1
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Berrigan EM, Wang L, Carrillo H, Echegoyen K, Kappes M, Torres J, Ai-Perreira A, McCoy E, Shane E, Copeland CD, Ragel L, Georgousakis C, Lee S, Reynolds D, Talgo A, Gonzalez J, Zhang L, Rajurkar AB, Ruiz M, Daniels E, Maree L, Pariyar S, Busch W, Pereira TD. Fast and Efficient Root Phenotyping via Pose Estimation. Plant Phenomics 2024; 6:0175. [PMID: 38629082 PMCID: PMC11020144 DOI: 10.34133/plantphenomics.0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
Image segmentation is commonly used to estimate the location and shape of plants and their external structures. Segmentation masks are then used to localize landmarks of interest and compute other geometric features that correspond to the plant's phenotype. Despite its prevalence, segmentation-based approaches are laborious (requiring extensive annotation to train) and error-prone (derived geometric features are sensitive to instance mask integrity). Here, we present a segmentation-free approach that leverages deep learning-based landmark detection and grouping, also known as pose estimation. We use a tool originally developed for animal motion capture called SLEAP (Social LEAP Estimates Animal Poses) to automate the detection of distinct morphological landmarks on plant roots. Using a gel cylinder imaging system across multiple species, we show that our approach can reliably and efficiently recover root system topology at high accuracy, few annotated samples, and faster speed than segmentation-based approaches. In order to make use of this landmark-based representation for root phenotyping, we developed a Python library (sleap-roots) for trait extraction directly comparable to existing segmentation-based analysis software. We show that pose-derived root traits are highly accurate and can be used for common downstream tasks including genotype classification and unsupervised trait mapping. Altogether, this work establishes the validity and advantages of pose estimation-based plant phenotyping. To facilitate adoption of this easy-to-use tool and to encourage further development, we make sleap-roots, all training data, models, and trait extraction code available at: https://github.com/talmolab/sleap-roots and https://osf.io/k7j9g/.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Wolfgang Busch
- Salk Institute for Biological Studies, La Jolla, CA 92037, USA
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Khamaysa M, Lefort M, Pélégrini-Issac M, Lackmy-Vallée A, Mendili MME, Preuilh A, Devos D, Bruneteau G, Salachas F, Lenglet T, Amador MM, Le Forestier N, Hesters A, Gonzalez J, Rolland AS, Desnuelle C, Chupin M, Querin G, Georges M, Morelot-Panzini C, Marchand-Pauvert V, Pradat PF. Quantitative brainstem and spinal MRI in amyotrophic lateral sclerosis: implications for predicting noninvasive ventilation needs. J Neurol 2024; 271:1235-1246. [PMID: 37910250 DOI: 10.1007/s00415-023-12045-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Respiratory complications resulting from motor neurons degeneration are the primary cause of death in amyotrophic lateral sclerosis (ALS). Predicting the need for non-invasive ventilation (NIV) in ALS is important for advance care planning and clinical trial design. The aim of this study was to assess the potential of quantitative MRI at the brainstem and spinal cord levels to predict the need for NIV during the first six months after diagnosis. METHODS Forty-one ALS patients underwent MRI and spirometry shortly after diagnosis. The need for NIV was monitored according to French health guidelines for 6 months. The performance of four regression models based on: clinical variables, brainstem structures volumes, cervical spinal measurements, and combined variables were compared to predict the need for NIV within this period. RESULTS Both the clinical model (R2 = 0.28, AUC = 0.85, AICc = 42.67, BIC = 49.8) and the brainstem structures' volumes model (R2 = 0.30, AUC = 0.85, AICc = 40.13, BIC = 46.99) demonstrated good predictive performance. In addition, cervical spinal cord measurements model similar performance (R2 = 0.338, AUC = 0.87, AICc = 37.99, BIC = 44.49). Notably, the combined model incorporating predictors from all three models yielded the best performance (R2 = 0.60, AUC = 0.959, AICc = 36.38, BIC = 44.8). These findings are supported by observed positive correlations between brainstem volumes, cervical (C4/C7) cross-sectional area, and spirometry-measured lung volumes. CONCLUSIONS Our study shows that brainstem volumes and spinal cord area are promising measures to predict respiratory intervention needs in ALS.
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Affiliation(s)
- M Khamaysa
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - M Lefort
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - M Pélégrini-Issac
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - A Lackmy-Vallée
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - M M El Mendili
- APHM, Hôpital Timone, CEMEREM, Marseille, France
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France
| | - A Preuilh
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - D Devos
- Département de Neurologie, Centre Référent SLA, CHU de Lille, Centre LICEND COEN, ACT4-ALS-MND network, Lille, France
- Départment de Pharmacologie Médicale, Université de Lille, INSERM UMRS_1172 LilNCog, CHU de Lille, Centre LICEND COEN, ACT4-ALS-MND network, Lille, France
| | - G Bruneteau
- APHP, Département de Neurologie, Hôpital Pitié-Salpêtrière, Centre Référent SLA, Paris, France
| | - F Salachas
- APHP, Département de Neurologie, Hôpital Pitié-Salpêtrière, Centre Référent SLA, Paris, France
| | - T Lenglet
- APHP, Département de Neurologie, Hôpital Pitié-Salpêtrière, Centre Référent SLA, Paris, France
- Faculté de Médecine de Nice, Département de Neurologie, Université Cote d'Azur, Nice, France
- Département de Neurophysiologie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Md M Amador
- APHP, Département de Neurologie, Hôpital Pitié-Salpêtrière, Centre Référent SLA, Paris, France
| | - N Le Forestier
- APHP, Département de Neurologie, Hôpital Pitié-Salpêtrière, Centre Référent SLA, Paris, France
- Département de Recherche en Éthique, EA 1610: Etudes des Sciences et Techniques, Université Paris Sud/Paris Saclay, Paris, France
| | - A Hesters
- APHP, Département de Neurologie, Hôpital Pitié-Salpêtrière, Centre Référent SLA, Paris, France
| | - J Gonzalez
- Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM UMRS1158, Sorbonne Université, Paris, France
| | - A-S Rolland
- Départment de Pharmacologie Médicale, Université de Lille, INSERM UMRS_1172 LilNCog, CHU de Lille, Centre LICEND COEN, ACT4-ALS-MND network, Lille, France
| | - C Desnuelle
- Faculté de Médecine de Nice, Département de Neurologie, Université Cote d'Azur, Nice, France
| | - M Chupin
- CATI, Plateforme d'Imagerie Neurologique Multicentrique, Paris, France
| | - G Querin
- APHP, Service de Neuromyologie, Hôpital Pitié-Salpêtrière, Centre Référent Pour les Maladies Neuromusculaires Rares, Paris, France
- Institut de Myologie, Plateforme d'essais cliniques I-Motion, Hôpital Pitié-Salpêtrière, Paris, France
| | - M Georges
- Département des Maladies Respiratoires et Soins Intensifs, Centre de Référence pour les Maladies Pulmonaires Rares, Hôpital Universitaire de Dijon-Bourgogne, Dijon, France
- Université de Bourgogne Franche-Comté, Dijon, France
- Centre des Sciences du Goût et de l'Alimentation, UMR 6265 CNRS 1234 INRA, Université de Bourgogne Franche-Comté, Dijon, France
| | - C Morelot-Panzini
- Neurophysiologie Respiratoire Expérimentale et Clinique, INSERM UMRS1158, Sorbonne Université, Paris, France
- Service de Pneumologie (Département R3S), Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - V Marchand-Pauvert
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - P-F Pradat
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France.
- APHP, Département de Neurologie, Hôpital Pitié-Salpêtrière, Centre Référent SLA, Paris, France.
- Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute Ulster University, C-TRIC, Altnagelvin Hospital, Derry, Londonderry, UK.
- Institut pour la Recherche sur la Moelle Epinière et l'encephale (IRME), 15 rue Duranton, 75015, Paris, France.
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3
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Berrigan EM, Wang L, Carrillo H, Echegoyen K, Kappes M, Torres J, Ai-Perreira A, McCoy E, Shane E, Copeland CD, Ragel L, Georgousakis C, Lee S, Reynolds D, Talgo A, Gonzalez J, Zhang L, Rajurkar AB, Ruiz M, Daniels E, Maree L, Pariyar S, Busch W, Pereira TD. Fast and efficient root phenotyping via pose estimation. bioRxiv 2023:2023.11.20.567949. [PMID: 38045278 PMCID: PMC10690188 DOI: 10.1101/2023.11.20.567949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Image segmentation is commonly used to estimate the location and shape of plants and their external structures. Segmentation masks are then used to localize landmarks of interest and compute other geometric features that correspond to the plant's phenotype. Despite its prevalence, segmentation-based approaches are laborious (requiring extensive annotation to train), and error-prone (derived geometric features are sensitive to instance mask integrity). Here we present a segmentation-free approach which leverages deep learning-based landmark detection and grouping, also known as pose estimation. We use a tool originally developed for animal motion capture called SLEAP (Social LEAP Estimates Animal Poses) to automate the detection of distinct morphological landmarks on plant roots. Using a gel cylinder imaging system across multiple species, we show that our approach can reliably and efficiently recover root system topology at high accuracy, few annotated samples, and faster speed than segmentation-based approaches. In order to make use of this landmark-based representation for root phenotyping, we developed a Python library (sleap-roots) for trait extraction directly comparable to existing segmentation-based analysis software. We show that landmark-derived root traits are highly accurate and can be used for common downstream tasks including genotype classification and unsupervised trait mapping. Altogether, this work establishes the validity and advantages of pose estimation-based plant phenotyping. To facilitate adoption of this easy-to-use tool and to encourage further development, we make sleap-roots, all training data, models, and trait extraction code available at: https://github.com/talmolab/sleap-roots and https://osf.io/k7j9g/.
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Affiliation(s)
| | - Lin Wang
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Hannah Carrillo
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Kimberly Echegoyen
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Mikayla Kappes
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Jorge Torres
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Angel Ai-Perreira
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Erica McCoy
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Emily Shane
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Charles D. Copeland
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Lauren Ragel
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | | | - Sanghwa Lee
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Dawn Reynolds
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Avery Talgo
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Juan Gonzalez
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Ling Zhang
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Ashish B. Rajurkar
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Michel Ruiz
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Erin Daniels
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Liezl Maree
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Shree Pariyar
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Wolfgang Busch
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
| | - Talmo D. Pereira
- Salk Institute for Biological Studies, La Jolla, CA 92037 United States of America
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4
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Ponnusamy S, Gonzalez J, Holtzclaw D. A Systematic Approach to Restoring Full Arch Length with Maxillary Fixed Implant Reconstruction: The PATZi Protocol. Int J Oral Maxillofac Implants 2023; 38:996-1004. [PMID: 37847841 DOI: 10.11607/jomi.10153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
The traditional configuration of four maxillary implants to restore full-arch maxillary fixed implant prostheses is not without pitfalls. Intraoperative variability, such as bone quality and quantity, may lead to unexpected intraoperative challenges that may not allow for execution of the original treatment plan. Additionally, extensive maxillary sinus pneumatization may inhibit posterior spread and lead to a shortened dental arch or excessive cantilever forces. The PATZi protocol is a systematized algorithm for maxillary full-arch implant treatment planning that addresses such intraoperative surprises and achieves full arch length in the planned prosthesis. PATZi also assigns a numbering classification to each implant configuration, which leads to uniform communication and grading of surgical difficulty, as well as predictable planning for developing future salvage plans. By using the PATZi protocol as a guideline, the surgeon may improve composite torque value and anteroposterior (AP) spread, eliminate distal cantilever forces, and ultimately improve the predictability of the prosthetic treatment plan.
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5
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Bartolomeu N, Gonzalez J, Valentim F, Reis E Silva M, Ramos N, Jacinto J. Improvement in quality of life of transfemoral amputees: Comparison between 2 types of transfemoral sockets and their influence on functionality and user comfort - A case report. Prosthet Orthot Int 2023:00006479-990000000-00173. [PMID: 37708337 DOI: 10.1097/pxr.0000000000000286] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 07/20/2023] [Indexed: 09/16/2023]
Abstract
Among the components of lower limb prostheses, a perfectly adapted prosthetic socket is crucial to a successful rehabilitation process. Thus, developing a more comfortable socket could improve the quality of life for transfemoral (TF) amputees. The objective of this case report was to compare 2 TF sockets by evaluating the relationship between socket stiffness and user comfort and their influence on functionality to improve the quality of life of TF amputees. The participant received 2 different sockets: (A) flexible Flixt® socket; (B) conventional socket. He used each socket for 90 days, and after that was submitted to an evaluation at the Gait Laboratory (kinematic and dynamic analyses), completed the Prosthesis Evaluation Questionnaire, and performed Timed Up and Go test, 6-Minute March Test (6MWT), 10-Meter Walk Test, and Amputee Mobility Predictor test. After results were analyzed, the socket that obtained the best degree of satisfaction was assigned to the amputee participant. Combined measures showed that socket B does not considerably change the kinematic parameters neither dynamics parameters namely at stance phase. At Prosthesis Evaluation Questionnaire results, socket A had a better rating than socket B. The results of the Timed Up and Go test, 6MWT, 10-Meter Walk Test, and Amputee Mobility Predictor test obtained identical values, except for the 6MWT. This case report shows evidence of participant satisfaction improvement when using the flexible socket. The study also demonstrates that both sockets are quite effective.
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Affiliation(s)
- Nicole Bartolomeu
- Orthotic and Prosthetic Unit, Centro de Medicina de Reabilitação de Alcoitão, Alcabideche, Portugal
| | | | - Fábio Valentim
- Orthotic and Prosthetic Unit, Centro de Medicina de Reabilitação de Alcoitão, Alcabideche, Portugal
| | - Miguel Reis E Silva
- Orthotic and Prosthetic Unit, Centro de Medicina de Reabilitação de Alcoitão, Alcabideche, Portugal
| | - Natália Ramos
- Orthotic and Prosthetic Unit, Centro de Medicina de Reabilitação de Alcoitão, Alcabideche, Portugal
| | - Jorge Jacinto
- Orthotic and Prosthetic Unit, Centro de Medicina de Reabilitação de Alcoitão, Alcabideche, Portugal
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Schultz H, Sobhani NC, Blissett S, Yogeswaran V, Hong J, Harris IS, Parikh N, Gonzalez J, Agarwal A. Cardiovascular events more than 6 months after pregnancy in patients with congenital heart disease. Open Heart 2023; 10:e002430. [PMID: 37709299 PMCID: PMC10503351 DOI: 10.1136/openhrt-2023-002430] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 08/08/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Patients with congenital heart disease (CHD) are increasingly pursuing pregnancy, highlighting the need for data on late cardiovascular events (more than 6 months after delivery). We aimed to determine the incidence of late cardiovascular events in postpartum patients with CHD and evaluate the accuracy of the existing risk scores in predicting these events. STUDY DESIGN We identified patients with CHD who delivered between 2008 and 2020 at a tertiary centre and had follow-up data for greater than 6 months post partum. Late cardiovascular events were defined as heart failure, arrhythmia, thromboembolic events, endocarditis, urgent cardiovascular interventions or death. Survival analysis and Cox proportional model were used to estimate the incidence of late cardiovascular events and determine the hazard ratio of factors associated with these events. RESULTS Of 117 patients, 19% had 36 late cardiovascular events over a median follow-up of 3.8 years. Annual incidence of any late cardiovascular event was 5.7%. Hazards of late cardiovascular events were significantly higher among those with higher Cardiac Disease in Pregnancy Study (CARPREG) II and Zwangerschap bij Aangeboren HARtAfwijking-Pregnancy in Women With Congenital Heart Disease (ZAHARA) risk scores and among patients with prepregnancy New York Heart Association class≥II. C-statistic to predict the late cardiovascular events was highest for ZAHARA (0.7823), followed by CARPREG II (0.6902) and prepregnancy New York Heart Association class≥ II (0.6677). CONCLUSIONS Currently available risk tools designed for prognostication during the peripartum period can also be used to determine risks of late maternal cardiovascular events among those with CHD. These findings provide important new information for counselling and risk modification.
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Affiliation(s)
- Hayley Schultz
- School of Medicine, University of California, San Francisco, California, USA
- Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, California, USA
| | - Nasim C Sobhani
- Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, USA
| | - Sarah Blissett
- Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, USA
- Department of Medicine, Division of Cardiology, Western University, London, Ontario, Canada
| | - Vidhushei Yogeswaran
- Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA
| | - Jessica Hong
- Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, USA
| | - Ian S Harris
- Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, USA
| | - Nisha Parikh
- Department of Medicine, Division of Cardiology, University of California, San Francisco, California, USA
| | - Juan Gonzalez
- Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, USA
| | - Anushree Agarwal
- Cardiology, University of California, San Francisco, California, USA
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7
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Oladimeji AM, Afe AJ, Olumuyiwa T, Offiong C, Turibekov B, Aikulola O, Persse C, Deadmon J, Hansen K, Barron C, Vijayan V, Mora W, Farris J, Dean K, Johnson T, Gonzalez J, Mansaray R, Short K. Preparedness and response of assisted living facilities toward COVID-19 infection control in Houston, Texas, USA. J Infect Prev 2023; 24:199-205. [PMID: 37736122 PMCID: PMC9968688 DOI: 10.1177/17571774231159390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
Background Long-term care facilities (LTCFs) including assisted living facilities (ALFs) are hubs for high transmission and poor prognosis of COVID-19 among the residents who are more susceptible due to old age and comorbidities. Aim Houston Health Department conducted assessments of ALFs within the City of Houston to determine preparedness and existing preventive measures at the facilities. Methods Onsite assessments were conducted at ALFs using a modified CDC Infection Control Assessment and Response (ICAR) Tool. Data was obtained on IPC measures, training, testing, vaccination etc. Data was analyzed, frequencies generated, and bivariate associations determined. Results A total of 118 facilities were assessed and categorized into small scale 46 (39%), medium scale 47 (40%), and large scale 25 (21%). The facilities had 2431 residents and 2290 staff. Thirty-one (26%) facilities reported an outbreak in 2020, while 14 (12%) had an ongoing outbreak. Twenty-three (97%) large-scale and 12 (26%) small-scale facilities had COVID-19 testing program. Vaccination coverage among residents ranged from 99% in large-scale to 40% in small-scale facilities but was smaller among staff at 748 (45%) in large scale, 71 (36%) in small scale, and 193 (45%) in medium scale. While 24 (96%) large-scale and 34 (77%) of small-scale facilities conducted staff training staff on IPC practices, 22 (92%) of large-scale and 19 (56%) of small-scale facility staff demonstrated capacity (p = 0.01), respectively. Visitor screening was done at 100% of large-scale and 80% of small-scale and the medium-scale ALFs. Discussion Assisted living facilities within the city of Houston are at various levels of preparedness and interventions with respect to COVID-19 response.
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Affiliation(s)
- Abisola M Oladimeji
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Abayomi Joseph Afe
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Tolulope Olumuyiwa
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Charlene Offiong
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Bakbergen Turibekov
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Oluwayemisi Aikulola
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Courtney Persse
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Jahana Deadmon
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Kristine Hansen
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Christine Barron
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Vijisha Vijayan
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Wanda Mora
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Jacob Farris
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Krysta Dean
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Thomas Johnson
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Juan Gonzalez
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Rahmatu Mansaray
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
| | - Kirstin Short
- Bureau of Epidemiology, Division of Disease Prevention and Control Houston Health Department, Houston, TX, USA
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8
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Chalouni M, Trickey A, Ingle SM, Sepuvelda MA, Gonzalez J, Rauch A, Crane HM, Gill MJ, Rebeiro PF, Rockstroh JK, Franco RA, Touloumi G, Neau D, Laguno M, Rappold M, Smit C, Sterne JAC, Wittkop L. Impact of hepatitis C cure on risk of mortality and morbidity in people with HIV after antiretroviral therapy initiation. AIDS 2023; 37:1573-1581. [PMID: 37199601 DOI: 10.1097/qad.0000000000003594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Hepatitis C virus (HCV) co-infection is associated with increased morbidity and mortality in people with HIV (PWH). Sustained virological response (SVR) decreases the risk of HCV-associated morbidity. We compared mortality, risk of AIDS-defining events, and non-AIDS nonliver (NANL) cancers between HCV-co-infected PWH who reached SVR and mono-infected PWH. DESIGN Adult PWH from 21 cohorts in Europe and North America that collected HCV treatment data were eligible if they were HCV-free at the time of ART initiation. METHODS Up to 10 mono-infected PWH were matched (on age, sex, date of ART start, HIV acquisition route, and being followed at the time of SVR) to each HCV-co-infected PWH who reached SVR. Cox models were used to estimate relative hazards (hazard ratio) of all-cause mortality, AIDS-defining events, and NANL cancers after adjustment. RESULTS Among 62 495 PWH, 2756 acquired HCV, of whom 649 reached SVR. For 582 of these, at least one mono-infected PWH could be matched, producing a total of 5062 mono-infected PWH. The estimated hazard ratios comparing HCV-co-infected PWH who reached SVR with mono-infected PWH were 0.29 [95% confidence interval (CI) 0.12-0.73] for mortality, 0.85 [0.42-1.74] for AIDS-defining events, and 1.21 [0.86-1.72] for NANL cancer. CONCLUSION PWH who reached SVR a short time after HCV acquisition were not at higher risk of overall mortality compared with mono-infected PWH. However, the apparent higher risk of NANL cancers in HCV-co-infected PWH who reached SVR after a DAA-based treatment compared with mono-infected PWH, though compatible with a null association, suggests a need for monitoring of those events following SVR.
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Affiliation(s)
- Mathieu Chalouni
- University Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, Bordeaux
- INRIA SISTM Team, Talence, France
| | - Adam Trickey
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Suzanne M Ingle
- Population Health Sciences, University of Bristol, Bristol, UK
| | | | - Juan Gonzalez
- HIV Unit, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - Andri Rauch
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Heidi M Crane
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - M John Gill
- Department of Medicine, University of Calgary, Alberta, Canada
| | - Peter F Rebeiro
- Department of Medicine & Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | | | - Ricardo A Franco
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
| | - Giota Touloumi
- Department of Hygiene, Epidemiology & Medical Statistics, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - Didier Neau
- CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, Pl. Amélie Raba Léon, Bordeaux, France
| | | | - Michaela Rappold
- Department of Dermatology and Venereology, Medical University of Innsbruck
- Austrian HIV Cohort Study, Innsbruck, Austria
| | - Colette Smit
- Stichting HIV Monitoring, Amsterdam, the Netherlands
| | | | - Linda Wittkop
- University Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, Bordeaux
- INRIA SISTM Team, Talence, France
- CHU de Bordeaux, Service d'information médicale, INSERM, Institut Bergonié, CIC-EC 1401, Bordeaux, France
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9
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Gutman CK, Thompson M, Gonzalez J, Fernandez R. Patient centered or provider centered? The inclusion of social determinants of health in emergency department billing and coding. Acad Emerg Med 2023; 30:882-884. [PMID: 36794328 PMCID: PMC10866376 DOI: 10.1111/acem.14698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Colleen K Gutman
- Department of Emergency Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Meredith Thompson
- Department of Emergency Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Juan Gonzalez
- Department of Emergency Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Rosemarie Fernandez
- Department of Emergency Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
- Center for Experiential Learning and Simulation, University of Florida College of Medicine, Gainesville, Florida, USA
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10
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Gonzalez J, Patel N, Ownby RL. Cognitive function and impact on driving after SARS-COV-2 infection in a man with long-standing HIV infection: a case report. J Neurovirol 2023; 29:355-357. [PMID: 37160535 PMCID: PMC10169180 DOI: 10.1007/s13365-023-01143-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/16/2023] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
A substantial number of individuals who experience COVID-19 infection experience prolonged physical and mental symptoms after resolution of their initial infection, and among them, many individuals experience cognitive difficulties including memory lapses and executive function difficulties, often referred to as "brain fog." The possible impact of COVID-19 infection on cognition in persons with HIV-related cognitive disorders is unknown. In this report, we describe post-COVID-19 cognitive and driving function in a 62-year-old man with HIV infection since the early 1990s.
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Affiliation(s)
- Juan Gonzalez
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Center for Collaborative Research Suite 430, 3301 College Avenue, Fort Lauderdale, FL, 33314, USA
| | - Neil Patel
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Center for Collaborative Research Suite 430, 3301 College Avenue, Fort Lauderdale, FL, 33314, USA
| | - Raymond L Ownby
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Center for Collaborative Research Suite 430, 3301 College Avenue, Fort Lauderdale, FL, 33314, USA.
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11
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Ownby RL, Waldrop D, Davenport R, Simonson M, Caballero J, Thomas-Purcell K, Purcell D, Ayala V, Gonzalez J, Patel N, Kondwani K. A mobile app for chronic disease self-management for individuals with low health literacy: A multisite randomized controlled clinical trial. medRxiv 2023:2023.04.01.23288020. [PMID: 37066256 PMCID: PMC10104214 DOI: 10.1101/2023.04.01.23288020] [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] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Objective The purpose of this study was to evaluate the effects of a mobile app designed to improve chronic disease self-management in older adult patients with low health literacy and who had at least one chronic health condition, and to assess the impact of delivering information at different levels of reading difficulty. Methods A randomized controlled trial was completed at two sites. Individuals 40 years of age and older screened for low health literacy who had at least one chronic health condition were randomly assigned to a tailored information multimedia app with text at one of three grade levels. Four primary outcomes were assessed: patient activation, chronic disease self-efficacy, health-related quality of life, and medication adherence. Results All groups showed overall increases in activation, self-efficacy, and health-related quality of life, but no change in medication adherence. No between-group differences were observed. Conclusions The mobile app was effective in increasing participants' levels of several psychosocial variables, but reading difficulty level was not significantly related to outcomes.Registered at clinicaltrials.gov NCT02922439.
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Affiliation(s)
- Raymond L Ownby
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Drenna Waldrop
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta GA
| | - Rosemary Davenport
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Michael Simonson
- Instructional Technology and Distance Education Program, Fischler College of Education, Nova Southeastern University, Fort Lauderdale FL
| | | | | | - Donrie Purcell
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Victoria Ayala
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Juan Gonzalez
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Neil Patel
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Kofi Kondwani
- Department of Community Health & Preventive Medicine, Morehouse School of Medicine, Fort Lauderdale FL
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12
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Vachier I, Crestani B, Chanez P, Gonzalez J. [J2R 2022 back in Reims]. Rev Mal Respir 2023; 40:107-108. [PMID: 36801046 DOI: 10.1016/j.rmr.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 02/18/2023]
Affiliation(s)
- I Vachier
- MED BIO MED, CHU de Montpellier Montpellier, France.
| | - B Crestani
- Centre de compétences des maladies pulmonaires rares, hôpital Bichat, AP-HP, Paris, France
| | - P Chanez
- Pneumologie clinique des bronches, CHU, Marseille, France
| | - J Gonzalez
- Pneumologie hôpital de la Pitié-Salpêtrière, Paris, France
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13
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Rodriguez JA, Gonzalez J, Arboleda-Bustos CE, Mendoza N, Martinez C, Pinzon A. Computational modeling of the effect of five mutations on the structure of the ACE2 receptor and their correlation with infectivity and virulence of some emerged variants of SARS-CoV-2 suggests mechanisms of binding affinity dysregulation. Chem Biol Interact 2022; 368:110244. [PMID: 36336003 PMCID: PMC9630301 DOI: 10.1016/j.cbi.2022.110244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/11/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
Interactions between the human angiotensin-converting enzyme 2 (ACE2) and the RBD region of the SARS-CoV-2 Spike protein are critical for virus entry into the host cell. The objective of this work was to identify some of the most relevant SARS-CoV-2 Spike variants that emerged during the pandemic and evaluate their binding affinity with human variants of ACE2 since some ACE2 variants can enhance or reduce the affinity of the interaction between the ACE2 and S proteins. However, no information has been sought to extrapolate to different variants of SARS-CoV-2. Therefore, to understand the impact on the affinity of the interaction between ACE2 protein variants and SARS-CoV-2 protein S variants, molecular docking was used in this study to predict the effects of five mutations of ACE2 when they interact with Alpha, Beta, Delta, Omicron variants and a hypothetical variant, which present mutations in the RBD region of the SARS-CoV-2 Spike protein. Our results suggest that these variants could alter the interaction of the Spike and the human ACE2 protein, losing or creating new inter-protein contacts, enhancing viral fitness by improving binding affinity, and leading to an increase in infectivity, virulence, and transmission. This investigation highlighted that the S19P mutation of ACE2 decreases the binding affinity between the ACE2 and Spike proteins in the presence of the Beta variant and the wild-type variant of SARS-CoV-2 isolated in Wuhan-2019. The R115Q mutation of ACE2 lowers the binding affinity of these two proteins in the presence of the Beta and Delta variants. Similarly, the K26R mutation lowers the affinity of the interaction between the ACE2 and Spike proteins in the presence of the Alpha variant. This decrease in binding affinity is probably due to the lack of interaction between some of the key residues of the interaction complex between the ACE2 protein and the RBD region of the SARS-CoV-2 Spike protein. Therefore, ACE2 mutations appear in the presence of these variants, they could suggest an intrinsic resistance to COVID-19 disease. On the other hand, our results suggested that the K26R, M332L, and K341R mutations of ACE2 expressively showed the affinity between the ACE2 and Spike proteins in the Alpha, Beta, and Delta variants. Consequently, these ACE2 mutations in the presence of the Alpha, Beta, and delta variants of SARS-CoV-2 could be more infectious and virulent in human cells compared to the SARS-CoV-2 isolated in Wuhan-2019 and it could have a negative prognosis of the disease. Finally, the Omicron variant in interaction with ACE2 WT, S19P, R115Q, M332L, and K341R mutations of ACE2 showed a significant decrease in binding affinity. This could be consistent that the Omicron variant causes less severe symptoms than previous variants. On the other hand, our results suggested Omicron in the complex with K26R, the binding affinity is increased between ACE2/RBD, which could indicate a negative prognosis of the disease in people with these allelic conditions.
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Affiliation(s)
- J A Rodriguez
- Bioinformatics and Systems Biology Laboratory (GIBBS). Instituto de Genética, Universidad Nacional de Colombia, Colombia.
| | - J Gonzalez
- Departamento de Nutrición y Bioquímica. Pontificia Universidad Javeriana Bogotá, Colombia
| | - C E Arboleda-Bustos
- Neurosciences Group. Instituto de Genética, Universidad Nacional de Colombia, Colombia
| | - N Mendoza
- Bioinformatics and Systems Biology Laboratory (GIBBS). Instituto de Genética, Universidad Nacional de Colombia, Colombia
| | - C Martinez
- Neurosciences Group. Instituto de Genética, Universidad Nacional de Colombia, Colombia
| | - A Pinzon
- Bioinformatics and Systems Biology Laboratory (GIBBS). Instituto de Genética, Universidad Nacional de Colombia, Colombia
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14
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Davo-Jimenez M, Baez Ferrer N, Igareta-Herraiz AT, Gonzalez J, Diaz R, Avanzas P, Dominguez-Gonzalez V, Hernandez-Baldomero IF, Parra-Esquivel PC, Garcia-Baute MC, Hernandez-Vaquero D, Dominguez-Rodriguez A. Women and authorship in an international journal dedicated to cardiovascular diseases: analysis of the last decade. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2423] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction and purpose
Scientific production has become very important in the progression of the healthcare profession, and the studies made in this field reflect a gender gap in the authorship of such production. In the last decade, a review of the publications made over 35 years in 6 high impact factor journals has evidenced a lesser proportion of women among the first and last signing authors (1,2). Nevertheless, the presence of women as preferential authors is desproportionately low considering the number of female cardiologists in Spain in the year 2017 (40%) (3). The Revista Española de Cardiología (REC) is an international journal dedicated to cardiovascular diseases. Our study investigates the authorship gender differences from publications in the REC.
Methods
A cross-sectional study was made of the REC issues published between January 2011 and December 2020. For each article we recorded the doi identifier, the year of publication, the type of article, the number of authors, the number of female authors, and the number of women with preferential authorship. Preferential authorship was defined as first signing author, corresponding author or last author. A gender-based analysis of the number of authors, the type and year of publication and preferential authorship was carried out. Female participation was calculated from the female/male ratio, with an analysis of the trend observed over the years.
Results
Of 2859 articles documented, 4275 signing authors were women and 12,061 were men.
699, 548 and 481 women were the first, corresponding and the last author, respectively. Table 1 shows the percentage of articles in which a woman was a preferential author, as well as the percentage of women that would have to be present in the general population to cancel statistical significance. The number of articles in which a woman was the first or the corresponding author was seen to increase (p=0.008 and p=0.002, respectively), while no significant changes were observed in relation to last authorship (p=0.09). The percentage of articles in which at least one woman held at least one of the three preferential authorship positions tended to increase over time (p=0.056). In the year 2011, a total of 90 articles out of 252 (35.7%) had at least one woman among the three preferential authors, while in the year 2020 the figure was 123 out of 296 (41.6%) (Figure 1).
Conclusions
Although the participation of female authors in the scientific production of the REC has increased during the last decade, authorship gender inequalities persist.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Davo-Jimenez
- University Hospital of the Canaries, Cardiology , Santa Cruz de Tenerife , Spain
| | - N Baez Ferrer
- University Hospital Nuestra Señora de la Candelaria , Santa Cruz de Tenerife , Spain
| | - A T Igareta-Herraiz
- University Hospital of the Canaries, Cardiology , Santa Cruz de Tenerife , Spain
| | - J Gonzalez
- University Hospital of the Canaries, Cardiology , Santa Cruz de Tenerife , Spain
| | - R Diaz
- Asturias Central University Hospital, Heart Area , Oviedo , Spain
| | - P Avanzas
- Asturias Central University Hospital, Heart Area , Oviedo , Spain
| | | | | | - P C Parra-Esquivel
- University Hospital of the Canaries, Cardiology , Santa Cruz de Tenerife , Spain
| | - M C Garcia-Baute
- University Hospital of the Canaries, Cardiology , Santa Cruz de Tenerife , Spain
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15
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Dreghici RD, Redican S, Lawrence J, Brown K, Wang F, Gonzalez J, Schneider J, Morris C, Shieh P, Byrne B. FP.28 IGNITE DMD phase I/II study of SGT-001 microdystrophin gene therapy for DMD: Long-term outcomes and expression update. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.234] [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: 11/05/2022]
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16
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Ahsan SA, Guha A, Gonzalez J, Bhimaraj A. Combined Heart-Kidney Transplantation: Indications, Outcomes, and Controversies. Methodist Debakey Cardiovasc J 2022; 18:11-18. [PMID: 36132574 PMCID: PMC9461692 DOI: 10.14797/mdcvj.1139] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 07/08/2022] [Indexed: 11/21/2022] Open
Abstract
Renal dysfunction, a prevalent comorbidity in advanced heart failure, is associated with significant morbidity and mortality after heart transplantation. In the recent era, the field of combined heart-kidney transplantation has experienced great success in the treatment of both renal and cardiac dysfunction in end-stage disease states, and the number of transplants has increased dramatically. In this review, we discuss appropriate indications and selection criteria, overall and organ-specific outcomes, and future perspectives in the field of combined heart-kidney transplantation.
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Affiliation(s)
- Syed Adeel Ahsan
- Methodist DeBakey Heart & Vascular Center, Houston Methodist, Houston, Texas, US
| | - Ashrith Guha
- Methodist DeBakey Heart & Vascular Center, Houston Methodist, Houston, Texas, US
| | - Juan Gonzalez
- The Kidney Institute, Houston Methodist, Houston, Texas, US
| | - Arvind Bhimaraj
- Methodist DeBakey Heart & Vascular Center, Houston Methodist, Houston, Texas, US
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17
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Atkinson MA, Jelin EB, Baschat A, Blumenfeld Y, Chmait R, O’Hare E, Moldenhauer J, Zaretsky M, Miller R, Ruano R, Gonzalez J, Johnson A, Mould A, Davis J, Hanley D, Keiser A, Rosner M, Miller JL. Design and Protocol of the Renal Anhydramnios Fetal Therapy (RAFT) Trial. Clin Ther 2022; 44:1161-1171. [PMID: 35918190 PMCID: PMC9847373 DOI: 10.1016/j.clinthera.2022.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/08/2022] [Accepted: 07/05/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Anhydramnios secondary to anuria before 22 weeks of gestational age and congenital bilateral renal agenesis before 26 weeks of gestational age are collectively referred to as early-pregnancy renal anhydramnios. Early-pregnancy renal anhydramnios occurs in at least 1 in 2000 pregnancies and is considered universally fatal when left untreated because of severe pulmonary hypoplasia precluding ex utero survival The Renal Anhydramnios Fetal Therapy (RAFT) trial is a nonrandomized, nonblinded, multicenter clinical trial designed to assess the efficacy, safety, and feasibility of amnioinfusions for patients with pregnancies complicated by early-pregnancy renal anhydramnios. The primary objective of this study is to determine the proportion of neonates surviving to successful dialysis, defined as use of a dialysis catheter for ≥14 days. METHODS A consortium of 9 North American Fetal Therapy Network (NAFTNet) centers was formed, and the RAFT protocol was refined in collaboration with the NAFTNet Scientific Committee. Enrollment in the trial began in April 2020. Participants may elect to receive amnioinfusions or to join the nonintervention observational expectant management group. Eligible pregnant women must be at least 18 years of age with a fetal diagnosis of isolated early-pregnancy renal anhydramnios. FINDINGS In addition to the primary study objective stated above, secondary objectives include (1) to assess maternal safety and feasibility of the serial amnioinfusion intervention (2) to perform an exploratory study of the natural history of untreated early pregnancy renal anhydramnios (3) to examine correlations between prenatal imaging and lung specific factors in amniotic fluid as predictive of the efficacy of serial percutaneous amnioinfusions and (4) to determine short- and long-term outcomes and quality of life in surviving neonates and families enrolled in RAFT IMPLICATIONS: The RAFT trial is the first clinical trial to investigate the efficacy, safety, and feasibility of amnioinfusions to treat the survival-limiting pulmonary hypoplasia associated with anhydramnios. Although the intervention offers an opportunity to treat a condition known to be almost universally fatal in affected neonates, the potential burdens associated with end-stage kidney disease from birth must be acknowledged. CLINICALTRIALS gov identifier: NCT03101891.
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Affiliation(s)
- Meredith A. Atkinson
- Department of Pediatrics, Division of Nephrology, Johns Hopkins University, Baltimore, MD
| | - Eric B. Jelin
- Department of Surgery, Division of Pediatric Surgery, Johns Hopkins University, Baltimore, MD
| | - Ahmet Baschat
- Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD
| | - Yair Blumenfeld
- Department of Obstetrics and Gynecology, Stanford University, Palo Alto, CA
| | - Ramen Chmait
- Department of Fetal Surgery, Children’s Hospital Los Angeles-USC Fetal-Maternal Center, Los Angeles, CA
| | - Elizabeth O’Hare
- Department of Surgery, Division of Pediatric Surgery, Johns Hopkins University, Baltimore, MD
| | - Julie Moldenhauer
- Center for Fetal Diagnosis and Treatment, Children’s Hospital of Philadelphia, Philadelphia, PA
| | | | - Russell Miller
- Department of Obstetrics and Gynecology, Columbia University, New York, NY
| | - Rodrigo Ruano
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Miami Medical School, Miami, FL
| | - Juan Gonzalez
- Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA
| | - Anthony Johnson
- Department of Obstetrics and Gynecology, University of Texas Health Center, Houston, TX
| | - Andrew Mould
- Department of Neurology, Division of Brain Injury Outcomes, Johns Hopkins University, Baltimore, MD
| | - Jonathan Davis
- Department of Pediatrics, Tufts Children’s Hospital, Boston, MA
| | - Daniel Hanley
- Department of Neurology, Division of Brain Injury Outcomes, Johns Hopkins University, Baltimore, MD
| | - Amaris Keiser
- Department of Pediatrics, Division of Neonatology, Johns Hopkins University, Baltimore, MD
| | - Mara Rosner
- Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD
| | - Jena L. Miller
- Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD
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18
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Rodriguez Ruiz C, Hermel M, Spierling Bagsic S, Salerno M, Newlander S, Bhavnani S, Robinson A, Gonzalez J, Wesbey G. 469 LDL Particle Number Association With Plaque Burden In Patients With Normal LDL-C. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.080] [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: 10/17/2022]
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19
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Pelter M, Almeida S, Bagsic S, Jayawardena E, Kinninger A, Newlander S, Robinson A, Bhavnani S, Gonzalez J, Budoff M, Wesbey G. 424 Image Quality, Radiation Dosimetry, And Diagnostic Accuracy Of Whole Heart Single Heartbeat Coronary Ct Angiography As Validated By Invasive Coronary Angiogram In A High Calcium Score Population. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.029] [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: 10/17/2022]
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20
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Hidalgo J, García JG, Cesarani A, Larios N, Atzori AS, Sánchez F, Espino M, Gorocica M, Salcedo R, Gonzalez J. Feedlot pens with greenhouse roofs improve beef cattle performance in temperate weather. Transl Anim Sci 2022; 6:txac042. [PMID: 35592094 PMCID: PMC9113336 DOI: 10.1093/tas/txac042] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Muddy pens can negatively affect welfare and performance of feedlot beef cattle. In some regions with temperate weather, plastic greenhouse covers, above the entire pens are used to fatten cattle in a clean and dry environment. The objective of this research was to investigate effects of greenhouse roofed pens on beef cattle feedlot performance in temperate weather. Data were collected from a feedlot located in Central Mexico between 2016 and 2019. The study included 1,062 closeouts of pens with 68,305 crossbred bulls fed in pens with or without a greenhouse roof. Feeding ranged from 82 to 210 d, depending on the initial weight of cattle, which ranged from 255 to 511 kg. For each pen, average daily dry matter intake (DMI, kg of dry matter intake•animal -1•d -1), average daily gain (ADG, kg•animal -1•d -1), and feed efficiency (G:F, ADG/DMI) were measured. Factorial analyses were performed to test the interaction and main effects of initial weight grouping (light, medium, and heavy), roof, and season as fixed effects, and year as a random effect. None of the 3-way interactions were significant (P > 0.51). There were no initial weight grouping × roof interactions for DMI and ADG (P > 0.31). There was (P = 0.03) an initial weight grouping × roof interaction for G:F, as pens of all initial weight groups had greater (P < 0.01) G:F in pens with greenhouse roof than its counterpart in pens without greenhouse roof, but the advantage was greater for pens with light cattle (0.178 vs. 0.166; P < 0.01). There were no initial weight grouping × season interactions for all variables (P > 0.39). There was no roof × season interaction for DMI (P = 0.47), but there were interactions for ADG and G:F (P < 0.01). The ADG was not different (P > 0.13) during summer and autumn based on the roofing system, but pens with greenhouse roofs had greater ADG during spring (1.70 vs. 1.61) and winter (1.68 vs. 1.64; P ≤ 0.01). The G:F was greater (P < 0.01) in all seasons for pens with a greenhouse roof, with the most prominent advantage during spring (0.173 vs. 0.160). There were main effects for cattle initial weight grouping and roof for all variables (P < 0.01). Season affected DMI and G:F (P < 0.01). Pens with greenhouse roofs had decreased DMI (9.70 vs. 9.86), greater ADG (1.67 vs. 1.63), and increased G:F (0.173 vs. 0.166) compared to pens without greenhouse roofs (P < 0.01). Pens with greenhouse roofs in feedlots located in temperate regions positively affect beef cattle performance.
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Affiliation(s)
- J Hidalgo
- Department of Animal and Dairy Science, University of Georgia, Athens, Georgia, GA 30602, US
- Phibro Animal Health Corporation, Guadalajara, JA 44130, Mexico
| | - J G García
- Departamento de Zootecnia, Posgrado en Producción Animal, Universidad Autónoma Chapingo, Chapingo, MX 56230, Mexico
| | - A Cesarani
- Department of Agricultural Science, University of Sassari, Sassari, Italy
| | - N Larios
- Departamento de Zootecnia, Posgrado en Producción Animal, Universidad Autónoma Chapingo, Chapingo, MX 56230, Mexico
| | - A S Atzori
- Department of Agricultural Science, University of Sassari, Sassari, Italy
| | - F Sánchez
- Phibro Animal Health Corporation, Guadalajara, JA 44130, Mexico
| | - M Espino
- Phibro Animal Health Corporation, Guadalajara, JA 44130, Mexico
| | - M Gorocica
- Phibro Animal Health Corporation, Guadalajara, JA 44130, Mexico
| | - R Salcedo
- Nutrientes Básicos de Monterrey, S.A. de C.V., Apodaca, NL 66636, Mexico
| | - J Gonzalez
- Department of Animal and Dairy Science, University of Georgia, Athens, Georgia, GA 30602, US
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Lopes LR, Losi MA, Sheikh N, Laroche C, Charron P, Gimeno J, Kaski JP, Maggioni AP, Tavazzi L, Arbustini E, Brito D, Celutkiene J, Hagege A, Linhart A, Mogensen J, Garcia-Pinilla JM, Ripoll-Vera T, Seggewiss H, Villacorta E, Caforio A, Elliott PM, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Erlinge D, Emberson J, Glikson M, Gray A, Kayikcioglu M, Maggioni A, Nagy KV, Nedoshivin A, Petronio AS, Hesselink JR, Wallentin L, Zeymer U, Caforio A, Blanes JRG, Charron P, Elliott P, Kaski JP, Maggioni AP, Tavazzi L, Tendera M, Komissarova S, Chakova N, Niyazova S, Linhart A, Kuchynka P, Palecek T, Podzimkova J, Fikrle M, Nemecek E, Bundgaard H, Tfelt-Hansen J, Theilade J, Thune JJ, Axelsson A, Mogensen J, Henriksen F, Hey T, Nielsen SK, Videbaek L, Andreasen S, Arnsted H, Saad A, Ali M, Lommi J, Helio T, Nieminen MS, Dubourg O, Mansencal N, Arslan M, Tsieu VS, Damy T, Guellich A, Guendouz S, Tissot CM, Lamine A, Rappeneau S, Hagege A, Desnos M, Bachet A, Hamzaoui M, Charron P, Isnard R, Legrand L, Maupain C, Gandjbakhch E, Kerneis M, Pruny JF, Bauer A, Pfeiffer B, Felix SB, Dorr M, Kaczmarek S, Lehnert K, Pedersen AL, Beug D, Bruder M, Böhm M, Kindermann I, Linicus Y, Werner C, Neurath B, Schild-Ungerbuehler M, Seggewiss H, Pfeiffer B, Neugebauer A, McKeown P, Muir A, McOsker J, Jardine T, Divine G, Elliott P, Lorenzini M, Watkinson O, Wicks E, Iqbal H, Mohiddin S, O'Mahony C, Sekri N, Carr-White G, Bueser T, Rajani R, Clack L, Damm J, Jones S, Sanchez-Vidal R, Smith M, Walters T, Wilson K, Rosmini S, Anastasakis A, Ritsatos K, Vlagkouli V, Forster T, Sepp R, Borbas J, Nagy V, Tringer A, Kakonyi K, Szabo LA, Maleki M, Bezanjani FN, Amin A, Naderi N, Parsaee M, Taghavi S, Ghadrdoost B, Jafari S, Khoshavi M, Rapezzi C, Biagini E, Corsini A, Gagliardi C, Graziosi M, Longhi S, Milandri A, Ragni L, Palmieri S, Olivotto I, Arretini A, Castelli G, Cecchi F, Fornaro A, Tomberli B, Spirito P, Devoto E, Bella PD, Maccabelli G, Sala S, Guarracini F, Peretto G, Russo MG, Calabro R, Pacileo G, Limongelli G, Masarone D, Pazzanese V, Rea A, Rubino M, Tramonte S, Valente F, Caiazza M, Cirillo A, Del Giorno G, Esposito A, Gravino R, Marrazzo T, Trimarco B, Losi MA, Di Nardo C, Giamundo A, Musella F, Pacelli F, Scatteia A, Canciello G, Caforio A, Iliceto S, Calore C, Leoni L, Marra MP, Rigato I, Tarantini G, Schiavo A, Testolina M, Arbustini E, Di Toro A, Giuliani LP, Serio A, Fedele F, Frustaci A, Alfarano M, Chimenti C, Drago F, Baban A, Calò L, Lanzillo C, Martino A, Uguccioni M, Zachara E, Halasz G, Re F, Sinagra G, Carriere C, Merlo M, Ramani F, Kavoliuniene A, Krivickiene A, Tamuleviciute-Prasciene E, Viezelis M, Celutkiene J, Balkeviciene L, Laukyte M, Paleviciute E, Pinto Y, Wilde A, Asselbergs FW, Sammani A, Van Der Heijden J, Van Laake L, De Jonge N, Hassink R, Kirkels JH, Ajuluchukwu J, Olusegun-Joseph A, Ekure E, Mizia-Stec K, Tendera M, Czekaj A, Sikora-Puz A, Skoczynska A, Wybraniec M, Rubis P, Dziewiecka E, Wisniowska-Smialek S, Bilinska Z, Chmielewski P, Foss-Nieradko B, Michalak E, Stepien-Wojno M, Mazek B, Lopes LR, Almeida AR, Cruz I, Gomes AC, Pereira AR, Brito D, Madeira H, Francisco AR, Menezes M, Moldovan O, Guimaraes TO, Silva D, Ginghina C, Jurcut R, Mursa A, Popescu BA, Apetrei E, Militaru S, Coman IM, Frigy A, Fogarasi Z, Kocsis I, Szabo IA, Fehervari L, Nikitin I, Resnik E, Komissarova M, Lazarev V, Shebzukhova M, Ustyuzhanin D, Blagova O, Alieva I, Kulikova V, Lutokhina Y, Pavlenko E, Varionchik N, Ristic AD, Seferovic PM, Veljic I, Zivkovic I, Milinkovic I, Pavlovic A, Radovanovic G, Simeunovic D, Zdravkovic M, Aleksic M, Djokic J, Hinic S, Klasnja S, Mircetic K, Monserrat L, Fernandez X, Garcia-Giustiniani D, Larrañaga JM, Ortiz-Genga M, Barriales-Villa R, Martinez-Veira C, Veira E, Cequier A, Salazar-Mendiguchia J, Manito N, Gonzalez J, Fernández-Avilés F, Medrano C, Yotti R, Cuenca S, Espinosa MA, Mendez I, Zatarain E, Alvarez R, Pavia PG, Briceno A, Cobo-Marcos M, Dominguez F, Galvan EDT, Pinilla JMG, Abdeselam-Mohamed N, Lopez-Garrido MA, Hidalgo LM, Ortega-Jimenez MV, Mezcua AR, Guijarro-Contreras A, Gomez-Garcia D, Robles-Mezcua M, Blanes JRG, Castro FJ, Esparza CM, Molina MS, García MS, Cuenca DL, de Mallorca P, Ripoll-Vera T, Alvarez J, Nunez J, Gomez Y, Fernandez PLS, Villacorta E, Avila C, Bravo L, Diaz-Pelaez E, Gallego-Delgado M, Garcia-Cuenllas L, Plata B, Lopez-Haldon JE, Pena Pena ML, Perez EMC, Zorio E, Arnau MA, Sanz J, Marques-Sule E. Association between common cardiovascular risk factors and clinical phenotype in patients with hypertrophic cardiomyopathy from the European Society of Cardiology (ESC) EurObservational Research Programme (EORP) Cardiomyopathy/Myocarditis registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:42-53. [PMID: 35138368 PMCID: PMC9745665 DOI: 10.1093/ehjqcco/qcac006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 12/15/2022]
Abstract
AIMS The interaction between common cardiovascular risk factors (CVRF) and hypertrophic cardiomyopathy (HCM) is poorly studied. We sought to explore the relation between CVRF and the clinical characteristics of patients with HCM enrolled in the EURObservational Research Programme (EORP) Cardiomyopathy registry. METHODS AND RESULTS 1739 patients with HCM were studied. The relation between hypertension (HT), diabetes (DM), body mass index (BMI), and clinical traits was analysed. Analyses were stratified according to the presence or absence of a pathogenic variant in a sarcomere gene. The prevalence of HT, DM, and obesity (Ob) was 37, 10, and 21%, respectively. HT, DM, and Ob were associated with older age (P<0.001), less family history of HCM (HT and DM P<0.001), higher New York Heart Association (NYHA) class (P<0.001), atrial fibrillation (HT and DM P<0.001; Ob p = 0.03) and LV (left ventricular) diastolic dysfunction (HT and Ob P<0.001; DM P = 0.003). Stroke was more frequent in HT (P<0.001) and mutation-positive patients with DM (P = 0.02). HT and Ob were associated with higher provocable LV outflow tract gradients (HT P<0.001, Ob P = 0.036). LV hypertrophy was more severe in Ob (P = 0.018). HT and Ob were independently associated with NYHA class (OR 1.419, P = 0.017 and OR 1.584, P = 0.004, respectively). Other associations, including a higher proportion of females in HT and of systolic dysfunction in HT and Ob, were observed only in mutation-positive patients. CONCLUSION Common CVRF are associated with a more severe HCM phenotype, suggesting a proactive management of CVRF should be promoted. An interaction between genotype and CVRF was observed for some traits.
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Affiliation(s)
- Luis R Lopes
- Corresponding author. Tel: +447765109343, , Twitter handle: @LuisRLopesDr
| | - Maria-Angela Losi
- Department of Advanced Biomedical Sciences, University Federico II, Corso Umberto I, 40, Naples 80138, Italy
| | - Nabeel Sheikh
- Department of Cardiology and Division of Cardiovascular Sciences, Guy's and St. Thomas’ Hospitals and King's College London, Strand, London WC2R 2LS, UK
| | - Cécile Laroche
- EORP, European Society of Cardiology, Sophia-Antipolis, France
| | | | | | - Juan P Kaski
- Institute of Cardiovascular Science, University College London, Gower St, London WC1E 6BT, UK,Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London WC1N 3JH, UK
| | - Aldo P Maggioni
- EORP, European Society of Cardiology, Sophia-Antipolis, France,Maria Cecilia Hospital, GVM Care&Research, Via Corriera, 1, Cotignola 48033 RA, Italy
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care&Research, Via Corriera, 1, Cotignola 48033 RA, Italy
| | | | - Dulce Brito
- Serviço de Cardiologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1169-050, Portugal,CCUL, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz MB, Lisbon 1649-028, Portugal
| | - Jelena Celutkiene
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Universiteto g. 3, Vilnius 01513, Lithuania,State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | | | - Ales Linhart
- 2nd Department of Internal Cardiovascular Medicine, General University Hospital and First Medical Faculty, Charles University, Opletalova 38, Prague 110 00, Czech Republic
| | - Jens Mogensen
- Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | - José Manuel Garcia-Pinilla
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares. Servicio de Cardiología. Hospital Universitario Virgen de la Victoria. IBIMA. Málaga and Ciber-Cardiovascular. Instituto de Salud Carlos III. Madrid, Spain
| | - Tomas Ripoll-Vera
- Inherited Cardiovascular Disease Unit Son Llatzer University Hospital & IdISBa, Palma de Mallorca, Spain
| | - Hubert Seggewiss
- Universitätsklinikum Würzburg, Deutsches Zentrum für Herzinsuffizienz (DZHI), Comprehensive Heart Failure Center (CHFC), Am Schwarzenberg 15, Haus 15A, 97078 Wurzburg, Germany
| | - Eduardo Villacorta
- Member of National Centers of expertise for familial cardiopathies (CSUR), Cardiology Department, University Hospital of Salamanca. Institute of Biomedical Research of Salamanca (IBSAL), CIBERCV, Salamanca, Spain
| | | | - Perry M Elliott
- Institute of Cardiovascular Science, University College London, Gower St, London WC1E 6BT, UK,St. Bartholomew's Hospital, Barts Heart Centre, Barts Health NHS Trust, Whitechapel Rd, London E1 1BB, UK
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Sosa C, Rivas M, Mascareño P, Amarilla L, Ricardo A, Rojas M, Gonzalez J, Sosa P. Outcome of fetal microneurosurgery for intrauterine spina bifida repair in country with deficient healthcare system. Ultrasound Obstet Gynecol 2022; 59:120-122. [PMID: 34255893 DOI: 10.1002/uog.23738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/26/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Affiliation(s)
- C Sosa
- Fundación Fetosur, Medicina Materno Fetal y Cirugía Fetal, Sanatorio Internacional, Ciudad del Este, Paraguay
- Unidad de Cirugía Experimental, Instituto Venezolano de Investigaciones Científicas, Altos de Pipe, Caracas, Venezuela
| | - M Rivas
- Departamento de Neurocirugía Pediátrica, Hospital de Clínicas, Facultad de Medicina, Universidad Nacional de Asunción, Asunción, Paraguay
| | - P Mascareño
- Fundación Fetosur, Medicina Materno Fetal y Cirugía Fetal, Sanatorio Internacional, Ciudad del Este, Paraguay
| | - L Amarilla
- Fundación Fetosur, Medicina Materno Fetal y Cirugía Fetal, Sanatorio Internacional, Ciudad del Este, Paraguay
| | - A Ricardo
- Fundación Fetosur, Medicina Materno Fetal y Cirugía Fetal, Sanatorio Internacional, Ciudad del Este, Paraguay
| | - M Rojas
- Fundación Fetosur, Medicina Materno Fetal y Cirugía Fetal, Sanatorio Internacional, Ciudad del Este, Paraguay
| | - J Gonzalez
- Departamento de Neurocirugía Pediátrica, Hospital de Clínicas, Facultad de Medicina, Universidad Nacional de Asunción, Asunción, Paraguay
| | - P Sosa
- Fundación Fetosur, Medicina Materno Fetal y Cirugía Fetal, Sanatorio Internacional, Ciudad del Este, Paraguay
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Burner E, Chang A, Hazime D, Gonzalez J, Garcia V, Mercado J, Berumen A, Menchine M, Arora S. 211 Long Term Effects of Mobile Health and Augmented Social Support on Emergency Department Patients With Diabetes. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.223] [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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Arastu S, Gonzalez J, Greenberg NE, Lucas EL, Wroolie TE, Rasgon NL. A-18 Early Pattern of Cognitive Changes Associated with Insulin Resistance in a Sample of Young Adults. Arch Clin Neuropsychol 2021. [DOI: 10.1093/arclin/acab062.36] [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
Insulin resistance increases the risk of developing type 2 diabetes and subsequently cardiovascular and cerebrovascular disease. It is also linked to neurocognitive disorders and accelerated cognitive aging (Ekblad et al, 2017; Levine, Harrati, & Crimmins, 2018). Using baseline data from a longitudinal study in a sample of 126 cognitively intact adults aged 25–50 years (36.5% males), we assessed cognitive performance in relation to insulin resistance to determine whether an early prodromal pattern of cognitive changes exists prior to advanced metabolic disease.
Methods
Steady state plasma glucose (SSPG) was used to measure insulin resistance. Multivariate regression analyses were conducted using age, years of education, body mass index (BMI), and SSPG as predictors of neuropsychological functioning. In-person and tele-neuropsychological assessment was administered using standard neuropsychological measures.
Results
Higher insulin resistance was associated with significantly worse attention (WAIS-III Digit Span total; B = -0.018, p = 0.03), executive functioning (D-KEFS Color-Word Inhibition/Switching; B = 0.047, p = 0.04) and dominant fine motor abilities (Purdue Pegboard; B = -0.008, p = 0.02). Higher insulin resistance was also associated with trend level worsening of other measures of executive functioning, namely D-KEFS Trails 4 (B = 0.099, p = 0.07) and DKEFS Color-Word Inhibition errors (B = 0.007, p = 0.09).
Conclusions
In young adults, higher insulin resistance was associated with declines in attention, executive functioning, and fine motor abilities. This early pattern of subtle cognitive changes associated with higher insulin resistance seen in this sample of younger adults is consistent with later cognitive declines found in type 2 diabetes and vascular neurocognitive disorder, namely declines in attention, executive functioning, and motor abilities with eventual memory declines in advanced disease.
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Navrazhina K, Renert-Yuval Y, Frew JW, Grand D, Gonzalez J, Williams SC, Garcet S, Krueger JG. Large-scale serum analysis identifies unique systemic biomarkers in psoriasis and hidradenitis suppurativa. Br J Dermatol 2021; 186:684-693. [PMID: 34254293 DOI: 10.1111/bjd.20642] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hidradenitis Suppurativa (HS) is now recognized as a systemic inflammatory disease, sharing molecular similarities with psoriasis. Direct comparison of the systemic inflammation in HS with psoriasis is lacking. OBJECTIVES To evaluate the serum proteome of HS and psoriasis, and to identify biomarkers associated with disease severity. METHODS In this cross-sectional study, 1,536 serum proteins were assessed using the Olink Explore (Proximity Extension Assay/PEA) high-throughput panel in moderate-to-severe HS (n=11), psoriasis (n=10) and age- and BMI-matched healthy controls (n=10). RESULTS HS displayed an overall greater dysregulation of circulating proteins, with 434 differentially expressed proteins (|FCH|≥1.2, p-value≤0.05) in HS versus controls, 138 in psoriasis versus controls, and 503 between HS and psoriasis. IL-17A levels and Th1/Th17 pathway enrichment were comparable between diseases, while HS presented greater TNF and IL-1β-related signaling. Th17-associated markers, PI3 and LCN2, were able to accurately differentiate psoriasis from HS. Both diseases presented increases of atherosclerosis-related proteins. Robust correlations between clinical severity scores and immune and atherosclerosis-related proteins were observed across both diseases. CONCLUSIONS HS and psoriasis share significant Th1/Th17 enrichment and upregulation of atherosclerosis-related proteins. Nevertheless, despite the greater body surface area involved in psoriasis, HS presents a greater serum inflammatory burden.
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Affiliation(s)
- K Navrazhina
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA.,Weill Cornell/Rockefeller, Sloan Kettering Tri-Institutional MD-PhD program, New York, NY, USA
| | - Y Renert-Yuval
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - J W Frew
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - D Grand
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - J Gonzalez
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - S C Williams
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA.,Weill Cornell/Rockefeller, Sloan Kettering Tri-Institutional MD-PhD program, New York, NY, USA
| | - S Garcet
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - J G Krueger
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
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Miller E, Blat C, Gosnell K, Gonzalez J, Ghaffari N. The Use of Sequential Integrated Screening to Stratify Risk in Monochorionic-Diamniotic Twin Pregnancies. Am J Perinatol 2021; 38:421-427. [PMID: 33032330 DOI: 10.1055/s-0040-1718371] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to identify differences in sequential integrated screening and early ultrasound markers in monochorionic/diamniotic (MC/DA) pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) and unequal placental sharing (UPS). STUDY DESIGN Retrospective cohort study of MC/DA pregnancies evaluated between January 2012 and July 2017 at the University of California San Francisco. MC/DA pregnancies with ultrasound surveillance up to 26 weeks who participated in the California Prenatal Screening Program (CPSP) were included. Pregnancies with structural or genetic anomalies were excluded. UPS was defined as an intertwin growth discordance ≥20%. Intertwin nuchal translucency (NT) discordance was calculated by the absolute value of the difference of the NT of cotwins. Kruskal-Wallis or ANOVA testing was performed where appropriate, and negative binomial regression models were chosen to test for differences in mean biomarker levels by outcome group. RESULTS A total of 191 MC/DA pregnancies were included; 85 were affected by TTTS, 35 by UPS, and 71 controls. Significant differences in intertwin NT discordance in pregnancies complicated by TTTS and UPS compared with controls (p = 0.007) were found. TTTS cases had a mean NT discordance greater than two times that of controls (p = 0.04), while UPS cases had a value more than three times greater (p = 0.003). There was a statistically significant difference in mean second trimester human chorionic gonadotropin (hCG) between the cohorts (p = 0.0002) with TTTS cases having a mean second trimester hCG value 1.5 greater than both controls (p < 0.001) and UPS cases (p = 0.001). Analysis showed a significant difference in mean second trimester inhibin between the three cohorts (p = 0.029). Pregnancies complicated by UPS had a mean second trimester inhibin 1.5 times greater than controls (p = 0.010). CONCLUSION Our study shows that there are unique differences in early ultrasound and sequential integrated serum markers between MC/DA gestations complicated by TTTS and UPS versus those unaffected. KEY POINTS · Differences exist in sequential integrated screening markers in monochorionic-diamniotic twin pregnancies.. · Early risk stratification of monochorionic-diamniotic twin pregnancies may be possible.. · Sequential integrated screening testing can provide useful information to clinicians when evaluating monochorionic-diamnitoic twin pregnancies..
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Affiliation(s)
- Edward Miller
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California
| | - Cinthia Blat
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California
| | - Kristen Gosnell
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California
| | - Juan Gonzalez
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California
| | - Neda Ghaffari
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California
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Kye J, Bagsic S, Kuo R, Cohoon T, Bhavnani S, Almeida S, Price M, Robinson A, Gonzalez J, Wesbey G. Gender interaction effect on coronary lumen volume to mass ratio after administration of sublingual GTN powder compared to tablet in coronary computed tomography angiography (CCTA). Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.238] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Nitroglycerin (GTN) results in improved CCTA image quality and diagnostic accuracy due to vasodilation and improved contrast density. Although studies have shown that sublingual (SL) GTN spray has greater vasodilation and faster onset and duration of action compared to SL tablet, it is not commonly used due to cost. The comparative efficacy of SL GTN powder in CCTA is unknown.
Purpose
The purpose of this study is to determine whether SL GTN powder can increase the coronary lumen volume (V) and the coronary lumen volume to left myocardial mass ratio (V/M) compared to SL GTN tablet.
Methods
34 patients (17 females) with 0.8 mg SL GTN powder and 34 patients (17 females) with 0.8 mg SL GTN tablet administration were included in this retrospective case-control study. GTN was given 5 minutes pre-CCTA on a 256 slice single-heartbeat CT. Inclusion criteria: CAD-RADS 0 or 1, precontrast LM + LAD AJ-130 CAC < 100, heart rate less than 75, phase of the cardiac cycle diastole, successful motion correction, Likert score 4 or 5, right- or co-dominance. The primary outcome assessed was left main plus left anterior descending (LM + LAD) V between GTN powder vs tablet. The secondary outcomes were LM + LAD V divided by 1) length of LM + LAD (derived mean area, A), and 2) M (V/M). The outcomes were measured by blinded PI with 17 yrs CCTA experience on GE workstation, 2020 version. Categorical variables were compared by Chi-Squared tests and continuous variables were compared between powder and tablet groups by unpaired t-tests if normally distributed, and Mann-Whitney U tests otherwise. Exploratory outcome analyses tested route of administration by sex interactions and main effects by Two-Way ANOVA’s. Further covariate-adjusted analyses were conducted using multiple linear regression models.
Results
Baseline characteristics were similar between powder and tablet administration. No statistically significant difference in median V, LM + LAD derived A , or median V/M was observed. A sex main effect demonstrated that females had significantly smaller V (630.6 mm3 vs 951.7 mm3, p< 0.0001) and A (4.2 mm2 vs 6.4 mm2, p< 0.0001) compared to males. These V and A sex differences were also observed when BMI or weight were included as covariates. When V and A were normalized by M, both revealed sex interactions depending on formulation. While males had higher normalized V and A in powder vs tablet (p < 0.04), females had the opposite with higher normalized V and A with tablet compared to powder (p < 0.04).
Conclusions
SL administration of the GTN powder 5 minutes before CCTA did not result in greater vasodilatory effect compared to the GTN tablet. However, gender interaction effects were observed, with greater V/M and A/M ratio in males with powder and greater V/M and A/M in women with tablet. These results suggest a potential differential gender effect based on the formulation of GTN. Prospective studies are warranted to evaluate these findings.
Abstract Figure. LM + LAD Lumen Volume to LV Mass by Sex
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Affiliation(s)
- J Kye
- Scripps Prebys Cardiovascular Institute, Pharmacy, La Jolla, United States of America
| | - S Bagsic
- Scripps Hub Academic Research Core , Scripps Whittier Diabetes Institute, La Jolla, United States of America
| | - R Kuo
- Scripps Prebys Cardiovascular Institute, Pharmacy, La Jolla, United States of America
| | - T Cohoon
- Scripps Prebys Cardiovascular Institute, Department of Medicine, La Jolla, United States of America
| | - S Bhavnani
- Scripps Prebys Cardiovascular Institute, Scripps Clinic Medical Group, Division of Cardiovascular Diseases, La Jolla, United States of America
| | - S Almeida
- HCA Midwest Heart and Vascular Specialists, Cardiology, Kansas City, United States of America
| | - M Price
- Scripps Prebys Cardiovascular Institute, Scripps Clinic Medical Group, Division of Cardiovascular Diseases, La Jolla, United States of America
| | - A Robinson
- Scripps Prebys Cardiovascular Institute, Scripps Clinic Medical Group, Division of Cardiovascular Diseases, La Jolla, United States of America
| | - J Gonzalez
- Scripps Prebys Cardiovascular Institute, Scripps Clinic Medical Group, Division of Cardiovascular Diseases and Radiology, La Jolla, United States of America
| | - G Wesbey
- Scripps Prebys Cardiovascular Institute, Scripps Clinic Medical Group, Division of Cardiovascular Diseases and Radiology, La Jolla, United States of America
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Favatela F, Horst M, Bracone M, Gonzalez J, Alvarez V, Lassalle V. Gelatin/Cellulose nanowhiskers hydrogels intended for the administration of drugs in dental treatments: Study of lidocaine as model case. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2020.101886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Arora S, P Patel H, Jani C, Thakkar S, Gonzalez J, Deshmukh A, Patel R, D'Hoit B. Impact of catheter ablation for atrial flutter on mortality and hospital readmission rates in patients with heart failure and reduced ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0441] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The effectiveness of catheter ablation as a management modality amongst patients with coexisting atrial flutter (AFL) and heart failure with reduced ejection fraction (HFrEF) is scarcely studied.
Methods
Appropriate ICD 10 codes were applied to the 2016 and 2017 National Readmission Database (NRD) to isolate patients having coexistent AFL and HFrEF including who had undergone an ablation. All-cause mortality at the end of 1 year was used as a primary outcome. Readmission due to AFL, heart failure (HF) and other causes were secondary outcomes. The hazard ratios were generated using Cox regression analysis while the time to event analysis was demonstrated with the Kaplan Meier curves.
Results
Out of a total of 9966 patients with AFL and HFrEF, 1980 (24.79%) patients underwent catheter ablation. The primary outcome, all-cause mortality (2.8% vs. 4.6%, HR: 0.610, 95% CI: 0.460–0.808, p=0.001) at the end of 1 year was significantly lower. Significant difference was also noted amongst two groups when it came to secondary outcomes such as readmissions due to AFL (1.6% vs. 6.3%, HR: 0.247, 95% CI: 0.173–0.354, p<0.001), HF (8.2% vs. 11.4%, HR: 0.693, 95% CI: 0.587–0.819, p<0.001) and other causes (29.4% vs. 37.1%, HR: 0.735, 95% CI: 0.673–0.804, p<0.001)
Conclusion
Ablative intervention amongst AFL patients with concomitant HFrEF showed a significant reduction in all-cause mortality. It also leads to significant reductions in readmissions due to AFL, HF and other causes at the end of one year.
Outcomes of AFL and HFrEF
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Arora
- Harrington Heart and Vascular institute/University Hospitals Cleveland Medical Center, Cardiovascular Diseases, Cleveland, United States of America
| | - H P Patel
- Louis A. Weiss Memorial Hospital, Internal Medicine, Chicago, United States of America
| | - C Jani
- Mount Auburn Hospital, Internal Medicine, Cambridge, United States of America
| | - S Thakkar
- Rochester General Hospital, Internal Medicine, Rochester, United States of America
| | - J Gonzalez
- Miami Cardiac and Vascular Institute, Cardiovascular Disease, Miami, United States of America
| | - A Deshmukh
- Mayo Clinic, Cardiovascular Disease, Rochester, United States of America
| | - R Patel
- Louis A Weiss Memorial Hospital, Internal Medicine, chicago, United States of America
| | - B D'Hoit
- Harrington Heart and Vascular institute/University Hospitals Cleveland Medical Center, Cardiovascular Disease, Cleveland, United States of America
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Thakkar S, Jani C, P Patel H, Arora S, Patel R, Kumar A, Gonzalez J, Deshmukh A, Rao M. Impact of catheter ablation for atrial flutter on mortality and hospital readmission rates in patients with heart failure and preserved ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0440] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The availability of real-world data regarding the impact of the catheter ablation in patients with concomitant atrial flutter (AFL) and heart failure with preserved ejection fraction (HFpEF) is limited.
Methods
2016 and 2017 National Readmission Database (NRD) was subjected to appropriate ICD-10 codes to identify and extract patients having coexistent atrial flutter and heart failure with preserved ejection fraction including who had undergone ablation. At 1 year, all-cause mortality was utilized as the primary outcome while readmissions due to AFL, heart failure (HF) and any other causes were designated as secondary outcomes. Kaplan Meier curves were used for a time to event analysis. Cox proportional hazard regression was used to generate hazard ratios.
Results
Out of a total 6099 patients with AFL and HFpEF, 906 (14.85%) underwent catheter ablation. At 1 year all cause mortality (3%, vs. 4.4%, HR: 0.661, 95% CI: 0.444–0.985, p=0.042) and readmissions due to AFL (2.3% vs. 5.3%, HR: 0.424, 95% CI: 0.272–0.661, p<0.001) were significantly less among ablation group. Readmission due to HF (9.3% vs. 9.7%, HR: 0.938, 95% CI: 0.745–1.182, p=0.587) and other causes (37% vs.40.3%, HR: 0.926, 95% CI: 0.825–1.040, p=0.193) did not show any significant difference in outcomes at the end of 1 year.
Conclusion
The utilization of catheter ablation amongst AFL patients with concomitant HFpEF showed a significant reduction in all-cause mortality and readmission due to AFL. However, it did not show any significant changes in readmissions due to HF or other causes at the end of one year.
Outcomes of AFL and HFpEF
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Thakkar
- Rochester General Hospital, Internal Medicine, Rochester, United States of America
| | - C Jani
- Mount Auburn Hospital, Internal Medicine, Cambridge, United States of America
| | - H P Patel
- Louis A. Weiss Memorial Hospital, Internal Medicine, Chicago, United States of America
| | - S Arora
- University Hospitals Case Medical Center, Divison of cardiovascular, Cleveland, United States of America
| | - R Patel
- Louis A. Weiss Memorial Hospital, Internal medicine, Chicago, United States of America
| | - A Kumar
- St John's Medical College Hospital, Critical care, Bangalore, India
| | - J Gonzalez
- Baptist Health South Florida, Cardiovascular Diseases, Miami, United States of America
| | - A Deshmukh
- Mayo Clinic, Cardiovascular Disease, Rochester, United States of America
| | - M Rao
- Rochester General Hospital, Cardiovascular Diseases, Rochester, United States of America
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Deslée G, Zysman M, Burgel PR, Perez T, Boyer L, Gonzalez J, Roche N. Chronic obstructive pulmonary disease and the COVID-19 pandemic: Reciprocal challenges. Respir Med Res 2020; 78:100764. [PMID: 32498023 PMCID: PMC7212957 DOI: 10.1016/j.resmer.2020.100764] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 12/28/2022]
Affiliation(s)
- G Deslée
- Service de Pneumologie, inserm U1250, CHU Reims, Université Reims Champagne Ardenne, Reims, France
| | - M Zysman
- Service des Maladies Respiratoires, CHU Bordeaux, Univ-Bordeaux, Centre de Recherche cardio-thoracique de Bordeaux, U1045, CIC 1401, Pessac, France
| | - P-R Burgel
- Service de Pneumologie, AP-HP Paris, Institut Cochin, inserm U1016, Université de Paris, Paris, France
| | - T Perez
- Service de Pneumologie, CHU Lille, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, Lille, France
| | - L Boyer
- Département de physiologie-explorations fonctionnelles, AP-HP Hôpital Henri-Mondor, Inserm U955, Créteil, France
| | - J Gonzalez
- Sorbonne Université, inserm, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique; AP-HP, Groupe Hospitalier Universitaire AP-HP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie, Médecine Intensive et Réanimation (Département R3S), Paris, France
| | - N Roche
- Service de Pneumologie, AP-HP Paris, Institut Cochin, inserm U1016, Université de Paris, Paris, France
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Treacy-Abarca S, Mercado J, Serrano J, Gonzalez J, Rincon Guerra N, Berumen A, Sanchez A, Hazime D, Raffi L, Burner E. 275 Age and Educational Attainment Predicts Engagement in a MHealth Intervention Conducted at a Safety-net Emergency Department. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rios C, Ling E, Rivera Gutierrez R, Gonzalez J, Bruce J, Barry M, de Jesus Perez V. Puerto Rico Health System Resilience After Hurricane Maria: Implications for Disaster Preparedness in the COVID-19 Era. medRxiv 2020:2020.09.20.20198531. [PMID: 32995821 PMCID: PMC7523162 DOI: 10.1101/2020.09.20.20198531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Every year, Puerto Rico faces a hurricane season fraught with potentially catastrophic structural, emotional and health consequences. In 2017, Puerto Rico was hit by Hurricane Maria, the largest natural disaster to ever affect the island. Several studies have estimated the excess morbidity and mortality following Hurricane Maria in Puerto Rico, yet no study has comprehensively examined the underlying health system weaknesses contributing to the deleterious health outcomes. METHODS A qualitative case study was conducted to assess the ability of the UPR health system to provide patient care in response to Hurricane Maria. An established five key resilience framework and inductive analysis was used to identify factors that affected health system resilience. Thirteen Emergency Medicine Physicians, Family Medicine Physicians, and Hospital Administrators in a University of Puerto Rico (UPR) Community Hospital were interviewed as part of our study. RESULTS Of the five key resiliency components, three domains were notably weak with respect to UPR resiliency. Prior to the Hurricane, key personnel at the UPR hospital were unaware of the limited capacity of back-up generators at hospitals and were ill-prepared to transfer ICU patients to appropriate hospitals. Post Hurricane, the hospital faced self-regulation challenges when triaging the provision of Hurricane-related emergency services with delivering core health services, in particular for patients with chronic conditions. Finally, during and after the Hurricane, integration of patient care coordination between the UPR hospital ambulances, neighboring hospitals, and national and state government was suboptimal. The two remaining resiliency factors, addressing diverse needs and system adaptiveness in a time of crisis, were seen as strengths. CONCLUSIONS Hurricane Maria exposed weaknesses in the Puerto Rican health system, notably the lack of awareness about the limited capacity of backup generators, poor patient care coordination, and interruption of medical care for patients with chronic conditions. As in other countries, the current COVID epidemic is taxing the capacity of the Puerto Rico health system, which could increase the likelihood of another health system collapse should another hurricane hit the island. Therefore, a resilience framework is a useful tool to help health systems identify areas of improvement in preparation for possible natural disasters.
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Cohoon T, Udoh E, Kolossváry M, Newlander S, Szilveszter B, Á. J, Maurovich-Horvat P, Bhavnani S, Gonzalez J, Wesbey G. Reconstructing Zero: The Impact Of Filtered Back Projection, Iterative Reconstruction, Deep Learning Reconstruction On Coronary Calcium Scoring Near Zero. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.129] [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: 10/23/2022]
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Udoh E, Cohoon T, Kolossváry M, Newlander S, Szilveszter B, Á. J, Maurovich-Horvat P, Bhavnani S, Gonzalez J, Wesbey G. The Effect Of Deep Learning Noise Reduction Image Reconstruction On CT Coronary Artery Calcium Agatston Score. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.022] [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: 11/16/2022]
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Kuppermann M, Kaimal AJ, Blat C, Gonzalez J, Thiet MP, Bermingham Y, Altshuler AL, Bryant AS, Bacchetti P, Grobman WA. Effect of a Patient-Centered Decision Support Tool on Rates of Trial of Labor After Previous Cesarean Delivery: The PROCEED Randomized Clinical Trial. JAMA 2020; 323:2151-2159. [PMID: 32484533 PMCID: PMC7267848 DOI: 10.1001/jama.2020.5952] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/03/2020] [Indexed: 12/15/2022]
Abstract
Importance Reducing cesarean delivery rates in the US is an important public health goal; despite evidence of the safety of vaginal birth after cesarean delivery, most women have scheduled repeat cesarean deliveries. A decision support tool could help increase trial-of-labor rates. Objective To analyze the effect of a patient-centered decision support tool on rates of trial of labor and vaginal birth after cesarean delivery and decision quality. Design, Setting, and Participants Multicenter, randomized, parallel-group clinical trial conducted in Boston, Chicago, and the San Francisco Bay area. A total of 1485 English- or Spanish-speaking women with 1 prior cesarean delivery and no contraindication to trial of labor were enrolled between January 2016 and January 2019; follow-up was completed in June 2019. Interventions Participants were randomized to use a tablet-based decision support tool prior to 25 weeks' gestation (n=742) or to receive usual care (without the tool) (n=743). Main Outcomes and Measures The primary outcome was trial of labor; vaginal birth was the main secondary outcome. Other secondary outcomes focused on maternal and neonatal outcomes and decision quality. Results Among 1485 patients (mean age, 34.0 [SD, 4.5] years), 1470 (99.0%) completed the trial (n = 735 in both randomization groups) and were included in the analysis. Trial-of-labor rates did not differ significantly between intervention and control groups (43.3% vs 46.2%, respectively; adjusted absolute risk difference, -2.78% [95% CI, -7.80% to 2.25%]; adjusted relative risk, 0.94 [95% CI, 0.84-1.05]). There were no statistically significant differences in vaginal birth rates (31.8% in both groups; adjusted absolute risk difference, -0.04% [95% CI, -4.80% to 4.71%]; adjusted relative risk, 1.00 [95% CI, 0.86-1.16]) or in any of the other 6 clinical maternal and neonatal secondary outcomes. There also were no significant differences between the intervention and control groups in the 5 decision quality measures (eg, mean decisional conflict scores were 17.2 and 17.5, respectively; adjusted mean difference, -0.38 [95% CI, -1.81 to 1.05]; scores >25 are considered clinically important). Conclusions and Relevance Among women with 1 previous cesarean delivery, use of a decision support tool compared with usual care did not significantly change the rate of trial of labor. Further research may be needed to assess the efficacy of this tool in other clinical settings or when implemented at other times in pregnancy.
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Affiliation(s)
- Miriam Kuppermann
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Anjali J. Kaimal
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston
| | - Cinthia Blat
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco
| | - Juan Gonzalez
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco
| | - Mari-Paule Thiet
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco
| | | | | | - Allison S. Bryant
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston
| | - Peter Bacchetti
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - William A. Grobman
- Feinberg School of Medicine, Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
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Gonzalez J, Garijo I, Sanchez A. Organ Trafficking and Migration: A Bibliometric Analysis of an Untold Story. Int J Environ Res Public Health 2020; 17:ijerph17093204. [PMID: 32380680 PMCID: PMC7246946 DOI: 10.3390/ijerph17093204] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/26/2020] [Accepted: 05/04/2020] [Indexed: 01/28/2023]
Abstract
The debate over trafficking of human beings for the purpose of organ removal (THBOR) remains largely absent from policy debates, as its crime is hardly detected, reported and sparsely researched. However, criminal networks continue to exploit vulnerable populations, particularly migrants. To help bridge this gap in knowledge, we employ a bibliometric analysis to examine whether the nexus between organ removal and migration is being addressed by the current academic literature. Our results indicate that (1) research exploring the link between THBOR and migrants is relatively scarce; (2) organ trafficking literature output is largely clustered in a couple of Western countries, and (3) despite the international nature of the topic, most empirical studies on organ trafficking and migration lack representation within the social sciences and humanities. Taken together, our results point to a huge gap on scientific publications between THBOR and migration. Quantitative data is required to lift the current knowledge constraints and better inform policymakers.
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McGhee S, Gonzalez J, Nadeau C, Ortega J. Mallet finger injuries: the signs, symptoms, diagnosis and management. Emerg Nurse 2020; 28:e1996. [PMID: 32153150 DOI: 10.7748/en.2020.e1996] [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] [Accepted: 11/11/2019] [Indexed: 11/09/2022]
Abstract
Patients commonly present to UK emergency departments with injuries to the tips of their fingers. Mallet finger is one of the most common injuries, resulting from an injury to the extensor tendon over the dorsal surface of the distal phalanges of the hand. Timely recognition, diagnosis and management are required to prevent complications. This article provides an overview of the pathophysiology, signs, symptoms, diagnosis and management of mallet finger injuries.
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Affiliation(s)
- Stephen McGhee
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States
| | - Juan Gonzalez
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States
| | - Catherine Nadeau
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States
| | - Johis Ortega
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States
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Gonzalez J, Gonzales F, Lund K, Muffly T. 80: Intraoperative suprapubic cystoscopy. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.12.229] [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: 10/24/2022]
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Guillen D, Gomez D, Hernandez I, Charris D, Gonzalez J, Leon D, Sanjuan M. Integrated methodology for industrial facilities management and design based on FCA and lean manufacturing principles. F 2020. [DOI: 10.1108/f-03-2019-0040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to provide a comprehensive methodology and a case study about the successful integration of FCA with continuous improvement tools for strategic decision-making processes. Reliable knowledge of the condition of tangible assets and their ability to fulfill their target activities over time are required for an assertive strategical decision process. Facility condition assessment (FCA) is a recognized methodology that allows the systematic evaluation of this performance. For those companies whose primary objective is the production of goods, decisions associated with improvements on the productive system or re-adaptation of existing assets may also require the implementation of alternative methodologies, with a direct impact on the indicators of the company and therefore on the FCA.
Design/methodology/approach
This study presents a methodology for the integration of FCA and lean manufacturing (LM) as a tool in strategic decision-making process that involves the integration of continuous improvement processes or significant changes in the production process, in which the condition of the installation impacts decisively the productivity of the system.
Findings
The results of the implementation on an insecticide and herbicide production plant indicate an increase of 33 per cent in the capacity of the formulation process and over 20 per cent reduction in the internal quality claims associated with the packaging system.
Practical implications
Those methodological stages are applicable to facilities in which the FCA shows the need for significant reconditioning of assets, the need to increase the efficiency and/or the production capacity. This methodology integrates elements of continuous improvement and redesign of production systems.
Originality/value
The original value of this paper is oriented to the capacity to integrate different FCA and LM tools through the company indicators of productivity key performance indicators and, in addition, of a comprehensive illustration based on a study case.
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Manzanarez B, Lopez K, Lipton-Inga M, Fink C, Radzik M, Buxton R, Gonzalez J, Davis C, Vidmar AP. Kids N Fitness: A Group-based Pediatric Weight Management Curriculum Adapted for a Clinical Care Model. J Pediatr Child Health Care 2020; 5:1028. [PMID: 32844162 PMCID: PMC7444754] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND The current AAP clinical practice guidelines for the management of pediatric obesity recommend a structured, comprehensive, multi-disciplinary clinical intervention. However, there is a gap in the current literature on standardized curriculums for implementation of such programs. The objective of the present study is to adapt an evidenced-based, family- centered, weekly, weight management curriculum that addresses nutritional, physical activity and behavioral topics for a clinical care model at a tertiary care children's hospital. METHODS The curriculum was adapted for use in six individual sessions offered monthly by a multidisciplinary team, including a health educator, physician, dietitian, physical therapist and psychologist. Each provider offered specific feedback and curriculum adaptation based on their specialty. All team members completed training with scheduled treatment fidelity monitoring during implementation. To evaluate the effectiveness of the adapted curriculum, 60 adolescents, ages 14-18 years, with overweight or obesity, and at least one family member, will complete the six month intervention. The primary outcome is mean change in zBMI and %BMIp95 at six month and 18 months. Secondary outcomes include retention, satisfaction, effect on metabolic factors and activity level. CONCLUSION There is a paucity of literature on utilizing a standard curriculum in clinical weight management programs. Drawing from evidenced-based curriculum to strengthen clinical care creates an opportunity to improve existing clinical programs and potentially increase access and implementation of the current treatment recommendations for this high risk population.
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Affiliation(s)
- B Manzanarez
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, USA
| | - K Lopez
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, USA
| | - M Lipton-Inga
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, USA
| | - C Fink
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, USA
| | - M Radzik
- Diabetes & Obesity Program and Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles and Keck School of Medicine of USC, USA
| | - R Buxton
- Physical Therapy and Rehabilitation Services, Children's Hospital Los Angeles and Keck School of Medicine of USC, USA
| | - J Gonzalez
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, USA
| | - C Davis
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, USA
| | - A P Vidmar
- Diabetes and Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, USA
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Rekadwad B, Gonzalez J, Khobragade C. One Plate-double Nutrient Endospore Activation Method. Bio Protoc 2020. [DOI: 10.21769/bioprotoc.3474] [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: 11/02/2022] Open
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Lauret J, Gonzalez J, Van Buren G, Nuñez R, Canal P, Naumann A. Extreme Compression for Large Scale Data Store. EPJ Web Conf 2020. [DOI: 10.1051/epjconf/202024506024] [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: 11/14/2022] Open
Abstract
For the last 5 years Accelogic pioneered and perfected a radically new theory of numerical computing codenamed “Compressive Computing”, which has an extremely profound impact on real-world computer science [1]. At the core of this new theory is the discovery of one of its fundamental theorems which states that, under very general conditions, the vast majority (typically between 70% and 80%) of the bits used in modern large-scale numerical computations are absolutely irrelevant for the accuracy of the end result. This theory of Compressive Computing provides mechanisms able to identify (with high intelligence and surgical accuracy) the number of bits (i.e., the precision) that can be used to represent numbers without affecting the substance of the end results, as they are computed and vary in real time. The bottom line outcome would be to provide a state-of-the-art compression algorithm that surpasses those currently available in the ROOT framework, with the purpose of enabling substantial economic and operational gains (including speedup) for High Energy and Nuclear Physics data storage/analysis. In our initial studies, a factor of nearly x4 (3.9) compression was achieved with RHIC/STAR data where ROOT compression managed only x1.4.
In this contribution, we will present our concepts of “functionally lossless compression”, have a glance at examples and achievements in other communities, present the results and outcome of our current, ongoing R&D, as well as present a high-level view of our plan to move forward with a ROOT implementation that would deliver a basic solution readily integrated into HENP applications. As a collaboration of experimental scientists, private industry, and the ROOT Team, our aim is to capitalize on the substantial success delivered by the initial effort and produce a robust technology properly packaged as an open-source tool that could be used by virtually every experiment around the world as means for improving data management and accessibility.
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Lopez-Monclus J, Artes M, Gonzalez J, Blazquez LA, Lucena JL, Robin A, Munoz JM, San-Miguel C, Garcia-Urena MA. Failure of talc seromadesis for the treatment of subcutaneous chronic seromas after incisional hernia surgery. Scand J Surg 2019; 110:105-109. [PMID: 31830877 DOI: 10.1177/1457496919891593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/17/2022]
Abstract
BACKGROUND AND AIM Talc poudrage has been used since many years for sclerosing chronic pleural effusion. Several reports have shown good results managing chronic seromas after breast, vascular, and incisional hernia surgeries. The purpose of this study is to determine the utility of talc seromadesis for the management of chronic seromas after incisional hernia surgery. MATERIALS AND METHODS Multicentric prospective observational study including patients diagnosed of chronic seromas after incisional hernia surgery. Under local anesthesia and ultrasonographic control, two percutaneous trocars were placed in the seroma, washing the seroma cavity with 0.9% saline solution and aspirating the remaining liquid. A sample of 4 g of talcum powder was introduced in the seroma cavity, and a 15-F drain was left in place. Patients were followed each week during at least 4 weeks after drainage removal. RESULTS Between January 2013 and December 2016, a total of six patients were enrolled in the study. Talc poudrage was performed without any complications. Drains were pulled out in a mean time of 3 (range: 2-4) weeks. One case of the chronic seromas was efficiently sclerosed with talc without recurrence in time. In three cases, the seroma recurred, and the final solution was surgical decortication of the seroma. In the other two cases, seroma also recurred and were managed with instillation of ethanol and iodine povidone. CONCLUSION In our experience, the management of chronic seromas after incisional hernia repair with talc seromadesis is ineffective and is associated with a high rate of seroma recurrence.
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Affiliation(s)
- J Lopez-Monclus
- Department of General Surgery, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Spain
| | - M Artes
- Department of General Surgery, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Spain
| | - J Gonzalez
- Department of General Surgery, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Spain
| | - L A Blazquez
- Department of General Surgery, Ramon y Cajal University Hospital, Madrid, Spain
| | - J L Lucena
- Department of General Surgery, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Spain
| | - A Robin
- Department of General Surgery, Henares University Hospital, Coslada, Spain
| | - J M Munoz
- Department of General Surgery, Henares University Hospital, Coslada, Spain
| | - C San-Miguel
- Department of General Surgery, Henares University Hospital, Coslada, Spain
| | - M A Garcia-Urena
- Department of General Surgery, Henares University Hospital, Coslada, Spain
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Olson B, Rice E, Gonzalez J, Vipham J, Houser T, Boyle E, Chao M, O’Quinn T. Evaluation of Beef Top Sirloin Steaks of Four Quality Grades Cooked to Three Degrees of Doneness. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10718] [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: 11/03/2022] Open
Abstract
ObjectivesThe objective of this study was to evaluate the impact of quality grade on beef eating quality of top sirloin steaks when cooked to multiple degrees of doneness (DOD).Materials and MethodsBeef top sirloin butts (IMPS #184; N = 60; 15/quality grade) were collected to equally represent 4 quality grades [Prime, Top Choice (Modest and Moderate marbling), Low Choice, and Select]. Top butts were cut into six consecutive steaks, and then divided laterally to get a total of twelve steaks per top butt. Steaks were assigned to one of three DOD: rare (60°C), medium (71°C), and well-done (77°C). Steaks within each DOD were assigned to consumer sensory analysis, trained sensory analysis, fat and moisture analysis, and Warner-Bratzler shear force (WBSF). Consumers (N = 236) were fed samples under red lighting and evaluated steaks for juiciness, tenderness, flavor, and overall liking on continuous line scales. Trained sensory panelists evaluated samples for initial and sustained juiciness, myofibrillar and overall tenderness, connective tissue amount, beef flavor intensity, and off flavor intensity on similar continuous line scales. Data were analyzed as a split-plot, with a whole plot factor of quality grade, and sub-plot factor of DOD.ResultsThere were no interactions (P > 0.05) for all consumer ratings of palatability traits. For quality grade, no differences (P > 0.05) were observed for consumer ratings of tenderness, flavor, and overall liking; however, there was a significant effect (P = 0.01) on juiciness. Prime top sirloin steaks had higher (P < 0.05) juiciness ratings than all other quality grades, except for Top Choice. Additionally, as DOD increased, consumer ratings and the percentage of steaks rated acceptable for all palatability traits decreased (P < 0.05; rare > medium > well-done). There was a quality grade × DOD interaction (P < 0.05) for trained sensory ratings of myofibrillar tenderness, initial juiciness, and sustained juiciness. When steaks were cooked to medium, Prime and Top Choice steaks had higher (P < 0.05) panelist ratings for initial and sustained juiciness than Low Choice and Select steaks. Similar to trained panelist ratings of juiciness, Prime and Top Choice steaks had higher (P < 0.05) ratings of myofibrillar tenderness than Select steaks. Prime and Top Choice steaks had similar (P > 0.05) and higher (P < 0.05) ratings for myofibrillar tenderness when compared to Low Choice steaks. Within DOD, each successive increase in DOD resulted in a concurrent decrease (P < 0.05; rare > medium > well) in trained panelist ratings of myofibrillar tenderness, initial juiciness, and sustained juiciness. There was no quality grade by DOD interactions (P > 0.05) for Warner-Bratzler shear force. Prime steaks were more (P < 0.05) tender than Low Choice and Select steaks but were similar (P > 0.05) to Top Choice. Moreover, as DOD increased, WBSF concurrently increased (P < 0.05; well-done > medium > rare), with well-done steaks having WBSF values 0.8 kg tougher than rare steaks.ConclusionThese results indicate that regardless of DOD, quality grade had minimal impact on the palatability of beef top sirloin steaks. Therefore, unless cooked to a medium DOD, it is unnecessary for consumers, retailers, and foodservice to pay premium prices for higher quality top sirloin steaks, as the same eating experience will be provided.
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Affiliation(s)
- B. Olson
- Kansas State University Animal Science & Industry
| | - E. Rice
- Kansas State University Animal Science & Industry
| | - J. Gonzalez
- University of Georgia Animal & Dairy Science
| | - J. Vipham
- Kansas State University Animal Science & Industry
| | - T. Houser
- Kansas State University Animal Science & Industry
| | - E. Boyle
- Kansas State University Animal Science & Industry
| | - M. Chao
- Kansas State University Animal Science & Industry
| | - T. O’Quinn
- Kansas State University Animal Science & Industry
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Najar F, Boyle E, Houser T, Vahl C, Gonzalez J, Wolf J, Kastner J, O’Quinn T, Chao M, Cox K. The Use of Bioelectrical Impedance to Assess Shelf-Life of Beef Longissimus Dorsi. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10662] [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: 11/03/2022] Open
Abstract
ObjectivesTo evaluate quality attributes of beef longissimus dorsi (LD) during 15 d of simulated retail display using surface and internal bioelectrical impedance analysis (BIA) measurement techniques.Materials and MethodsThe experiment was designed as a split-plot with loin as the whole-plot and pairekd steaks as the sub-plot. Display day (DD) was treated as the sub-plot treatment. Postmortem age time (PM) and DD were treated as fixed effects. Beef strip loins (N = 18; IMPS #180), obtained from 3 commercial processors (PM = 27, 34, or 37 d), were fabricated into 12 2.54-cm thick steaks (N = 216). Steaks were subdivided into 6 consecutively cut pairs and pairs were randomly assigned to one of 6 display days: 0, 3, 6, 9, 12, and 15. For all pairs, one steak was allocated to microbiological analysis and pH and the paired steak for BIA, objective color assessment, proximate composition, and TBARS. Surface BIA (S-BIA) and internal BIA (I-BIA) assessment were compared. Steaks were packaged on styrofoam trays with a moisture absorbent pad, overwrapped with polyvinyl chloride film, and displayed under fluorescent lighting at 0–4°C in coffin-style retail cases.ResultsThere was a PM × DD interaction (P < 0.05) for S-BIA values. From d 0 to 12 of display, steaks aged 27 d had higher (P < 0.05) S-BIA values than steaks aged 34 and 37 d; however, on d 15 of display, steaks aged 34 d had 22% higher (P < 0.05) S-BIA values than steaks aged 37 d, but had similar (P > 0.05) values compared to steaks aged 27 d. There was no PM × DD interaction (P < 0.05) for I-BIA values; however, an effect on PM and DD was found (P < 0.05). Steaks aged 27 d were 17% higher for I-BIA values (P < 0.05) than 37 d, but similar (P > 0.05) to steaks aged 34 d. For all PM aging times, d 0 had the lowest (P < 0.05) I-BIA values among all display days with 81.44. D 3 was the second lowest (P < 0.05) and 8% higher than d 0 for I-BIA values. D 6 was 16% higher (P < 0.05) than d 3 but similar (P > 0.05) to d 9 and d 12. D 12 and D 15 were similar (P > 0.05). There was a DD × BIA method interaction (P < 0.05). On d 0, 3, and 6, BIA values were different (P < 0.05); however, after d 6 onward, BIA values were similar (P > 0.05). Covariance component was smaller in I-BIA than S-BIA. There were no PM × DD interactions (P > 0.05) for a* and b* values; however, there was an interaction for L* values. Postmortem aging had no effect (P > 0.05) on L*; however, an effect on a* and b* was found (P < 0.05). For APC populations, there was a PM × DD interaction (P < 0.05). No PM × DD interaction or PM effect (P > 0.05) were found for TBARS; however, there was a DD effect (P < 0.05). There was no PM day × DD interaction (P > 0.05) or PM day (P > 0.05) for moisture content. Display day (P < 0.05) had an effect on moisture content. Moderate negative correlations occurred between S-BIA values and a*, b*, and moisture content with –0.48, –0.46, and –0.46, respectively; and –0.51, –0.48, and –0.43, respectively, for I-BIA. Conversely, moderate positive correlation was found between S-BIA values and APC and TBARS with 0.34 and 0.53, respectively; and 0.29 and 0.51, respectively, for I-BIA.ConclusionI-BIA has potential for use to assess shelf-life of retail steaks and it was more precise than S-BIA; however, I-BIA may translocate bacteria into the muscle. Protein degradation and WHC should be evaluated to better understand BIA changes over time.
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Affiliation(s)
- F. Najar
- Kansas State University Animal Science and Industry
| | - E. Boyle
- Kansas State University Animal Science and Industry
| | - T. Houser
- Kansas State University Animal Science and Industry
| | - C. Vahl
- Kansas State University Statistics
| | - J. Gonzalez
- Kansas State University Animal Science and Industry
| | - J. Wolf
- Kansas State University Animal Science and Industry
| | - J. Kastner
- Kansas State University Diagnostic Medicine/Pathobiology
| | - T. O’Quinn
- Kansas State University Animal Science and Industry
| | - M. Chao
- Kansas State University Animal Science and Industry
| | - K. Cox
- Seafood Analytics Quality Control
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Santana E, Gonzalez J, Byrd D, Rivera Mindt M. The Roles of Health Literacy and Physician-Patient Relationship in Self-Reported Health Outcomes Within a Diverse Sample of Persons Living with HIV. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz029.40] [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: 11/14/2022] Open
Abstract
Abstract
Objective
Barriers like poor health literacy and patient-provider communication add to health disparities in diverse populations. Perceived autonomy has been shown to improve patients’ health satisfaction and knowledge of their illness. However, no studies have examined these issues in HIV patients. This study examined the roles of health literacy and physician-patient relationship in health outcomes (e.g., mental health and emotional/physical functioning) in persons living with HIV (PLWH).
Participants and Method
This cross-sectional study included 91 PLWH (74% Latinx and 26% non-Latinx White; 68% Male) who completed the Test of Functional Health Literacy in Adults (TOFHLA), Physician–Patient Relationship Scale (PPRS), and Medical Outcomes Study-HIV Health Survey (MOS). The study variables included: TOFHLA total score, PPRS Part Decision- Making (PDM) and Trust subscales, and MOS Mental Health and Health Transition subscales.
Results
A linear regression showed that our model (ethnicity, TOFHLA, PPRS PDM and Trust) predicted MOS HT (R2 = .14, p < 0.05), such that Latinx ethnicity (β = .30) and better TOFHLA scores (β = -.22) predicted better MOS HT scores (ps < .05). Another regression showed that our model predicted MOS MH (R2 = 0.07, p = <.01), such that greater PPRS PDM scores predicted better MOS MH scores (β = .27, p = <.01).
Conclusions
Ethnicity and better health literacy were related to improved emotional/physical functioning over a 4-week period and greater shared decision-making was related to better overall mental health. These findings highlight the importance of identifying sociocultural factors and interpersonal processes of care to inform culturally-tailored interventions that can result in enhanced and effective treatment for PLWH patients and in improved physical and mental health outcomes.
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Santas Olmeda E, De La Espriella R, Minana G, Valero E, Palau P, Amiguet M, Gonzalez J, Soler M, Sanchis J, Chorro FJ, Nunez J. P3543Rehospitalization burden in heart failure with mid-range ejection fraction and morbidity burden. Is it a distinct phenotype? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0406] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Heart failure with mid-range ejection fraction (HFmrEF) has been recognized as a distinct HF phenotype, but wether patients on this category fare worse, similarly, or better than those with HF with reduced EF (HFrEF) or preserved EF (HFpEF) in terms of rehospitalization risk over time remains unclear. We therefore sought to characterize the mordibity burden of HFmrEF patients by evaluating the risk of recurrent hospitalizations following an admission for acute HF.
Methods
We prospectively included 2,961 consecutive patients discharged for acute HF in our institution from 2004 to 2017. Patients were categorized according to their ejection fraction (EF) obtained by an echocardiography during the index admission: HFmrEF (EF 41–49%), HFrEF (EF≤40%) and HFpEF (EF≥50%). Negative binomial regression method was used to evaluate the association between EF status and recurrent all-cause and HF-related admissions. Risk estimates were expressed as incidence ratio ratios (IRR).
Results
Mean age of the cohort was 73.9±11.1 years, 49% were women, and 46.0% had suffered from previous HF admissions. 472 patients (15.9%) had HFmrEF, 956 (32.3%) had HFrEF, and 1,533 (51.8%) had HFpEF. At a median (interquartile range) follow-up of 2.4 (4.4) years, 1,821 (61.5%) patients died and 6,035 all-cause readmissions were registered in 2,026 patients (68.4%), being 2,163 of them HF-related. Rates of all-cause readmission per 100 patients-years of follow-up were 43.4, 47.1 and 50.1 per HFrEF, HFmrEF and HFpEF categories, respectively. After multivariable adjustment, and compared to patients with HFrEF, HFmrEF status was not associated with a higher risk of all-cause or HF-related recurrent admissions (IRR=1.06; 95% confidence interval (CI), 0.93–1.20; p=0.89), and IRR=1.07; 95% CI, 0.91–1.26; p=0.389, respectively), whereas HFpEF status was associated with a non-significant increase in the risk of all-cause recurrent admissions but a similar risk of HF-related readmissions (IRR=1.10; 95% confidence interval (CI), 0.99–1.22; p=0.06, and IRR=1.01; 95% CI, 0.88–1.16; p=0.900, respectively)
Conclusion
Following an admission for acute HF, patients with HFmrEF have a similar all-cause and HF-related rehospitalization burden when compared to patients with HFrEF, by means of recurrent events analysis.
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Affiliation(s)
- E Santas Olmeda
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - R De La Espriella
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - G Minana
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - E Valero
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - P Palau
- Hospital General de Castellόn. Universitat Jaume I, Castellon, Spain
| | - M Amiguet
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - J Gonzalez
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - M Soler
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - J Sanchis
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - F J Chorro
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - J Nunez
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
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Marcos Garces V, Gonzalez J, Gavara J, Rios-Navarro C, Bonanad C, Chorro FJ, Ortiz JT, Rodriguez J, Mendieta G, Rodriguez-Palomares JF, Valente F, Garcia-Dorado D, Lopez-Lereu MP, Monmeneu JV, Bodi V. P1475Risk stratification after STEMI. Ejection fraction by echocardiography as the gatekeeper for a selective use of cardiac magnetic resonance. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0240] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Cardiac magnetic resonance (CMR) has emerged as the most potent non-invasive imaging technique for risk stratification after ST-segment elevation myocardial infarction (STEMI) but an indiscriminate use in all patients is unfeasible. Echocardiography (Echo) has been universally used for prognostication in this scenario. We hypothesized that left ventricular ejection fraction (LVEF) by Echo can represent the gatekeeper for selecting those patients who benefit most from CMR for prognostic purposes.
Methods
Data were obtained from a large prospective registry of reperfused STEMI patients (n=516) in whom Echo (2D and Doppler variables) and CMR (cine images, microvascular obstruction and infarct size) were simultaneously recorded at pre-discharge (7±2 days). Major adverse cardiac events (MACE) were defined as a combined clinical end-point: death or re-admission for acute heart failure (whichever occurred first). Patients were categorized in reduced LVEF (r-LVEF, <40%), mid-range LVEF (mr-LVEF, 40–49%) and preserved LVEF (p-LVEF, ≥50%). Hierarchical multivariate Cox regression analyses including first clinical+Echo variables and then CMR variables where carried out. C-statistics, “net reclassification” (NRI) and “integrated discrimination” (IDI) indexes were obtained.
Results
During a mean and median follow-up of 4 years, 86 first MACE (17%) were registered (39 deaths and 47 re-admissions for acute heart failure). In the whole study group (n=516), the independent predictors of MACE were time to revascularization (min), GRACE score, CMR-LVEF (%) and CMR-microvascular obstruction (% of LV mass); C-statistic 0.82 (p<0.001). The MACE rate in patients with r-LVEF, mr-LVEF and p-LVEF was 47%, 23% and 11% by Echo-LVEF and 45%, 17% and 8% by CMR-LVEF. LVEF was lower by CMR than by Echo (51±13 vs. 54±10, p<0.001) and r-LVEF was more frequently detected by CMR (n=94, 18%) than by Echo (n=48, 9%), p<0.001. CMR significantly improved clinical+Echo stratification in those 112 patients (22%) with mr-Echo-LVEF (C-statistitics 0.74 vs 0.82; NRI and IDI: p<0.05) but it did not in those 355 patients (69%) with p-Echo-LVEF (C-statistitics 0.75 vs 0.76; NRI and IDI: non-significant) and in those 49 patients (9%) with r-Echo-LVEF (C-statistitics 0.77 vs 0.77; NRI and IDI: non-significant).
Figure 1. Risk stratification after STEMI
Conclusions
Applied in an individualized manner, Echo-LVEF appears as a useful gatekeeper for a selective use of CMR soon after STEMI for prognostic purposes. The event rate is high in patients with reduced Echo-LVEF and low in those with preserved Echo-LVEF; CMR does not seem to significantly improve risk stratification in these scenarios. Nevertheless, the occurrence of mid-range Echo-LVEF permits discriminating the specific subset of STEMI patients (less than a quarter) who really benefit from pre-discharge CMR in terms of risk assessment.
Acknowledgement/Funding
Funded by “Instituto de Salud Carlos III”/FEDER (PIE15/00013, PI17/01836, and CIBERCV16/11/00486 grants) and Generalitat Valenciana (GV/2018/116).
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Affiliation(s)
- V Marcos Garces
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - J Gonzalez
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - J Gavara
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | | | - C Bonanad
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - F J Chorro
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - J T Ortiz
- Hospital Clinic de Barcelona, Department of Cardiology, Barcelona, Spain
| | - J Rodriguez
- Hospital Clinic de Barcelona, Department of Cardiology, Barcelona, Spain
| | - G Mendieta
- Hospital Clinic de Barcelona, Department of Cardiology, Barcelona, Spain
| | | | - F Valente
- Vall d'Hebron University Hospital, Department of Cardiology, Barcelona, Spain
| | - D Garcia-Dorado
- Vall d'Hebron University Hospital, Department of Cardiology, Barcelona, Spain
| | - M P Lopez-Lereu
- ERESA, Cardiovascular Magnetic Resonance Unit, Valencia, Spain
| | - J V Monmeneu
- ERESA, Cardiovascular Magnetic Resonance Unit, Valencia, Spain
| | - V Bodi
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
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Kaimal AJ, Grobman WA, Bryant A, Blat C, Bacchetti P, Gonzalez J, Thiet MP, Bermingham Y, Kuppermann M. The association of patient preferences and attitudes with trial of labor after cesarean. J Perinatol 2019; 39:1340-1348. [PMID: 31270433 PMCID: PMC8593844 DOI: 10.1038/s41372-019-0399-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/31/2019] [Accepted: 04/12/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the association of patient preferences and attitudes with TOLAC. STUDY DESIGN Prospective observational study of TOLAC-eligible women at 26-34 weeks gestation. Preferences (utilities) were elicited using the time trade-off and standard gamble metrics. Logistic regression was used to identify preference- and attitude-based factors associated with TOLAC. RESULTS Of the 231 participants, most (n = 197, 85%) preferred vaginal delivery, but only 40% (n = 93) underwent TOLAC. Utilities for uterine rupture outcomes did not differ based on delivery approach. In multivariable analysis, strength of preference for vaginal delivery, value for the experience of labor, and the opinion of the person whom the participant thought of as most important to this decision were associated with TOLAC. CONCLUSIONS Future decision support interventions incorporating individualized information regarding the likelihood of vaginal birth and empowering patients to express their preferences and engage their families in the decision-making process may improve decision quality and increase TOLAC rates.
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Affiliation(s)
- Anjali J Kaimal
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA.
| | - William A Grobman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Allison Bryant
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
| | - Cinthia Blat
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Peter Bacchetti
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Juan Gonzalez
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Mari-Paule Thiet
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | | | - Miriam Kuppermann
- Departments of Obstetrics, Gynecology & Reproductive Sciences and Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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