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Morad A, Johnson K, Bate S, Birkby I, Schofield S, Harvey J. Ten-year trend analysis of breast cancer, oncoplastic, and reconstructive breast surgery in a single institution (2010-2019), what has not changed? Breast Cancer Res Treat 2024:10.1007/s10549-024-07294-x. [PMID: 38689173 DOI: 10.1007/s10549-024-07294-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/08/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE There has been a UK national directive to ensure that patients are offered reconstructive surgical options. We aimed to assess any change in oncoplastic practice over a 10-year period. METHODS The surgical management of 7019 breast cancers was retrospectively assessed at Nightingale Breast Centre, Manchester University UK, from 2010 to 2019. The procedures were categorised into breast conservative surgery (BCS) and mastectomy ± immediate reconstruction. The data were analysed using inclusion and exclusion criteria. RESULTS The overall rates of BCS and mastectomy were 60.1% and 39.9% respectively. No statistically significant change in the overall rates of BCS or mastectomy was observed over the last decade (p = 0.08). The rate of simple wide local excision (WLE) decreased from 98.7% to 89.3% (p < 0.001), whilst the rate of therapeutic mammoplasty (TM) increased from 1.3% to 8% (p < 0.01). The rate of chest wall perforator flaps (CWPF) changed from zero to account for 2.7% of all BCS by 2019. The overall rate of immediate breast reconstruction (IBR) did not significantly change over the study period, but it consistently remained above the national average of 27%. The rate of implant-based IBR increased from 61.3% to 76.5% (p = 0.012), whilst the rate of Latissimus Dorsi (LD) reconstruction decreased from 26.7% to 5.1% (p < 0.05). Additionally, the rate of nipple-sparing mastectomy significantly increased from 5.2% to 24%. CONCLUSION No significant changes in the overall rates of BCS was observed, the rates of advanced breast conservation techniques, nipple-sparing mastectomy, and implant-based IBR all have increased, whilst the use of LD reconstruction decreased.
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Affiliation(s)
- A Morad
- Nightingale Breast Cancer Centre, Manchester University, NHS Foundation Trust, Manchester, UK.
- Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Hucknall Rd, Nottingham, NG5 1PB, UK.
| | - K Johnson
- Nightingale Breast Cancer Centre, Manchester University, NHS Foundation Trust, Manchester, UK
| | - S Bate
- Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - I Birkby
- Nightingale Breast Cancer Centre, Manchester University, NHS Foundation Trust, Manchester, UK
| | - S Schofield
- Nightingale Breast Cancer Centre, Manchester University, NHS Foundation Trust, Manchester, UK
| | - J Harvey
- Nightingale Breast Cancer Centre, Manchester University, NHS Foundation Trust, Manchester, UK
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Yang HW, Thapa R, Johnson K, DuPont ST, Khan A, Zhao Y. Examination of Large Chromosomal Inversions in the Genome of Erwinia amylovora Strains Reveals Worldwide Distribution and North America-Specific Types. Phytopathology 2023; 113:2174-2186. [PMID: 36935376 DOI: 10.1094/phyto-01-23-0004-sa] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Erwinia amylovora is a relatively homogeneous species with low genetic diversity at the nucleotide level. However, phenotypic differences and genomic structural variations among E. amylovora strains have been documented. In this study, we identified 10 large chromosomal inversion (LCI) types in the Spiraeoideae-infecting (SI) E. amylovora strains by combining whole genome sequencing and PCR-based molecular markers. It was found that LCIs were mainly caused by homologous recombination events among seven rRNA operons (rrns) in SI E. amylovora strains. Although ribotyping results identified inter- and intra-variations in the internal transcribed spacer (ITS1 and ITS2) regions among rrns, LCIs tend to occur between rrns transcribed in the opposite directions and with the same tRNA content (tRNA-Glu or tRNA-Ile/Ala) in ITS1. Based on the LCI types, physical/estimated replichore imbalance (PRI/ERI) was examined and calculated. Among the 117 SI strains evaluated, the LCI types of Ea1189, CFBP1430, and Ea273 were the most common, with ERI values at 1.31, 7.87, and 4.47°, respectively. These three LCI types had worldwide distribution, whereas the remaining seven LCI types were restricted to North America (or certain regions of the United States). Our results indicated ongoing chromosomal recombination events in the SI E. amylovora population and showed that LCI events are mostly symmetrical, keeping the ERI less than 15°. These findings provide initial evidence about the prevalence of certain LCI types in E. amylovora strains, how LCI occurs, and its potential evolutionary advantage and history, which might help track the movement of the pathogen.
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Affiliation(s)
- Ho-Wen Yang
- Department of Crop Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61802
| | - Ranjita Thapa
- School of Integrative Plant Science Plant Pathology and Plant-Microbe Biology, Cornell University, Geneva, NY 14456
| | - Kenneth Johnson
- Department of Botany and Plant Pathology, Oregon State University, Corvallis, OR 97331
| | | | - Awais Khan
- School of Integrative Plant Science Plant Pathology and Plant-Microbe Biology, Cornell University, Geneva, NY 14456
| | - Youfu Zhao
- Department of Crop Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61802
- Department of Plant Pathology, WSU-IAREC, Prosser, WA 99350
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Berman AT, Schmidt C, Truong D, Reddy S, Avalos-Reyes E, Yeon H, Brito R, Verbrugge D, Johnson K. Differences in Radiotherapy-Treated Members with Cancer during COVID-19 Pandemic Using Nationwide Claim Data. Int J Radiat Oncol Biol Phys 2023; 117:e567. [PMID: 37785733 DOI: 10.1016/j.ijrobp.2023.06.1892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) This study aimed to identify the impact of the pandemic on radiotherapy activity among members with cancer. MATERIALS/METHODS This retrospective study included fully-insured commercial members of a large national payor with cancer aged ≥18 years undergoing radiotherapy from March 1, 2018 to February 28, 2022. Radiotherapy activity was defined as the mean weekly number of treatment courses and attendances (fractions) per month pre-COVID (March 2018 to February 2020); during COVID (March 2020 to February 2021); and post-COVID (March 2021 to February 2022). T-tests assessed differences between pre-COVID and post-COVID on radiotherapy activity by age, gender, and cancer type. Interrupted time series analysis (ITS) assessed change in activity overtime, controlling for pre-COVID trends and other potential confounders. A p-value of <0.05 was considered significant. RESULTS The study included 9,275 members, 10,121 courses, and 169,257 fractions; most members were female (57%), the mean age was 57 years (SD = 12). Overall, there was a decline in mean weekly number of courses from the pre-COVID to post-COVID (-18%, p<0.05) timeframe. Females < 70 years experienced the largest decline in mean weekly number of courses (-23%, p<0.05) followed by males aged 70+ (-16%, p<0.05) and males < 70 years (-16%, p<0.05). All cancer types saw a significant decline (p<0.05); breast cancer reported the largest decline (-21%, p<0.05). Fraction numbers significantly declined overall by 27% (p<0.05) from the pre-COVID to post-COVID timeframe. The largest decline in fraction numbers was observed in females < 70 (-28%, p<0.05) followed by males < 70 years (-24%, p<0.05) and males aged 70+ (-22%, p<0.05). No difference between COVID and pre-COVID weeks for courses was observed once pre-COVID trends were accounted for using ITS. Females aged 70+ received 25% (p<0.05) fewer fractions during COVID compared to pre-COVID; a decline which continued to grow even as the pandemic eased (March 2021 to February 2022). Males aged 70+ also experienced a decreased level of fractions during the pandemic (-30%, p<0.05), but increased in the recovery period (+24%, p<0.05). Males < 70 years had an increased level of fractions during the pandemic (+14%, p<0.05). CONCLUSION Radiation mean weekly number of courses and fractions between pre-COVID and post-COVID declined with the effect more pronounced in females < 70 years. A decrease in fraction number was observed in all cancer types; specifically, breast cancer had the largest decline. ITS analysis revealed no difference between COVID and pre-COVID weeks for courses as the downward trend was already present prior to the pandemic. These findings suggest while radiotherapy courses and fractions were significantly impacted, fractionation was decreased to a greater extent, indicating an increased adoption of hypofractionation during the pandemic.
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Barnes JM, Johnson K. State Mandatory Paid Family Leave and Survival among Children with Cancer. Int J Radiat Oncol Biol Phys 2023; 117:S16-S17. [PMID: 37784400 DOI: 10.1016/j.ijrobp.2023.06.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Childhood cancer treatment is often costly and time intensive and may require parents/caregivers to stop working. Since 2012, several states have introduced mandatory paid family leave policies. We hypothesized that such policies, whether by reducing financial toxicity or by providing parents greater flexibility to care for their sick children, would improve outcomes among children with cancer. MATERIALS/METHODS Children ages 0-18 years diagnosed with cancer between 2010 and 2019 were identified from the Surveillance, Epidemiology, and End Results program (SEER) database. The primary outcome was overall survival (OS). The exposure of interest was state mandatory paid family leave. Difference-in-differences (DID) analyses with additive hazards regression models were utilized to compare changes in OS from pre- to post- mandatory paid sick leave policy implementation in states with vs. without paid sick leave policies. The models were adjusted for year fixed effects, state fixed effects, state Medicaid expansion status, age, race, sex, metropolitan residence status, county-level income and education, cancer site, cancer stage, and insurance status. Clustered standard errors by state were achieved via the cluster bootstrap. The plausibility of the common trends assumption was tested using event study analyses and was satisfied for all analyses. RESULTS A total of 38,053 children with cancer were identified. In adjusted difference-in-differences analyses, there was no significant change in OS in states with vs. without state mandatory paid family leave policies after policy enactment (hazard difference: 0.0001, 95% CI = -0.0002 to 0.0016, P = .47). However, among non-metropolitan residents, 1-year OS improved from 93.0% to 95.5% (2-year OS: 88.6% to 93.4%) in states with mandatory paid family leave policies compared to 92.7% to 92.5% (2-year OS: 88.0% to 87.7%) in states without such policies after policy enactment. This translates to a 2.7% improvement in 1-year OS (5.2%, 2-year OS) (hazard difference: -0.0021, 95% CI = -0.0034 to -0.0005, P = .037). There was no corresponding change for metropolitan residents (hazard DID = 0.0001, P = .47). By cancer site, the largest policy-associated improvements in survival were observed for rhabdomyosarcoma (hazard DID = -0.0037, P = .11), osteosarcoma (hazard DID = -0.0036, P<.001), and Intracranial and intraspinal embryonal tumors (hazard DID = -0.0026, P = .061). CONCLUSION State mandatory paid family leave policies were associated with improved survival for some children with cancer, most notably for those residing in non-metropolitan areas. The improvements for non-metropolitan residents may be related to alleviating otherwise increased travel burdens for cancer treatment if treatment occurs out-of-town, where working while taking care of a child is less feasible. These data also suggest a slight narrowing in rural-urban-metropolitan childhood cancer disparities associated with paid family leave policies.
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Affiliation(s)
- J M Barnes
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, Saint Louis, MO
| | - K Johnson
- Washington University in St. Louis, St. Louis, MO
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Johnson K, Delaney JC, Guillard T, Reffuveille F, Varin-Simon J, Li K, Wollacott A, Frapy E, Mong S, Tissire H, Viswanathan K, Touti F, Babcock GJ, Shriver Z, Pentelute BL, Plante O, Skurnik D. Development of an antibody fused with an antimicrobial peptide targeting Pseudomonas aeruginosa: A new approach to prevent and treat bacterial infections. PLoS Pathog 2023; 19:e1011612. [PMID: 37676873 PMCID: PMC10508631 DOI: 10.1371/journal.ppat.1011612] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/19/2023] [Accepted: 08/12/2023] [Indexed: 09/09/2023] Open
Abstract
The increase in emerging drug resistant Gram-negative bacterial infections is a global concern. In addition, there is growing recognition that compromising the microbiota through the use of broad-spectrum antibiotics can impact long term patient outcomes. Therefore, there is the need to develop new bactericidal strategies to combat Gram-negative infections that would address these specific issues. In this study, we report and characterize one such approach, an antibody-drug conjugate (ADC) that combines (i) targeting the surface of a specific pathogenic organism through a monoclonal antibody with (ii) the high killing activity of an antimicrobial peptide. We focused on a major pathogenic Gram-negative bacterium associated with antibacterial resistance: Pseudomonas aeruginosa. To target this organism, we designed an ADC by fusing an antimicrobial peptide to the C-terminal end of the VH and/or VL-chain of a monoclonal antibody, VSX, that targets the core of P. aeruginosa lipopolysaccharide. This ADC demonstrates appropriately minimal levels of toxicity against mammalian cells, rapidly kills P. aeruginosa strains, and protects mice from P. aeruginosa lung infection when administered therapeutically. Furthermore, we found that the ADC was synergistic with several classes of antibiotics. This approach described in this study might result in a broadly useful strategy for targeting specific pathogenic microorganisms without further augmenting antibiotic resistance.
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Affiliation(s)
- Kenneth Johnson
- Visterra, Inc., Waltham, Massachusetts, United States of America
| | - James C. Delaney
- Visterra, Inc., Waltham, Massachusetts, United States of America
| | - Thomas Guillard
- Inserm UMR-S 1250 P3 Cell, Université de Reims-Champagne-Ardenne, Reims, France
| | - Fany Reffuveille
- Inserm UMR-S 1250 P3 Cell, Université de Reims-Champagne-Ardenne, Reims, France
| | | | - Kai Li
- Visterra, Inc., Waltham, Massachusetts, United States of America
| | - Andrew Wollacott
- Visterra, Inc., Waltham, Massachusetts, United States of America
| | - Eric Frapy
- CNRS, INSERM, Institut Necker Enfants Malades-INEM, F-75015 Paris, France; Faculté de Médecine, University of Paris City, Paris, France
| | - Surin Mong
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Hamid Tissire
- Visterra, Inc., Waltham, Massachusetts, United States of America
| | | | - Faycal Touti
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | | | - Zachary Shriver
- Visterra, Inc., Waltham, Massachusetts, United States of America
| | - Bradley L. Pentelute
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Obadiah Plante
- Visterra, Inc., Waltham, Massachusetts, United States of America
| | - David Skurnik
- CNRS, INSERM, Institut Necker Enfants Malades-INEM, F-75015 Paris, France; Faculté de Médecine, University of Paris City, Paris, France
- Department of Clinical Microbiology, Fédération Hospitalo-Universitaire Prématurité (FHU PREMA), Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris City, Paris, France
- Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
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Camará M, da Costa FP, Chambe G, Betunde A, Cardoso P, Johnson K, Rullan-Oliver P, Lopez A. Strengthening surveillance, disease detection, and outbreak response through Guinea-Bissau's Frontline Field Epidemiology Training Program: a cross-sectional descriptive study. Pan Afr Med J 2023; 45:133. [PMID: 37790146 PMCID: PMC10543894 DOI: 10.11604/pamj.2023.45.133.30807] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 03/17/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction the goal of the Field Epidemiology Training Program (FETP) - Frontline is to strengthen the country's surveillance capacity at the district level to prepare and respond to health emergencies, including outbreaks, by training a skilled frontline public health workforce. We describe the FETP - Frontline program, including implementation, structure, achievements, impact, and its role in improving the epidemiological workforce capacity of Guinea-Bissau. Methods this cross-sectional descriptive study uses 2015-2019 program data collected through record reviews and historical narratives from FETP students and graduates. We generated descriptive summary statistics using the Guinea-Bissau's FETP-Frontline program database, student assignments, and investigation reports, after reviewing the FETP standardized curriculum and program guidelines. Results since its inception in 2016, FETP Frontline has implemented 14 cohorts and trained 198 frontline surveillance officers. Program participants improved surveillance data quality, investigated 51 outbreaks at national and regional levels, and contributed to disease research and surveillance in 227 separate field investigations. Participants frequently responded to priority health emergencies, including clusters or outbreaks of Zika, microencephalies, dengue, yellow fever, anthrax, malaria, and tuberculosis. Conclusion Guinea-Bissau's FETP - Frontline program provides a practical example of an effective strategy to strengthen health systems through a well-prepared workforce trained to quickly detect and respond to health threats.
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Affiliation(s)
- Mamadú Camará
- Guinea Bissau Frontline Field Epidemiology Training Program Frontline, National Institute of Health, Bissau, Guinea-Bissau
| | - Fernanda Paulino da Costa
- Guinea Bissau Frontline Field Epidemiology Training Program Frontline, National Institute of Health, Bissau, Guinea-Bissau
| | - Geraldo Chambe
- Guinea Bissau Frontline Field Epidemiology Training Program Frontline, National Institute of Health, Bissau, Guinea-Bissau
| | - Agostinho Betunde
- Guinea Bissau Frontline Field Epidemiology Training Program Frontline, National Institute of Health, Bissau, Guinea-Bissau
| | | | | | | | - Augusto Lopez
- Centers for Disease Control and Prevention, Atlanta, USA
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Senis L, Rathore V, Andersson P, Johnson K, Jädernäs D, Losin C, Minghetti D, Wright J, Schrire D. Performance evaluation of a novel gamma transmission micro-densitometer for PIE of nuclear fuel. ANN NUCL ENERGY 2023. [DOI: 10.1016/j.anucene.2023.109783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Bangaru S, Uppalapati S, Palluri S, Ram K, Sudheendra K, Jain S, Johnson K, Hynes D, Madhushankar A, Grinstein J, Pinney S, Onsager D, Rodgers D, Jeevanandam V. A Less Restrictive Approach to Procuring Organs is Not an Indicator of Prognostic Survival in Heart Transplantation: A Retrospective Analysis of 118 Adult Heart Transplant Centers from 2020 to 2022. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.103] [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: 04/05/2023] Open
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Ochoa E, Jain S, Rodgers D, de Matos SN, Uppalapati S, Bangaru S, Johnson K, Sudheendra K, Ram K, Hynes D, Sorensen K, Paluri S, Madhushankar A, Jeevanandam V. As Comfortable as a Pillow: The Superiority of the Sternasafe® Device Over the Standard of Care. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.567] [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: 04/05/2023] Open
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Paluri S, Siddiqi U, Rodgers D, Uppalapati S, Bangaru S, Ram K, Sorensen K, Sudheendra K, Madhushankar A, Johnson K, Hynes D, Jain S, Jeevanandam V. A Probable Winner in the Race for the Best Cardiac Preservation Solution: A Single-Center's Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.556] [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: 04/05/2023] Open
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Uppalapati S, Rodgers D, Paluri S, Ram K, Jain S, Sorensen K, Bangaru S, Madhushankar A, Sudheendra K, Johnson K, Hynes D, Grinstein J, Kalathiya R, Jeevanandam V. Changes in Echocardiographic Parameters after Transcatheter Aortic Valve Replacement in Patients with a Left Ventricular Assist Device: A Case Series. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.846] [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: 04/05/2023] Open
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Sorensen K, Rodgers D, Uppalapati SC, Siddiqi U, Jain S, Paluri S, Madhushanka A, Sudheendra K, Johnson K, Bangaru S, Ram K, Hynes D, Ozcan C, Lee L, Kim G, Jeevanandam V. A Retrospective Study on Gender, LAA Morphology and Stroke Risk. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.565] [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: 04/05/2023] Open
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13
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Bangaru S, Uppalapati S, Palluri S, Ram K, Madhushankar A, Johnson K, Hynes D, Jain S, Sudheendra K, Rodgers D, Jeevanandam V, Onsager D. Continuous Temperature Measurements in Donor Hearts During Cold Organ Procurement. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.744] [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: 04/05/2023] Open
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Fisher L, Ahmed O, Chalchal H, Deobald R, El-Gayed A, Graham P, Groot G, Haider K, Iqbal N, Johnson K, Le D, Mahmood S, Manna M, Meiers P, Pauls M, Salim M, Sami A, Wright P, Younis M, Ahmed S. P058 Outcomes of Rural Men With Breast Cancer: A Multicenter Population Based Retrospective Cohort Study. Breast 2023. [DOI: 10.1016/s0960-9776(23)00177-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
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Ulfsdottir H, Johnson K, Rubertsson C, Ekelin M, Edqvist M. A complex and demanding situation - Midwifery preceptors and midwifery students' experiences of teaching and learning prevention of severe perineal trauma. Women Birth 2023; 36:e118-e124. [PMID: 35568665 DOI: 10.1016/j.wombi.2022.05.003] [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: 01/20/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Many high-income countries have seen an increase in severe perineal trauma. Teaching strategies and conditions for learning during the active second stage of labour are scarcely described. AIM To describe midwifery preceptors and midwifery students' experiences' of teaching and learning how to manage the second stage of labour, with the specific aim of preventing severe perineal trauma. METHODS A qualitative study with focus group discussions and individual in depth-interviews with preceptor midwives (n = 23) and student midwives (n = 10). Data were analysed by qualitative content analysis. RESULTS "A complex and demanding situation with mutual need for feedback, reflection and safety" was the overall theme describing the conditions. Three sub-themes were identified. "Adapting to a unique situation" refers to the difficulty of teaching and learning the aspects needed to prevent severe perineal trauma, and to provide care during this stage. "Hindering and limiting circumstances" describes teaching strategies that were perceived negatively, and how midwifery students tried to adapt to the preceptors rather than the birthing women. "A trustful and communicative relationship" describes the importance of the relationship between the student and the preceptor, where communication was a central, but not obvious part. CONCLUSION An increased awareness among preceptors is needed to optimize teaching strategies, enabling the students to focus on learning the art of the second stage of labour; supporting the woman, preventing severe perineal trauma and ensuring the safety of the unborn baby. Future research should address how existing prevention models can include training to increase preceptors' confidence in teaching.
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Affiliation(s)
- H Ulfsdottir
- Department of Women's Health and Health professions Karolinska University Hospital, Stockholm, Sweden
| | - K Johnson
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - C Rubertsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
| | - M Ekelin
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
| | - M Edqvist
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Ho M, Dasari S, Visram A, Drake M, Charlesworth C, Johnson K, Pujari G, Jevremovic D, Kourelis T. An atlas of the bone marrow bone proteome in patients with dysproteinemias. Res Sq 2023:rs.3.rs-2468383. [PMID: 36747663 PMCID: PMC9900982 DOI: 10.21203/rs.3.rs-2468383/v1] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Multiple myeloma (MM) bone disease is a significant cause of morbidity but there is a paucity of data on the impact of malignant plasma cells on adjacent trabecular bone within the BM. Here, we characterize the proteome of trabecular bone tissue from BM biopsies of 56 patients with monoclonal gammopathy of undetermined significance (MGUS), smoldering (SMM), newly diagnosed (NDMM), relapsed MM (RMM), and normal controls. Proteins involved in extracellular matrix (ECM) formation and immunity pathways were decreased in SMM and active MM. Among the proteins most decreased were immunoglobulins, type IV collagen, and TIMP3, suggesting increased immunoparesis and decreased ECM remodelling within trabecular bone. Proteins most increased in SMM/MM were APP (enhances osteoclast activity), ENPP1 (enhances bone mineralization), and MZB1 (required for normal plasmablast differentiation). Pathway analyses showed that proteins involved in gamma -carboxylation, a pathway implicated in osteocalcin function, osteoblast differentiation, and normal hematopoiesis, were also overexpressed in SMM/MM. This study is the first comprehensive proteomic atlas of the BM bone proteome in dysproteinemias. We identify new key proteins and pathways for MM bone disease and potentially impaired hematopoiesis, and show for the first time that gamma -carboxylation pathways are increased in the bone tissue of SMM/MM.
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Berman A, Warde P, Avalos-Reyes E, Yeon H, Cavers W, Reddy S, Brito R, Johnson K. Predicting Total Hospitalizations and Emergency Visits in Radiotherapy Patients: A Claims-Based Model. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yeon H, Warde P, Avalos-Reyes E, Cavers W, Reddy S, Johnson K, Brito R, Berman A. Defining the Cost Variation by Site-of-Care for Radiotherapy: A Claims-Based Analysis. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1434] [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: 10/31/2022]
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Barnes J, Johnson K, Osazuwa-Peters N, Spraker M. The Impact of Federal Poverty Level on the Association between Insurance Status and Overall Survival among Adults with Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.529] [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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Rubery MS, Ose N, Schneider M, Moore AS, Carrera J, Mariscal E, Ayers J, Bell P, Mackinnon A, Bradley D, Landen OL, Thompson N, Carpenter A, Winters S, Ehrlich B, Sarginson T, Rendon A, Liebman J, Johnson K, Merril D, Grant G, Shingleton N, Taylor A, Ruchonnet G, Stanley J, Cohen M, Kohut T, Issavi R, Norris J, Wright J, Stevers J, Masters N, Latray D, Kilkenny J, Stolte WC, Conlon CS, Troussel P, Villette B, Emprin B, Wrobel R, Lejars A, Chaleil A, Bridou F, Delmotte F. A 2-4 keV multilayer mirrored channel for the NIF Dante system. Rev Sci Instrum 2022; 93:113502. [PMID: 36461505 DOI: 10.1063/5.0101695] [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] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/09/2022] [Indexed: 06/17/2023]
Abstract
During inertial confinement fusion experiments at the National Ignition Facility (NIF), a capsule filled with deuterium and tritium (DT) gas, surrounded by a DT ice layer and a high-density carbon ablator, is driven to the temperature and densities required to initiate fusion. In the indirect method, 2 MJ of NIF laser light heats the inside of a gold hohlraum to a radiation temperature of 300 eV; thermal x rays from the hohlraum interior couple to the capsule and create a central hotspot at tens of millions degrees Kelvin and a density of 100-200 g/cm3. During the laser interaction with the gold wall, m-band x rays are produced at ∼2.5 keV; these can penetrate into the capsule and preheat the ablator and DT fuel. Preheat can impact instability growth rates in the ablation front and at the fuel-ablator interface. Monitoring the hohlraum x-ray spectrum throughout the implosion is, therefore, critical; for this purpose, a Multilayer Mirror (MLM) with flat response in the 2-4 keV range has been installed in the NIF 37° Dante calorimeter. Precision engineering and x-ray calibration of components mean the channel will report 2-4 keV spectral power with an uncertainty of ±8.7%.
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Affiliation(s)
- M S Rubery
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - N Ose
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - M Schneider
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - A S Moore
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Carrera
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - E Mariscal
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Ayers
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - P Bell
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - A Mackinnon
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - D Bradley
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - O L Landen
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - N Thompson
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - A Carpenter
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - S Winters
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - B Ehrlich
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - T Sarginson
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - A Rendon
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Liebman
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - K Johnson
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - D Merril
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - G Grant
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - N Shingleton
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - A Taylor
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - G Ruchonnet
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Stanley
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - M Cohen
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - T Kohut
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - R Issavi
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Norris
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Wright
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Stevers
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - N Masters
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - D Latray
- Lawrence Livermore National Laboratory, P. O. Box 808, Livermore, California 94551-0808, USA
| | - J Kilkenny
- General Atomics, San Diego, California 92121, USA
| | - W C Stolte
- MSTS, Mission Support and Test Services LLC, Livermore, California 94550-9239, USA
| | - C S Conlon
- MSTS, Mission Support and Test Services LLC, Livermore, California 94550-9239, USA
| | - Ph Troussel
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - B Villette
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - B Emprin
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - R Wrobel
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - A Lejars
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - A Chaleil
- Commissariat à l'Énergie Atomique (CEA), DAM, DIF, F-91297 Arpajon, France
| | - F Bridou
- Laboratoire Charles Fabry, 2, Av. Augustin Fresnel, 91127 Palaiseau Cedex, France
| | - F Delmotte
- Laboratoire Charles Fabry, 2, Av. Augustin Fresnel, 91127 Palaiseau Cedex, France
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Ruiz Munoz A, Guala A, Dux-Santoy L, Rodriguez-Palomares JF, Garcia-Duran A, Garrido-Oliver J, Galian-Gay L, Valente F, Casas G, Fernandez-Galera R, Johnson K, Wieben O, Ferreira-Gonzalez I, Evangelista A, Teixido-Tura G. Aortic flow patterns by 4D flow CMR in Marfan and Loeys-Dietz patients before and after valve sparing aortic root replacement: a comparison with healthy volunteers. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1944] [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
Introduction
Abnormal aortic flow patterns in patients with a connective tissue disorder (CTD), such as Marfan or Loeys-Dietz syndrome, may contribute to aortic root dilation [1,2]. Valve sparing aortic root replacement, which is effective in reducing the risk of aortic dissection in case of severe dilation, may also normalize flow patterns beyond the replaced aorta and potentially slow its progressive aortic dilation.
Purpose
To assess aortic flow dynamics in patients with a CTD by 4D flow cardiovascular magnetic resonance (CMR) before and after valve sparing aortic root replacement, and to compare the results with those of healthy volunteers (HV).
Methods
Patients with Marfan or Loeys-Dietz syndrome underwent two non-contrast enhanced 4D flow CMR, one before and another after undergoing valve sparing aortic root replacement. Healthy volunteers matched for age, sex and BSA were also included for comparison. Maximum velocity, in-plane rotational flow (IRF), systolic flow reversal ratio (SFRR) and wall shear stress (WSS) magnitude and its axial and circumferential components were obtained at 24 planes covering the thoracic aorta from the sinotubular junction to the descending aorta at the diaphragmatic level [3–5].
Results
Sixteen patients and 21 healthy volunteers were included. Demographic and clinical data is presented in Table. The mean time between the CMR prior and posterior to surgery was 15 months. Compared to HV, patients with CTD before intervention presented lower maximum velocity at the proximal ascending aorta (Fig. 1A), lower IRF and circumferential WSS at the arch and the proximal descending aorta (Fig. 1B and F), lower magnitude and axial WSS at the proximal ascending and descending aorta (Fig. 1E and D), and increased SFRR at the proximal descending aorta (Fig. 1C). The intervention completely restored maximum velocity and partially-restored physiological helical flow and circumferential WSS, but barely improved axial WSS and SFRR.
Conclusion
Valve sparing aortic root replacement in patients with Marfan or Loeys-Dietz syndrome partially restore to physiological level both in-plane rotational flow and circumferential wall shear stress in the descending aorta. This flow normalization may contribute to prevent progressive dilation after the surgery.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Instituto de Salud Carlos III (Spain) (PI17/00381)Spanish Society of Cardiology (SEC/FEC-INV-CLI 20/015)
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Affiliation(s)
- A Ruiz Munoz
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - A Guala
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - L Dux-Santoy
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | | | - A Garcia-Duran
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - J Garrido-Oliver
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - L Galian-Gay
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - F Valente
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - G Casas
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | | | - K Johnson
- University of Wisconsin , Wisconsin , United States of America
| | - O Wieben
- University of Wisconsin , Wisconsin , United States of America
| | | | - A Evangelista
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - G Teixido-Tura
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
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22
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Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D'Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T'Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, Arcelus J. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health 2022; 23:S1-S259. [PMID: 36238954 PMCID: PMC9553112 DOI: 10.1080/26895269.2022.2100644] [Citation(s) in RCA: 494] [Impact Index Per Article: 247.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
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Affiliation(s)
- E Coleman
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A E Radix
- Callen-Lorde Community Health Center, New York, NY, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - W P Bouman
- Nottingham Centre for Transgender Health, Nottingham, UK
- School of Medicine, University of Nottingham, Nottingham, UK
| | - G R Brown
- James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
- James H. Quillen VAMC, Johnson City, TN, USA
| | - A L C de Vries
- Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M B Deutsch
- Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA
- UCSF Gender Affirming Health Program, San Francisco, CA, USA
| | - R Ettner
- New Health Foundation Worldwide, Evanston, IL, USA
- Weiss Memorial Hospital, Chicago, IL, USA
| | - L Fraser
- Independent Practice, San Francisco, CA, USA
| | - M Goodman
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - J Green
- Independent Scholar, Vancouver, WA, USA
| | - A B Hancock
- The George Washington University, Washington, DC, USA
| | - T W Johnson
- Department of Anthropology, California State University, Chico, CA, USA
| | - D H Karasic
- University of California San Francisco, San Francisco, CA, USA
- Independent Practice at dankarasic.com
| | - G A Knudson
- University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health, Vancouver, Canada
| | - S F Leibowitz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - H F L Meyer-Bahlburg
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - J Motmans
- Transgender Infopunt, Ghent University Hospital, Gent, Belgium
- Centre for Research on Culture and Gender, Ghent University, Gent, Belgium
| | - L Nahata
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - T O Nieder
- University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany
| | - S L Reisner
- Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - C Richards
- Regents University London, UK
- Tavistock and Portman NHS Foundation Trust, London, UK
| | | | - V Tangpricha
- Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - A C Tishelman
- Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA
| | - M A A Van Trotsenburg
- Bureau GenderPRO, Vienna, Austria
- University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria
| | - S Winter
- School of Population Health, Curtin University, Perth, WA, Australia
| | - K Ducheny
- Howard Brown Health, Chicago, IL, USA
| | - N J Adams
- University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada
- Transgender Professional Association for Transgender Health (TPATH)
| | - T M Adrián
- Asamblea Nacional de Venezuela, Caracas, Venezuela
- Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela
| | - L R Allen
- University of Nevada, Las Vegas, NV, USA
| | - D Azul
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - H Bagga
- Monash Health Gender Clinic, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - K Başar
- Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - D S Bathory
- Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA
| | - J J Belinky
- Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina
| | - D R Berg
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J U Berli
- Oregon Health & Science University, Portland, OR, USA
| | - R O Bluebond-Langner
- NYU Langone Health, New York, NY, USA
- Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA
| | - M-B Bouman
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - M L Bowers
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - P J Brassard
- GrS Montreal, Complexe CMC, Montreal, Quebec, Canada
- Université de Montreal, Quebec, Canada
| | - J Byrne
- University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - L Capitán
- The Facialteam Group, Marbella International Hospital, Marbella, Spain
| | | | - J M Carswell
- Harvard Medical School, Boston, MA, USA
- Boston's Children's Hospital, Boston, MA, USA
| | - S C Chang
- Independent Practice, Oakland, CA, USA
| | - G Chelvakumar
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University, College of Medicine, Columbus, OH, USA
| | - T Corneil
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
| | - K B Dalke
- Penn State Health, PA, USA
- Penn State College of Medicine, Hershey, PA, USA
| | - G De Cuypere
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
| | - E de Vries
- Nelson Mandela University, Gqeberha, South Africa
- University of Cape Town, Cape Town, South Africa
| | - M Den Heijer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - A H Devor
- University of Victoria, Victoria, BC, Canada
| | - C Dhejne
- ANOVA, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - A D'Marco
- UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas
- D M A R C O Organization, Nassau, The Bahamas
| | - E K Edmiston
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L Edwards-Leeper
- Pacific University, Hillsboro, OR, USA
- Independent Practice, Beaverton, OR, USA
| | - R Ehrbar
- Whitman Walker Health, Washington, DC, USA
- Independent Practice, Maryland, USA
| | - D Ehrensaft
- University of California San Francisco, San Francisco, CA, USA
| | - J Eisfeld
- Transvisie, Utrecht, The Netherlands
| | - E Elaut
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium
| | - L Erickson-Schroth
- The Jed Foundation, New York, NY, USA
- Hetrick-Martin Institute, New York, NY, USA
| | - J L Feldman
- Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A D Fisher
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | - M M Garcia
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA
| | - L Gijs
- Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - B P Hall
- Duke University Medical Center, Durham, NC, USA
- Duke Adult Gender Medicine Clinic, Durham, NC, USA
| | - T L D Hardy
- Alberta Health Services, Edmonton, Alberta, Canada
- MacEwan University, Edmonton, Alberta, Canada
| | - M S Irwig
- Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - A C Janssen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - K Johnson
- RMIT University, Melbourne, Australia
- University of Brighton, Brighton, UK
| | - D T Klink
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium
- Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
| | - B P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - L E Kuper
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA
- Department of Endocrinology, Children's Health, Dallas, TX, USA
| | - E J Kvach
- Denver Health, Denver, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - M A Malouf
- Malouf Counseling and Consulting, Baltimore, MD, USA
| | - R Massey
- WPATH Global Education Institute
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - T Mazur
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- John R. Oishei Children's Hospital, Buffalo, NY, USA
| | - C McLachlan
- Professional Association for Transgender Health, South Africa
- Gender DynamiX, Cape Town, South Africa
| | - S D Morrison
- Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
| | - S W Mosser
- Gender Confirmation Center, San Francisco, CA, USA
- Saint Francis Memorial Hospital, San Francisco, CA, USA
| | - P M Neira
- Johns Hopkins Center for Transgender Health, Baltimore, MD, USA
- Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA
| | - U Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - J M Oates
- La Trobe University, Melbourne, Australia
- Melbourne Voice Analysis Centre, East Melbourne, Australia
| | - J Obedin-Maliver
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford, CA, USA
| | - G Pagkalos
- Independent PracticeThessaloniki, Greece
- Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece
| | - J Patton
- Talkspace, New York, NY, USA
- CytiPsychological LLC, San Diego, CA, USA
| | - N Phanuphak
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - K Rachlin
- Independent Practice, New York, NY, USA
| | - T Reed
- Gender Identity Research and Education Society, Leatherhead, UK
| | - G N Rider
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Ristori
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | | | - S A Roberts
- Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA
| | - K A Rodriguez-Wallberg
- Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - S M Rosenthal
- Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA
- UCSF Child and Adolescent Gender Center
| | - K Sabir
- FtM Phoenix Group, Krasnodar Krai, Russia
| | - J D Safer
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA
| | - A I Scheim
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - L J Seal
- Tavistock and Portman NHS Foundation Trust, London, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - K Spencer
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C St Amand
- University of Houston, Houston, TX, USA
- Mayo Clinic, Rochester, MN, USA
| | - T D Steensma
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - J F Strang
- Children's National Hospital, Washington, DC, USA
- George Washington University School of Medicine, Washington, DC, USA
| | - G B Taylor
- Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA
| | - K Tilleman
- Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - G G T'Sjoen
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Endocrinology, Ghent University Hospital, Gent, Belgium
| | - L N Vala
- Independent Practice, Campbell, CA, USA
| | - N M Van Mello
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - J F Veale
- School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - J A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - B Vincent
- Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK
| | - L M Wesp
- College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA
- Health Connections Inc., Glendale, WI, USA
| | - M A West
- North Memorial Health Hospital, Robbinsdale, MN, USA
- University of Minnesota, Minneapolis, MN, USA
| | - J Arcelus
- School of Medicine, University of Nottingham, Nottingham, UK
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
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Corvaro M, Johnson K, Himmelstein M, Bianchi E, Mingoia R, Bartels M, Reiss R, Terry C, LaRocca J, Murphy L, Gehen S. P06-13 Spinosad – mode of action and human relevance assessment of dystocia in rats. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Montoya L, Johnson K, O'Haver J, Price H. 356 Infantile hemangioma referral delays persist despite 2019 American Academy of Pediatrics Clinical Practice Guideline: Experience at a single quaternary pediatric institution. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Patil YSS, Yu J, Frazier S, Wang Y, Johnson K, Fox J, Reichel J, Harris JGE. Measuring High-Order Phonon Correlations in an Optomechanical Resonator. Phys Rev Lett 2022; 128:183601. [PMID: 35594119 DOI: 10.1103/physrevlett.128.183601] [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] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/18/2022] [Indexed: 06/15/2023]
Abstract
We use single photon detectors to probe the motional state of a superfluid ^{4}He resonator of mass ∼1 ng. The arrival times of Stokes and anti-Stokes photons (scattered by the resonator's acoustic mode) are used to measure the resonator's phonon coherences up to the fourth order. By postselecting on photon detection events, we also measure coherences in the resonator when ≤3 phonons have been added or subtracted. These measurements are found to be consistent with predictions that assume the acoustic mode to be in thermal equilibrium with a bath through a Markovian coupling.
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Affiliation(s)
- Y S S Patil
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J Yu
- Department of Applied Physics, Yale University, New Haven, Connecticut 06520, USA
| | - S Frazier
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Wang
- Department of Applied Physics, Yale University, New Haven, Connecticut 06520, USA
| | - K Johnson
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J Fox
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J Reichel
- Laboratoire Kastler Brossel, ENS-Université PSL, CNRS, Sorbonne Université, Collège de France 24 rue Lhomond, 75005 Paris, France
| | - J G E Harris
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
- Department of Applied Physics, Yale University, New Haven, Connecticut 06520, USA
- Yale Quantum Institute, Yale University, New Haven, Connecticut 06520, USA
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Suleman NJ, Oates AJ, Johnson K. Re: value of additional lateral radiographs in paediatric skeletal surveys for suspected physical abuse. Clin Radiol 2022; 77:474-475. [PMID: 35339250 DOI: 10.1016/j.crad.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 11/29/2022]
Affiliation(s)
- N J Suleman
- Birmingham Children's Hospital, Birmingham, UK.
| | - A J Oates
- Birmingham Children's Hospital, Birmingham, UK
| | - K Johnson
- Birmingham Children's Hospital, Birmingham, UK
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Johnson K, Pushparajan J, Anjana P, Gopinadh SV, Anoopkumar V, Peddinti VP, John B, Mercy T. Synthesis, characterisation and electrochemical evaluation of lithium titanate anode for lithium ion cells. INORG CHEM COMMUN 2022. [DOI: 10.1016/j.inoche.2021.109188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Amaral J, Paulus J, Johnson K, Gregg W. An integrated method for contained laparoscopic specimen removal. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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29
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Low S, Tan Y, Patel H, Johnson K. Four-year experience of paediatric penetrating injuries: findings from a paediatric major trauma centre in the UK. Clin Radiol 2022; 77:244-254. [DOI: 10.1016/j.crad.2022.01.037] [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] [Received: 02/02/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022]
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Wells KJ, Drizin JH, Ustjanauskas AE, Vázquez-Otero C, Pan-Weisz TM, Ung D, Carrizosa C, Laronga C, Roetzheim RG, Johnson K, Norton M, Aguilar RC, Quinn GP. The psychosocial needs of underserved breast cancer survivors and perspectives of their clinicians and support providers. Support Care Cancer 2022; 30:105-116. [PMID: 34231040 PMCID: PMC8639634 DOI: 10.1007/s00520-021-06286-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/09/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE Breast cancer survivors (BrCS) experience many psychosocial difficulties following treatment, leading to an increased risk of psychological distress compared to the general population. This is especially true for underserved BrCS whose unmet supportive care needs can result in worse physical and mental health outcomes. This qualitative study compared healthcare and support providers' perceptions of BrCS' needs to survivors' perceptions of their own needs. METHODS Semi-structured in-depth interviews were conducted with 25 underserved BrCS and 20 cancer survivorship stakeholders identified using purposeful sampling. Using the constant comparison method and content analysis, data were analyzed via an iterative process of coding and discussion. Data were summarized according to three intermediate and proximal themes mentioned by both stakeholders and survivors: (1) psychosocial needs of cancer survivors, (2) support, and (3) benefit finding/positive feelings about cancer. Demographic data were analyzed by calculating descriptive statistics. RESULTS There was consistency in providers' and survivors' perceptions of post-treatment mood changes, financial burden, familial stress, and physical changes. Providers and survivors differed in perceptions of BrCS' preferred sources of care and support, effects of cancer treatment on body image, the effects of fear of cancer recurrence on follow-up care, and benefit finding. CONCLUSIONS This study provides valuable insight into areas in which healthcare and support providers' perceptions may differ from underserved BrCS' lived experiences. Results from this study can be used to develop interventions and inform healthcare and support providers on how to provide high-quality care to underserved BrCS.
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Affiliation(s)
- Kristen J. Wells
- San Diego State University, San Diego, CA, USA; SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Julia H. Drizin
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Amy E. Ustjanauskas
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego, San Diego, CA, USA
| | - Coralia Vázquez-Otero
- Harvard T.H. Chan School of Public Health, Boston, MA, USA; Dana-Farber Cancer Institute, Boston, MA, USA
| | - Tonya M. Pan-Weisz
- Veteran Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego, San Diego, CA, USA
| | | | | | | | | | | | | | | | - Gwendolyn P. Quinn
- Departments of OB-GYN, Population Health, Grossman School of Medicine, New York University, NY, NY
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Marolt C, Freed B, Coker C, Steele R, Johnson K, Arellanes R, Gordon V, Wright B, Stephens R, Surek CC. Key Anatomical Clarifications for the Marginal Mandibular Branch of the Facial Nerve: Clinical Significance for the Plastic Surgeon. Aesthet Surg J 2021; 41:1223-1228. [PMID: 33326569 DOI: 10.1093/asj/sjaa368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The marginal mandibular branch (MMBr) of the facial nerve is the least likely to recover from injury due to infrequent anastomosis with other branches. The MMBr has been described as coursing superior to the inferior border of the mandible. However, studies have reported variations in its location in embalmed and fresh specimens. It has been postulated that the embalming process may effect its anatomic position. OBJECTIVES The aim of this study was to re-evalulate the location of the MMBr relative to the inferior border of the mandible in both fresh and embalmed cadavers, and investigate variation in its position with sex, side of the face, and age. METHODS Superficial fascial planes were dissected to reveal the MMBr and its anatomic relations. Distance between the most inferior branch of the MMBr and the antegonial notch were measured bilaterally. The most inferior position of the MMBr between the antegonial notch and gonion was measured. Fresh heads were used as a comparison, with an additional measurement taken of the distance between the MMBr and the gonial angle. RESULTS The MMBr was located inferior to the border of the mandible (90.3%) more often than above (9.6%). No significant differences were found between fresh and embalmed cadavers, sex, side of body, or age (P > 0.05). No significant difference was found between intact cadavers and fresh heads (P > 0.05). CONCLUSIONS This study confirms and describes reliable landmarks for safety zones for the MMBr during plastic and reconstructive surgery of the lower face and upper neck. These data add reliability to studies that have investigated nerve locations in embalmed cadavers.
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Affiliation(s)
- Clayton Marolt
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
| | - Blair Freed
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
| | - Charles Coker
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
| | - Robert Steele
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
| | - Kenneth Johnson
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
| | - Russell Arellanes
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
| | - Victoria Gordon
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
| | - Barth Wright
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
| | - Robert Stephens
- Kansas City University of Medicine and Biosciences, Kansas City, MO, USA
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Evenson A, Doan C, Johnson K, Berens B. Dietary Intake Changes in College Students During the COVID-19 Pandemic. J Acad Nutr Diet 2021. [PMCID: PMC8372426 DOI: 10.1016/j.jand.2021.06.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Evenson A, Johnson K, Berens B, Wachowiak J, Knapek J, Giachino C, Keyler T, Bohn-Gettler C. The Relationship Between GI symptoms, State and Trait Anxiety, and Lifestyle Factors in Males and Females During the SARS-CoV-2 Pandemic. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kocakavuk E, Anderson K, Varn F, Johnson K, Amin S, Barthel F, Verhaak R. 340O Radiotherapy is associated with deletion signatures that contribute to poor survival outcomes in cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Guala A, Teixido-Tura G, Dux-Santoy L, Ruiz-Munoz A, Valente F, Galian L, Gutierrez L, Gonzalez-Alujas T, Johnson K, Wieben O, Sao-Aviles A, Ferreira-Gonzalez I, Evangelista A, Rodriguez-Palomares J. Bicuspid aortic valve fusion length correlates with maximum aortic diameter and heamodynamic abnormalities: a 4D flow CMR study. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.106] [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
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Guala A. received funding from the Spanish Ministry of Science, Innovation and Universities.
Background
Bicuspid aortic valve (BAV), a congenital heart defect, is associated with ascending aorta dilation, possibly via alteration of aortic blood flow [1]. In BAV abnormal flow condition have been associated with aortic extracellular matrix dysregulation and elastic fiber degeneration [2]. Current morphological classification of BAV patients with aortic valve with a single fusion between two adjacent leaflets does not allow for risk stratification.
Purpose
This research work tested whether the extent of fusion between leaflets is related to AAo diameter and flow alterations.
Methods
Ninety BAV patients free from moderate and severe aortic valve disease and with no previous aortic or aortic valve surgery or replacement were prospectively enrolled. A comprehensive magnetic resonance protocol comprised a stack of double-oblique 2D balanced steady-state free-precession (bSSFP) cine CMR of the aortic valve, which was used to measure the length of the fusion between leaflets, a cine CMR at the level of the pulmonary bifurcation to assess aortic diameter and 4D flow MRI sequence to assess flow characteristics and regional stiffness [3]. Jet angle and flow radial displacement, quantifying the extent of flow eccentricity, and systolic flow reversal ratio (SFRR), assessing the relative amount of backward flow during systole, were computed at 8 equidistant planes in the ascending aorta and 4 equidistant planes in the aortic arch [4]. A two-tailed p-value < 0.05 was considered statistically significant.
Results
The length of leaflet fusion varied widely (median 7.7 mm, inter-quartile range [5.5; 10.2]), Table 1). In bivariate analysis, fusion length was also associated to ascending aortic diameter (R = 0.391, p < 0.001), age (R = 0.313, p = 0.005) and body surface area (R = 0.396, p < 0.001). It was also positively related to flow abnormalities: like displacement in the proximal and distal ascending aorta, jet angle in the mid ascending aorta, and SFRR in the ascending aorta and the aortic arch (see Figure 1). The association between fusion length and ascending aorta diameter persisted in multivariate analysis after correction for age (p = 0.006).
Conclusions
Bicuspid aortic valve fusion extent varies greatly and it is associated with aortic diameter, possibly through flow alterations. Prospective longitudinal studies are needed to establish whether fusion length may allow for risk stratification in bicuspid aortic valve patients.
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Affiliation(s)
- A Guala
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - L Dux-Santoy
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Galian
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - K Johnson
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - O Wieben
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - A Sao-Aviles
- University Hospital Vall d"Hebron, Barcelona, Spain
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Ruiz Munoz A, Guala A, Rodriguez-Palomares JF, Dux-Santoy L, Servato L, Lopez-Sainz A, La Mura L, Gonzalez-Alujas T, Galian-Gay L, Gutierrez L, Johnson K, Wieben O, Ferreira I, Evangelista A, Teixido-Tura G. Aortic rotational flow patterns and stiffness by 4D flow CMR in patients with Loeys-Dietz syndrome compared to healthy volunteers and patients with Marfan syndrome. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.078] [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
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): La Marató de TV3, Instituto de Salud Carlos III through the project and Spanish Ministry of Science, Innovation and Universities.
BACKGROUND
Loeys-Dietz (LDS) and Marfan (MFS) syndromes are rare genetic connective tissue disorders associated with progressive aortic dilation, however, aortic dissections have been observed at lower aortic root diameters in LDS than in MFS. Recent CMR studies in MFS patients reported increased aortic stiffness (1–3) and altered rotational flow (4), but research on aortic flow dynamics and biomechanics in LDS is lacking.
PURPOSE
The aim of this study was to assess rotational aortic flow and aortic stiffness in LDS compared to healthy volunteers (HV) and MFS patients, using 4Dflow CMR.
METHODS
Twenty-one LDS and 44 MFS patients, without previous aortic dissection or surgery, and 43 HV underwent a non-contrast-enhanced 4D flow CMR. Aortic stiffness was quantified at the AAo and DAo using pulse wave velocity (PWV). In-plane rotational flow (IRF), systolic flow reversal ratio (SFRR) (5) and local aortic diameters were obtained at 20 equidistant planes from the ascending (AAo) to the proximal descending aorta (DAo).
RESULTS
LDS patients had lower IRF at the distal AAo and proximal DAo compared to HV (p = 0.053 and 0.004, respectively), once adjusted for age, stroke volume and local aortic diameter; but no differences were found with respect to MFS (Figure). Although SFRR at the proximal DAo was increased in LDS patients compared to both HV (p = 0.037) and MFS populations (p = 0.015), once adjusted for age and aortic diameter, the difference in magnitude was small (Figure). On the other hand, AAo and DAo PWV revealed stiffer aortas in LDS patients compared to HV but no differences versus MFS patients (Table).
CONCLUSIONS
Patients with Loeys-Dietz syndrome showed decreased in-plane rotational flow and abnormally-high regional aortic stiffness compared to healthy controls, and similar hemodynamics and aortic stiffness with respect to patients with Marfan syndrome.
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Affiliation(s)
- A Ruiz Munoz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Guala
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | | - L Dux-Santoy
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Servato
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Lopez-Sainz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L La Mura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | | - L Galian-Gay
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - K Johnson
- University of Wisconsin, Wisconsin, United States of America
| | - O Wieben
- University of Wisconsin, Wisconsin, United States of America
| | - I Ferreira
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - G Teixido-Tura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
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Hendry J, Ali S, Ahmed O, Chalchal H, El-Gayed A, Haider K, Iqbal N, Johnson K, Le D, Maas B, Manna M, Pauls M, Salim M, Sami A, Wright P, Younis M, Ahmed S. 59P Outcomes of women HER2 positive T1a/bN0M0 breast cancer treated with adjuvant trastuzumab: A retrospective population-based cohort study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Patel PG, Keen P, McManus H, Duck T, Callander D, Selvey C, Power C, Gray RT, Knight V, Asselin J, Read P, Johnson K, Bavinton BR, Bowden VJ, Grulich AE, Guy R. Increased targeted HIV testing and reduced undiagnosed HIV infections among gay and bisexual men. HIV Med 2021; 22:605-616. [PMID: 33876526 DOI: 10.1111/hiv.13102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 02/17/2021] [Accepted: 02/24/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To evaluate the impact of government HIV strategies that aimed to increase HIV testing uptake and frequency among gay and bisexual men (GBM) in New South Wales (NSW), Australia. DESIGN We analysed HIV testing data from existing passive and sentinel surveillance systems between 2010 and 2018. METHODS Six indicators were measured: (1) state-wide total HIV laboratory tests; (2) number of GBM attending publicly-funded clinics; (3) 12-monthly testing uptake; (4) annual testing frequency; (5) HIV testing with a STI diagnosis; and (6) HIV positivity. Mathematical modelling was used to estimate (7) the proportion of men with undiagnosed HIV. Indicators were stratified by Australian vs. overseas-born. RESULTS Overall, 43,560 GBM attended participating clinics (22,662 Australian-born, 20,834 overseas-born) from 2010-2018. Attendees increased from 5,186 in 2010 to 16,507 in 2018. There were increasing trends (p<0.001 for all) in testing uptake (83.9% to 95.1%); testing with a STI diagnosis (68.7% to 94.0%); annual HIV testing frequency (1.4 to 2.7); and a decreasing trend (p<0.01) in HIV positivity (1.7% to 0.9%).Increases in testing were similar in Australian-born and overseas-born GBM. However, there were decreasing trends in the estimated undiagnosed HIV proportion overall (9.5% to 7.7%) and in Australian-born GBM (7.1% to 2.8%), but an increasing trend in overseas-born GBM (15.3% to 16.9%) (p<0.001 for all).
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Affiliation(s)
- P G Patel
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - P Keen
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - H McManus
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - T Duck
- New South Wales Ministry of Health, Sydney, NSW, Australia
| | - D Callander
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.,New York University Spatial Epidemiology Lab, School of Medicine, New York University, New York, NY, USA
| | - C Selvey
- Health Protection NSW, Sydney, Australia
| | - C Power
- New South Wales Ministry of Health, Sydney, NSW, Australia
| | - R T Gray
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - V Knight
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.,Sydney Sexual Health Centre, Sydney, NSW, Australia
| | - J Asselin
- Burnet Institute, Melbourne, NSW, Australia
| | - P Read
- Kirketon Road Centre, Kings Cross, NSW, Australia
| | | | - B R Bavinton
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - V J Bowden
- Health Protection NSW, Sydney, Australia
| | - A E Grulich
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - R Guy
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Özdemir İ, Johnson K, Mohr-Allen S, Peak KE, Varner V, Hoyt K. Three-dimensional visualization and improved quantification with super-resolution ultrasound imaging - validation framework for analysis of microvascular morphology using a chicken embryo model. Phys Med Biol 2021; 66:085008. [PMID: 33765676 PMCID: PMC8463964 DOI: 10.1088/1361-6560/abf203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/23/2020] [Accepted: 03/25/2021] [Indexed: 12/20/2022]
Abstract
The purpose of this study was to improve the morphological analysis of microvascular networks depicted in three-dimensional (3D) super-resolution ultrasound (SR-US) images. This was supported by qualitative and quantitative validation by comparison to matched brightfield microscopy and traditional B-mode ultrasound (US) images. Contrast-enhanced US (CEUS) images were collected using a preclinical US scanner (Vevo 3100, FUJIFILM VisualSonics Inc.) equipped with an MX250 linear array transducer. CEUS imaging was performed after administration of a microbubble (MB) contrast agent into the vitelline network of a developing chicken embryo. Volume data was collected by mechanically scanning the US transducer throughout a tissue volume-of-interest in 90μm step increments. CEUS images were collected at each increment and stored as in-phase/quadrature data (2000 frames at 152 frames per sec). SR-US images were created for each cross-sectional plane using established data processing methods. All SR-US images were then used to reconstruct a final 3D volume for vessel diameter (VD) quantification and for surface rendering. VD quantification from the 3D SR-US data exhibited an average error of 6.1% ± 6.0% when compared with matched brightfield microscopy images, whereas measurements from B-mode US images had an average error of 77.1% ± 68.9%. Volume and surface renderings in 3D space enabled qualitative validation and improved visualization of small vessels below the axial resolution of the US system. Overall, 3D SR-US image reconstructions depicted the microvascular network of the developing chicken embryos. Improved visualization of isolated vessels and quantification of microvascular morphology from SR-US images achieved a considerably greater accuracy compared to B-mode US measurements.
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Affiliation(s)
- İpek Özdemir
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, United States of America
| | - Kenneth Johnson
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, United States of America
| | - Shelby Mohr-Allen
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, United States of America
| | - Kara E Peak
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, United States of America
| | - Victor Varner
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, United States of America
| | - Kenneth Hoyt
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, United States of America
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
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Andrahennadi S, Sami A, Haider K, Chalchal H, Le D, Iqbal N, Ahmed O, Salim M, Manna M, Elgayed A, Wright P, Johnson K, Ahmed S. Efficacy of fulvestrant in hormone refractory metastatic breast cancer (mBC): a Canadian province experience. Breast 2021. [DOI: 10.1016/s0960-9776(21)00144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Dumitrascu OM, Rosenberry R, Khansari M, Shi Y, Torbati T, Sherman D, Sherzai AZ, Sheyn J, Johnson K, Czeszynki A, Verdooner S, Frautschy S, Koronyo-Hamaoui M, Black K, Koronyo Y, Lyden PD, Cheng S. Abstract P55: Retinal Microvascular Parameters Predict Retinal Amyloid Burden and Co-Jointly Predict Verbal Memory. Stroke 2021. [DOI: 10.1161/str.52.suppl_1.p55] [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: 11/16/2022]
Abstract
Introduction:
Retinal vascular features predict cognitive performance and retinal imaging is a non-invasive tool to study brain health. Patients with Alzheimer’s disease (AD)-related cognitive disorders exhibit both retinal vascular abnormalities and intraretinal accumulation of amyloid-beta (Aβ) plaque. Curcumin-enhanced retinal fluorescence imaging (CRFI) was recently translated as a safe imaging tool for retinal Aβ plaque quantification. In this study, we sought to determine whether and which retinal arterial and venous parameters are predictive of retinal Aβ burden and cognitive Z-scores.
Methods:
We used scanning laser ophthalmoscopy with RetiaTM (Centervue, Inc) to obtain CRFI in a cohort of patients with cognitive decline. Retinal blood vessels were segmented in a predefined circumpapillary region of interest. For each centerline, vessel tortuosity index (VTI), vessel inflection index (VII), and branching angle (VBA) were quantified, independently for arteries and veins. Additionally, we automatically quantified retinal amyloid count in the supero-temporal quadrant and its subregions: posterior pole (PP), proximal mid-periphery (PMP), and distal mid-periphery (DMP). All quantifications were done blinded to the subjects’ clinical characteristics. Linear regression models were used to assess the correlations between retinal vascular and amyloid parameters.
Results:
29 subjects (55% female, mean age 64±6 years) were included in the analysis: 11 had normal cognition, 16 mild cognitive impairment and 2 probable AD. Venous VTI was the only vascular parameter significantly different across levels of Clinical Dementia Rate scores and between cognitively normal and impaired. Venous VBA was a significant predictor of DMP amyloid count (p=0.03). Arterial VII significantly predicted PP amyloid count (p=0.02). VBA predicted Wechsler Adult Intelligence Scale Z-score (p=0.08). The combined VTI-PMP amyloid index significantly predicted Wechsler Memory Scale, California Verbal Learning Test and SF-36 mental component score Z-scores (p<0.05).
Conclusion:
Retinal venous tortuosity discriminates across cognitive scores and in combination with PMP amyloid count may predict verbal memory and related quality-of-life scores.
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Affiliation(s)
| | | | | | | | - Tania Torbati
- Neurosurgery and Biomedical Sciences, Cedars-Sinai Med Cntr, Los Angeles, CA
| | - Dale Sherman
- Psychology, Cedars-Sinai Med Cntr, Los Angeles, CA
| | | | - Julia Sheyn
- Neurosurgery, Cedars-Sinai Med Cntr, Los Angeles, CA
| | | | | | | | | | | | | | - Yosef Koronyo
- Neurosurgery, Cedars-Sinai Med Cntr, Los Angeles, CA
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Guala A, Dux-Santoy L, Teixido-Tura G, Ruiz-Munoz A, Lopez-Sainz A, La Mora L, Galian L, Gutierrez L, Valente F, Gonzalez-Alujas T, Johnson K, Wieben O, Ferreira I, Evangelista A, Rodriguez-Palomares J. Regional curvature in thoracic aortic aneurysms of different aetiologies and its relationship with established risk factors. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.320] [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
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spanish Ministry of Science, Innovation and Universities ; Instituto de Salud Carlos III
Introduction
The aorta is a 3D hollow, curvilinear elastic structure whose diseases have life-threatening consequences. Despite much effort has been paid to study aortic diameter, diameter is a poor predictor of events. Conversely, much less is known about aortic curvature, its distribution in the thoracic aorta and the potential impact of risk factors in aneurysms associated with different conditions. Currently, 4D flow magnetic resonance imaging (4D flow CMR) allows to obtain 3D geometry, 4D flow data and regional aortic stiffness.
Purpose
We aim to study regional aortic curvature in thoracic aorta aneurysms of different aetiologies and define its relationship with established risk factors.
Methods
One-hundred twenty patients (40 for each group, selected out of prospective cohorts of 156 bicuspid aortic valve – BAV-, 77 Marfan –MFS- and 67 patients with a degenerative aneurysm – TAVdeg-) were matched for age, sex and BSA via propensity score with 40 healthy volunteers (HV). The thoracic aorta was semi-automatically segmented from angiograms and the centreline was computed. Local curvature was assessed at 20 planes covering the thoracic aorta from the sinotubular junction to the proximal descending aorta (DAo) at the level of the pulmonary artery bifurcation. Local curvature was normalized by subject mean thoracic aorta curvature. Length was measured as centreline length. Aortic stiffness was measured in the DAo by pulse wave velocity (PWV). Aneurysm was defined by z-score ≥ 2 using diameters measured by double-oblique cine CMR.
Results
Matching was successful in all groups with the exception of a residual age difference between HV and TAVdeg. Curvature in HV showed a fairly smooth transition between the straighter ascending aorta (AAo) and DAo to a more curved aortic arch, with a peak in the mid aortic arch (Figure 1A). Conversely, all patients’ groups presented a peak in curvature in the proximal DAo and a decreased local curvature in the aortic arch and mid DAo close to the level of the pulmonary artery. BAV and TAVdeg patients showed also increased curvature in the mid AAo, were dilation is prevalent. Conversely, in the same area MFS showed a reduced curvature and limited prevalence of aneurysm. In the overall population, age, AAo and root diameters, mean blood pressure, DAo PWV and aortic length, all established risk factors for aortic events, were inversely related to curvature in the distal AAo and aortic arch (Figure 1B).
Conclusions
Aneurysms related to different aetiologies show similar abnormalities in aortic curvature, with limited curvature in the aortic arch and a peak soon after the third supra-aortic vessel. Age, aortic diameter, length, stiffness and blood pressure, all known risk factors, are all related to reduced curvature in the distal ascending aorta and aortic arch.
Abstract Figure.
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Affiliation(s)
- A Guala
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - A Ruiz-Munoz
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - L La Mora
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Galian
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - K Johnson
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - O Wieben
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - I Ferreira
- University Hospital Vall d"Hebron, Barcelona, Spain
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Aisen PS, Bateman RJ, Carrillo M, Doody R, Johnson K, Sims JR, Sperling R, Vellas B. Platform Trials to Expedite Drug Development in Alzheimer's Disease: A Report from the EU/US CTAD Task Force. J Prev Alzheimers Dis 2021; 8:306-312. [PMID: 34101788 PMCID: PMC8136263 DOI: 10.14283/jpad.2021.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A diverse range of platforms has been established to increase the efficiency and speed of clinical trials for Alzheimer's disease (AD). These platforms enable parallel assessment of multiple therapeutics, treatment regimens, or participant groups; use uniform protocols and outcome measures; and may allow treatment arms to be added or dropped based on interim analyses of outcomes. The EU/US CTAD Task Force discussed the lessons learned from the Dominantly Inherited Alzheimer's Network Trials Unit (DIAN-TU) platform trial and the challenges addressed by other platform trials that have launched or are in the planning stages. The landscape of clinical trial platforms in the AD space includes those testing experimental therapies such as DIAN-TU, platforms designed to test multidomain interventions, and those designed to streamline trial recruitment by building trial-ready cohorts. The heterogeneity of the AD patient population, AD drugs, treatment regimens, and analytical methods complicates the design and execution of platform trials, yet Task Force members concluded that platform trials are essential to advance the search for effective AD treatments, including combination therapies.
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Affiliation(s)
- P S Aisen
- P.S. Aisen, University of Southern California Alzheimer's Therapeutic Research Institute, San Diego, CA, USA,
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Krittanawong C, Narasimhan B, Hahn J, Wang Z, Johnson K, Tang W, Baber U, Amos C. A genome-wide association study identifies novel genetic loci associated with pulmonary embolism. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2274] [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
Pulmonary embolism (PE) is a life-threatening cardiovascular condition. Studies showed that PE patients were associated with disorders of lipid metabolism and had higher triglyceride and lower HDL-C levels compared with healthy. We conducted the genome-wide association study to identify novel loci contributing to PE.
Methods
We conducted a large-scale GWAS of PE in 5,466 PE cases and 461,219 controls of European ancestry from the UK Biobank (466,685 participants total). We used genome-wide summary statistics to test for enrichment of functional annotations using ENRICHR. Example pathways included in Enrichr for testing include membership of genes in pathway databases such as the Kyoto Encyclopedia of Genes and Genomes (KEGG), Wikipathway, PANTHER, BioCarta or NCI-Nature pathways. We analyzed the pathways using combined score and p-values which were well validated by comparing to several methods. For pathway analyses, we considered a nominal P-value threshold of 0.05.
Results
We identified genome-wide significant genetic associations in 63 independent genetic loci for PE (P<5.0x10–7). Our findings for top pathways highlight that lipid metabolism (LIPC, LCAT, NPC2), caffeine metabolism (NAT2), and sudden cardiac death (ABCG8) related genetic loci play an important role in PE alongside genes already associated with coagulation-thrombosis pathway (VWF, THPO, PTPN11, INPP5D, UROS, HMBS) (all p-values p-values <0.05).
Conclusion
Our findings uncovered unexpected novel factors of PE etiology, suggesting novel mechanistic concepts of PE pathophysiology.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Krittanawong
- Baylor College of Medicine, Houston, United States of America
| | - B Narasimhan
- Mount Sinai School of Medicine, New York, United States of America
| | - J Hahn
- Baylor College of Medicine, Houston, United States of America
| | - Z Wang
- Mayo Clinic, Rochester, United States of America
| | - K Johnson
- Mount Sinai School of Medicine, New York, United States of America
| | - W Tang
- Baylor College of Medicine, Houston, United States of America
| | - U Baber
- Mount Sinai School of Medicine, New York, United States of America
| | - C Amos
- Baylor College of Medicine, Houston, United States of America
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Barnes J, Srivastava A, Johnson K, Perkins S. Risk of Suicide Among Survivors of Childhood Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Barnes J, Johnson K, Osazuwa-Peters N. Associations of Early Medicaid Expansion and Cancer Mortality. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ruiz Munoz A, Guala A, Rodriguez-Palomares J, Dux-Santoy L, Servato L, Lopez-Sainz A, La Mura L, Gonzalez-Alujas T, Galian-Gay L, Gutierrez L, Johnson K, Wieben O, Ferreira I, Evangelista A, Teixido-Tura G. Aortic stiffness and hemodynamics in Loeys-Dietz syndrome by 4Dflow CMR: a comparison with healthy volunteers and patients with Marfan syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2336] [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
Connective tissue disorders, such as Loeys-Dietz (LDS) and Marfan (MFS) syndromes, are rare genetic diseases associated with progressive aortic dilation. Aortic dissections have been observed at lower aortic root diameters in LDS than in MFS, and research on aortic flow dynamics and biomechanics in LDS is lacking.
Purpose
To evaluate rotational aortic flow and aortic stiffness in LDS compared to healthy volunteers (HV) and MFS patients, using 4Dflow CMR.
Methods
Twenty-one LDS and 44 MFS patients, without previous aortic dissection or surgery, and 44 HV underwent a non-contrast-enhanced 4D flow CMR. In-plane rotational flow (IRF), systolic flow reversal ratio (SFRR) and local aortic diameters were obtained at 20 equidistant planes from the ascending (AAo) to the proximal descending aorta (DAo). Aortic stiffness was quantified at the AAo and DAo using pulse wave velocity (PWV).
Results
LDS patients had lower IRF at the distal AAo and proximal DAo compared to HV (p=0.053 and 0.004, respectively), once adjusted for age, stroke volume and local aortic diameter; but no differences were found with respect to MFS (Figure). Although SFRR at the proximal DAo was increased in LDS patients compared to both HV (p=0.037) and MFS populations (p=0.015), once adjusted for age and aortic diameter, the difference in magnitude was small (Figure). On the other hand, AAo and DAo PWV revealed stiffer aortas in LDS patients compared to HV but no differences versus MFS patients (Table).
Conclusions
LDS patients showed decreased in-plane rotational flow and abnormally-high regional aortic stiffness compared to healthy controls, and similar hemodynamics and aortic stiffness with respect to MFS patients
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Instituto de Salud Carlos III, La Maratό TV3
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Affiliation(s)
- A Ruiz Munoz
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - A Guala
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | | | - L Dux-Santoy
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - L Servato
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - A Lopez-Sainz
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - L La Mura
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | | | - L Galian-Gay
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - K Johnson
- University of Wisconsin, Wisconsin, United States of America
| | - O Wieben
- University of Wisconsin, Wisconsin, United States of America
| | - I Ferreira
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - G Teixido-Tura
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
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Low S, Oates A, Patel H, Mcguirk S, Johnson K. Re: clinical characteristics and radiological features of children infected with the 2019 novel coronavirus. Clin Radiol 2020; 75:870-871. [PMID: 32811668 PMCID: PMC7392173 DOI: 10.1016/j.crad.2020.07.015] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/07/2020] [Indexed: 11/29/2022]
Affiliation(s)
- S Low
- Birmingham Children's Hospital, Birmingham, UK.
| | - A Oates
- Birmingham Children's Hospital, Birmingham, UK
| | - H Patel
- Birmingham Children's Hospital, Birmingham, UK
| | - S Mcguirk
- Birmingham Children's Hospital, Birmingham, UK
| | - K Johnson
- Birmingham Children's Hospital, Birmingham, UK
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Rixe J, Cullison K, Frisch A, Guyette M, Johnson K, Callaway C. 331 Effect of Emergency Department Hallway Care Location on Patient Outcomes Across 14 Hospitals: Higher Rates of Return to the Emergency Department and Inpatient Admission. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.346] [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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