and limited mouth opening (painful locking) that is mostly attributed to disc displacement without reduction (DDwoR), or less commonly to anchored disc phenomenon (ADP). Both conditions are described clinically as CL that can be 'acute' or 'chronic' depending on the duration of locking. There is, however, no consensus about the duration of locking that defines the acute state and its effect on the success of interventions. This review paper, therefore, aims to provide: (i) a narrative review of the pathophysiological need for early intervention in DDwoR and the clinical implications of acute/chronic CL stages on the management pathway; (ii) a systematic review investigating the effects of locking duration on the success of interventions for CL management. Electronic and manual searches until mid-August 2013 were conducted for English-language studies of any design investigating the effects of non-surgical and surgical interventions for acute or chronic CL (DDwoR or ADP). A total of 626 records were identified, and 113 studies were included. Data extraction and quality assessment were completed for all included studies. Included studies were, however, heterogeneous and mostly of poor-quality leading to contradictory and inconsistent evidence on the effect of the duration of locking on treatment outcomes. Future high-quality trials investigating the effect of CL duration on treatment outcome are needed. At present, early intervention by 'unlock' mandibular manipulation seems to be the most practical and realistic approach that can be attempted first in every CL patient as an initial diagnostic/therapeutic approach.
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EPA-1758 - Globus pallidus abnormalities in opiate dependent patients receiving methadone maintenance therapy. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78888-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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EPA-1759 - Brain structural abnormalities in medial temporal lobe are associated with mood and anxiety in methadone maintenance treatment. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78889-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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The Bionanoprobe: hard X-ray fluorescence nanoprobe with cryogenic capabilities. JOURNAL OF SYNCHROTRON RADIATION 2014; 21:66-75. [PMID: 24365918 PMCID: PMC3874019 DOI: 10.1107/s1600577513029676] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 10/28/2013] [Indexed: 05/20/2023]
Abstract
Hard X-ray fluorescence microscopy is one of the most sensitive techniques for performing trace elemental analysis of biological samples such as whole cells and tissues. Conventional sample preparation methods usually involve dehydration, which removes cellular water and may consequently cause structural collapse, or invasive processes such as embedding. Radiation-induced artifacts may also become an issue, particularly as the spatial resolution increases beyond the sub-micrometer scale. To allow imaging under hydrated conditions, close to the `natural state', as well as to reduce structural radiation damage, the Bionanoprobe (BNP) has been developed, a hard X-ray fluorescence nanoprobe with cryogenic sample environment and cryo transfer capabilities, dedicated to studying trace elements in frozen-hydrated biological systems. The BNP is installed at an undulator beamline at sector 21 of the Advanced Photon Source. It provides a spatial resolution of 30 nm for two-dimensional fluorescence imaging. In this first demonstration the instrument design and motion control principles are described, the instrument performance is quantified, and the first results obtained with the BNP on frozen-hydrated whole cells are reported.
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Are we following a restrictive red cell transfusion practice? A multi-centre audit of paediatric transfusion practice in PICU. Transfus Med 2013; 23:274-5. [PMID: 23659766 DOI: 10.1111/tme.12044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 03/26/2013] [Accepted: 04/15/2013] [Indexed: 11/30/2022]
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188 Three years experience of chemotherapy for small cell lung cancer at a tertiary referral centre. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70188-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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