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Andrews C, Pade A, Flenady V, Moore J, Tindal K, Farrant B, Stewart S, Loughnan S, Robinson N, Oba Y, Pollock D. Improving the capacity of researchers and bereaved parents to co-design and translate stillbirth research together. Women Birth 2024; 37:403-409. [PMID: 38155062 DOI: 10.1016/j.wombi.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/06/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Working with bereaved parents in co-designed stillbirth research, policy and practice is essential to improving care and outcomes. PROBLEM Effective parent engagement is often lacking. This may be due to bereaved parents not feeling adequately and appropriately supported to be involved. AIM To consult bereaved parents with the aim to understand their experiences, attitudes, and needs around involvement in stillbirth research and gain feedback about the usefulness and appropriateness of a proposed co-designed guide to support their involvement, including content and design aspects of this resource. METHODS An online co-designed survey was disseminated via Australian parent support organisations social media in August 2022. FINDINGS All 90 respondents were bereaved parents, 94% (n = 85) were female. Two-thirds (67%, n = 60) had never participated in stillbirth research, 80% (n = 72) agreed involvement of bereaved parents in research was important or extremely important and 81% (n = 73) were interested in future research involvement. Common motivations for involvement were wanting to leave a legacy for their baby and knowing research outcomes. Common barriers included not having been asked to participate or not knowing how. Most (89%, n = 80) agreed the proposed guide would be useful. Highly valued topics were the importance of bereaved parents' voices in stillbirth research and how they can make a difference. CONCLUSION The majority of bereaved parents we surveyed want to be involved in stillbirth research and would value a resource to support this. The proposed concept and content for a co-designed guide to aid engagement was well supported.
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Affiliation(s)
- C Andrews
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia.
| | - A Pade
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - J Moore
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - K Tindal
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia; The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
| | - B Farrant
- Telethon Kids Institute, The University of Western Australia, Nedlands, Australia
| | - S Stewart
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - S Loughnan
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - N Robinson
- The Phoebe Joan Foundation Australia, Stanthorpe, Australia
| | - Y Oba
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - D Pollock
- Health Evidence Synthesis, Recommendations and Impact (HESRI), School of Public Health, Faculty of Health and Medical Science, University of Adelaide, Australia
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Lilaonitkul M, Zacharia A, Law TJ, Yusuf N, Saria P, Moore J. Evaluation of practice change following SAFE obstetric courses in Tanzania: a prospective cohort study. Anaesthesia 2023; 78:1354-1364. [PMID: 37431149 DOI: 10.1111/anae.16091] [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] [Accepted: 06/16/2023] [Indexed: 07/12/2023]
Abstract
Anaesthesia has been shown to contribute disproportionately to maternal mortality in low-resource settings. This figure exceeds 500 per 100,000 live births in Tanzania, where anaesthesia is mainly provided by non-physician anaesthetists, many of whom are working as independent practitioners in rural areas without any support or opportunity for continuous medical education. The three-day Safer Anaesthesia from Education (SAFE) course was developed to address this gap by providing in-service training in obstetric anaesthesia to improve patient safety. Two obstetric SAFE courses with refresher training were delivered to 75 non-physician anaesthetists in the Mbeya region of Tanzania between August 2019 and July 2020. To evaluate translation of knowledge into practice, we conducted direct observation of the SAFE obstetric participants at their workplace in five facilities using a binary checklist of expected behaviours, to assess the peri-operative management of patients undergoing caesarean deliveries. The observations were conducted over a 2-week period at pre, immediately post, 6-month and 12-month post-SAFE obstetric training. A total of 320 cases completed by 35 participants were observed. Significant improvements in behaviours, sustained at 12 months after training included: pre-operative assessment of patients (32% (pre-training) to 88% (12 months after training), p < 0.001); checking for functioning suction (73% to 85%, p = 0.003); using aseptic spinal technique (67% to 100%, p < 0.001); timely administration of prophylactic antibiotics (66% to 95%, p < 0.001); and checking spinal block adequacy (32% to 71%, p < 0.001). Our study has demonstrated positive sustained changes in the clinical practice amongst non-physician anaesthetists as a result of SAFE obstetric training. The findings can be used to guide development of a checklist specific for anaesthesia for caesarean section to improve the quality of care for patients in low-resource settings.
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Affiliation(s)
- M Lilaonitkul
- Department of Anesthesia and Peri-operative Care, University of California San Francisco, California, USA
| | - A Zacharia
- Mbeya Zonal Referral Hospital, University of Dar es Salaam, Mbeya College of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - T J Law
- Department of Anesthesia and Peri-Operative Care, University of California San Francisco, California, USA
| | - N Yusuf
- Department of Anaesthesia, Tanga Regional Referral Hospital, Tanzania
| | - P Saria
- Department of Anesthesia, CCBRT Hospital, Dar es Salaam, Tanzania
| | - J Moore
- Department of Anaesthesia, NHS Grampian, Aberdeen, UK
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Smith CP, Armstrong WR, Clark K, Moore J, Roberts M, Farolfi A, Reiter RE, Rettig M, Shen J, Valle L, Nickols NG, Steinberg ML, Czernin J, Kishan AU, Calais J. PSMA PET Guided Salvage Radiotherapy Among Prostate Cancer Patients in the Post-Prostatectomy Setting: A Single Center Post-Hoc Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e438. [PMID: 37785423 DOI: 10.1016/j.ijrobp.2023.06.1612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) shows improved sensitivity and specificity for detection of locoregional and distant metastatic prostate cancer (PCa) compared to conventional imaging, especially at lower PSA levels as is often the case in the biochemically recurrent (BCR), post radical prostatectomy (RP) setting. Providers are now utilizing PSMA PET findings to guide their salvage radiotherapy (sRT) treatment fields and doses, although it is not well understood how PSMA PET guided sRT impacts patient outcomes. MATERIALS/METHODS This was a post-hoc analysis of 5 prospective studies of PSMA PET conducted at UCLA from 2016 to 2021 that included patients with recurrent PCa following RP. Patients were included in this retrospective study if they initiated sRT within 3 months of PSMA PET, had at least 12 months of follow up after sRT completion, had available sRT treatment details, and did not have distant metastases (DM) by conventional imaging on upfront staging. Patients treated with palliative RT were excluded. BCR following sRT was defined as an increase in PSA of 0.2 ng/ml above the post sRT nadir. Metastasis directed therapy (MDT) was defined as sRT to all PSMA+ N1 and M1 lesions. Baseline patient demographics, PSMA PET findings, sRT & ADT treatment details, and patient outcome data were collected. RESULTS A total of 176 patients were included in this study. Median time between RP and PSMA PET was 38 months (range 1-329). Median PSA at the time of the PSMA PET was 0.625 ng/mL (range 0.063-35). PSMA PET was positive in 128 patients (73%): 21 (12%) miT+N0M0, 55 (31%) miTxN1M0 and 52 (30%) miTxNxM1 with 19 (11%) miTxNxM1a, 31 (18%) miTxNxM1b, and 2 (1%) miTxNxM1c. Median number of lesions seen on positive PSMA scans was 1 (range 1-8). 39 (22%) patients were subsequently treated with sRT to the prostate bed (PB) only, 59 (34%) to PB + pelvic lymph nodes (PLNs), 33 (19%) to PLNs only, 7 (4%) to PB + PLNs + DM, 7 (4%) to PLNs + DM, and 31 (18%) to DM only. 59 (34%) patients were treated with concurrent ADT at a median duration of 6 months (range 1-39). At a median follow-up of 32 months (range 12-70) after sRT, 80 patients (45%) did not develop BCR or imaging relapse (IR) following sRT, 24 patients (14%) developed BCR but not IR, 1 patient (<1%) developed IR only, and 70 patients (40%) developed both BCR and IR. The median time to BCR and IR following sRT was 15 months (range 1-48) and 19 months (range 6-61), respectively. 1 year post sRT biochemical recurrence free survival was 77%. Of the 83 patients treated with MDT, 32 (39%) did not develop subsequent disease relapse. CONCLUSION This post hoc analysis assessed the outcomes of 176 patients treated with PSMA PET guided salvage RT, proving it to be an effective method for treating both pelvic and extrapelvic recurrent PCa. Further investigation is needed to assess the full extent of patient outcomes in this population.
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Affiliation(s)
- C P Smith
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - W R Armstrong
- Ahmanson Translational Theranostics Division, UCLA Nuclear Medicine, Los Angeles, CA
| | - K Clark
- Ahmanson Translational Theranostics Division, Los Angeles, CA
| | - J Moore
- Ahmanson Translational Theranostics Division, UCLA Nuclear Medicine, Los Angeles, CA
| | - M Roberts
- Ahmanson Translational Theranostics Division, UCLA Nuclear Medicine, Los Angeles, CA
| | - A Farolfi
- Ahmanson Translational Theranostics Division, UCLA Nuclear Medicine, Los Angeles, CA
| | - R E Reiter
- Department of Urology, University of California, Los Angeles, Los Angeles, CA
| | - M Rettig
- Department of Medical Oncology, University of California, Los Angeles, Los Angeles, CA
| | - J Shen
- Department of Medical Oncology, University of California, Los Angeles, Los Angeles, CA
| | - L Valle
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - N G Nickols
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - M L Steinberg
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - J Czernin
- Ahmanson Translational Theranostics Division, UCLA Nuclear Medicine, Los Angeles, CA
| | - A U Kishan
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - J Calais
- Ahmanson Translational Theranostics Division, UCLA Nuclear Medicine, Los Angeles, CA
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Yoganandan N, Moore J, Humm JR, Baisden JL, Banerjee A, Pintar FA, Barnes DR, Loftis KL. Human pelvis injury risk curves from underbody blast impact. BMJ Mil Health 2023; 169:436-442. [PMID: 34711674 DOI: 10.1136/bmjmilitary-2021-001863] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/07/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Underbody blast loading can result in injuries to the pelvis and the lumbosacral spine. The purpose of this study was to determine human tolerance in this region based on survival analysis. METHODS Twenty-six unembalmed postmortem human surrogate lumbopelvic complexes were procured and pretest medical images were obtained. They were fixed in polymethylmethacrylate at the cranial end and a six-axis load cell was attached. The specimens were aligned in a seated soldier posture. Impacts were applied to the pelvis using a custom vertical accelerator. The experimental design consisted of non-injury and injury tests. Pretest and post-test X-rays and palpation were done following non-injury test, and after injury test medical imaging and gross dissections were done. Injuries were scored using the Abbreviated Injury Scale (AIS). Axial and resultant forces were used to develop human injury probability curves (HIPCs) at AIS 3+ and AIS 4 severities using survival analysis. Then ±95% CI was computed using the delta method, normalised CI size was obtained, and the quality of the injury risk curves was assigned adjectival ratings. RESULTS At the 50% probability level, the resultant and axial forces at the AIS 3+ level were 6.6 kN and 5.9 kN, and at the AIS 4 level these were 8.4 kN and 7.5 kN, respectively. Individual injury risk curves along with ±95% CIs are presented in the paper. Increased injury severity increased the HIPC metrics. Curve qualities were in the good and fair ranges for axial and shear forces at all probability levels and for both injury severities. CONCLUSIONS This is the first study to develop axial and resultant force-based HIPCs defining human tolerance to injuries to the pelvis from vertical impacts using parametric survival analysis. Data can be used to advance military safety under vertical loading to the seated pelvis.
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Affiliation(s)
- Narayan Yoganandan
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - J Moore
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - J R Humm
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - J L Baisden
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - A Banerjee
- Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - F A Pintar
- Joint Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - D R Barnes
- SURVICE Engineering, Belcamp, Maryland, USA
| | - K L Loftis
- DEVCOM, Aberdeen Proving Ground, Maryland, USA
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Grant-Freemantle M, Moore J, McBrien D, Condon F, Harmon D. The role of perceived patient injustice on pain related and functional outcomes in orthopaedic patients; a systematic review. J Orthop 2023; 36:19-23. [PMID: 36582546 PMCID: PMC9793222 DOI: 10.1016/j.jor.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 10/15/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Higher levels of perceived patient injustice has been associated with higher levels of pain and poor functional outcomes in patients with chronic musculoskeletal pain. We wanted to investigate if there was any evidence of this association in patients who underwent orthopaedic surgery. Materials and methods A systematic search of the literature was performed independently by two researchers on the electronic databases of MEDLINE, EMBASE, Google Scholar, Web of Science, and the Cochrane Database of Systematic Reviews and data extracted in accordance with PRISMA guidelines for systematic reviews. Outcomes of interest were pain, pain intensity, pain interference, opiate use, disability, physical function, return to work, quality of life, depression, anxiety, post-traumatic stress, social functioning and quality of life. Results Five studies were identified for qualitative analysis involving elective and trauma orthopaedic patients. All studies identified a positive correlation between higher levels of perceived injustice and depression, pain intensity and interference as well as reduced function and higher levels of disability. Conclusions Higher levels of perceived patient injustice is associated with worse pain and functional outcomes in patients who undergo orthopaedic surgery in the traumatic and elective setting. Further research is warranted to further elucidate this association and identify potential therapeutic interventions.
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Affiliation(s)
- M.C. Grant-Freemantle
- Department of Trauma and Orthopaedic Surgery, University Hospital Limerick, Limerick, Ireland
| | - J. Moore
- Department of Trauma and Orthopaedic Surgery, University Hospital Limerick, Limerick, Ireland
| | - D. McBrien
- Department of Trauma and Orthopaedic Surgery, University Hospital Limerick, Limerick, Ireland
| | - F. Condon
- Department of Trauma and Orthopaedic Surgery, University Hospital Limerick, Limerick, Ireland
- University of Limerick, Limerick, Ireland
| | - D.C. Harmon
- Department of Anaesthesia and Pain Medicine, University Hospital Limerick, Limerick, Ireland
- University of Limerick, Limerick, Ireland
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Durrand J, Livingston R, Tew G, Gillis C, Yates D, Gray J, Greaves C, Moore J, O’Doherty AF, Doherty P, Danjoux G, Avery L. Systematic development and feasibility testing of a multibehavioural digital prehabilitation intervention for patients approaching major surgery (iPREPWELL): A study protocol. PLoS One 2022; 17:e0277143. [PMID: 36574417 PMCID: PMC9794053 DOI: 10.1371/journal.pone.0277143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/25/2022] [Indexed: 12/28/2022] Open
Abstract
Improving outcomes for people undergoing major surgery, specifically reducing perioperative morbidity and mortality remains a global health challenge. Prehabilitation involves the active preparation of patients prior to surgery, including support to tackle risk behaviours that mediate and undermine physical and mental health and wellbeing. The majority of prehabilitation interventions are delivered in person, however many patients express a preference for remotely-delivered interventions that provide them with tailored support and the flexibility. Digital prehabilitation interventions offer scalability and have the potential to benefit perioperative healthcare systems, however there is a lack of robustly developed and evaluated digital programmes for use in routine clinical care. We aim to systematically develop and test the feasibility of an evidence and theory-informed multibehavioural digital prehabilitation intervention 'iPREPWELL' designed to prepare patients for major surgery. The intervention will be developed with reference to the Behaviour Change Wheel, COM-B model, and the Theoretical Domains Framework. Codesign methodology will be used to develop a patient intervention and accompanying training intervention for healthcare professionals. Training will be designed to enable healthcare professionals to promote, support and facilitate delivery of the intervention as part of routine clinical care. Patients preparing for major surgery and healthcare professionals involved with their clinical care from two UK National Health Service centres will be recruited to stage 1 (systematic development) and stage 2 (feasibility testing of the intervention). Participants recruited at stage 1 will be asked to complete a COM-B questionnaire and to take part in a qualitative interview study and co-design workshops. Participants recruited at stage 2 (up to twenty healthcare professionals and forty participants) will be asked to take part in a single group intervention study where the primary outcomes will include feasibility, acceptability, and fidelity of intervention delivery, receipt, and enactment. Healthcare professionals will be trained to promote and support use of the intervention by patients, and the training intervention will be evaluated qualitatively and quantitatively. The multifaceted and systematically developed intervention will be the first of its kind and will provide a foundation for further refinement prior to formal efficacy testing.
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Affiliation(s)
- J. Durrand
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-Upon-Tyne, United Kingdom
- Department of Anaesthesia and Perioperative Medicine, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
- * E-mail: (JD); (LA)
| | - R. Livingston
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - G. Tew
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-Upon-Tyne, United Kingdom
| | - C. Gillis
- School of Human Nutrition, McGill University, Montreal, Canada
| | - D. Yates
- Department of Anaesthesia and Critical Care, York & Scarborough Teaching Hospitals NHS Foundation Trust, York, United Kingdom
- North Yorkshire Academic Alliance of Perioperative Medicine, England
| | - J. Gray
- School of Nursing Midwifery and Health, Northumbria University, Upon-Tyne, United Kingdom
| | - C. Greaves
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - J. Moore
- Department of Anaesthesia and Critical Care, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - A. F. O’Doherty
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-Upon-Tyne, United Kingdom
| | - P. Doherty
- Department of Health Sciences, University of York, York, United Kingdom
| | - G. Danjoux
- Department of Anaesthesia and Perioperative Medicine, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
- North Yorkshire Academic Alliance of Perioperative Medicine, England
| | - L. Avery
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
- * E-mail: (JD); (LA)
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Gwilym BL, Pallmann P, Waldron CA, Thomas-Jones E, Milosevic S, Brookes-Howell L, Harris D, Massey I, Burton J, Stewart P, Samuel K, Jones S, Cox D, Clothier A, Edwards A, Twine CP, Bosanquet DC, Benson R, Birmpili P, Blair R, Bosanquet DC, Dattani N, Dovell G, Forsythe R, Gwilym BL, Hitchman L, Machin M, Nandhra S, Onida S, Preece R, Saratzis A, Shalhoub J, Singh A, Forget P, Gannon M, Celnik A, Duguid M, Campbell A, Duncan K, Renwick B, Moore J, Maresch M, Kamal D, Kabis M, Hatem M, Juszczak M, Dattani N, Travers H, Shalan A, Elsabbagh M, Rocha-Neves J, Pereira-Neves A, Teixeira J, Lyons O, Lim E, Hamdulay K, Makar R, Zaki S, Francis CT, Azer A, Ghatwary-Tantawy T, Elsayed K, Mittapalli D, Melvin R, Barakat H, Taylor J, Veal S, Hamid HKS, Baili E, Kastrisios G, Maltezos C, Maltezos K, Anastasiadou C, Pachi A, Skotsimara A, Saratzis A, Vijaynagar B, Lau S, Velineni R, Bright E, Montague-Johnstone E, Stewart K, King W, Karkos C, Mitka M, Papadimitriou C, Smith G, Chan E, Shalhoub J, Machin M, Agbeko AE, Amoako J, Vijay A, Roditis K, Papaioannou V, Antoniou A, Tsiantoula P, Bessias N, Papas T, Dovell G, Goodchild F, Nandhra S, Rammell J, Dawkins C, Lapolla P, Sapienza P, Brachini G, Mingoli A, Hussey K, Meldrum A, Dearie L, Nair M, Duncan A, Webb B, Klimach S, Hardy T, Guest F, Hopkins L, Contractor U, Clothier A, McBride O, Hallatt M, Forsythe R, Pang D, Tan LE, Altaf N, Wong J, Thurston B, Ash O, Popplewell M, Grewal A, Jones S, Wardle B, Twine C, Ambler G, Condie N, Lam K, Heigberg-Gibbons F, Saha P, Hayes T, Patel S, Black S, Musajee M, Choudhry A, Hammond E, Costanza M, Shaw P, Feghali A, Chawla A, Surowiec S, Encalada RZ, Benson R, Cadwallader C, Clayton P, Van Herzeele I, Geenens M, Vermeir L, Moreels N, Geers S, Jawien A, Arentewicz T, Kontopodis N, Lioudaki S, Tavlas E, Nyktari V, Oberhuber A, Ibrahim A, Neu J, Nierhoff T, Moulakakis K, Kakkos S, Nikolakopoulos K, Papadoulas S, D'Oria M, Lepidi S, Lowry D, Ooi S, Patterson B, Williams S, Elrefaey GH, Gaba KA, Williams GF, Rodriguez DU, Khashram M, Gormley S, Hart O, Suthers E, French S. Short-term risk prediction after major lower limb amputation: PERCEIVE study. Br J Surg 2022; 109:1300-1311. [PMID: 36065602 DOI: 10.1093/bjs/znac309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/06/2022] [Accepted: 07/31/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND The accuracy with which healthcare professionals (HCPs) and risk prediction tools predict outcomes after major lower limb amputation (MLLA) is uncertain. The aim of this study was to evaluate the accuracy of predicting short-term (30 days after MLLA) mortality, morbidity, and revisional surgery. METHODS The PERCEIVE (PrEdiction of Risk and Communication of outcomE following major lower limb amputation: a collaboratIVE) study was launched on 1 October 2020. It was an international multicentre study, including adults undergoing MLLA for complications of peripheral arterial disease and/or diabetes. Preoperative predictions of 30-day mortality, morbidity, and MLLA revision by surgeons and anaesthetists were recorded. Probabilities from relevant risk prediction tools were calculated. Evaluation of accuracy included measures of discrimination, calibration, and overall performance. RESULTS Some 537 patients were included. HCPs had acceptable discrimination in predicting mortality (931 predictions; C-statistic 0.758) and MLLA revision (565 predictions; C-statistic 0.756), but were poor at predicting morbidity (980 predictions; C-statistic 0.616). They overpredicted the risk of all outcomes. All except three risk prediction tools had worse discrimination than HCPs for predicting mortality (C-statistics 0.789, 0.774, and 0.773); two of these significantly overestimated the risk compared with HCPs. SORT version 2 (the only tool incorporating HCP predictions) demonstrated better calibration and overall performance (Brier score 0.082) than HCPs. Tools predicting morbidity and MLLA revision had poor discrimination (C-statistics 0.520 and 0.679). CONCLUSION Clinicians predicted mortality and MLLA revision well, but predicted morbidity poorly. They overestimated the risk of mortality, morbidity, and MLLA revision. Most short-term risk prediction tools had poorer discrimination or calibration than HCPs. The best method of predicting mortality was a statistical tool that incorporated HCP estimation.
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Affiliation(s)
- Brenig L Gwilym
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | | | | | | | | | | | - Debbie Harris
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Ian Massey
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Jo Burton
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Phillippa Stewart
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Katie Samuel
- Department of Anaesthesia, North Bristol NHS Trust, Bristol, UK
| | - Sian Jones
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - David Cox
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - Annie Clothier
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | - Adrian Edwards
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Christopher P Twine
- Bristol, Bath and Weston Vascular Network, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - David C Bosanquet
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
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Marbin S, Rodriguez S, Moore J, Carugno J. 8182 Does Menopausal Status Impact Pain Perception during in-Office Hysteroscopy? Findings from a Single-Center Study. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pepe P, Moore J, Bachista K, Debaty G, Lurie K, Salverda B, Emanuelson L, Parquette B, Quinn R, Labarère J, Lick C. 3 Clinical Confirmation of Improved Likelihood of Survival Associated With the Use of the Head-Up CPR Bundle for Non-Shockable Cardiac Arrest Presentations. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Singhi A, Chen T, Madison R, Bhardwaj N, Jin D, Fleischmann Z, Newberg J, Moore J, Frampton G, Hegde P, Fabrizio D, He J, Schrock A, Ebot E, Sokol E. 1300P Exploration of a novel HRD signature (HRDsig) as a biomarker of first line FOLFIRINOX benefit in metastatic pancreatic cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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McCance L, Smith EC, Moore J, Forget P. Erector spinae plane block with catheter infusion for analgesia in a patient undergoing transaxillary first rib resection. Anaesth Rep 2022; 10:e12190. [PMID: 36275395 PMCID: PMC9581724 DOI: 10.1002/anr3.12190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
Analgesia for first rib resection can be challenging with short- and long-term consequences for patients such as acute distress, difficulty participating in physiotherapy and chronic pain. We report utilising an erector spinae plane block with a continuous infusion catheter as analgesia for a transaxillary first rib removal in a patient with venous thoracic outlet syndrome (Paget-Schroetter syndrome). We could find no reports of erector spinae plane block in transaxillary rib resection, and a limited number of reports using a paravertebral approach to analgesia for this procedure. In our case, an erector spinae plane block provided effective analgesia, allowing the patient to participate freely in postoperative physiotherapy; no complications of erector spinae plane block were encountered. Further research into the safety and efficacy of erector spinae plane block for first rib resection is warranted.
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Affiliation(s)
- L. McCance
- Department of AnaesthesiaAberdeen Royal Infirmary, NHS GrampianAberdeenUK
| | - E. C. Smith
- School of Medicine, Medical Sciences and NutritionUniversity of AberdeenAberdeenUK
| | - J. Moore
- Department of AnaesthesiaAberdeen Royal Infirmary, NHS GrampianAberdeenUK
- School of Medicine, Medical Sciences and NutritionUniversity of AberdeenAberdeenUK
| | - P. Forget
- Department of AnaesthesiaAberdeen Royal Infirmary, NHS GrampianAberdeenUK
- School of Medicine, Medical Sciences and NutritionUniversity of AberdeenAberdeenUK
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al 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Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Moore J, Goodson N, Wicks P, Reites J. What role can decentralized trial designs play to improve rare disease studies? Orphanet J Rare Dis 2022; 17:240. [PMID: 35725484 PMCID: PMC9207830 DOI: 10.1186/s13023-022-02388-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
People affected by rare diseases want to be involved in research and the search for new treatments. Randomized controlled trials remain the best way of finding new interventions, but many elements of traditional study design are not best suited for rare diseases. Barriers to patients and families include the use of specialist hospital sites for recruitment, requiring frequent site-based study visits for data collection, and a high burden of tests and outcome measures in research. While decentralized clinical trial (DCT) designs have been developed in some rare disease trials, changes necessitated by the COVID-19 pandemic present an opportunity for them to become a standard approach. DCT approaches have been shown to be more resilient to changes in enrolment and attrition during COVID-19 than traditional designs and offer benefits in terms of patient burden, convenience, inclusion, and data quality. Digital tools such as wearable devices and electronic clinical outcome assessments may also provide more convenient and environmentally valid measures of how a condition affects the life of an individual in their regular environment (e.g. mobility around the home versus a hospital corridor). Digital solutions have greater ability to support language localization, accessibility, and may lead to increase access to global rare disease trials. In parallel, challenges exist, such as the technical support, the digital divide, ensuring high quality data, and delivering safe trials.
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Affiliation(s)
- J Moore
- THREAD Research, 155 El Camino Real, Tustin, CA, 92780, USA
| | - N Goodson
- THREAD Research, 155 El Camino Real, Tustin, CA, 92780, USA.
| | - P Wicks
- THREAD Research, 155 El Camino Real, Tustin, CA, 92780, USA.,Wicks Digital Health, Advantage House, Lichfield, WS13 6AQ, Staffordshire, UK
| | - J Reites
- THREAD Research, 155 El Camino Real, Tustin, CA, 92780, USA
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Morris R, Standerline G, Webster E, Moore J, Godfrey A, Amjad A. iFall: An instrumented application for falls reporting in Parkinson's disease. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Siemers E, Hitchcock J, Sundell K, Dean R, Jerecic J, Cline E, Iverson K, Moore J, Edgar C, Manber R, Fuin N, Poppe T, Barton R. ACU193, a Monoclonal Antibody that Selectively Binds Soluble Aß Oligomers: Development Rationale, Phase 1 Trial Design, and Clinical Development Plan. J Prev Alzheimers Dis 2022; 10:19-24. [PMID: 36641606 DOI: 10.14283/jpad.2022.93] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Alzheimer's disease is a large and growing unmet medical need. Clinical trial designs need to assess disease-related outcomes earlier to accelerate the development of better treatments for Alzheimer's disease. ACU193 is a monoclonal antibody that selectively targets amyloid β oligomers, thought to be the most toxic species of Aβ that accumulates early in AD and contributes to downstream pathological effects. Nonclinical data indicate that ACU193 can reduce the toxic effects of amyloid β oligomers. ACU193 is currently being investigated in a phase 1 clinical trial designed with the properties described in this report. This phase 1 trial is designed to provide data to enable a go/no-go decision regarding the initiation of a subsequent phase 2/3 study. OBJECTIVES To design a phase 1 study that assesses target engagement and incorporates novel measures to support more rapid development of a potential disease-modifying treatment for Alzheimer's disease. DESIGN The INTERCEPT-AD trial for ACU193 is an ongoing randomized, placebo-controlled phase 1a/b study that assesses safety, tolerability, pharmacokinetics, target engagement, clinical measures, and several Alzheimer's disease biomarkers, including novel digital and imaging biomarkers. SETTING For INTERCEPT-AD, brief inpatient stays for patients in the single ascending dose portion of the study, with the remainder of the evaluations being performed as outpatients at multiple clinical trial sites in the U.S. PARTICIPANTS Patients with early Alzheimer's disease (mild cognitive impairment or mild dementia with a positive florbetapir positron emission tomography scan). INTERVENTION ACU193 administered intravenously at doses of 2- 60 mg/kg. MEASUREMENTS Safety assessments including magnetic resonance imaging for the presence of amyloid-related imaging abnormalities, clinical assessments for Alzheimer's disease including the Alzheimer's Disease Rating Scale-cognition and Clinical Dementia Rating scale, pharmacokinetics, a measure of target engagement, and digital and imaging biomarkers, including a computerized cognitive test battery and a measure of cerebral blood flow using arterial spin labelling magnetic resonance imaging. RESULTS A phase 1 study design was developed for ACU193 that allows collection of data that will enable a go/no-go decision for initiation of a subsequent adaptive phase 2/3 study. CONCLUSIONS A phase 1a/b trial and an overall clinical development plan for an Alzheimer's disease treatment can be designed that maintains patient safety, allows informed decision-making, and achieves an accelerated timeline by using novel biomarkers and adaptive study designs.
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Affiliation(s)
- E Siemers
- Eric Siemers, Acumen Pharmaceuticals, Inc., 11711 N. Meridian St., Ste. 310, Carmel, IN 46032, USA,
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17
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Bello N, Moore J, Miller E, Tom S, Bairey Merz C, Haas DM, Ferries-Rowe E, Grobman W, Greenland P, Khan S, Kim J, Chung JH, Huynh P, Varagic J, McNeil R, Parker C, Wapner R. Cardiometabolic health after first pregnancy: Associations with social determinants of health. A nuMoM2b-HHS study. Am Heart J Plus 2022; 13:100114. [PMID: 37122821 PMCID: PMC10134060 DOI: 10.1016/j.ahjo.2022.100114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Study objective This study sought to evaluate the associations between social determinants of health (SDOH) at the time of first pregnancy and subsequent cardiometabolic health, defined as the development of metabolic syndrome. Design nuMoM2b-HHS (Nulliparous Pregnancy Outcomes Study- Monitoring Mothers-to-Be-Heart Health Study) is an ongoing prospective cohort study. Setting Eight academic medical centers enrolled and continue to follow participants. Participants 4484 participants followed a mean of 3.2 years from the time of their first pregnancy. Interventions N/a. Main outcome measure Unadjusted and adjusted Poisson regression models with robust standard errors were used to obtain relative risks and 95% confidence intervals estimating the risk of metabolic syndrome for each baseline SDOH. In secondary analyses we examined the associations between SDOH and incident hypertension, obesity, and diabetes mellitus. Results Metabolic syndrome developed in 13.6% of participants. Higher socioeconomic position at the time of pregnancy was associated with lower rates of metabolic syndrome [income > 200% poverty level aRR 0.55 (95% CI, 0.42-0.71), attainment of a bachelor's degree aRR 0.62 (0.46-0.84) or higher aRR 0.50 (0.35-0.71)], while being single [aRR 1.45 (95% CI, 1.18-1.77)] and having low health literacy were associated with a greater risk of metabolic syndrome [aRR 1.98 (95% CI, 1.28-3.07)]. Conclusions Over a short interval following first pregnancy, participants accumulated high proportions of cardiovascular risk factors and metabolic syndrome, with some risk associated with SDOH. The impact of interventions addressing SDOH in pregnant people on cardiometabolic health should be tested as a means of reducing health inequities at the population level.
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Affiliation(s)
- N.A. Bello
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, United States of America
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, United States of America
- Corresponding author at: Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, AHSP, A3100, Los Angeles, CA 90048, United States of America. (N.A. Bello). @NatalieBello9
| | - J. Moore
- Research Triangle Institute, United States of America
| | - E.C. Miller
- Department of Neurology, Division of Stroke and Cerebrovascular Disease, Columbia University Vagelos College of Physicians and Surgeons, United States of America
| | - S.E. Tom
- Departments of Neurology and Epidemiology, Columbia University, United States of America
| | - C.N. Bairey Merz
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, United States of America
| | - D. M. Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, United States of America
| | - E.A. Ferries-Rowe
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, United States of America
| | - W.A. Grobman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, United States of America
| | - P. Greenland
- Department of Preventive Medicine and Division of Cardiology, Feinberg School of Medicine, Northwestern University, United States of America
| | - S.S. Khan
- Department of Preventive Medicine and Division of Cardiology, Feinberg School of Medicine, Northwestern University, United States of America
| | - J.K. Kim
- Department of Medicine, Division of Cardiology, University of California, Irvine, United States of America
| | - J. H. Chung
- Department of Obstetrics and Gynecology, University of California, Irvine, United States of America
| | - P.L.L. Huynh
- Department of Obstetrics and Gynecology, University of California, Irvine, United States of America
| | - J. Varagic
- Division of Cardiovascular Sciences, Vascular Biology and Hypertension Branch, National Heart Lung and Blood Institute, United States of America
| | - R.B. McNeil
- Research Triangle Institute, United States of America
| | - C.B. Parker
- Research Triangle Institute, United States of America
| | - R. Wapner
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Columbia University Irving Medical Center, United States of America
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Durrand JW, Moore J, Danjoux G. Prehabilitation and preparation for surgery: has the digital revolution arrived? Anaesthesia 2021; 77:635-639. [PMID: 34793598 DOI: 10.1111/anae.15622] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 12/24/2022]
Affiliation(s)
- J W Durrand
- Northern School of Anaesthesia and Intensive care Medicine, Health Education England-North East, Newcastle-upon-Tyne, UK.,Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, UK
| | - J Moore
- Department of Anaesthesia and Intensive Care Medicine, Manchester University NHS Foundation Trust, Manchester, UK.,Greater Manchester Cancer Clinical Director for Prehab and Recovery, Manchester, UK
| | - G Danjoux
- Department of Peri-operative and Sleep Medicine, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.,Hull York Medical School, York, UK
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Penugonda M, Walsh J, Barry JJ, Govern RM, Bradley D, Bolger M, English G, Moore J, Nolan N, Treacy E, Burke J, Dwyer N, Gallagher D, Macken S, McCaffrey S, Moloney S, Murphy R, Murray M, Hanlon EO. 231 ESTABLISHING AN INTERVENTIONS BUNDLE TO IMPROVE INPATIENT CARE FOR PATIENTS WITH PARKINSON’S DISEASE: A MULTIDISCIPLINARY QUALITY IMPROVEMENT PROJECT. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.231] [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: 02/25/2023] Open
Abstract
Abstract
Background
Patients with Parkinson’s (PwP) are at a higher risk of complications once admited to hospital compared to their age-matched peers. Medication mismanagement is a well-known obstacle, which puts PwP at risk of sub-optimal treatment leading to an unnecessary deterioration of baseline and potentially increases risk of adverse sequelae.
Methods
Retrospective electronic patient records (EPR)/chart review of 47 admissions was conducted, across three hospital sites.
Data attaining to correct prescribing of medication on admission and discharge, prescribing of contraindicated medications, reasons for medication lapses and complications of inpatient stay were collected. EPR of 17 patients’ were reviewed to assess if Parkinson’s disease (PD) medication administrations occurred within 30 minutes of patient schedule, as recommended by NICE guidelines. Key areas for improvement were identified based on the results.
Results
47 charts (30 Males, 17 Females) with mean age 72 (range:57–90), were reviewed. Average number of co-morbidities:4.5 and Clinical Frailty Scale ranged 5–9 (n = 30). LOS averaged 12.4 days and 43% of patients had ≥2 hospital admissions in the preceeding year.
38% (17/44) of admissions correctly documented patient specific medication times. Only 48% of patients (n = 638) received their medications within 30 minutes of the scheduled time. 47% (22/47) experienced complications attributable to PD. Contraindicated medications were noted in 5 cases. 84% of discharging prescriptions did not mention timing of PD medication and 3 prescriptions had errors with regards to dosage/omission of medication.
Conclusion
We implemented across two sites: 1) Care protocol flag in patient’s chart highlighting simple avoidable complications. 2) Laminated over the bed signpost alerting ‘time critical medication’. 3) ‘Time critical medication’ stickers in drug kardex 4) Education sessions for Medical, Nursing and Ward staff. 6) Establishing out of hours access to PD medications and protocols for NPO/poor swallow. We plan to reassess significance of efforts post intervention.
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Affiliation(s)
| | - J Walsh
- St. Luke's General Hospital , Kilkenny, Ireland
| | - J J Barry
- St. Michael's Hospital , Dublin, Ireland
| | - R M Govern
- St. Luke's General Hospital , Kilkenny, Ireland
| | - D Bradley
- St. James Hospital , Dublin, Ireland
| | - M Bolger
- St. Luke's General Hospital , Kilkenny, Ireland
| | - G English
- St. Luke's General Hospital , Kilkenny, Ireland
| | - J Moore
- St. Luke's General Hospital , Kilkenny, Ireland
| | - N Nolan
- St. Luke's General Hospital , Kilkenny, Ireland
| | - E Treacy
- St. Luke's General Hospital , Kilkenny, Ireland
| | - J Burke
- St. Michael's Hospital , Dublin, Ireland
| | - N Dwyer
- St. Michael's Hospital , Dublin, Ireland
| | | | - S Macken
- St. Michael's Hospital , Dublin, Ireland
| | | | - S Moloney
- St. Michael's Hospital , Dublin, Ireland
| | - R Murphy
- St. Michael's Hospital , Dublin, Ireland
| | - M Murray
- St. Michael's Hospital , Dublin, Ireland
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Armbruster C, Marshall C, Garber A, Melvin J, Zemke A, Moore J, Zamora P, DePas W, Lee S, Cooper V, Bomberger J. 408: Pseudomonas aeruginosa adapts and evolves toward host restriction in the sinuses of people with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01832-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Moore J, Travis S, Lee M. Assessing the Efficacy of Predictive Resting Energy Expenditure in Strength and Power Athletes. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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22
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O’Reilly A, Tibbs M, Booth A, Doyle E, McKeague B, Moore J. A rapid review investigating the potential impact of a pandemic on the mental health of young people aged 12-25 years. Ir J Psychol Med 2021; 38:192-207. [PMID: 32912358 PMCID: PMC7711353 DOI: 10.1017/ipm.2020.106] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/28/2020] [Accepted: 09/07/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES In March 2020, the World Health Organization (WHO) officially declared the spread of coronavirus disease 2019 (COVID-19) as a pandemic. Adolescence and early adulthood are peak times for the onset of mental health difficulties. Exposure to a pandemic during this vulnerable developmental period places young people at significant risk of negative psychological experiences. The objective of this research was to summarise existing evidence on the potential impact of a pandemic on the mental health of 12-25 year olds. METHODS A rapid review of the published peer-reviewed literature, published between 1985 and 2020, using PsycINFO (Proquest) and Medline (Proquest) was conducted. Narrative synthesis was used across studies to identify key themes and concepts. RESULTS This review found 3,359 papers, which was reduced to 12 papers for data extraction. Results regarding the prevalence of psychological difficulties in youth were mixed, with some studies finding this group experience heightened distress during an infectious disease outbreak, and others finding no age differences or higher distress among adults. Gender, coping, self-reported physical health and adoption of precautionary measures appear to play a role in moderating the psychological impact of an infectious disease outbreak. Most studies were conducted after the peak of an epidemic/pandemic or in the recovery period. CONCLUSIONS More longitudinal research with young people, particularly adolescents in the general population, before and during the early stages of an infectious disease outbreak is needed to obtain a clear understanding of how best to support young people during these events.
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Affiliation(s)
- A. O’Reilly
- Jigsaw – The National Centre for Youth Mental Health, Dublin, Ireland
| | - M. Tibbs
- Jigsaw – The National Centre for Youth Mental Health, Dublin, Ireland
| | - A. Booth
- Jigsaw – The National Centre for Youth Mental Health, Dublin, Ireland
| | - E. Doyle
- Jigsaw – The National Centre for Youth Mental Health, Dublin, Ireland
| | - B. McKeague
- Department of Psychology, Maynooth University, Maynooth, County Kildare
| | - J. Moore
- Jigsaw – The National Centre for Youth Mental Health, Dublin, Ireland
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Moore J, Lakshmanan S, Kinninger A, Sheppard J, Spiers S, Prusty B, Lopez B, Agbalog J, Budoff M. Coronary Plaque Burden Is Similar Between Young Female Adults With Systemic Lupus Erythematosus And Type 2 Diabetes Mellitus. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Matthay ZA, Hellmann ZJ, Callcut RA, Matthay EC, Nunez-Garcia B, Duong W, Nahmias J, LaRiccia AK, Spalding MC, Dalavayi SS, Reynolds JK, Lesch H, Wong YM, Chipman AM, Kozar RA, Penaloza L, Mukherjee K, Taghlabi K, Guidry CA, Seng SS, Ratnasekera A, Motameni A, Udekwu P, Madden K, Moore SA, Kirsch J, Goddard J, Haan J, Lightwine K, Ontengco JB, Cullinane DC, Spitzer SA, Kubasiak JC, Gish J, Hazelton JP, Byskosh AZ, Posluszny JA, Ross EE, Park JJ, Robinson B, Abel MK, Fields AT, Esensten JH, Nambiar A, Moore J, Hardman C, Terse P, Luo-Owen X, Stiles A, Pearce B, Tann K, Abdul Jawad K, Ruiz G, Kornblith LZ. Outcomes after ultramassive transfusion in the modern era: An Eastern Association for the Surgery of Trauma multicenter study. J Trauma Acute Care Surg 2021; 91:24-33. [PMID: 34144557 PMCID: PMC8243874 DOI: 10.1097/ta.0000000000003121] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Indexed: 01/28/2023]
Abstract
BACKGROUND Despite the widespread institution of modern massive transfusion protocols with balanced blood product ratios, survival for patients with traumatic hemorrhage receiving ultramassive transfusion (UMT) (defined as ≥20 U of packed red blood cells [RBCs]) in 24 hours) remains low and resource consumption remains high. Therefore, we aimed to identify factors associated with mortality in trauma patients receiving UMT in the modern resuscitation era. METHODS An Eastern Association for the Surgery of Trauma multicenter retrospective study of 461 trauma patients from 17 trauma centers who received ≥20 U of RBCs in 24 hours was performed (2014-2019). Multivariable logistic regression and Classification and Regression Tree analysis were used to identify clinical characteristics associated with mortality. RESULTS The 461 patients were young (median age, 35 years), male (82%), severely injured (median Injury Severity Score, 33), in shock (median shock index, 1.2; base excess, -9), and transfused a median of 29 U of RBCs, 22 U of fresh frozen plasma (FFP), and 24 U of platelets (PLT). Mortality was 46% at 24 hours and 65% at discharge. Transfusion of RBC/FFP ≥1.5:1 or RBC/PLT ≥1.5:1 was significantly associated with mortality, most pronounced for the 18% of patients who received both RBC/PLT and RBC/FFP ≥1.5:1 (odds ratios, 3.11 and 2.81 for mortality at 24 hours and discharge; both p < 0.01). Classification and Regression Tree identified that age older than 50 years, low initial Glasgow Coma Scale, thrombocytopenia, and resuscitative thoracotomy were associated with low likelihood of survival (14-26%), while absence of these factors was associated with the highest survival (71%). CONCLUSION Despite modern massive transfusion protocols, one half of trauma patients receiving UMT are transfused with either RBC/FFP or RBC/PLT in unbalanced ratios ≥1.5:1, with increased associated mortality. Maintaining focus on balanced ratios during UMT is critical, and consideration of advanced age, poor initial mental status, thrombocytopenia, and resuscitative thoracotomy can aid in prognostication. LEVEL OF EVIDENCE Prognostic, level III.
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Affiliation(s)
- Zachary A Matthay
- From the Department of Surgery at Zuckerberg San Francisco General Hospital, University of California San Francisco (Z.A.M., Z.J.H., R.A.C., B.N.-G., L.Z.K., E.E.R., J.J.P., B.R., M.K.A., A.T.F.), San Francisco, California; Department of Epidemiology and Biostatistics, University of California San Francisco (E.C.M), San Francisco, California; Department of Laboratory Medicine, University of California, San Francisco (J.H.E., A.N., J.M.), San Francisco, California; Department of Surgery, University of California Irvine (W.D., J.N.), Irvine, Orange, California; Department of Surgery, Ohio Health Grant Medical Center (A.K.L., M.C.S.), Columbus, Ohio; Department of Surgery, University of Kentucky (S.S.D., J.K.R.), Lexington, Kentucky; Department of Surgery, Miami Valley Hospital (H.L., Y.W., C.H.), Dayton, Ohio; Department of Surgery, R Adams Cowley Shock Trauma Center (A.M.C., R.A.K., P.T.), University of Maryland School of Medicine, Baltimore, Maryland; Department of Surgery, Loma Linda Medical Center (L.P., K.M., X.L.-O.), Loma Linda, California; Department of Surgery, University of Kansas Medical Center (K.T., C.A.G.), Kansas City, Kansas; Department of Surgery, Crozer-Chester Medical Center (S.S.S., A.R.), Upland, Pennsylvania; Department of Surgery, WakeMed Health and Hospitals (A.M., P.U., A.S., B.P., K.T.), Raleigh, North Carolina; Department of Surgery, University of New Mexico School of Medicine (K.M., S.A.M.), Albuquerque, New Mexico; Department of Surgery, Wellspan York Hospital (J.G.), York, Pennsylvania; Department of Surgery, Ascension Via Christi Hospitals St. Francis (J.K., J.H., K.L.), Wichita, Kansas; Department of Surgery, Maine Medical Center (J.B.O., D.C.C.), Portland, Maine; Department of Surgery, South Shore Hospital/Brigham and Women's Hospital (S.A.S., J.C.K.), Boston, Massachusetts; Department of Surgery, Penn State Hershey Medical Center (J.G., J.P.H.), Hershey, Pennsylvania; Department of Surgery, Northwestern University Feinberg School of Medicine (A.Z.B., J.A.P.), Chicago, Illinois; Department of Surgery, University of California (R.A.C.), UC Davis, Sacramento, California; Department of Surgery, Ryder Trauma Center (K.A.J., G.R.), University of Miami Miller School of Medicine, Miami, Florida; and Washington University School of Medicine St. Louis (J.K.), Missouri
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Burrage EN, Aboaziza E, Hare L, Reppert S, Moore J, Goldsmith WT, Kelley EE, Mills A, Dakhlallah D, Chantler PD, Olfert IM. Long-term cerebrovascular dysfunction in the offspring from maternal electronic cigarette use during pregnancy. Am J Physiol Heart Circ Physiol 2021; 321:H339-H352. [PMID: 34170194 DOI: 10.1152/ajpheart.00206.2021] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Electronic cigarettes (E-cigs) have been promoted as harm-free or less risky than smoking, even for women during pregnancy. These claims are made largely on E-cig aerosol having fewer number of toxic chemicals compared with cigarette smoke. Given that even low levels of smoking are found to produce adverse birth outcomes, we sought to test the hypothesis that vaping during pregnancy (with or without nicotine) would not be harm-free and would result in vascular dysfunction that would be evident in offspring during adolescent and/or adult life. Pregnant female Sprague Dawley rats were exposed to E-cig aerosol (1 h/day, 5 days/wk, starting on gestational day 2 until pups were weaned) using e-liquid with 0 mg/mL (E-cig0) or 18 mg/mL nicotine (E-cig18) and compared with ambient air-exposed controls. Body mass at birth and at weaning were not different between groups. Assessment of middle cerebral artery (MCA) reactivity revealed a 51%-56% reduction in endothelial-dependent dilation response to acetylcholine (ACh) for both E-cig0 and E-cig18 in 1-mo, 3-mo (adolescent), and 7-mo-old (adult) offspring (P < 0.05 compared with air, all time points). MCA responses to sodium nitroprusside (SNP) and myogenic tone were not different across groups, suggesting that endothelial-independent responses were not altered. The MCA vasoconstrictor response (5-hydroxytryptamine, 5-HT) was also not different across treatment and age groups. These data demonstrate that maternal vaping during pregnancy is not harm-free and confers significant cerebrovascular health risk/dysfunction to offspring that persists into adult life. NEW & NOTEWORTHY These data established that vaping electronic cigarettes during pregnancy, with or without nicotine, is not safe and confers significant risk potential to the cerebrovascular health of offspring in early and adult life. A key finding is that vaping without nicotine does not protect offspring from cerebrovascular dysfunction and results in the same level of cerebrovascular dysfunction (compared with maternal vaping with nicotine), indicating that the physical and/or chemical properties from the base solution (other than nicotine) are responsible for the cerebrovascular dysfunction that we observed. Listen to this article's corresponding podcast at https://ajpheart.podbean.com/e/maternal-vaping-impairs-vascular-function-in-theoffspring/.
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Affiliation(s)
- E N Burrage
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,Department of Neuroscience, West Virginia University, Morgantown, West Virginia
| | - E Aboaziza
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,West Virginia Clinical and Translational Science Institute, West Virginia University, Morgantown, West Virginia
| | - L Hare
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,Division of Exercise Physiology, West Virginia University, Morgantown, West Virginia
| | - S Reppert
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,Division of Exercise Physiology, West Virginia University, Morgantown, West Virginia
| | - J Moore
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia
| | - W T Goldsmith
- Center for Inhalation Toxicology, West Virginia University, Morgantown, West Virginia.,Department of Physiology and Pharmacology, West Virginia University, Morgantown, West Virginia
| | - E E Kelley
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, West Virginia
| | - A Mills
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, West Virginia
| | - D Dakhlallah
- Department of Microbiology, Immunology and Cell Biology, West Virginia University, Morgantown, West Virginia
| | - P D Chantler
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,Department of Neuroscience, West Virginia University, Morgantown, West Virginia.,West Virginia Clinical and Translational Science Institute, West Virginia University, Morgantown, West Virginia.,Division of Exercise Physiology, West Virginia University, Morgantown, West Virginia
| | - I M Olfert
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,West Virginia Clinical and Translational Science Institute, West Virginia University, Morgantown, West Virginia.,Division of Exercise Physiology, West Virginia University, Morgantown, West Virginia.,Center for Inhalation Toxicology, West Virginia University, Morgantown, West Virginia.,Department of Physiology and Pharmacology, West Virginia University, Morgantown, West Virginia
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Roy S, Cheng M, Chang S, Moore J, De Luca G, Nawab S, De Luca C. A Combined sEMG and Accelerometer System for Monitoring Functional Activity in Stroke. IEEE Trans Neural Syst Rehabil Eng 2021; PP. [PMID: 34077365 DOI: 10.1109/tnsre.2009.2039597] [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: 11/08/2022]
Abstract
Remote monitoring of physical activity using bodyworn sensors provides an alternative to assessment of functional independence by subjective, paper-based questionnaires. This study investigated the classification accuracy of a combined surface electromyographic (sEMG) and accelerometer (ACC) sensor system for monitoring activities of daily living in patients with stroke. sEMG and ACC data were recorded from 10 hemi paretic patients while they carried out a sequence of 11 activities of daily living (Identification tasks), and 10 activities used to evaluate misclassification errors (non-Identification tasks). The sEMG and ACC sensor data were analyzed using a multilayered neural network and an adaptive neuro-fuzzy inference system to identify the minimal sensor configuration needed to accurately classify the identification tasks, with a minimal number of misclassifications from the non-Identification tasks. The results demonstrated that the highest sensitivity and specificity for the identification tasks was achieved using a subset of 4 ACC sensors and adjacent sEMG sensors located on both upper arms, one forearm, and one thigh, respectively. This configuration resulted in a mean sensitivity of 95.0 %, and a mean specificity of 99.7 % for the identification tasks, and a mean misclassification error of < 10% for the non-Identification tasks. The findings support the feasibility of a hybrid sEMG and ACC wearable sensor system for automatic recognition of motor tasks used to assess functional independence in patients with stroke.
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27
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Kim Hoehamer Y, Riberdy J, Zheng F, Park J, Shang N, Metais J, Velasquez P, Akel S, Moore J, Triplett B, Talleur A, Gottschalk S, Zhou S. Development of a cgmp-compliant process to manufacture donor-derived, CD45RA-depleted memory cd19- car T-Cells. Cytotherapy 2021. [DOI: 10.1016/s1465324921005685] [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: 10/21/2022]
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Napier J, Zhou AY, Moore J. A service evaluation of an occupational health Covid-19 referral pathway. Occup Med (Lond) 2021; 71:75-78. [PMID: 33420507 PMCID: PMC7928657 DOI: 10.1093/occmed/kqaa223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background A rapid management referral pathway was established by a private UK occupational health (OH) provider to offer assessments and advice on managing individual risk relating to Covid-19 in the workplace. Aims The aim of this service evaluation was to assess the utilization and effectiveness of the pathway in supporting referrers during a pandemic. Methods Referrals between March–August 2020 were analysed by date and industry to assess service utilization. A survey was sent to a convenience sample of referrers throughout this period, requesting feedback on whether the report led to a change in how the worker was managed, and whether it increased referrer confidence in managing the worker. Results Five hundred and seventy referrals were made, predominantly from wholesale and retail; professional, scientific and technical; and food and drink production. There was a small peak of referrals from manufacturing in April and a larger peak in July–August from wholesale and retail, and food and drink production. Of 166 surveys sent, 58 were completed (35% response rate). In 71% of cases, referrers indicated that the report led to change in how the worker was managed, and in 86% of cases, referrers reported being more confident in managing the worker. Conclusions The pathway was well-utilized. OH assessments and advice have an important role to play in a pandemic, with useful impact on how workers are managed and how confident managers feel in managing workers.
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Affiliation(s)
- J Napier
- RPS Group Ltd, Occupational Health, London, UK
| | - A Y Zhou
- RPS Group Ltd, Occupational Health, Ellesmere Port, UK
| | - J Moore
- RPS Group Ltd, Occupational Health, London, UK
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29
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O'Doherty M, Rendall J, Moore J, Millar C. P228 Concerns for people with cystic fibrosis when travelling pre-COVID-19. J Cyst Fibros 2021. [PMCID: PMC8192133 DOI: 10.1016/s1569-1993(21)01253-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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30
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Casavant SG, Li H, Cong X, Starkweather A, Moore J, Rosenkrantz TS, Fitch RH. Behavioral and neuroanatomical outcomes following altered serotonin expression in a hypoxic-ischemic injury neonate rodent model. J Neonatal Perinatal Med 2021; 14:353-360. [PMID: 33164949 DOI: 10.3233/npm-200418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Children born prematurely (<37 gestational weeks) are at risk for a variety of adverse medical events. They may experience ischemic and/or hemorrhagic events leading to negative neural sequelae. They are also exposed to repeated stressful experiences as part of life-saving care within the neonatal intensive care unit (NICU). These experiences have been associated with methylation of SLC6A4, a gene which codes for serotonin transport proteins, and is associated with anxiety, depression, and increased incidence of autism spectrum disorders.The purpose of this study was to examine the effects of altered serotonin levels on behavioral and neuroanatomical outcomes in a neonatal rodent model with or without exposure to hypoxic-ischemic (HI) injury. METHODS Wistar rat pups were randomly assigned to either HI injury or sham groups. Pups within each group were treated with a chronic SSRI (Citalopram HBr) to simulate the effects of SLC6A4 methylation, or saline (NS). Subjects were assessed on behavioral tasks and neuropathologic indices. RESULTS HI injured subjects performed poorly on behavioral tasks. SSRI subjects did not display significantly greater anxiety. HI + SSRI subjects learned faster than HI+NS. Histologically, SSRI subjects had predominantly larger brain volumes than NS. CONCLUSION SSRI treated subjects without injury showed patterns of increased anxiety, consistent with theories of SLC6A4 methylation. The paradoxical trend to improved cognition in HI+SSRI subjects relative to HI alone, may reflect an unexpected SSRI neuroprotective effect in the presence of injury, and may be related to serotonin-induced neurogenesis.
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Affiliation(s)
- S G Casavant
- University of Connecticut, School of Nursing, Storrs, CT, USA
| | - H Li
- University of Connecticut, Department of Statistics, Storrs, CT, USA
| | - X Cong
- University of Connecticut, School of Nursing, Storrs, CT, USA
| | - A Starkweather
- University of Connecticut, School of Nursing, Storrs, CT, USA
| | - J Moore
- University of Connecticut School of Medicine, Farmington, CT, USA
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - T S Rosenkrantz
- University of Connecticut School of Medicine, Farmington, CT, USA
- Connecticut Children's Medical Center, Hartford, CT, USA
| | - R H Fitch
- University of Connecticut, Department of Psychological Sciences, Storrs, CT, USA
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Barcellos-Hoff M, Sauquet IG, Moore J, Pujana M. Mechanism based signatures of TGFβ competency and DNA repair predict response to genotoxic therapies across cancer types. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31101-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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32
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Foschetti DA, Braga-Neto MB, Bolick D, Moore J, Alves LA, Martins CS, Bomfin LE, Santos A, Leitão R, Brito G, Warren CA. Clostridium difficile toxins or infection induce upregulation of adenosine receptors and IL-6 with early pro-inflammatory and late anti-inflammatory pattern. ACTA ACUST UNITED AC 2020; 53:e9877. [PMID: 32725081 PMCID: PMC7405017 DOI: 10.1590/1414-431x20209877] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/29/2020] [Indexed: 02/06/2023]
Abstract
Clostridium difficile causes intestinal inflammation, which increases adenosine. We compared the expression of adenosine receptors (AR) subtypes A1, A2A, A2B, and A3 in HCT-8, IEC-6 cells, and isolated intestinal epithelial cells, challenged or not with Clostridium difficile toxin A and B (TcdA and TcdB) or infection (CDI). In HCT-8, TcdB induced an early A2BR expression at 6 h and a late A2AR expression at 6 and 24 h. In addition, both TcdA and TcdB increased IL-6 expression at all time-points (peak at 6 h) and PSB603, an A2BR antagonist, decreased IL-6 expression and production. In isolated cecum epithelial cells, TcdA induced an early expression of A2BR at 2s and 6 h, followed by a late expression of A2AR at 6 and 24 h and of A1R at 24 h. In CDI, A2AR and A2BR expressions were increased at day 3, but not at day 7. ARs play a role in regulating inflammation during CDI by inducing an early pro-inflammatory and a late anti-inflammatory response. The timing of interventions with AR antagonist or agonists may be of relevance in treatment of CDI.
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Affiliation(s)
- D A Foschetti
- Departamento de Morfologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - M B Braga-Neto
- Departamento de Morfologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - D Bolick
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - J Moore
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - L A Alves
- Departamento de Ciências Médicas, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - C S Martins
- Departamento de Morfologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - L E Bomfin
- Departamento de Ciências Médicas, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - Aaqa Santos
- Departamento de Morfologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - Rfc Leitão
- Departamento de Morfologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - Gac Brito
- Departamento de Morfologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
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Payne SR, Fowler S, Mundy AR, Alhasso A, Almallah Y, Anderson P, Andrich D, Baird A, Biers S, Browning A, Chapple C, Cherian J, Clarke L, Conn I, Dickerson D, Doble A, Dorkin T, Duggan B, Eardley I, Garaffa G, Greenwell T, Hadway P, Harding C, Hilmy M, Inman R, Kayes O, Kirchin V, Krishnan R, Kumar V, Lemberger J, Malone P, Moore J, Moore K, Mundy A, Noble J, Nurse D, Palmer M, Payne S, Pickard R, Rai J, Rees R, Roux J, Seipp C, Shabbir M, Saxby M, Sharma D, Sinclair A, Summerton D, Tatarov O, Thiruchelvam N, Venn S, Watkin N, Zacherakis E. The logistical management of tertiary urethral disease in the United Kingdom: Implications from an online audit of male reconstructive urethral surgery. Journal of Clinical Urology 2020. [DOI: 10.1177/2051415819894182] [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: 12/24/2022]
Abstract
Objective: To determine those patient groupings, based on volume and risk, whose optimal urethral reconstructive management might be provided by a reorganisation of UK reconstructive surgeons. Methods: Between 2010 and 2017, ~689 men/year were enrolled onto an online audit platform collecting data about urethral reconstruction in the UK; this accrual was compared against hospital episode statistics (HES). The available workforce, and where this was based, was collected. Individual and institutional incumbent patient volumes, pathology, surgical complexity and outcomes from treatment were collated to stratify volume/risk groups. Results: More than 90% of all HES-recorded data were accrued, being provided by 50 surgeons at 39 operative sites. Most reconstructive surgery was provided at 10 centres performing >20 procedures/year. More than 50% of all interventions were of a high-volume low-risk type. Of activity, 32.3% was intermediate volume or moderate risk, and 12.5% of men presented for lower-volume or higher-risk procedures. Conclusion: Correlation of detailed volume/outcome data allows the definition of patient populations presenting for urethral reconstruction. Stratification of each group’s management, to optimise the surgical outcome, may be applied to a hierarchical service delivery model based on the complexity of the patient’s presenting urethral pathology. Level of evidence: Level IV
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Affiliation(s)
| | - Sarah Fowler
- British Association of Urological Surgeons, London, UK
| | - Anthony R Mundy
- University College London Hospitals NHS Foundation Trust, London, UK
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Hollimon L, Moore J, Richards S, Robbins R, Grandner M, Chung A, Chung D, Jean-Louis G, Seixas A. 1212 A Systematic Assessment Of Engagement, Functionality, Aesthetics, Information, And Recommendation Features In Sleep Mobile Applications. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Initial download and use of sleep tracking is very high, but prolonged use is very low. Poor prolonged use may be attributable to several factors such as engagement, functionality, aesthetics, information, and recommendation. We appraised these five factors in 16 consumer- and research/medical- grade digital sleep devices.
Methods
Three reviewers independently assessed 16 consumer- and medical-grade sleep digital devices using the Mobile Application Rating Scale (MARS) App quality ratings, which measures engagement (engagement, entertainment, interest, customization, interactivity, target group), functionality (functionality, performance, ease of use, navigation, gestural design), aesthetics (layout, graphics, visual appeal), information (Accuracy. Goals, Quality of information, Quantity of information, Visual information, Credibility, and Evidence base) and recommended on a Likert scale, with 1- Inadequate to 5 Excellent. Each subcategory is rated on a 1-5 Likert scale which is summed for each category: engagement (30), functionality (25), aesthetics (15), information (35) and recommended (yes or no).
Results
Devices that had the highest engagement score were Fitbit (27), Apple Watch (27), Garmin (27), and Dreem 2 headband (25.5). Apple Watch (30) had highest score; while Fitbit (13), Apple Watch (13), Garmin (13), Samsung Gear (13) had highest aesthetic score. While for information, ActiGraph (35), SOMNOwatch plus (35), CleveMed SleepView Monitor (35), CleveMed Sapphire PSG (35), SOMNOscreen plus (35), Nox T3 Sleep Monitor (35) and Nox A1 PSG System (35) had the highest ratings. The Dreem 2 headband has the potential induce prolong use among users with and without sleep disorders, based on high scores on engagement (25.5), Functionality (20.5), and Information (26.5).
Conclusion
Consumer- and research-grade digital devices that measure sleep have varying levels of engagement, functionality, aesthetics, information and recommendations to facilitate prolong use. Consumer grade devices had higher engagement, functionality and aesthetics scores, while research grade devices had higher information and recommendation scores. If consumer- and research-grade devices are to have prolonged use, standardization is needed across the five MARS components.
Support
K01HL135452, R01MD007716, R01HL142066, and K07AG052685
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Affiliation(s)
- L Hollimon
- NYU Grossman School of Medicine, New York, NY
| | - J Moore
- NYU Grossman School of Medicine, New York, NY
| | - S Richards
- NYU Grossman School of Medicine, New York, NY
| | | | | | - A Chung
- NYU Grossman School of Medicine, New York, NY
| | - D Chung
- NYU Grossman School of Medicine, New York, NY
| | | | - A Seixas
- NYU Grossman School of Medicine, New York, NY
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Garcia J, Moore J, Payano L, Rogers A, Poke P, Casimir G, Jean-Louis G, Seixas A. 1102 Relationship Between Emotional Distress And Sleep Duration Among Hispanics Using The 2018 National Health Interview Survey Dataset. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Although Hispanics experience a high level of shorter sleep duration (< 7 hrs./24 period), a clear mechanism or cause is lacking. Previous research indicate that emotional distress may explain the burden of shorter sleep among blacks. Applying these findings to Hispanics, we investigated whether emotional distress explains the burden of short sleep duration (< 7 hrs.) among Hispanics and if this relationship varies by sex
Methods
We used data from the 2018 National Health Interview Survey (NHIS) dataset, a nationally representative sample, in which only Hispanic ethnicity participants (N=3,091) were analyzed. Average sleep duration was self-reported and measured in hours. Emotional distress was measured using Kessler 6, which measures how an individual felt over the past 30 days: nervous, hopeless, restless/fidgety, depressed, effortful and worthless. To assess the association between short sleep duration and emotional distress, we performed Pearson correlation, hierarchical regression analyses, and stratified this relationship by sex to determine if this relationship differed between males and females, adjusting for covariates.
Results
Of the total sample of 3,091 Hispanics, 1,762 were female, and 1,329 were male. Sleep duration and emotional distress were negatively correlated among females (r = -.27, p <.001) and males (r=-.18, p <.001). Among Hispanic females, sleep duration significantly predicted emotional distress, β = -.27, t = -11.60, p <.001, and explained a significant portion of variance in emotional distress, R2 = .07, F= 134.63, p <.001. While, among Hispanic males, sleep significantly predicted emotional distress (β = -.18, t =-6.5, p <.001) and explained a significant portion of the variance in emotional distress (R2 = .03, F= 42.37, p <.001).
Conclusion
Our findings indicate that a negative sleep-ED relationship, suggesting that shorter sleep was predictive of higher levels of emotional distress among Hispanics and that this relationship is greater among Hispanic females, compared males.
Support
K01HL135452, R01MD007716, R01HL142066, and K07AG052685
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Affiliation(s)
- J Garcia
- NYU Grossman School of Medicine, New York, NY
| | - J Moore
- NYU Grossman School of Medicine, New York, NY
| | - L Payano
- NYU Grossman School of Medicine, New York, NY
| | - A Rogers
- St. John’s University, Queens, NY
| | - P Poke
- NYU Grossman School of Medicine, New York, NY
| | - G Casimir
- SUNY Downstate Medical Center, Brooklyn, NY
| | | | - A Seixas
- NYU Grossman School of Medicine, New York, NY
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Moore J, Williams N, Chung D, Parra Y, Jean-Louis G, Seixas A. 1113 Physical Activity Moderates The Sleep-emotional Distress Relationship, But Less So Among Blacks Vs. Whites. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Emotional distress (ED) is associated with poor sleep. Research shows that minority populations experience greater vulnerabilities to both ED and poor sleep. Interventions such as relaxation training and behavioral therapy address this relationship but are not always successful. Research shows that physical activity (PA) is negatively associated with ED and positively associated with sleep duration. However, it is unclear whether PA attenuates the relationship between ED and sleep, and if this relationship differs by race/ethnicity.
Methods
We analyzed data from the 2005-2015 National Health Interview Survey (NHIS), a nationally representative dataset of 416,152 participants. ED, hours of PA per day, and average sleep duration were collected. Regression models with covariates (age, sex, employment status, BMI) were used to analyze the moderation effect of PA within sleep and ED. Regression models were stratified by race/ethnicity.
Results
261,686 participants (45,926 blacks, 17.55%, and 215,760 whites, 82.45%) responded with the required variables for analysis. 63% of participants reported at least some physical activity. The results of the regression showed that a significant amount of variance in ED stemmed from sleep duration; F (7, 121088) = 1,619.72, p < 0.001. PA was found to have a significant main effect, t(121,088) = 9.01, p= <0.001. There was a significant moderation effect of PA, t(121088) =7.26, p < 0.001. Stratification showed that the moderation effect of PA was not significant among blacks t(121,088) = -1.45, p=0.149 and significant among whites b = -.08, t(101,754) = -7.82, p < 0.001.
Conclusion
The present study found support for moderation of PA in the sleep-ED relationship. However, it found that blacks do not experience the same benefits of PA in this relationship as whites. Further research should be performed to understand the connection of PA to sleep duration and ED.
Support
This study was supported by funding from the NIH: R01MD007716, R01HL142066, R01AG056531, K01HL135452, and K07AG052685
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Affiliation(s)
- J Moore
- NYU Grossman School of Medicine, New York, NY
| | - N Williams
- NYU Grossman School of Medicine, New York, NY
| | - D Chung
- NYU Grossman School of Medicine, New York, NY
| | - Y Parra
- NYU Grossman School of Medicine, New York, NY
| | | | - A Seixas
- NYU Grossman School of Medicine, New York, NY
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Aird C, Seixas A, Moore J, Nunes J, Gyamfi L, Garcia J, Blanc J, Williams N, Zizi F, Jean-Louis G. 1189 Recruiting, Training, And Implementing Sleep Health Educators In Community-based Research To Improve Sleep Health. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1183] [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] Open
Abstract
Abstract
Introduction
Adherence to OSA assessment and treatment is low among racial/ethnic minorities, particularly among blacks. Navigating patients along the continuum of care from assessment to treatment adherence requires motivation, social support, and self-efficacy. Previous studies indicate that community health educators can provide motivation, social support, and skills to patients to better navigate the complex OSA care continuum. However, recruiting, training, and implementing sleep health educators in clinical or research settings is complex. For the current study, we describe how we recruit, train, and implement sleep health educators in research and clinical settings and assess what makes a sleep health educator successful.
Methods
We recruited and trained twenty-five self-identified black sleep health educators for a randomized clinical trial (R01MD007716) focused on increasing OSA assessment and treatment adherence among blacks. During recruitment, we assessed key personality attributes that translate to being an effective sleep health educator, via behavioral and personality surveys, focused groups, and process forms filled out by educators. Sleep health educators underwent an 8-week training program on sleep health and motivational interviewing. In order to be certified, sleep health educators had to pass a written and scenario-based assessment. During the implementation phase of the trial, we assessed how many interviews each health educator conducted and whether individual characteristics were related to how many interviews.
Results
Of the trained educators, 80% were female, ranging from 25 to 58 years old. They all completed at least high school. All educators rated the program highly and were very satisfied with dispensing tailored sleep health education. Educators who displayed the highest knowledge about sleep health, provided frequent emotional and strategic support, committed to helping their assigned participants, and who rated their rapport highly with their assigned participants were most effective in getting their participant to adhere to OSA assessment and treatment.
Conclusion
Sleep health educators can be vital to increasing OSA assessment and treatment adherence among blacks. In order to ensure success, sleep health educators must undergo a thorough recruitment, training, and implementation and dissemination process.
Support
K01HL135452, R01MD007716, R01HL142066, K01HL135452,and K07AG052685
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Affiliation(s)
- C Aird
- NYU Grossman School of Medicine, New York, NY
| | - A Seixas
- NYU Grossman School of Medicine, New York, NY
| | - J Moore
- NYU Grossman School of Medicine, New York, NY
| | - J Nunes
- City College/ CUNY, New York, NY
| | - L Gyamfi
- NYU Grossman School of Medicine, New York, NY
| | - J Garcia
- NYU Grossman School of Medicine, New York, NY
| | - J Blanc
- NYU Grossman School of Medicine, New York, NY
| | - N Williams
- NYU Grossman School of Medicine, New York, NY
| | - F Zizi
- NYU Grossman School of Medicine, New York, NY
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Rogers A, Seixas A, Moore J, Zizi F, Williams S, Gyamfi L, Pichardo Y, Jean-Louis G. 0621 Utilization of the Ares to Predict OSA Among Blacks Using Home-Based Watchpat Recording. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
In two waves of data we collected in Brooklyn New York, we observed blacks were at high risk for obstructive sleep apnea (OSA). In the NIH-funded study ‘Metabolic Syndrome Outcome Study (MetSO), blacks enrolled from primary-care settings had a 59% risk of OSA. Similarly, blacks surveyed in churches and barbershops had a 43% risk of OSA. While these studies showed higher than expected risk as noted in the general population (29%), it remains uncertain how many of those blacks would be diagnosed with OSA in that population. The purpose of this study was to explore the rate of OSA using the WatchPat device in a community-based setting.
Methods
Data were collected from an NIH-funded study ‘Peer-Enhanced Education to Reduce Sleep Ethnic Disparities, designed to navigate blacks at risk of OSA to receive timely diagnosis and treatment using peer-delivered linguistically and culturally tailored sleep health education. Blacks were screened for OSA using the Apnea Risk Evaluation System (ARES) Questionnaire; a score ≥6 denoted moderate-high OSA risk. Individuals were asked to wear the WatchPAT 200 for one night during a week-long sleep assessment. WatchPat 200 measures SaO2 to determine respiratory-related arousals, defined as an Apnea-Hypopnea Index (AHI) ≥5, which is used to identify and diagnose OSA. We used SPSS 25.0 to perform logical regression analysis to assess associations between ARES and WatchPat AHI.
Results
A sample of 111 blacks provided valid ARES and WatchPat data for the present analyses. Of the sample, the mean age was 62.26 (SD=13.52 years; female = 55%); 49% reported annual income >20K and 79.5% reported a high school education. Moreover, 27% reported high blood pressure, 13%, diabetes, and 65% were overweight/obese. Multivariate-adjusted logical regression analyses indicated that blacks at risk for OSA were 66% more likely to receive an OSA diagnosis based on WatchPat AHI data (OR = 1.662, p < 0.01). The model adjusted for age, sex, income, and education.
Conclusion
The present study demonstrated that blacks at risk for OSA at the community level have a significant likelihood of receiving an OSA diagnosis using home-based recordings.
Support
NIH Support (T32HL129953, RO1MD007716, K01HL135452 and K07AG052685).
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Affiliation(s)
- A Rogers
- St. John’s University, Queens, NY
| | - A Seixas
- NYU Grossman School of Medicine, New York, NY
| | - J Moore
- NYU Grossman School of Medicine, New York, NY
| | - F Zizi
- NYU Grossman School of Medicine, New York, NY
| | - S Williams
- NYU Grossman School of Medicine, New York, NY
| | - L Gyamfi
- NYU Grossman School of Medicine, New York, NY
| | - Y Pichardo
- NYU Grossman School of Medicine, New York, NY
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Moore J, Seixas A, Casimir G, Nunes J, Matadiaby F, Khosrof A, Jean-Louis G. 1114 Urbanicity And The Sleep-mental Health Relationship. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Inadequate sleep has been found to be associated with poor mental health. This is especially true in low-income and minority populations, who are concentrated in cities. It is not understood to what degree living in a city vs. a rural environment affects sleep and resulting mental health outcomes. This study seeks to understand how living in an urban environment affects the relationship between inadequate sleep and mental health.
Methods
The study used data from the 2018 US Behavioral Risk Factor Surveillance System (BRFSS,) a nationwide health dataset collected by telephone. Respondents were classified as living in either an urban or rural environment based on their zip code. Respondents reported hours of sleep per night and mental health status. This study classified mental health status based on whether the respondent reported one or more incidences of poor mental health in the previous 30 days.
Results
After filtration, 348,540 respondents were split into urban and rural groups. Binary logistic regression was run in each group to compare how much living in an urban environment contributed to the relationship between sleep duration and mental health. Sleep in the analysis was found to significantly contribute to both models; urban X2(15, N=295,796) = 11,485.70, p <0.001 rural X2(15, N=52,744) = 2,465.64, p <0.001. The estimated odds ratio resulted in a decrease of 13.9% [Exp(B) = 0.861] in reported poor mental health for every unit increase of sleep in the urban population, and decrease of 14.9% [Exp(B) = 0.851] in the rural population.
Conclusion
In urban and rural dwellers, sleep duration predicted poor mental health. Contrary to expectations, sleep was more strongly tied to mental health in rural than urban populations. This was true even after controlling for sex, income, and education level. Further research should seek to understand how environment affects sleep and mental health.
Support
This study was supported by funding from the NIH: R01MD007716, R01HL142066, R01AG056531, K01HL135452, and K07AG052685.
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Affiliation(s)
- J Moore
- NYU Grossman School of Medicine, New York, NY
| | - A Seixas
- NYU Grossman School of Medicine, New York, NY
| | - G Casimir
- SUNY DownState Medical Center, Brooklyn, NY
| | - J Nunes
- City College / CUNY, New York, NY
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Abstract
Organismal fitness is partly determined by how well the nutritional intake matches sex-specific metabolic requirements. Metabolism itself is underpinned by complex genomic interactions involving products from both nuclear and mitochondrial genomes. Products from these two genomes must coordinate how nutrients are extracted, used and recycled, processes vital for fuelling reproduction. Given the complicated nature of metabolism, it is not well understood how the functioning of these two genomes is modulated by nutrients. Here we use nutritional geometry techniques on Drosophila lines that only differ in their mtDNA, with the aim to understand if there is nutrient-dependent mitochondrial genetic variance for male reproduction. We first find genetic variance for diet consumption, indicating that flies are consuming different amounts of food to meet new physiological requirements. We then find an interaction between mtDNA and diet for fitness, suggesting that the mtDNA plays a role in modulating diet-dependent fitness. Our results enhance our basic understanding of nutritional health and our chimeric genomes.
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Affiliation(s)
- M F Camus
- Research Department of Genetics, Evolution and Environment, University College, Gower Street, London WC1E 6BT, UK
| | - J Moore
- Research Department of Genetics, Evolution and Environment, University College, Gower Street, London WC1E 6BT, UK
| | - M Reuter
- Research Department of Genetics, Evolution and Environment, University College, Gower Street, London WC1E 6BT, UK
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Affiliation(s)
- R.R. Bennett
- Nephrology and Urology Service Walter Reed Army Medical Center Washington. DC 20307
| | - D.A. Bloom
- Nephrology and Urology Service Walter Reed Army Medical Center Washington. DC 20307
| | - J. Moore
- Nephrology and Urology Service Walter Reed Army Medical Center Washington. DC 20307
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Gangar V, Curiale MS, Lindberg K, Gambrel-Lenarz S, Adamson E, Barbari W, Brodsky M, Blackwell G, Bryce J, Cook P, Davis B, Deabel J, D’Onorio A, Follmi-Lieder E, Franklin J, Gambrel-Lenarz S, Horne S, James-Davis L, Lindgren S, McIntyre D, Moore J, Moorman M, Puccini M, Pulusani S, Sass A, Saunders L, Schop R, Sigua CA, Sinclair P, Story R, Westmoreland R, Windsor S, Witt JL. Dry Rehydratable Film Method for Enumerating Confirmed Escherichia coli in Poultry, Meats, and Seafood: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/82.1.73] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A rehydratable dry-film plating method for Escherichia coli, the Petrifilm E. coli/Coliform (EC) Count Plate in foods, has been compared with the AOAC INTERNATIONAL most probable number (MPN) method. Eleven laboratories participated in the collaborative study. Three E. coli levels in 8 samples each of frozen raw ground turkey, frozen raw ground beef, and frozen cooked fish were tested in duplicate. Mean log counts for the Petri film plate procedure were not significantly different from those for the MPN procedure for cooked fish samples inoculated with low or high inocula levels, for samples of raw turkey inoculated at medium level, and for beef inoculated at low, medium, and high levels. Repeatability and reproducibility vari ances of the Petrifilm EC Plate method recorded at 24 h were as good as or better than those of the MPN method. The dry rehydratable film method for enumerating confirmed E. coli in poultry, meats, and seafood has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
- Vidhya Gangar
- Silliker Laboratories Group, Inc., Corporate Research Center, 160 Armory Dr, South Holland, IL 60473
| | - Michael S Curiale
- Silliker Laboratories Group, Inc., Corporate Research Center, 160 Armory Dr, South Holland, IL 60473
| | - Kathryn Lindberg
- 3M Microbiology Products, 3M Center, Building 260-6B-01, St. Paul, MN 55144-1000
| | - Sonya Gambrel-Lenarz
- 3M Microbiology Products, 3M Center, Building 260-6B-01, St. Paul, MN 55144-1000
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Abeysinghe P, Morawaka L, Gunasekara S, Suresh S, Jayathilake P, Udara P, Siriwardena P, Milliken S, Moore J, Ma D. Country Report: The Report of Transplant Activity and Outcome During the First 12 Months at the First National Hematopoietic Stem Cell Transplant Center in Sri Lanka. Blood Cell Ther 2019; 2:50-53. [PMID: 37588103 PMCID: PMC10427228 DOI: 10.31547/bct-2019-007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/25/2019] [Indexed: 08/18/2023]
Abstract
Sri Lanka is a developing country with a population of 21 million. Nation Cancer Institute (NCI) is the largest tertiary cancer centre with universal health coverage. Absence of hematopoietic stem cell transplant (HSCT) was a major deficiency as most patients cannot afford transplant abroad. In 2013-14, NCI decided to establish the first National HSCT center in collaboration with St. Vincent's Hospital Sydney. Eventually, the first Autologous HSCT was established at NCI in December 2016. Patients with multiple myeloma (MM) in very good partial remission or better remission, and patients with relapsed Non-Hodgkin's lymphoma (NHL) and Hodgkin lymphoma (HL), who were less than 65 years with good performance status were selected. Stem cells were mobilized with cyclophosphamide and G-CSF and the products were cryopreserved. Melphalan was the conditioning regime for MM while BEAM was used for HL and NHL. Twenty autologous transplants were performed in the first year. Mean age was 47 years (range: 17-62) and male to female ratio was 3: 2. There were 17 MM and one each of NHL, HL and POEMS syndrome patients. Median CD34+ stem cells collected was 12.72×106/kg (range: 3-31) and median infused cell dose was 4.07×106/kg (range: 2-7.4). Median engraftment day was 13 (range: 11-19) and median hospitalization was 16 days (range: 14-20). All developed febrile neutropenia and GradeⅢ thrombocytopenia. Zero transplant-related mortality was observed with acceptable morbidity. At the median follow-up of 47 weeks, the overall survival was 100% with all the patients still in remission.
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Affiliation(s)
| | - L Morawaka
- National Blood Transfusion Service, Sri Lanka
| | | | - S Suresh
- National Cancer Institute, Sri Lanka
| | | | | | | | - S Milliken
- Department of Haematology and BM Transplantation, St. Vincent's Hospital Sydney, NSW, Australia
| | - J Moore
- Department of Haematology and BM Transplantation, St. Vincent's Hospital Sydney, NSW, Australia
| | - Ddf Ma
- Department of Haematology and BM Transplantation, St. Vincent's Hospital Sydney, NSW, Australia
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Lengfelder L, Lee J, Ueckert H, Connors R, Mahlke S, Martin E, Wieser J, Zhang X, Thomas L, Moore J, McHenry M, Williams G. Validation of Nursing Nutrition Screening Tool in Adult Acute Inpatient Setting. J Acad Nutr Diet 2019. [DOI: 10.1016/j.jand.2019.08.061] [Citation(s) in RCA: 1] [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: 11/16/2022]
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45
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Senko C, Moore J, Hay K, Lwin Z, Pratt G, Fong K, Hughes B. P1.18-14 The Prognostic Significance of Significant Weight Loss in Stage III NSCLC Undergoing Definitive CRT After FDG-PET Staging. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1330] [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: 10/25/2022]
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46
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Hazell S, Hales R, Wang K, Ford K, McNutt T, Hrinivich W, Han P, Anderson L, Ferro A, Moore J, Voong K. Applying Non-Homogeneous Dose Optimization to Improve Conventionally-fractionated IMRT Plan Quality in Patients with NSCLC. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.739] [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: 11/30/2022]
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47
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Morcos M, Moore J, Rezaee M, Viswanathan A. Efficient Vaginal Cylinder Brachytherapy: Forgoing Daily Re-planning with Mobile CT Image-guidance. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.827] [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: 10/26/2022]
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48
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Smith L, Helphrey J, Sawyer J, Rodriguez D, Rose D, Fierro L, Moore J, Parsons T, Barnett M. A-21 Inhibition of Overlearned Verbal Responses and Quantity of Speech Among Age Cohorts. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.21] [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: 11/13/2022] Open
Abstract
Abstract
Objective
Off-topic speech (OTS) has been linked with deficits in executive functioning, and specifically inhibition. OTS research has focused primarily on tangentiality, whereas in this study we focused on quantity of speech. The purpose of this study was to investigate the relationship between inhibition of overlearned responses using a Stroop task and quantity of speech.
Method
A college sample of young adults (n = 63; age 18-28) and healthy, community-dwelling older adults (n = 76; age 60-99) completed the Delis-Kaplan Executive Function Systems (D-KEFS) Color-Word Interference Test and provided a verbal sample in which they recounted a procedural memory and an episodic memory. These samples were transcribed and rated for quantity of speech by three independent judges.
Results
Among all participants, longer time to complete color naming (r = -.21, p = .02) and inhibition (r = -.21, p = .01) was associated with lower quantity of speech on procedural memory. Among young adults, longer time to complete inhibition was associated with lower quantity of speech (r = -.26, p = .04). Among older adults, longer time to complete color naming (r = -.32, p = .005), word reading (r = -.27, p = .02), and inhibition (r = -.35, p = .002) was associated with lower quantity of speech. No relationships were found between performance on Stroop conditions and quantity of speech for episodic memory.
Conclusions
Results suggest that among both age cohorts, difficulty inhibiting overlearned verbal responses is associated with lower quantity of speech regarding a procedural memory but not an episodic memory.
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49
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Helphrey J, Smith L, Rodriguez D, Rose III D, Sawyer J, Edzards S, Fierro L, Moore J, Parsons T, Barnett M. A-13 Sustained Attention, Impulsivity, and Tangentiality of Speech Among Young Adults and Older Adults. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.13] [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: 11/12/2022] Open
Abstract
Abstract
Objective
Previous research has linked off-topic verbosity (OTV) among older adults with lower performance on neuropsychological tests tapping attention and executive functioning. However, most of this research has utilized relatively brief neurocognitive measures. Continuous performance tests (CPTs) measure sustained attention and impulsivity. The purpose of this study was to investigate relationships between sustained attention, impulsivity, and tangentiality of speech among young adults and older adults.
Method
Young adult college students (age 18-29; n= 61) and healthy, community-dwelling older adults (age 60-99; n = 81) were administered the Conners’ Continuous Performance Test – 3 and provided a sample of speech (one episodic memory and one procedural memory). These speech samples were transcribed and rated for tangentiality by three independent reviewers.
Results
Among all participants, greater tangentiality of speech was associated with omission errors (r = .22, p = .01) but not with commission errors. This same pattern was found among older adults: omission errors (r = .23, p = .04) were associated with greater tangentiality but commission errors were not. Among young adults, these relationships were not statistically significant.
Conclusions
Results suggest that tangentiality of speech is associated with inattentiveness but not impulsivity, and this relationship may be more marked among older adults than young adults. OTV among older adults may stem from difficulty sustaining attention over time rather than diminished capacity for inhibiting impulses.
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50
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Horstemeyer MF, Berthelson PR, Moore J, Persons AK, Dobbins A, Prabhu RK. A Mechanical Brain Damage Framework Used to Model Abnormal Brain Tau Protein Accumulations of National Football League Players. Ann Biomed Eng 2019; 47:1873-1888. [PMID: 31372858 PMCID: PMC6757135 DOI: 10.1007/s10439-019-02294-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 07/20/2018] [Accepted: 05/22/2019] [Indexed: 12/14/2022]
Abstract
A mechanics-based brain damage framework is used to model the abnormal accumulation of hyperphosphorylated p-tau associated with chronic traumatic encephalopathy within the brains of deceased National Football League (NFL) players studied at Boston University and to provide a framework for understanding the damage mechanisms. p-tau damage is formulated as the multiplicative decomposition of three independently evolving damage internal state variables (ISVs): nucleation related to number density, growth related to the average area, and coalescence related to the nearest neighbor distance. The ISVs evolve under different rates for three well known mechanical boundary conditions, which in themselves introduce three different rates making a total of nine scenarios, that we postulate are related to brain damage progression: (1) monotonic overloads, (2) cyclic fatigue which corresponds to repetitive impacts, and (3) creep which is correlated to damage accumulation over time. Different NFL player positions are described to capture the different types of damage progression. Skill position players, such as quarterbacks, are expected to exhibit a greater p-tau protein accumulation during low cycle fatigue (higher amplitude impacts with a lesser number), and linemen who exhibit a greater p-tau protein accumulation during high cycle fatigue (lower amplitude impacts with a greater number of impacts). This mechanics-based damage framework presents a foundation for developing a multiscale model for traumatic brain injury that combines mechanics with biology.
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Affiliation(s)
- M F Horstemeyer
- Department of Mechanical Engineering, Mississippi State University, Starkville, MS, 39762, USA. .,Center for Advanced Vehicular Systems, Mississippi State University, Starkville, MS, 39759, USA. .,School of Engineering, Liberty University, 1971 Liberty Avenue, Lynchburg, VA, 24515, USA.
| | - P R Berthelson
- Center for Advanced Vehicular Systems, Mississippi State University, Starkville, MS, 39759, USA.,Department of Agricultural and Biological Engineering, Mississippi State University, 130 Creelman St., Starkville, MS, 39762, USA
| | - J Moore
- Department of Mechanical Engineering, Mississippi State University, Starkville, MS, 39762, USA.,Center for Advanced Vehicular Systems, Mississippi State University, Starkville, MS, 39759, USA
| | - A K Persons
- Department of Mechanical Engineering, Mississippi State University, Starkville, MS, 39762, USA.,Center for Advanced Vehicular Systems, Mississippi State University, Starkville, MS, 39759, USA
| | - A Dobbins
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - R K Prabhu
- Center for Advanced Vehicular Systems, Mississippi State University, Starkville, MS, 39759, USA.,Department of Agricultural and Biological Engineering, Mississippi State University, 130 Creelman St., Starkville, MS, 39762, USA
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